Mental Health New wave of research puts psychedelics forward to treat mental health ->

[mr peabody]

Mental health care is too expensive. Can therapy collectives help?

by Lauren Vinopal| MEL Magazine

They might not be completely mainstream yet, but they’re doing their best to make sure support for depression, trauma and anxiety isn’t only for the rich and well-insured.

I first heard about Open Path Collective last year when I was without insurance and looking for a therapist. For a one-time lifetime membership fee of $59, Open Path offers primarily teletherapy, which starts at $30 a session, depending on your financial situation. That’s not free, but it’s notably less than what therapy usually costs out-of-pocket — upwards of $100 an hour depending on where you live.

A positive of the pandemic is that it’s normalized teletherapy as well as made it more accessible, as a recent study found that 37 percent of U.S. counties don’t have any practicing psychologists. But as therapy from home has become more mainstream, the same cannot be said for the concept of collectives — groups of therapists who come together as independent contractors to collaborate and provide affordable and readily available counseling. Collectives have quietly surfaced over the past decade to address the ongoing mental-health crisis in the U.S. — the number of adults experiencing some form of mental illness increased by 1.5 million people between 2017 and 2018 alone — yet few know what they are and how they can help.

Collectives help address issues around affordability and access that have persisted since deinstitutionalization in the 1960s. When asylums shut down, mental health care was put into two distinct categories: 1) community mental-health organizations that serve people with severe mental illness (nonprofits generally funded by the state); and 2) private practices for more moderate cases, which require patients to have insurance coverage or a lot of extra cash. Collectives seek to fill some of the middle ground, as most people fall somewhere in between — i.e., they’re not sick enough to qualify for community mental-health services, but they also can’t afford to pay for therapy on their own. (Approximately half of people with a mental illness receive no treatment for it, and a study of more than 20,000 adults with depression found nearly half of them cited money as the reason.)

As for Open Path, since the nonprofit was founded in 2012 by psychotherapist Paul Fugelsang, it has matched over 40,000 people with affordable mental health care across the U.S. and inspired a number of other collectives such as the Chicago Therapy Collective, the BEAM Collective and the Therapist Collective. Open Path maintains a small support staff with their one-time membership fees, and pursues grants and other forms of funding. To be a part of the Open Path network, therapists are simply asked to take on just a single Open Path client for a reduced rate. “Our model takes what therapists have been doing in their local communities and scales it up to the national level,” Fugelsang wrote in 2017.

Nicholas Mancini, a Denver-based therapist, thinks Open Path has been very successful in creating “a great platform for people who want to seek services but don’t have insurance.” He joined the Open Path network about three years ago when he was making the transition from community mental health to private practice. Working alone, Mancini was lonely and missed bouncing ideas off a team. He could’ve joined a group practice or a private practice that employs multiple therapists, but at the expense of his independence. A collective like Open Path allowed him to be a part of a community of therapists, but with the freedom of an independent contractor. Embracing teletherapy helped him provide some sessions at a reduced rate and grow his private practice of full-price customers at the same time.

Open Path was such a positive experience for him that last year, Mancini co-founded a collective of his own with fellow counselor Eric Hilborn. “We started Collective Counseling Solutions to help bridge that gap, and to help other providers in private practice feel like they have a community of support, while also honoring their independence and autonomy,” Mancini tells me. After only a year, they’ve grown to 20 mental-health professionals across 10 different locations nationwide.

Again, in terms of pricing, the model of a collective gives Mancini the freedom to have a sliding scale that meets people where they’re at — without putting themselves out of business. “There’s a couple people I see for free, and there are some people I see for our full rate,” Mancini says, adding that a full-price session is $165 out-of-pocket and $175 for the initial intake. When he’s at capacity or not a good fit for a person’s needs, the collective gives him a pool of colleagues to pull from, increasing the likelihood that the patient will receive care.

While Open Path is reserved for people without insurance coverage, Mancini decided to work with insurance companies because he thought the collective could reach more people that way. In addition, dealing with insurance companies was what he struggled with the most in his private practice, so he wanted to help other therapists navigate the process. In order for therapists to bill insurance companies for services, they first have to be accepted to a panel in a process known as “getting credentialed.”

However, individual therapists starting new practices can get denied for reasons that have nothing to do with their licensure, education or ability, and more because of administrative errors, deadlines or capacity issues.

Among other ethical reasons, this is why many private-practice therapists don’t take insurance — they can’t. One loophole is that individual therapists don’t have to bother with getting credentialed if they’re part of a group or collective that’s already approved, which takes a massive administrative task off of their plate and incentivizes them to join.

Yet, as proud as Mancini is of the collective he’s built, he doesn’t think more of them are the answer to fixing the mental-health crisis. At least not until people stop treating therapy like a dark secret, and the stigma around mental-health treatment is better addressed through education and media.

To that end, Mancini encourages his clients to talk about their experience with therapy to whatever extent they feel comfortable, because it could help someone else. "The goal is to make going to a mental-health provider like going to the doctor and getting an annual physical. It’s part of your overall wellness,” Mancini argues. “The question isn’t about more collectives, but about how do we as a nation address mental health?”

Mental Health Care Is Too Expensive. Can Therapy Collectives Help?

They might not be completely mainstream yet, but they’re doing their best to make sure support for depression, trauma and anxiety isn’t only for the rich and well-insured

melmagazine.com

 

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Tripping out of depression: Overcoming mental health disorders with psychedelic drugs

by Pailin Chiaranunt | Impress Magazine | July 20, 2018

You’re in a hut in the jungle, the music of wildlife and aroma of smoking herbs permeating the air. The shaman, dressed in traditional Amazonian garb, hands you the brownish sludgy concoction called ayahuasca. As you drink it – the nastiest, most foul-smelling thing you’ve ever had – the shaman begins singing, calling out to the “spirits of the jungle”. The purging begins: your stomach churns, you sweat profusely and vomit intensely, your skin burning like literal hell. And then it hits. You see yourself melting away, dissolving into the universe, and you relive your life, re-experiencing all your childhood traumas and repressed emotions, the past fusing with the present, until there is no more sense of time nor self. In what feels like multiple lifetimes, you finally awaken a few hours later with a sense of overwhelming tranquility and bliss the likes of which you’ve never felt before…

Such an experience may seem an unconventional and perhaps “unscientific” method of treatment for mental health disorders. Yet psychedelic drugs have recently garnered renewed interest in both the public and scientific communities for their potential therapeutic effects on major depressive disorders (MDD), anxiety disorders, and addictions. The allure of these “enlightenment” drugs is certainly understandable, given the growing incidence and awareness of mental health disorders coupled with the inefficacy of current medications.

The difficulty in finding effective medication for mental health disorders stems from our weak understanding of the pathophysiology of these conditions. For example, there currently exist multiple theories for depression, including monoamine deficiency, neuroinflammation, and dysfunction of the neuroendocrine system. Medications aim to address each of these biological pathways in a rather reductive manner. Despite their low efficacy and plethora of adverse effects, selective serotonin reuptake inhibitors (SSRIs) are still the first line treatment for MDD. In fact, traditional antidepressants have either no effect or adverse ones in a whopping 1 of every 3 patients.

Furthermore, depression is not simply a neurological disorder; social and psychological determinants play a significant, if not primary, role in its pathogenesis. Studies have shown strong correlations between childhood trauma and adult onset MDD, as psychologists suggest that patients develop ingrained behavioural patterns that contribute to depression. Certainly, the heterogeneity of depression itself presents additional challenges not only in how we diagnose it, but also in patients’ responses to different treatments.

Enter psychedelic drugs, which proponents tout as a potential cure for mental health disorders. In contrast to harmful drugs such as alcohol, cocaine, or heroin, psychedelics are neither addictive nor acutely toxic. Human brain functional magnetic resonance imaging (fMRI) studies indicate that psychedelics function by fundamentally changing the architecture of the prefrontal cortex via neurogenesis and induction of novel neural pathways. However, how these changes alter mood and induce hallucinations remains unclear. Some studies suggest neuronal excitation creating transient neural scaffolds is involved, while others demonstrate decreased activity in the brain’s key connector hubs to enable unrestrained cognition.

Of course, the hallmark of psychedelic drugs lies not in its pharmacological actions, but in its phenomenological effects on the user. Despite their similar mechanisms, each type of psychedelic has different methods of administration, hallucinogenic effects, and public perceptions, all of which influence the experience itself and post-trip outcomes. It is important, then, to differentiate the history and uses of each drug for a more nuanced understanding of their therapeutic potential in different mental health disorders.

LSD) was first synthesized in 1938 by Swiss chemist Albert Hofmann. Its psychedelic effects were uncovered after the chemist accidentally ingested it, and in 1947, LSD was introduced as a psychiatric drug to treat alcoholism, neurosis, and schizophrenia. Since then, the drug has been used in an infamous CIA mind control program Project MKUltra, endorsed as a route towards consciousness expansion, touted as “the next big thing” in psychiatry, and prominently featured in the arts and music scene of the 1960s. During this period, LSD became a popular recreational drug, and its association with the counterculture hippie movement prompted the United States government to outlaw the drug in 1968, despite its therapeutic potential and lack of harm or abuse risk. The turn of the 21st century saw a resurgence of research into LSD for psychedelic therapy.

LSD is typically processed into strips that can be placed on the tongue for ingestion. Trips start within 20-30 minutes of ingestion and can last from 6 to 12 hours in a dose-dependent manner. While trips are highly variable and context-dependent, an early clinical study describes them as “psychic states in which the subject becomes aware of repressed memories and other unconscious material”, and anecdotal reports include descriptions of visual hallucinations, synesthesia, and ego dissolution. In terms of medical efficacy, randomized controlled trials have shown beneficial effects of LSD-assisted psychotherapy on alcoholism and on anxiety associated with life-threatening diseases, without any acute or chronic side effects.

Psychedelic mushrooms are a group of fungi that contain psychoactive compounds such as psilocybin, psilocin, and baeocystin. Mushrooms became popularized in modern Western culture after the American mycologist R. Gordon Wasson participated in an indigenous psilocybin ritual in Mexico and publicized his experience in 1957. As with LSD, psilocybin was heavily studied in the 1960s for its therapeutic potential and similarly outlawed by the end of the decade.

