Can psychedelic therapy alleviate the nation’s mental health crisis?

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Demonized in the early 1960s despite promising research, psychedelic drugs are making a resurgence as therapeutic tools, capturing the attention of medical scientists and the public. Two initiatives aimed at the November ballot in Colorado would open the door to treatment in the state and likely facilitate the initiation of studies in University of Colorado Anschutz Medical Campus.

Based on early research into hallucinogenic compounds – rooted for millennia in many ethnic cultures as a wellness tool – psychedelics could pave the way for much-needed therapy for the mental health crises plaguing the nation. , from severe depression and suicide to stress disorders and addictions.

Watch for future related articles, including:

  • Personal testimony of a patient under treatment with ketamine.
  • A doctor’s perspective on how therapy could fill a critical gap in palliative care.

“Our treatments don’t work for everyone, and with a few exceptions, there haven’t been new approaches to these mental health issues for some time now,” said Edward MacPheeMD, psychiatrist and associate professor of clinical practice at the UC School of Medicine. “As a result, we are at an impasse when it comes to helping our patients.”

From Hofmann to Leary and vice versa

The discovery of LSD by Swiss chemist Albert Hofmann launched psychedelic research in the late 1940s and 1950s. Thousands of studies have been published on the beneficial effects of the hallucinogen, especially for alcoholics and people with severe depression, continuing in the 1960s with the work of renowned Harvard psychologist Timothy Leary.

“There was a lot of writing at the time,” MacPhee said. “There was a review of LSD research from that time, and it looked promising.”

But once the proclaimed “War on Drugs” — fueled in large part by a counterculture movement embracing LSD — colored public perception, the search stopped. Regulators have classified LSD as a Schedule 1 substance, calling it a dangerous and addictive drug with no medical benefit.

“We need alternative therapies”

Now, with a rise in mental health issues fueled by tumultuous times, a renewed interest in psychedelic-assisted therapy has emerged. Over the past decade, major college campuses have dedicated centers for the study of drugs, including Johns Hopkins University, University of California, Berkeley, and New York University.

“Part of the reason this research has started to take off is that our medications and psychotherapies aren’t as effective as we would like them to be,” MacPhee said. “There are a good number of people who don’t get remission from their depression, anxiety or PTSD. And then there are a significant number of people who simply have no effect. So we need alternative treatments.

Researchers observe a patient undergoing psychedelic-assisted mental health therapy at Johns Hopkins University.

While targeted research in the psychedelic field has yet to take place on the CU Anschutz medical campus, MacPhee said. UC Department of Psychiatry members and other campus specialists are discussing ways to achieve this.

“My jaw hit the ground”

Researchers are increasingly looking “outside the box”, studying the effects of various psychedelics, particularly LSD (street name acid), psilocybin (the hallucinogenic compound in psychedelic mushrooms) and MDMA (street name molly or ecstasy), MacPhee said.

“It’s really started to flourish, largely because we’ve seen the effects, and they can be profound. My field is PTSD (post-traumatic stress disorder), and when I saw the first article on psychotherapy for PTSD, my jaw hit the ground,” he said. “I didn’t expect these kinds of results, and they seemed much better than the other options we have now.”

LSD and psilocybin treatment have shown positive results in severe depression, anxiety, addiction, and existential distress in cancer and terminally ill patients. “The only other thing I can think of recently where we’ve seen these types of effects is ketamine, particularly in getting people quickly out of deep depression with suicidal tendencies,” MacPhee said.

“Deeply Connected to the Universe”

Targeted for patients with treatment-resistant mental health conditions, psychedelic-assisted therapy is not for all patients or therapists, MacPhee said. “You need an open mind. You go on a trip.

Especially with classic psychedelics, such as LSD and psilocybin, patients enter an altered state of consciousness. “It lowers their defenses and allows them to see their life in a different way,” MacPhee said. “And that’s not everyone’s business.”

Neurologists have identified the effects of drugs on neurotransmitters and derived theories about how they work to “reset” the brain, MacPhee said. But from a psychiatric perspective, psychedelic-assisted therapy creates a sense of connection and openness that would not otherwise exist for the patient, setting the stage for highly productive follow-up talk therapy. “It’s like a shortcut for the therapist,” he says.

A pop culture response to public curiosity about psychedelics for mental health therapy:

The Netflix drama series “Nine Perfect Strangers,” starring Nicole Kidman and Melissa McCarthy, explores the use of hallucinogens for multiple mental health issues. And the just-released Netflix documentary “How to Change Your Mind” directed by Michael Pollan – author of the book of the same name – chronicles the history and use of psychedelics.

“Psychedelics create a transcendental state and you feel deeply connected to the universe,” MacPhee said. “There is a feeling of peace and tranquility.” And that, MacPhee said, is something many people could use today in this pandemic era marked by racism, violence, and social and political divisions, all of which have weighed on the psyche of Americans.

“Be careful and thoughtful”

Two initiatives Coloradans may see on their ballots in November are aimed at decriminalize certain psychoactive substances and legalize the use of psychedelic mushrooms at designated healing centerswhat could happen in the next two years.

While he sees value in the potential new tool for therapists, MacPhee hopes for a slow and steady implementation. More research needs to happen, he said. And issues of cost and access — currently barriers for many patients who could benefit from ketamine therapy — need to be resolved, which presents no easy puzzles, MacPhee said.

“I’m optimistic that it can help deal with the mental health crisis, but I want us to be careful and thoughtful about it, so it can benefit most people.”

Psychedelic-assisted therapy

How it works?

For psychedelic-assisted therapy to be life-changing, it has to be done right, and that means in a health care facility with a trained therapist — not in a basement with a couple of friends, said the psychiatrist Edward MacPhee, MD. Done correctly, he says, the treatment consists of three phases:

  • Preparation involves screening and setting the stage for patients, including telling them what to expect and generally providing them with a safe, dimly lit, comfortable environment with soothing music.
  • The therapy can take most of the day and is sometimes done in several sessions. A therapist (often two, including a man and a woman), is present at all times.
  • Synthesis is key, where the therapist guides patients through evaluating the experience and seeking out the lessons it has offered.

Is it safe?

Hallucinogens are a generally non-addictive and safe class of drugs, far more so than other “street drugs,” or even alcohol or tobacco, MacPhee said. In the professional setting, patients are given the pure, therapeutic drug, which is uncertain when buying something like ‘ecstasy’ on the ‘street’.

Certain drugs, such as ketamine and MDMA, can raise blood pressure. A controlled setting where vital signs are monitored and screening to exclude vulnerable patients, such as those with a history of heart problems, are crucial.

“Bad trips”, although rare at the dosages used, can occur, where a patient can become anxious and agitated, and trained therapists know what to do to ease the anxiety and respond to emergencies.

Although the science still lags behind, patients who experience hallucinations with their mental health conditions (such as schizophrenia) are advised not to undergo psychedelic-assisted therapy, as it may lead to more severe psychosis.

Where can I receive it?

Currently, the only way to try therapy (other than ketamine, which is not a classic psychedelic and is available in some clinics) is to participate in a study or find a “clandestine” therapist.

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