In contrast to LSD, psilocybin induces different hallucinogenic experiences. Mushrooms are typically eaten, brewed into tea, or taken in pill form, with trips lasting 3 to 6 hours. Shroom trips have been described as “more giggly than LSD”, during which visions are more saturated, “mundane aspects of life can become comical”, and one’s sense of self disintegrates. Given its relatively mild psychedelic effects and weaker social stigma, it is not surprising then that the scientific community is now turning its head towards psilocybin.

Recently, open-label feasibility studies indicate one to two doses of psilocybin in conjunction with therapy can assist in treatment of alcohol dependence and treatment-resistant depression for up to nine months. Similar results were found on patients with anxiety associated with advanced-stage cancer, obsessive-compulsive disorder, and substance addictions. Nevertheless, these studies have extremely small sample sizes, and definitive conclusions cannot be made due to their absence of placebo-controlled groups. To address these issues, Imperial College London has recently established a Psychedelic Research Group, with upcoming double-blind randomized controlled trials on psilocybin treatment for MDD.

Ayahuasca, Quechuan for “vine of the spirit”, is a psychotropic brew traditionally used for spiritual and therapeutic purposes in Amazonian indigenous populations. The concoction, made from the Banisteriopsis caapi vine boiled with leaves from the Psychotria viridis shrub, contains the powerful hallucinogen N,N-dimethyltryptamine (DMT) and monoamine oxidase A (MAO-A) inhibitors, which allow the former to bypass gastrointestinal degradation and enter the circulation and central nervous system. Interestingly, DMT is the only known psychoactive compound that is naturally found, albeit at low levels, in the human brain.

Unlike LSD and mushrooms, Ayahuasca-induced psychedelic experiences seem much stronger and more spiritual in nature, with stories of users going through “hell”, seeing horrific visions, reliving traumas, and talking to the plant itself, before emerging with a sense of bliss and newfound understanding of one’s place in the world. Physically, Ayahuasca users usually undergo vomiting, diarrhea, and tachycardia, considered to be a necessary purging. Although the Ayahuasca experience may not appear to be a very pleasant one, multiple self-reports of long-lasting psychological improvements suggest the plant may be worth a deeper look.

Psychological guidance is a major part of Ayahuasca ceremonies, with a shaman typically guiding users physically and emotionally. This guidance throughout and after the Ayahuasca experience is vital for the healing process and has been implemented in the clinic. In 2010-2011, Canadian physician Dr. Gabor Mate successfully treated multiple addiction patients at his Vancouver-based clinic with Ayahuasca and guided therapy, helping them to work out their past traumas to get to what he believes is the root cause of many addictions. This approach is widely used in many Ayahuasca retreats in South America, where the drug is legal for spiritual use. To date, researchers from the University of Barcelona and University of Sao Paulo have found significant improvements in addiction patients who received Ayahuasca treatment in preliminary studies. These findings have prompted neuroscientists in the United States to seek government approval to bring this traditional brew to patients in North America.

While preliminary research into psychedelic therapy looks promising, these results should not be interpreted as an endorsement for psychedelic drugs as self-medication nor as recreational use. Most studies so far have been small open-label trials that often do not include placebo controls, have extensive exclusion criteria, and have not measured the long-term outcomes of psychedelic treatment. Appropriate administration, psychological guidance, and extensive support, both during and after the experience, are extremely important; it’s been shown that the psychological context and expectations during the acute psychedelic experience can predict long-term outcomes on mental health.

What this ultimately points to, however, is the need for further research, which is currently restricted by social stigma and the legal status of these drugs. A common thread in the most researched psychedelic drugs is the experience of reliving past traumas and integrating those reflections into reinventing oneself. It is crucial that we look past preconceived notions of these psychotropic plants, which have arguably co-existed with, and helped, us since prehistoric times. In a society that is growing evermore disconnected with the world, perhaps it is time we look deep into our roots and journey back into our interconnected experience of life with nature.

http://www.immpressmagazine.com/tri...ntal-health-disorders-with-psychedelic-drugs/​

 

[mr peabody]

Psychotic- vs. psychedelic-induced hallucinations: A closer look*

Are there more differences than similarities?

by Jose Alexandre Salerno, MS | Psychedelic Science Review | 17 Mar 2021

The perception of the senses is partially driven by the past experiences, the thoughts at the moment and the expectations for the future, in what is called top-down brain processing. This means that the minds’ background influences how senses are perceived. Thereupon, the sight can play tricks on the brain and vice-versa. For example, it is not uncommon to see shapes that look like objects and things that are not really there.

Interestingly, these experiences fit reasonably into the definition of hallucinations, which is the perception occurring inside the brain in the absence of the corresponding external stimulus. It is true that hallucinations are frequently correlated to psychotic disorders, which makes sense since it is one of the five remarkable symptoms of diagnostic criteria for them.1 However, it is not an exclusive feature of brain malfunction and can be experienced by healthy subjects.

Physicians have proposed in the past that the altered state of consciousness induced by psychedelics could share neural mechanisms and clinical features with psychosis, constituting – therefore – a reliable “model of psychosis.” This theory was fairly well accepted by mainstream culture and even among specialists for some decades. LSD, upon its discovery, was given to people and self-administered by doctors in order to mimic psychosis and better understand it. However, a deeper look into the neurobiological and phenomenological perspectives about hallucinations reveals that they are more nuanced than previously believed regarding the related mechanisms underlying these two experiences.

The two experiences compared using different approaches

The first thing to pinpoint is that it is not completely clear whether synesthesia and synesthesia-like experiences qualify or not as hallucinations. That would be a distinctive feature since they occur very often under serotonergic psychedelics but are quite uncommon in psychotic episodes. Synesthesia is characterized by the blending of the different senses producing the sensation of a different modality, such as hearing shapes and tasting colors.

In terms of the consensual definition of hallucinations, the most common modality in schizophrenia is by far the auditive one, whereas psychedelic-induced hallucinations occur mostly for visual processing. When present, visual hallucinations in schizophrenia are highly detailed and concrete, typically reproducing faces and events from real life. On the other hand, psychedelic-induced visuals are often elementary (fractals, spirals, cobwebs, and geometric patterns), although sometimes more complex hallucinations can occur under higher and heroic doses. However, people under psychedelics usually preserve the acknowledgment about the etiology of hallucinations and can distinguish between drug effects and reality whilst schizophrenic patients lose their self-monitoring of reality.

The molecular mechanisms underlying schizophrenia at the neurotransmitter level are not completely understood by pharmacologists. But, they are known to be mostly linked to dopamine signaling, while psychedelics are use mostly serotonin receptors. Still, some psychedelic drugs mimic certain aspects of schizophrenia, especially paranoia.

A couple of antipsychotics were discovered empirically in the past by their assumed ability to neutralize LSD effects, supporting psychedelics as a model for psychosis. However, LSD also interacts with dopamine receptors, and serotonergic-only high-affinity antagonists show little or no efficacy as antipsychotics. Therefore, if the mechanisms were exactly the same, some psychedelics that act only at serotonin receptors (such as phenethylamines) would not induce hallucinogenic experiences. Moreover, a compound named ketanserin (serotonin receptor blocker) effectively abolishes the psychedelic subjective experience and has little effect on dopamine receptors.

When it comes to brain imaging studies, the differences and similarities between these two phenomena become foggy. The onset of hallucination in schizophrenic patients is correlated with hyperactivity within associative cortices related to the hallucinatory modality (i.e., auditive, visual, etc) rather than primary sensory cortices. LSD and psilocybin seem to induce the opposite – overactivation of primary cortices and reduced association. However, both psychotic- and psychedelic-induced hallucinations are associated with reduced stability of functional brain networks, such as the disintegration of resting-state networks. Recently, a comprehensive speech analysis pushed away the kinship between psychedelic-induced and schizophrenic behavior using machine learning algorithms. Computational modelling now can help to make inferences about the shared mechanisms and clarify whether or not psychedelics trigger psychotic-like hallucinations.

Concluding remarks

In summary, there are probably more differences than similarities underlying psychotic and psychedelic-induced hallucination experiences. It cannot be overlooked that the social stigma and political constraints – that marked the whole history of psychedelics in modern western culture – can shape the general thinking of these drugs as harmful for brain health and devoid of therapeutic value.

It is important to mention that when analyzing answers from more than 135,000 respondents of the US National Survey on Drug Use and Health (NSDUH), individuals who declared having used a “classic” psychedelic at least once were not at increased risk of developing mental health issues, including schizophrenia, psychotic episodes, and suicide attempts.

Psychedelics are believed to be useful tools to treat neuropsychiatric conditions and visual hallucinations are part of the insightful experiences that some argue being necessary for therapeutic effects. Still, the promising therapeutic potential and possible differences between psychosis- and psychedelic-induced hallucinations do not refute the strong contraindication for patients with psychotic disorders or predisposed to developing them.

*From the article here :

Psychotic- vs. Psychedelic-Induced Hallucinations: A Closer Look

Do psychedelics mimic psychosis, or are there more differences than similarities between tripping and a psychotic state?

psychedelicreview.com

 

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LSD could be the key to alleviating the mental health crisis*

Foundation for Economic Education | 9 Jan 2021

The general public is starting to warm to the idea that psychedelics, just like marijuana, should be legalized, or, at the very least, removed from the Schedule I list.

On April 16, 1943, a Swiss chemist by the name of Albert Hofmann accidentally ingested a drug he created five years earlier while working at Sandoz Laboratories (now a subsidiary of Novartis) and began to experience very unusual sensations and hallucinations. He later described this altered state of mind as “a not unpleasant, intoxicated-like condition characterized by an extremely stimulated imagination.”

While I am sure Dr. Hofmann realized that he discovered something worthy of further investigation, he could not have possibly imagined that his drug—lysergic acid diethylamide, popularly known as LSD or acid—would eventually become our best hope for solving the opioid epidemic and the global mental health crisis.

When most of us think of LSD, we are immediately transported to the 1960s—the era of the proverbial sex, drugs, and rock ’n’ roll. Indeed, it is difficult to imagine the 60s without the freedom-loving hippie counterculture that challenged an otherwise extraordinarily conservative nation. However, few people know that during the 50s and 60s, scientists began to explore the potential uses of psychedelic substances, including LSD, for therapeutic purposes.

What eventually came to be known as psychedelic or psychedelic-assisted therapy was first pioneered in Canada by Abram Hoffer and Humphrey Osmond roughly a decade after Dr. Hofmann’s accidental LSD trip. Humphrey Osmond initially speculated that, by giving a high dose of LSD to individuals suffering from alcoholism, he could frighten them to the point where they would want to quit drinking. However, much to Osmond’s surprise, all of the patients’ experiences on LSD were pleasant and, most importantly, transformative.

Between 1954 and 1960, Osmond and Hoffer treated about 2,000 alcoholics with LSD and reported that 40-45 percent of them did not return to drinking after a year. Similar positive results were achieved by a Czech-born psychiatrist by the name of Stanislov Grof, who used LSD to treat heroin addicts in Prague (During this same timeframe, the CIA conducted hundreds of cruel and unethical experiments on unwitting subjects using LSD in the attempt to develop a “truth serum” for interrogations).

The groundbreaking research in the nascent field of psychedelic therapy came to a halt in 1970 with the introduction of the Controlled Substances Act, which not only made the manufacturing, sale, and possession of LSD illegal, but categorized it as a Schedule I controlled substance.

Increasing evidence suggests that psychedelic medicines, such as LSD, MDMA, and psilocybin, can serve as a sort of “reset button” for the brain.

At the same time, the rates of opioid addiction and overdose have continued to rise year after year. Today, roughly 1 percent of our nation’s adult population—2.4 million people—has an opioid-use disorder. Further, virtually every statistic on mental health points to the fact that the US is facing a mental health crisis of unprecedented scale, and yet we have not seen any more breakthrough medicines in the psychiatric-drug industry since Prozac arrived on the market more than 30 years ago.

It is clear that we are desperately in need of something better, and it may as well be LSD.

So what makes LSD, and psychedelics in general, so special? Increasing evidence suggests that psychedelic medicines, such as LSD, MDMA, and psilocybin (the main psychoactive compound in magic mushrooms), can serve as a sort of “reset button” for the brain that gives individuals the tools they need to face and address their struggles in a constructive way. As Julie Holland M.D. points out in her book, Good Chemistry: The Science of Connection, from Soul to Psychedelics...​

Psychedelics are growth promoters and life shifters, in part because they’re meaning makers. The resetting is part of a resettling. First, the default mode network is quieted, then there is a hyperconnection of nearly every other area of the brain. After all these areas communicate, things are never quite the same. The brain may have been “shaken up” a bit, and old ruts and trenches may have been smoothed over in the process. The most impressive resetting occurs with some of the strongest psychedelics.​

More recently, Silicon Valley has started a trend of microdosing LSD and other psychedelic substances (i.e. taking less than a tenth of a recreational dose of a drug). Those who partake in this practice have reported an increase in energy and creativity, improved overall well-being, reduced stress and anxiety, and improved sleep without adverse side effects. The vast array of prescription medications currently on the market still cannot consistently accomplish this.

The general public is starting to warm up to the idea that psychedelics, just like marijuana, should be legalized, or, at the very least, removed from the Schedule I list.

During the last decade, a number of biopharmaceutical start-ups, such as COMPASS Pathways PLC and Mind Medicine Inc. (MindMed), have been working on developing psychedelic-inspired medicines through clinical trials. Presently, MindMed is collaborating with the University Hospital of Basel on a Phase 2 Clinical Trial of LSD for cluster headaches and the Maastricht University in Netherlands on a Phase 2 LSD Microdosing Trial for adult ADHD. (In addition to LSD, other psychedelic substances currently are or have been tested in clinical trials, including 18-MC for treatment of opioid addiction, MDMA for treatment of severe PTSD, psilocybin for alleviating depression and anxiety in patients with terminal cancer, and many others).

Given the success of the early research into LSD, as well as the growing body of anecdotal evidence confirming its safety and efficacy, it is extremely likely that the various clinical trials currently in the pipeline will produce life-changing medicines. It is also clear that the general public is starting to warm up to the idea that psychedelics, just like marijuana, should be legalized, or, at the very least, removed from the Schedule I list.

Albert Hofmann used to call LSD his “problem child.” But shortly before his death in 2008, Dr. Hofmann learned that a medical trial of LSD was approved in his native Switzerland. He was truly overjoyed that, after three and a half decades, LSD was once again being recognized for its tremendous potential as a medicine. Eager to share his excitement with his friends, he told one of them that his "problem child had come home, [and] had become a wonder child.”

Indeed, it seems it has.

*From the article here :

LSD Could Be the Key to Alleviating the Mental Health Crisis—if Government Allows It | Sasha Butts

During the last decade, a number of biopharmaceutical start-ups have been working on developing psychedelic-inspired medicines through clinical trials. Given the success of early research into LSD, as well as the growing body of anecdotal evidence confirming its safety and efficacy, it is highly...

fee.org

 

[mr peabody]

Growing interest in psychedelic treatments for mental illness*

by Padraig Moran | CBC Radio | 2 Mar 2021

"Studies are small in scale, should be viewed with 'critical lens,' " says clinician scientist.

After decades of therapy for anxiety and suicidal thoughts, nurse Stephanie Hug says she found relief from a 12-week pilot treatment program that combines the psychedelic anesthetic ketamine with psychotherapy.

"I had tried different medications, I exercised, I did the positive self-talk, you know, I tried so many things," said Hug, an operating room nurse in Nanaimo, B.C.

As a child, Hug says she was groomed and sexually assaulted, long dealing with feelings of shame and high anxiety.

"I just felt like this is just going to be my life. I'm going to be anxious, sad, I'm going to have these [thoughts]."

Late last year, she took part in Roots to Thrive, a ketamine-assisted therapy program run through Vancouver Island University in Nanaimo, B.C. The program, which involved 16 people, is different from a clinical trial that can include thousands of participants.

Ketamine is an anesthetic that is controlled under the Controlled Drugs and Substances Act, and is illegal to use unless authorized for medical, scientific or industrial purposes. The drug is recreationally used by some illegally for its psychedelic properties, ability to separate mind from body, and alter sensory experiences with sight and sound.

Hug says the results she got in the ketamine-assisted therapy have been "amazing."

"My inner monologue is a lot kinder and not so rampant. It used to just be like uncontrolled chaos in there all the time with the underlying negativity."

Dr. Ishrat Husain, a clinician scientist and psychiatrist at the Centre for Addiction and Mental Health in Toronto, says he understands the hope around psychedelic-assisted therapy, but more robust research is needed.

"I encourage that research, but I think that we need the findings of that research — and the research needs to be well-designed and controlled — before we can recommend it for clinical practice."

In recent years, scientists have been looking at treating mental health with psychedelics, including ketamine, MDMA and psilocybin — the active ingredient in magic mushrooms — though approvals from Health Canada remain limited.

Globally there are 74 ongoing registered clinical trials using ketamine as a treatment for depression, according to ClinicalTrials.gov, a U.S. government database, nine of which are underway in Canada.

A recent systematic review of 28 studies, conducted by Quebec researchers, found that while ketamine appears "promising" for short-term treatment of treatment-resistant depression (TRD), "more clinical and experimental data is needed with regards to the efficacy, tolerance and security of long-term administration."

Channel 'inner therapist,' says facilitator

The Roots to Thrive program, run by Shannon Dames, a professor of nursing at Vancouver Island University, was "devised to help front-line workers with TRD and PTSD. Ketamine was added to the existing program for its 'mind-loosening' effects, and to address barriers that are preventing people from living well, she said.

"We don't look at the ketamine as the medicine, we look at it as a facilitator."

Compared to much therapy, which involves talking out the trauma, Dames says the focus of her program is "really about going in."

"We really teach people kind of how to be their inner therapist."

Participants received medical and mental health screenings before the first program last year. They then received three doses of ketamine over 12 weeks, in the form of a lozenge or an intramuscular injection, and wore eye masks in each session to block out external stimuli.

In her first session, Hug said she saw herself as a toddler at her grandparents' house, playing with a bucket of water, and was struck by the unconditional love children receive.

"This knowledge came where I suddenly knew that me and this child have the same heart, we're the same person. And I am just as deserving of love now as I was then."

While Hug felt unwell after the second session — something she attributes to taking her mask off — her third session left her with a feeling that "no matter what happens, I love me, I trust me, I am safe inside of me."

"I just hope that this medicine will reach the people that are feeling hopeless."

"11 of the 16 participants, initially diagnosed with PTSD, screened negative after treatment. Meanwhile, 13 participants suffering from anxiety and depression showed "significant and clinically meaningful improvements," Dames said.

"It was almost like it was like riding a magical bus for three months, just watching all of that happen."

"While some results from studies of psychedelic treatments are promising, they should be viewed with 'a critical lens,' " Husain said.

"Many studies involve a small number of patients by clinical trial standards, and often do not contain a placebo group, or comparisons with standard available treatments. Some studies are also so new that any potential long-term effects are unknown."

"I do think we need to be cautiously optimistic and take a critical look before we just bring them into clinical practice, because we don't want to bring the cart before the horse," he said.

"We need robust clinical trials. We need good governance of those studies. We need a critical appraisal of the evidence and they need to be regulated."

Dames received $50,000 in federal funding for the first program, and in January, received $450,000 over five years from the Michael Smith Foundation for Health Research, B.C.'s health research funding agency, and the Lotte & John Hecht Memorial Foundation, a charity that offers grants in education and medicine.

Psilocybin, MDMA being studied

Aside from ketamine-assisted therapy, Canadian researchers are looking at the use of other psychedelics in mental health work.

In August last year, Health Canada granted several exemptions to the Controlled Drugs and Substances Act to allow terminally ill patients to use psilocybin, the psychoactive ingredient in magic mushrooms, to manage end-of-life distress. More than three dozen additional exemptions were granted to patients and health-care providers in the months that followed.

Dr. Bruce Tobin worked on securing the first exemption, and says he has seen a tipping point in how these treatments have been perceived in recent years.

"Five years ago, I wasn't meeting very many doctors who knew much about it or were very supportive of it," said Tobin, founder of TheraPsil, a Victoria-based advocacy group for patients.

"I would say that things have changed dramatically at this point. We have many doctors who are very interested in learning more about this therapy."

Tobin described psilocybin's effect as "a loosening of emotional defences."

"Patients let out the fear, the anger, the anxiety, the grief, old resentments so many of us tend to hold."

The exemptions granted so far have focused on end-of-life distress, but as more research is conducted its use could expand to TRD, chronic anxiety, addictions and PTSD, Tobin said.

"I feel very confident that we're going to see the promise of psilocybin confirmed rather than discredited."

In a statement to The Current, Health Canada said it "thoroughly reviews all requests for exemption and makes decisions after taking into account the risks and benefits."

"We still have much to learn about the risks, which is why the sale and possession of psilocybin is still illegal," the statement continued.

"Until there is a sufficient evidence base, Health Canada will review each request for an exemption on a case-by-case basis."

Dr. Evan Wood, a professor of medicine at UBC in Vancouver, says there is "a real openness" to psychedelic-assisted therapies because existing treatments don't work for everyone.

"Our existing mental health treatments have major limitations. And anyone who works in mental health, you know, has good insight into that," said Wood, who last year became chief medical officer with Numinus, a company licensed by Health Canada to research psychedelic-assisted therapies.

Wood also believes there won't be "the same kind of political headwinds, for instance, that medical cannabis faced" — as long as the studies can robustly demonstrate safety and cost effectiveness.

"Even if psychedelic-assisted treatments become more mainstream, they won't be a cure for everyone or all conditions, but could become another tool in the mental health-care system," he added.

"That will be a huge leg up for people that are looking to be able to make change, that otherwise existing treatments and therapies just simply aren't effective for."

*From the article here :

https://www.cbc.ca/radio/thecurrent/the-current-for-feb-25-2021-1.5927501/growing-interest-in-psychedelic-treatments-for-mental-illness-but-expert-warns-more-robust-research-needed-1.5929902

​

 

[mr peabody]

Are psychedelics the future of mental health care?*

by Maya Singer VOGUE | 19 Feb 2021

At seven o’clock on a recent evening, I dim the bedroom lights, call out a reminder to my boyfriend to rouse me in an hour with a gentle tap, and close the door. “Have a great trip,” I hear him say from the living room as the two ketamine tablets I’ve pressed into the pockets of my cheeks dissolve, leaving a bitter residue. Minutes later, I’m flying over water that reflects a sourceless golden light. Am I the light? The thought triggers a sensation of being stretched like taffy in all directions. It’s not my body being stretched – I don’t have a body anymore – but the immaterial me moving in tune with the ambient music in my headphones. I stretch and spread until at last I’ve dissolved – pixelated – at which point a small voice in my head calls out, “Do you really think this will help you quit smoking?”

The last time I was on ketamine, I was hooked up to an IV following surgery. This time, the drug – in general medical use as an anaesthetic since 1970 – arrived on my doorstep courtesy of Mindbloom, a new telemedicine company specialising in ketamine-based psychedelic therapy. This was no shady dark-web deal. Prescribed by a psychiatric nurse practitioner following an extensive intake evaluation, and compounded by a licensed pharmacy, the ketamine came bundled with an eye mask, a hardbound journal, and a blood-pressure cuff that I was instructed to use before and after dosing, to test my vitals. The tablets themselves were housed in a mirrored pouchette with the tagline ACHIEVE YOUR BREAKTHROUGH spelled out in sleek, sans serif font. I was tempted to post a shot to Instagram, but I had a Zoom call with my psychedelic-integration coach in half an hour, and I wanted to meditate first.

Welcome to the brave new world of psychedelic wellness. After decades underground, hallucinogens such as ketamine, LSD, psilocybin, and MDMA are getting a fresh look from the medical establishment, thanks to myriad studies suggesting silver bullet-like efficacy in the treatment of anxiety, depression, and addiction, among other ailments. MDMA, renowned for its bliss-inducing effect – hence the street name “ecstasy” – is on course to be approved for the treatment of post-traumatic stress disorder (PTSD) in the US within the next year or two. Synthetic forms of psilocybin, the active compound in magic mushrooms, were given “breakthrough” designation by America’s Food & Drug Administration (FDA) in 2018, allowing for the fast-tracking of drug trials. Meanwhile, this past November, Oregon became the first state to legalise psilocybin for medical use, an advance not lost on the investors flocking to start-ups like MindMed and Compass Pathways, both of which are developing psilocybin treatments in anticipation of a cannabis-style psychedelics boom. A mental health revolution is at hand – and it’s long overdue, according to experts such as Frederick Streeter Barrett, PhD, assistant professor of psychiatry and behavioural sciences at Johns Hopkins School of Medicine and a faculty member at the university’s recently opened Centre for Psychedelic & Consciousness Research.

“The current model for treating problems like anxiety and depression just isn’t very good,” Barrett says. “Patients take pills every day, for years, and these medications not only have nasty side effects, they often don’t even work. But with psychedelics-assisted therapy, there’s the potential to truly alter someone’s life with just one or two sessions, because you’re getting at suffering at the source.”

I’m not suffering, exactly, but for lack of more technical language, I’ve kind of been freaking out. Straining to maintain a productive work schedule under lockdown, I fell back into the habit of smoking as I write – and soon thereafter, the habit of trying to quit. The addiction struck me as fundamentally psychological. If I was so hooked on nicotine, why did I reach for my American Spirits only when I was stuck at my desk, staring down a deadline? But reach for them I did, and the harder I worked not to – with the aid of gum, apps, hypnosis, you-name-it – the more fixated I became on the fear that I simply could not write without cigarettes. I was starting to feel truly hopeless when I stumbled across a news item about studies showing that with the aid of psilocybin, long-time smokers were quitting cold turkey and sticking with it at rates that put all other remedies to shame; two-thirds of participants in one recent study were confirmed cigarette-free after one year.

Intrigued, I did a little more digging and discovered that ketamine – a dissociative hallucinogen that is already legal for supervised medical use, including in the treatment of depression – seemed to draw out the mind in a way similar to psilocybin by putting the brain in a “neuroplastic” state, explains Julie Holland, MD, a New York-based psychiatrist and the author of the 2020 book Good Chemistry. “They have different chemical properties, but both ketamine and psilocybin have an ego-dissolving effect, where you’re breaking the mental loop that’s symptomatic of conditions like depression and anxiety and addiction, and allowing the brain to form new connections.”

Maybe a little ego-dissolution was the answer, I mused as I stamped out another butt in the ashtray next to my laptop and Googled “ketamine therapy – New York.”

“The truth is, we don’t really know how this stuff works,” Michael Pollan, author of the bestselling psychedelics primer How to Change Your Mind, tells me. “A leading theory is that psychedelics quiet the brain’s ‘default-mode network’, and that opens up new pathways for thought.” As Pollan goes on to explain, the default-mode network is where “the ego has its address” – it’s the part of our brains where we construct the narrative of who we are and, thus, the place we get stuck in destructive thought patterns about ourselves. “That could be ‘I’m a worthless person who doesn’t deserve love,’ or it could mean telling yourself that you can’t get through the day without smoking,” Pollan continues. “Either way, the idea is that, by muffling those thoughts, psychedelics help you out of the rut.”

Pollan’s précis on the science of psychedelics is reassuringly down-to-earth. For years, I’d been put off by the drugs’ woo-woo connotations, and to judge by the refined, minimalist aesthetics of new ketamine-therapy chains such as Field Trip Health, which has serene locations in New York City, Toronto, Atlanta, Chicago, and Los Angeles, I’m not the only person with zero interest in a tie-dye mental makeover. It’s all a far cry from Timothy Leary and The Electric Kool-Aid Acid Test. But Leary – who famously conducted psychedelics experiments at Harvard in the early 1960s, before he ran afoul of the law and, in turn, helped prompt the criminalisation of psilocybin and LSD – does continue to exert an influence. His “set and setting” theory is a cornerstone of all contemporary psychedelics-aided therapy. “Set basically refers to mindset, going into your journey, and setting is your environment,” explains Ronan Levy, who cofounded Field Trip in 2019 after establishing – then selling – Canada’s largest network of cannabis clinics. “They matter as much as the drug you’re taking,” he continues. “You need to be in a place – mentally and physically – where you feel inspired and at ease.”

Because I’d chosen to work with Mindbloom, thanks to their Covid-friendly process, the setting for my four, hour-long treatments, was my bedroom. To be perfectly clear, I wasn’t microdosing. Nor was I popping a pill just to see what colours spilled out of my head. Prior to receiving my Mindbloom package, I spent over an hour on Zoom with a board-certified psychiatric nurse practitioner who quizzed me on everything from my family medical history to my typical responses to stress. (According to Mindbloom founder and CEO, Dylan Beynon, about 35 per cent of potential patients are screened out at this point, for reasons such as past experience of psychosis or, at the other end of the spectrum, not meeting the threshold for a diagnosis of anxiety and/or depression.) “Set” was established in conversation with Laura Teodori, my psychedelic-integration-support coach, who – after obtaining confirmation from my boyfriend that he’d check on me every 20 minutes – helped me formulate an “intention” for the trip immediately after our call. My goal, we ascertained, was to recall moments in my life when I could create without smoking. With that in mind, I tucked the tablets inside my mouth, pressed play on the Mindbloom-curated soundtrack that would be piping through my headphones, lowered my eye mask, and waited for my default-mode network to go off-line.

Hallucinogens come in many forms, from the low-dose ketamine I was taking to wallop-packing plant medicines, like ayahuasca and ibogaine and peyote, that have been used in sacred rituals for hundreds, perhaps thousands of years (and are illegal in the US). But a feature common to all is the sense of coming into contact with the cosmic. “It’s like there’s no boundary between you and others, or you and the universe,” notes Johns Hopkins’s Barrett, saying that "virtually all subjects in psilocybin studies have reported such a feeling of oneness. Some people call this an experience of God, or nirvana.” I went into my first ketamine journey matter-of-factly, with a problem to solve, and even so, that first trip commenced with a vision of the world rewinding, a kind of reverse big bang that exposed the heretofore invisible filaments connecting everyone and everything. The vision moved me – tears puddled behind my eye mask – and then it yielded to more personal impressions, such as a recurring image of myself, age six or seven, playing with my dollhouse.

“What do you think was important about the dollhouse?” Teodori asked me in our post-trip call. I was still pretty woozy as we Zoomed – the effect wore off by the next day – but suddenly, it was like a light bulb went on in my head. “I think…I think I was remembering what it felt like to create without smoking,” I told her. “When there wasn’t any pressure, and I could just play.”

This download is part of integration, another cornerstone of modern psychedelic medicine. “The goal is to take advantage of the neuroplastic state, which lasts for about a week after dosing,” explains Beynon. “You want the changes in your brain to stick, so the question becomes, ‘How do you turn these new thoughts into new behaviours?’” For me, this entailed finding ways to get back in touch with that dollhouse sense of play.

Easier said than done. My ketamine experiences were clarifying and often even profound, but they didn’t change certain nerve-racking facts of life, such as that I write for a living and thus have deadlines to meet if I wish to pay my bills. Or that it’s hard – like, really hard – to stay motivated in the midst of a global pandemic, when each day brings fresh spurs to panic and depression. “There’s a huge mental health crisis happening parallel to, and in response to, this pandemic,” notes Benjamin Brody, MD, assistant professor of clinical psychiatry at Weill Cornell Medicine in New York, and chief of the Division of Inpatient Psychiatry at the university hospital, where ketamine infusions are typically administered. “People who are grieving, people who have lost jobs, people who are feeling disconnected, whose lives have been upended .…” With demand for care rising “across the board”, as Brody notes,"it’s no surprise that psychiatrists such as Amanda Itzkoff, MD, are seeing a huge uptick in inquiries about ketamine therapy. But it may or may not be the right tool for every job, Itzkoff points out."

“The thing is, if you got laid off and you don’t know how you’re going to pay rent, ketamine won’t change that,” says Itzkoff, an early adopter who has been providing ketamine infusions at her Manhattan practice since 2014. “It doesn’t remove the external pressures. But when you’ve got someone with severe depression, who has kind of given up, then there’s real promise in this treatment.” Itzkoff cites the example of a former patient, a high-powered attorney and mother of two, who was on disability and “almost catatonic” when they began working together. “She had to be retrieved from this state,” recalls Itzkoff. “By breaking the negative thought loop – even temporarily – you show someone it’s possible to feel another way. And that,” she adds, “can be channeled toward getting people back on their feet.”

Chad Kuske didn’t just get back on his feet following his first psilocybin treatment a year and a half ago; he experienced what he calls an immediate and profound “sense of meaning and a desire to live”. A former Navy SEAL, Kuske, 40, had tried psychoanalysis and various pharmaceuticals before being medically retired from the service in 2017. Reentering civilian life, he found himself using drugs and alcohol as a way of coping with the anxiety, depression, and alienation that he now comprehends as the symptoms of PTSD. “Nothing else had worked. And I knew that sooner or later, if I kept doing things the same way, my life would be over – either literally or metaphorically, like I’d wind up in jail,” Kuske explains. “The mushrooms helped me see my situation clearly: I was in hell, but it was a hell of my own creation, and I could make the choice whether to stay there and suffer or leave and start the work of changing.”

One of the key insights Kuske has taken away from his trips – and from his integration process, which is ongoing – is that he’s not alone in struggling to meet the challenges of daily life. Likewise, Itzkoff suggests that the feeling of interconnectedness induced by psychedelic therapy – and near-psychedelics, such as ketamine and MDMA – may help alleviate the isolation brought on by Covid. It may also play a role in helping the people hardest hit by the pandemic recuperate: Nautilus Sanctuary, a nonprofit psychedelics-research and training centre in New York, is already planning a study exploring the use of MDMA to treat frontline workers with severe PTSD – one of the many inquiries to expand on the drug’s groundbreaking FDA trials sponsored by MAPS, which entered phase three in 2017. Other studies sponsored by the organisation have focused on veterans in Israel and the US, and the Department of Veterans Affairs has exhibited a willingness to approve such studies, so long as they are safe, beneficial, and scientifically sound.

This kind of conservative approach is merited, notes Weill Cornell’s Brody. “I’m very concerned about this atmosphere, that the floodgates are opening. I work with ketamine, a drug that’s been in use for decades, and even there, we don’t know all that much about its long-term effects,” says Brody, who provides ketamine-infusion therapy only to patients in whom he’s observed severe, treatment-resistant depression – and who was positively aghast when I relayed rumours that self-dosing with inhalers of esketamine, a synthetic form of the drug given FDA approval for supervised use in 2019, was all the rage in LA. “Ketamine is a serious drug!” he reiterates. “This isn’t a spa service. It’s not like getting Botox. And what worries me about all these clinics popping up is that people are going to start thinking about it that way.”

Brody is hardly alone in fearing the commercialisation of psychedelics – a trend that, if canny investors like Peter Thiel, a backer of Compass Pathways, are correct, is on pace to increase rapidly. “It’s a unique space because so much of the technology has been developed by Indigenous healers,” notes Pip Deely, cofounder of the venture-capital firm Delphi, which is eyeing investments in psychedelics start-ups and supporting a new psilocybin-legalisation campaign in Hawaii. “We see a lot of dread that if this all goes the way of cannabis, the people who have been doing this work the longest will be cut out of the conversation, and those Indigenous roots will be erased.” Unprompted, I hear a version of this concern from one Berkshires-area healer who, for legal reasons, prefers to remain unnamed; she tells me that, although she supports expanding access to psychedelics, she worries about the experience becoming pro forma and “clinical.”

Though they come at their misgivings from opposite angles, both traditional healers and Brody are wary of psychedelics’ getting marketed as a quick fix – and in all honesty, I’m the target demographic for that pitch. When I sat down at my computer to fill out Mindbloom’s candidate questionnaire, what I wanted was to detangle a few mental wires. By the time I’d completed my final ketamine treatment, I’d come to realise that those wires were crossed very deep down. My writing-while-smoking problem was really a problem with the little voice in my head telling me that I’m not good enough, I haven’t achieved enough, I’m falling behind. As I wrote in my integration journal after my second session, “Every little deal is a big deal.” I added a frowny face to underline the point.

I can’t blame Mindbloom for my failure of mindset. All my conversations with Teodori were oriented around getting me to probe the heart of my fears, and she was diligent in supporting me as I attempted to integrate the lessons of my journeys into daily life, checking in with me every few days via text and reminding me that she was always available to talk. Alas, I didn’t take her up on that offer as often as I should have – I had a ton of writing to do! – and in the end, I felt changed but not transformed. Which could be a me thing, or it could be a drug thing. Barrett of Johns Hopkins pointed me to studies from the university’s Centre for Psychedelic & Consciousness Research indicating that, where smoking cessation is concerned, the more “mystical” the trip, the more effective the treatment. “There’s a big difference between a low dose of ketamine and taking what we call a ‘breakthrough’ dose of psilocybin,” he notes. “That’s where you’re really going to break down your sense of self.”

Is that what I want? Is that what we all want, in some subconscious way? “There’s a spiritual hunger these medicines satisfy,” Pollan points out, and I can attest that once you’ve visited the astral plane, you want to go back. Most hallucinogens are not physically addictive, but the psychedelic experience is itself addicting. I spoke to numerous people for this story who described their encounters with psychedelics as “life-changing” in ways large and small; one woman even credited peyote with restoring movement to her paralysed arm. But Ann Watson’s account is the most relatable. A former VP and fashion director at Henri Bendel in New York City, and now a cochair of The Vaquera Group, a global marketing firm, Watson, 52, is also a self-described “explorer” who, like me, kept a pretty tight lid on her deepest, darkest feelings – until she began working with psychedelics 12 years ago. “My childhood was chaotic; there was a lot of abandonment, but I didn’t associate with the word trauma, because I thought it was reserved for people who have experienced things like rape or war. But I was seeking something,” explains Watson, who tried a variety of treatments to relieve an “ever-present vibration of anxiety,” including counselling and prescribed antidepressants, before experimenting with a long list of psychedelics. Eventually she arrived at a treatment plan with a doctor in Los Angeles she sees four times a year for guided psilocybin trips; she also microdoses psilocybin on a more regular basis, mixing magic mushrooms with Lion’s Mane. “It’s an ongoing process,” she tells me. “The thing is, once you start looking inward, you realise there’s always more to see.”

Perhaps that is the main takeaway from my own journey: that I’m just at the start of it. I have work to do on myself. But in the meantime, I also have work to do, period – as in, I’m on deadline for this piece. And I regret to inform you that as I write these words, I am indeed smoking.

*From the article here :

Are Psychedelics The Future Of Mental Health Care? One Vogue Writer Conducts A Personal Investigation

“I was tempted to post a shot to Instagram, but I had a Zoom call with my psychedelic-integration coach in half an hour, and I wanted to meditate first...”

www.vogue.co.uk

 

[mr peabody]

Can magic mushrooms heal us?

by Ezra Klein | New York Times | 18 Mar 2021

A very promising mental health experiment is taking shape in Oregon.

Gov. Kate Brown of Oregon announced the members of the state’s newly formed Psilocybin Advisory Board this week. Why does Oregon need an official board to offer advice about the active ingredient in magic mushrooms, you ask? Because Oregon is about to become the first state in the country to try to build a support infrastructure through which psychedelic mushrooms can be woven into everyday life. This framework is different from what we’ve seen before: not legalization, not medicalization, but therapeutic use, in licensed facilities, under the guidance of professionals trained to guide psychedelic experiences. Whoa.

“Like many, I was initially skeptical when I first heard of Measure 109,” Brown said in a statement. “But if we can help people suffering from PTSD, depression, trauma and addiction — including veterans, cancer patients, and others — supervised psilocybin therapy is a treatment worthy of further consideration.”

Measure 109, the Oregon Psilocybin Services Act, approved as a ballot measure in November, is the brainchild of Tom and Sheri Eckert, who shared a therapy practice in Portland. In 2015, the Eckerts read an article by Michael Pollan in The New Yorker titled “The Trip Treatment.” The article described the emerging research around using psychedelics as a therapeutic tool and unearthed the largely forgotten pre-Timothy Leary period in which psychedelics were widely used by psychiatrists. In the past, the government had funded more than a hundred studies, and as Pollan recounts in “How to Change Your Mind,” his subsequent book, Anaïs Nin, Jack Nicholson and Cary Grant all underwent LSD-assisted therapy. Bill Wilson, a co-founder of Alcoholics Anonymous, who’d given up drinking with the aid of a hallucinogenic plant called belladonna, considered bringing LSD-assisted therapy into AA in the 1950s, but was met with disapproval from his board.

This was a very different model of psychedelic use: There was a trained mental health professional in the room and subsequent therapy to help turn the insights into action. The early results were promising, though the studies were poorly designed. At times, the fear was that the compounds were too powerful and left people too malleable to the suggestions of their guide. One early practitioner worried that on psychedelics, “the fondest theories of the therapist are confirmed by his patient,” and that even though the healing was real, the pathway was “nihilistic,” bordering on something like hypnosis. This era of study ended before these questions could be resolved, when psychedelics slipped into the counterculture, where they were used without therapeutic safeguards, and the Nixon administration targeted them as part of its culture war. A remnant of healers who used psychedelics in their work remained, but they were driven underground.

The Eckerts had personal experience with psilocybin, and Pollan’s piece, and the research it led them to, made sense to them as therapists. This was work they could do, should do, but the law made it impossible. “It was a desire to specialize in this field, and we realized we couldn’t,” Tom Eckert told me. “And then the question was: Would we accept that answer or were we going to do something about it?”

Sheri Eckert passed away unexpectedly, after a surgery in December, but Tom recounted a hike they had taken together before embarking on what they knew would be a consuming, multiyear political project. “We decided to consult the mushroom,” he said. They drove to Mount Rainier, hiked through the woods and took psilocybin over a campfire. Tom found his mind wandering to the far future, when historians would look back on our era. “I got to thinking that they probably wouldn’t care so much about our politics and technologies,” he said. “They’d probably notice how estranged and detached we are from our own consciousness.” The couple couldn’t have children but Tom remembers Sheri’s voice piercing the quiet. “An idea could be like a child,” she said.

This is where I should stop for a moment, before I lose you. The only thing worse than hearing about someone else’s dream is hearing about their mushrooms trip. But these experiences have an unusual power, a power Oregon is trying to harness. “The definition of personality is it’s a trait, it doesn’t change,” Matthew Johnson, a professor psychiatry at Johns Hopkins University and the associate director of its Center for Psychedelic and Consciousness Research, told me. But Johnson has conducted multiple studies in which participants ranging from the very ill to so-called healthy-normals report profound changes to outlook and even personality after one well-facilitated dose.

In particular, traits revolving around openness to change and uncertainty seem to loosen, with people questioning their own judgments, holding other viewpoints and tolerating more ambiguity with greater ease. Openness to new experiences tends to diminish as we age, so the potential of psychedelics to unlatch the windows of the mind is, in Johnson’s words, “a bit of a fountain of youth effect.” Psilocybin is also a reliable generator of profound, mystical experiences in people who try it with the right intentions and the right support — experiences that, months and years later, many recall as among the most meaningful of their lives. “Until our work with psilocybin, there was never an experimental manipulation which you could schedule for a Thursday and change your personality,” Johnson told me.

But the more pressing case for psilocybin comes from research out of Johns Hopkins, U.C.L.A., N.Y.U. and elsewhere that has shown it to be a potentially effective treatment for major depression, end-of-life anxiety and drug addiction. “One of the things I’ve come to is that addiction medicine in 2021 is in desperate need of transformative technologies,” Todd Korthuis, a professor of medicine who specializes in addiction at Oregon Health & Science University and a member of Oregon’s Psilocybin Advisory Board, told me. The studies so far are preliminary, but they are “showing dramatic change in people’s lives — that’s what we need for cocaine use disorder, methamphetamine use disorder, even alcohol and tobacco.”

Some of the early results are so remarkable that they fall into the too-good-to-be-believed category, at least until far more research is done. A recent study on major depressive disorder, published in JAMA Psychiatry, found more than half of the subjects in remission four weeks later, after just two treatments alongside psychotherapy. A study on tobacco addiction, out of Johns Hopkins, found two-thirds of the subjects who received psilocybin in combination with cognitive behavioral therapy abstinent a year later. These would be miraculous effect sizes if they hold up in larger samples and other contexts. Even if further research finds psilocybin only 50 percent as effective as these experiments suggest, it would be still be a breakthrough.

There isn’t a simple explanation for why psychedelics possess these powers. M.R.I. scans show the psychedelic brain aflame with activity, with areas that rarely connect lighting up in electric conversation. “I think that’s what’s responsible for this radically different associative net, this different ability to absorb the gestalt,” Johnson told me. "You are hearing, thinking, processing differently than normal, which can lead to new experiences and epiphanies. Some of those are classic psychedelia, the kind of thing visualized in 'Yellow Submarine.' Synesthesia, for instance, where you’ll hear in colors. But just as often, the experience defies those expectations: It’s more like a difficult, but powerful, therapy session."

I avoided psychedelics when I was younger, fearful of the loss of control, and tried them later, desperately, when there was more darkness in my mind than light. It was not an easy time for me, and these were not easy experiences. They kicked down doors around my anxiety, my marriage, my work, my family, my resentments, my attachments, my self. Those rooms were often unpleasant to enter. There was ecstasy and beauty, yes, but also fear and, often, so often, intense nausea. Things I’d fought to ignore resurfaced. Disparate parts of my life and beliefs and personality connected, and I became more legible to myself. I am not cleansed of anxiety, but I am more aware that my outlook, at any given moment, is just a dance of brain chemistry and experience, and far from the only state possible. That a few micrograms of chemical was all it took to upend my confident grip on reality shook me in ways I’m grateful for. I hold my judgments and worldviews more lightly, and I am friendlier to mystery and strangeness.

But as with more traditional therapy, to the extent that these experiences changed me, it is because I acted on the insights later, once sobriety had returned. A trip is of little value if you refuse to leave the hotel after you arrive. “You can have an amazing experience, but if you don’t do the work to ground it in a practice of self-development, it may not have the impact you would hope,” Eckert told me. "It can fade, like a dream.”

Or it can crack you. Psilocybin isn’t addictive, and there is no known lethal dose. “If you look at the safety profile of psilocybin, it’s dead last in terms of its risk of harm either to self or others,” Korthuis told me. But these experiences can be psychologically searing, even scarring. There is evidence that terror-filled trips can cause lingering trauma or even trigger psychosis or suicide in rare cases. Looking back, I wish I had had the option of skilled support, both to get more out of the experiences and to protect me from harm. These are not trivial chemicals. Here there be dragons.

The Eckerts wanted to bring back not the louche psychedelic use of the late ’60s and ’70s, but the supported psychedelic use of the ’50s and early ’60s. “We wanted to put psychedelic therapy and wellness on its own foundation,” Tom told me. Under Measure 109, no one will be able to walk into a store and buy magic mushrooms. Instead, there will be regulated centers, with trained and licensed facilitators who are there both for the trip itself and to help people integrate the experience afterward. There will be screening for psychological and physical conditions that could make the experience unsafe and help on-site for anyone who does fall into psychological or physical crisis. “We wanted to think deeply about how we might integrate psychedelics back into the culture,” Eckert said.

The Eckerts’ initiative caught the attention of a broader group of organizations trying to shift the laws around psychedelics. They were invited to present at a meeting of the Multidisciplinary Association for Psychedelic Studies, or MAPS. There, they met with other key groups that would become backers of their project: David Bronner, the chief executive of Dr. Bronner’s soaps, which uses some of its profits to support drug reform initiatives, and Graham Boyd, a co-founder of the Psychedelic Science Funders Collaborative, who brought his experience winning ballot initiative campaigns to the effort.

MAPS, which is led by its founder, Rick Doblin, is at the center of the decades-long effort to revive research into the medical benefits of psychedelics and is currently deep in F.D.A. trials to get MDMA, an empathogenic chemical associated with the drug ecstasy, approved as a treatment for post-traumatic stress disorder. Doblin supports the Oregon initiative, but he is cautious about the difficulties inherent in getting it right. How will facilitators be trained? How will patients be screened? Psilocybin remains illegal at the federal level, and the federal government could choose to act on that at any time, he noted. In the early years of state cannabis legalization, there were raids on dispensaries. “I worry those with the most at stake in terms of licenses will be fearful of participating, when those are the people we most want to participate,” Doblin told me.

Lurking in Doblin’s comments is a concern I heard from many reformers working to change the legal status of psychedelics: Too much, too fast could imperil decades of hard work and steady progress. A few stories, even exaggerated ones, of harmful trips and incompetent or predatory facilitators, could turn this into a rerun of the ’70s, when society turned sharply against these substances. “There’s a real Achilles’ heel,” Boyd told me. “Public opinion can really turn against this. Just because you’ve got science on your side doesn’t mean public policy will follow.” It was his influence, in part, that got a two-year implementation process included in the ballot initiative, where regulators and scientists could come together to carefully devise the program and to roll it out slowly, with plenty of public education and legal consideration.

What’s striking to me about Measure 109, though, is that it breaks away from the medicalization-legalization binary that has defined drug reform for the past few decades. It does not allow anyone to sell psilocybin pills in stores. Nor does it restrict treatment to those with a diagnosis of mental illness. The measure does not grudgingly accept psilocybin as the lesser evil compared with, say, the drug war or PTSD. Instead, it is based on the idea that psilocybin has the potential to change our lives for the good, whether we are sick or well, and so it is worth investing in the frameworks and safeguards so that it can be used safely and productively. It would be foolish to posit psilocybin-assisted therapy as an answer to all that ails our society, or even our mental health system. But it would be one more option for those who need it, and both evidence and anecdote suggest it would be life-changing for many. That would be enough. That would be so much.

“Oregon has always been a pioneer state,” Korthuis told me. “It’s been a hotbed of innovation around drug policy for at least 25 years. This is just the next contribution in that history.”

Opinion | Can Magic Mushrooms Heal Us?

A very promising mental health experiment is taking shape in Oregon.

www.nytimes.com

 

[mr peabody]

Psychedelic Therapy for Borderline Personality Disorder?

Psychedelic therapy may be able to target BPD’s hallmark symptoms.

by Abigail E. Calder, MSc | Psychedelic Science Review | 10 May 2021

Theories of how psychedelics work in the brain are still evolving, but one of the best-supported ideas right now is the REBUS (Relaxed Beliefs Under Psychedelics) theory: psychedelics relax prior beliefs and thought patterns to make room for new, healthier ones. In depression, for example, they can break patterns of negative thoughts about oneself or the world at large. At the neurobiological level, this may correspond to opening a window of neuroplasticity during which there is an increased capacity for positive change.

REBUS is not only attractive for what it explains, but also for what it implies. How many other psychological disorders are characterized by persistent, maladaptive beliefs? Is there one that is not? Psychedelic research so far has largely focused on mood disorders, PTSD, and addiction, but there may be potential for other “disorders of rigidity” as well. And though psychedelics are certainly not going to fix every psychological issue, scientists are still feeling out their limits.

Borderline Personality Disorder

One candidate for clinical research is borderline personality disorder (BPD), which affects about 1-2% of the population and is characterized by extreme instability in various aspects of patients’ lives. Patients struggle with impulse control and unstable relationships, and their emotional lives and self-image are also highly volatile. BPD is a severe condition that may cause people to harm themselves or self-medicate to deal with their multifaceted emotional pain. About 10% of patients with BPD commit suicide. As far as treatment, it’s a familiar story: some therapies help some of the time, but many patients struggle chronically.

A recent paper makes the case that psychedelics could help where other treatments fail. At first glance, psychedelics would not seem to be good weapons against a disorder characterized by instability. After all, the psychedelic state itself is highly unstable, causing people to switch rapidly between intense emotions and hallucinatory states. Perhaps they would just make things worse. But Richard Zeifman and Anne Wagner, both specialists in clinical psychology, say not to judge too quickly: Psychedelic therapy may be able to specifically target some of BPD’s hallmark symptoms. At least, they argue, it’s worth a careful shot.

Psychedelics for BPD: Four symptoms of interest

No direct clinical data exists on psychedelic therapy for BPD. However, many symptoms of BPD are not unique to that disorder, and previous studies have shown that psychedelics may improve some of these symptoms. For example, patients from a study on alcohol use disorder reported more control over their own behavior after psilocybin-assisted therapy. Similar findings exist for healthy subjects, who show reduced impulsivity and aggression after using psychedelics. Many BPD patients struggle with exactly these problems.

As with behavior, BPD patients also struggle to regulate their emotions. They experience more unpleasant emotions, such as rage, loneliness, or shame, and they are worse at coping with them. Psychedelics have been shown to help with emotional dysregulation, including in people who are high in BPD-like traits. Depression and anxiety, which are characterized by specific deficits in emotional regulation, respond particularly well to psychedelics. To the extent that psychedelics improve people’s ability to regulate their own emotions – rather than being controlled by emotion – they may help BPD patients the same way they help those with mood disorders. Additionally, psychedelics synergize nicely with mindfulness practice, which is already an effective tool to help patients understand and manage turbulent feelings.

Perhaps as a consequence of dysregulated behavior and emotions, people with BPD also struggle with maintaining healthy relationships. They may find it hard to trust or empathize with others and can be highly sensitive to exclusion and rejection. Psychedelics, in particular psilocybin and MDMA, have been associated with improvements in relationships and enhanced feelings of empathy, trust, and closeness to others. They may also reduce sensitivity to rejection and others’ negative facial expressions, and therefore emotional reactivity. Given that social problems are some of the hardest BPD symptoms to treat, drugs that make relationships easier would be valuable therapeutic tools.

Lastly, BPD is characterized by instability in someone’s sense of who they are – their identity. People may see themselves very negatively and have difficulty showing themselves compassion, or they may have an incoherent and confused sense of identity. Psychedelics may particularly help with the first problem: they consistently encourage patients and healthy people alike to be kinder to themselves and see their own positive qualities.

Slow and safe wins the race

Though psychedelics could improve some symptoms of BPD, this is all speculative. Therapists are highly cautious about including BPD patients in psychedelic studies, mainly due to concerns that they could make an unstable condition worse.6 How might clinicians figure out whether psychedelics will really help, without exposing patients to unnecessary harm?

One conceivable avenue could be that of compassionate use exemptions. In Switzerland, for example, approved physicians may request permission to treat patients with psychedelic therapy based on their professional judgment of how an individual patient will respond. A few patients with BPD have been legally treated in this way and seemed to respond well, though they have not been systematically analyzed.

Importantly, many of these patients had other disorders as well. Accepting patients with specific comorbidities for clinical trials would allow researchers to offer patients a likely benefit from psychedelic therapy, while also investigating whether BPD symptoms improve. Indeed, one study of ayahuasca therapy for treatment-resistant depression has included several participants with comorbid BPD, all of whom showed an improvement in depressive symptoms without any worrying adverse effects. That study did not investigate BPD symptoms specifically, but future ones could.

Either way, clinicians considering psychedelic therapy for BPD agree that safety precautions are even more important than usual.6 Due to BPD’s unstable nature, it may take a particularly skilled therapist to work with these patients. Building an effective therapeutic alliance, which is essential for safe psychedelic therapy, could be more challenging than usual. Therapists would have to be able to carefully prepare their patients, set their expectations, and convince them to commit to the difficult work inherent in psychedelic therapy. If they can do that, a cautious exploration of psychedelics for BPD might take place.

Ketamine, which shares some mechanisms of action with classic psychedelics, is currently being investigated for treating suicidality in BPD in a Phase 2 clinical trial at Yale. For more information, visit clinicaltrials.gov.

Psychedelic Therapy for Borderline Personality Disorder?

Psychedelic therapy may be able to target BPD’s hallmark symptoms.

psychedelicreview.com

 

[izo]

UM SOM researchers identify potentially revolutionary antidepressant compound​

University of Maryland School of Medicine | May 04, 2016

In mice, ketamine metabolite Hydroxynorketamine lifts depression quickly, without serious side effects.

For years, scientists and doctors have known that ketamine can treat depression very rapidly, often working within hours, compared to weeks or months for widely used antidepressants. However, the drug, which is approved as an anesthetic, has major side effects – it is linked to hallucinations and dissociation - a sense of being outside your own body – and for these reasons is abused as a club drug. Not surprisingly, this limits its use in the treatment of depression.

A solution may be at hand. Researchers at the University of Maryland School of Medicine (UM SOM) have identified a metabolite of ketamine that quickly reverses depression in mice, but without ketamine's side effects. The study was published today in the journal Nature.

“This is potentially a major breakthrough,” said the study's senior author, Todd Gould, MD, an Associate Professor of Psychiatry at UM SOM. “It could allow depressed patients to get the rapid benefits of ketamine, while at the same time avoiding the risks.”

Most people with depression take medications that increase levels of the neurochemicals serotonin or norepinephrine in the brain. The most common of these drugs, such as Prozac and Lexapro, are selective serotonin reuptake inhibitors, or SSRIs. However, SSRIs are effective in only half of patients with depression, and even when these drugs work, they typically take between three and eight weeks to relieve symptoms. Ketamine, which does not work via serotonin or norepinephrine, can lift depression much more quickly, within hours after administration.

The work was a collaboration between scientists at UM SOM, the NIH National Institute of Mental Health (NIMH), the NIH National Center for Advancing Translational Sciences, the NIH National Institute on Aging, and the University of North Carolina.

“For years, we have been searching for ways to treat depression faster and more effectively,” said another co-author, Scott Thompson, PhD, Professor and Chair of the Department of Physiology at UM SOM, who has spent more than a decade studying glutamate and depression. “These results open up exciting new vistas for the first new generation of antidepressant compounds in the last 30 years.”

Using mice, the researchers tested the effects of several ketamine metabolites, chemicals produced by the breakdown of ketamine. They eventually focused on one called hydroxynorketamine, a compound that had been thought to have no psychoactive effects. In mice, blocking the transformation of ketamine to hydroxynorketamine prevented ketamine's antidepressant actions. Hydroxynorketamine itself also showed antidepressant effects, and none of ketamine's side effects.

“This discovery fundamentally changes our understanding of how this rapid antidepressant mechanism works, and holds promise for development of more robust and safer treatments," said Carlos Zarate, MD, of NIMH, a study co-author and a pioneer of research using ketamine to treat depression. "By using a team approach, researchers were able to reverse-engineer ketamine from the clinic to the lab to pinpoint what makes it so unique.”

The anesthetic and dissociative actions of ketamine are due to the fact that it blocks a particular glutamate receptor, the NMDA glutamate receptor. Researchers had assumed that ketamine acts as an antidepressant via the same mechanism. This appears not to be true, however, because hydroxynorketamine does not inhibit the NMDA receptor. Instead, hydroxynorketamine seems to activate another type of glutamate receptor, the AMPA receptor. Gould says that hydroxynorketamine likely works on depression via these AMPA receptors, either directly or indirectly.

Gould and his colleagues at NIH are already planning to begin testing hydroxynorketamine for its safety in humans. But he points out that the compound has, in effect, already been in humans in years as a metabolite following ketamine administration. "This gives us confidence it will be safe," said Gould.

“This study underscores the fact that our school is doing a range of important brain research. The Departments of Psychiatry, Physiology, and Neurology, as well as the Brain Science Research Consortium Unit and others, all are doing their part to advance our understanding of the brain and its diseases,” said UM SOM Dean E. Albert Reece, MD, PhD, MBA, who is also the vice president for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor. “In years to come, this finding may well change how depression is treated in millions of patients.”

About the University of Maryland School of Medicine

The University of Maryland School of Medicine was chartered in 1807 and is the first public medical school in the United States and continues today as an innovative leader in accelerating innovation and discovery in medicine. The School of Medicine is the founding school of the University of Maryland and is an integral part of the 11-campus University System of Maryland. Located on the University of Maryland’s Baltimore campus, the School of Medicine works closely with the University of Maryland Medical Center and Medical System to provide a research-intensive, academic and clinically based education. With 43 academic departments, centers and institutes and a faculty of more than 3,000 physicians and research scientists plus more than $400 million in extramural funding, the School is regarded as one of the leading biomedical research institutions in the U.S. with top-tier faculty and programs in cancer, brain science, surgery and transplantation, trauma and emergency medicine, vaccine development and human genomics, among other centers of excellence. The School is not only concerned with the health of the citizens of Maryland and the nation, but also has a global presence, with research and treatment facilities in more than 35 countries around the world. http://medschool.umaryland.edu/

2016 Archive - UM SOM Researchers Identify Potentially Revolutionary Antidepressant Compound | University of Maryland School of Medicine

www.medschool.umaryland.edu

 

[mr peabody]

Growing interest in psychedelic treatments for mental illness

by Padraig Moran | CBC Radio | 3 Mar 2021

After decades of therapy for anxiety and suicidal thoughts, nurse Stephanie Hug says she found relief from a 12-week pilot treatment program that combines the psychedelic anesthetic ketamine with psychotherapy.

"I had tried different medications, I exercised, I did the positive self-talk, you know, I tried so many things," said Hug, an operating room nurse in Nanaimo, B.C.

As a child, Hug says she was groomed and sexually assaulted, long dealing with feelings of shame and high anxiety.

"I just felt like this is just going to be my life. I'm going to be anxious, sad, I'm going to have these."

Late last year, she took part in Roots to Thrive, a ketamine-assisted therapy program run through Vancouver Island University in Nanaimo, B.C. The program, which involved 16 people, is different from a clinical trial that can include thousands of participants.

Ketamine is an anesthetic that is controlled under the Controlled Drugs and Substances Act, and is illegal to use unless authorized for medical, scientific or industrial purposes. The drug is recreationally used by some illegally for its psychedelic properties, ability to separate mind from body, and alter sensory experiences with sight and sound.

Hug says the results she got in the ketamine-assisted therapy have been "amazing."

"My inner monologue is a lot kinder and not so rampant. It used to just be like uncontrolled chaos in there all the time with the underlying negativity."

Dr. Ishrat Husain, a clinician scientist and psychiatrist at the Centre for Addiction and Mental Health in Toronto, says he understands the hope around psychedelic-assisted therapy, but more robust research is needed.

"I encourage that research, but I think that we need the findings of that research — and the research needs to be well-designed and controlled — before we can recommend it for clinical practice."

In recent years, scientists have been looking at treating mental health with psychedelics, including ketamine, MDMA and psilocybin — the active ingredient in magic mushrooms — though approvals from Health Canada remain limited.

Globally there are 74 ongoing registered clinical trials using ketamine as a treatment for depression, according to ClinicalTrials.gov, a U.S. government database, nine of which are underway in Canada.

A recent systematic review of 28 studies, conducted by Quebec researchers, found that while ketamine appears "promising" for short-term treatment of treatment-resistant depression (TRD), "more clinical and experimental data is needed with regards to the efficacy, tolerance and security of long-term administration."

Channel 'inner therapist,' says facilitator

The Roots to Thrive program, run by Shannon Dames, a professor of nursing at Vancouver Island University, was devised to help front-line workers with TRD and PTSD. "Ketamine was added to the existing program for its 'mind-loosening' effect to address barriers that are preventing people from living well," she said.

"We don't look at the ketamine as the medicine, we look at it as a facilitator."

"Compared to much therapy, which involves talking out the trauma, the focus of her program is 'really about going in,' " Dames said.

"We really teach people kind of how to be their inner therapist."

Shannon Dames

Participants received medical and mental health screenings before the first program last year. They then received three doses of ketamine over 12 weeks, in the form of a lozenge or an intramuscular injection, and wore eye masks in each session to block out external stimuli.

In her first session, Hug said she saw herself as a toddler at her grandparents' house, playing with a bucket of water, and was struck by the unconditional love children receive.

"This knowledge came where I suddenly knew that me and this child have the same heart, we're the same person. And I am just as deserving of love now as I was then."

While Hug felt unwell after the second session — something she attributes to taking her mask off — her third session left her with a feeling that "no matter what happens, I love me, I trust me, I am safe inside of me."

"I just hope that this medicine will reach the people that are feeling hopeless."

Dames said 11 of the 16 participants, initially diagnosed with PTSD, screened negative after treatment. Meanwhile, 13 participants suffering from anxiety and depression showed "significant and clinically meaningful improvements."

"It was almost like it was like riding a magical bus for three months, just watching all of that happen."

Husain says that while some results from studies of psychedelic treatments are promising, they should be viewed with "a critical lens."

Many studies involve a small number of patients by clinical trial standards, he said, and often do not contain a placebo group, or comparisons with standard available treatments. Some studies are also so new that any potential long-term effects are unknown.

"I do think we need to be cautiously optimistic and take a critical look before we just bring them into clinical practice, because we don't want to bring the cart before the horse," he said.

"We need robust clinical trials. We need good governance of those studies. We need a critical appraisal of the evidence and they need to be regulated."

Dames received $50,000 in federal funding for the first program, and in January, received $450,000 over five years from the Michael Smith Foundation for Health Research, B.C.'s health research funding agency, and the Lotte & John Hecht Memorial Foundation, a charity that offers grants in education and medicine.

Psilocybin, MDMA being studied

Aside from ketamine-assisted therapy, Canadian researchers are looking at the use of other psychedelics in mental health work.

In August last year, Health Canada granted several exemptions to the Controlled Drugs and Substances Act to allow terminally ill patients to use psilocybin, the psychoactive ingredient in magic mushrooms, to manage end-of-life distress. More than three dozen additional exemptions were granted to patients and health-care providers in the months that followed.

Dr. Bruce Tobin worked on securing the first exemption, and says he has seen a tipping point in how these treatments have been perceived in recent years.

"Five years ago, I wasn't meeting very many doctors who knew much about it or were very supportive of it," said Tobin, founder of TheraPsil, a Victoria-based advocacy group for patients.

"I would say that things have changed dramatically at this point. We have many doctors who are very interested in learning more about this therapy."

Tobin described psilocybin's effect as "a loosening of emotional defences."

"Patients let out the fear, the anger, the anxiety, the grief, old resentments so many of us tend to hold."

The exemptions granted so far have focused on end-of-life distress, but as more research is conducted its use could expand to TRD, chronic anxiety, addictions and PTSD, Tobin said.

"I feel very confident that we're going to see the promise of psilocybin confirmed rather than discredited."

In a statement to The Current, Health Canada said it "thoroughly reviews all requests for exemption and makes decisions after taking into account the risks and benefits."

"We still have much to learn about the risks, which is why the sale and possession of psilocybin is still illegal," the statement continued.

"Until there is a sufficient evidence base, Health Canada will review each request for an exemption on a case-by-case basis."

Dr. Evan Wood

Dr. Evan Wood, a professor of medicine at UBC in Vancouver, says "there is 'a real openness' to psychedelic-assisted therapies because existing treatments don't work for everyone."

"Our existing mental health treatments have major limitations. And anyone who works in mental health, you know, has good insight into that," said Wood, who last year became chief medical officer with Numinus, a company licensed by Health Canada to research psychedelic-assisted therapies.

"There won't be the same kind of political headwinds, for instance, that medical cannabis faced — as long as the studies can robustly demonstrate safety and cost effectiveness," Wood said.

He added that even if psychedelic-assisted treatments become more mainstream, they won't be a cure for everyone or all conditions, but could become another tool in the mental health-care system.

"That will provide a huge leg up for people that are looking to be able to make change, that otherwise existing treatments and therapies just simply aren't effective for."

*From the article here :

https://www.cbc.ca/radio/thecurrent/the-current-for-feb-25-2021-1.5927501/growing-interest-in-psychedelic-treatments-for-mental-illness-but-expert-warns-more-robust-research-needed-1.5929902

 

[mr peabody]

Psilocybin-assisted Therapy for Mental Health: A new paradigm?

by Amanda Feilding | voltface

We are living through a mental health crisis. Existing treatments barely scratch the surface of the problem, and have not translated into real world benefit for a huge number of people.

An estimated 1 billion people worldwide now live with a mental disorder, with depression affecting an estimated 264 million people of all ages around the world. It is the single biggest contributing factor to suicide, responsible, globally, for an estimated 800,000 deaths every year, and is the second most frequent cause of death among 15-29 year olds. In the UK, 30% of patients find existing therapies to be ineffective, with 1.2 million people suffering from treatment-resistant depression.

Despite the rapidly growing problem, there has, arguably, been little progress in terms of treatment options since 1974, with the discovery of SSRIs (selective serotonin re-uptake inhibitors), such as fluoxetine and citalopram. That is, until now.

It is more than 50 years since I first realised what amazing tools psychedelics can be. In 1965 I was introduced to LSD, and most importantly, in 1966 I met, and became deeply involved with, an exceptional Dutch scientist, called Bart Huges, from whom I learnt two important hypotheses: the first one about the mechanisms underlying altered states of consciousness; and the second, the description of the ego as a conditioned reflex mechanism that controls the distribution of the blood in the brain.

That is when I decided that I had found my ‘mission’ in life – to scientifically research these changing states of consciousness, and their potential value for humanity, and to integrate this knowledge into modern society.

I realised then that the only way to overcome the Taboo surrounding cannabis and psychoactive compounds was with the very best science, as our society has replaced the authority of the spiritual with the supremacy of science.

Thus, in 1998, I founded the Beckley Foundation with the goal of undertaking unimpeachable scientific research into psychedelic compounds, and evaluating their therapeutic benefits for mental health and wellbeing. Over the years, I have undertaken many collaborations with leading scientists around the world. In the UK, my partnership with Prof. David Nutt has been particularly rewarding. In 2008, David moved to Imperial College London, and we began the Beckley/Imperial Research Programme, co-directed by David and me, with Robin Carhart-Harris as our Principal Investigator.

While my true passion lay with LSD, David and I decided that decades of poisonous propaganda, plus its unfortunate nickname: ‘Acid’, had made it too taboo in the public (and regulatory) consciousness to work with. With that in mind, we instead decided first to pursue research into its relatively unknown cousin, psilocybin. In 2012, we published the first images of the brain under the influence of psilocybin, obtained with functional Magnetic Resonance Imaging (fMRI), in healthy participants. Ground-breaking results from this work demonstrated for the first time a decrease in blood supply to regions of the Default-Mode Network (DMN), a network of brain regions involved, among other things, in introspection, narrative identity and thinking about past or future events, and whose hyperactivity had recently been associated with the excessive rumination underlying depression, and other psychological disorders.

Employing cutting-edge methods of connectivity analysis and graph theory, we found an association between psilocybin-induced ‘ego-dissolution’, and decreased functional connectivity between regions of the DMN. Our research also revealed how the acute psychedelic state is characterised, neurologically, by a dramatic increase in communication between the different networks of the brain. Connections appear, or are strengthened, between regions that don’t normally communicate with each other. This leads to a looser style of cognition, more prone to making new associations, which can facilitate spontaneous self-insight, fresh perspectives, and creativity.

Most importantly, the effects of psychedelics are not limited to the acute experience, but often lead to lasting changes that can transform patterns of thought and behaviour in the long-term. An increase in cognitive flexibility and openness are two key elements in the long-term therapeutic benefits of psychedelics, providing individuals with the ability and willingness to change and adapt, thereby breaking rigid thought patterns that have kept them prisoners of their own mind.

Our early findings with psilocybin presented a breakthrough in our understanding of mental illness and how we might be able to improve the treatment of a variety of associated disorders, all based on psychological rigidity, such as depression, addiction, obsessive compulsive disorders, and post-traumatic stress disorder, that blight the lives of millions of people worldwide.

This initial Beckley/ Imperial study led to the Medical Research Council, a government body, funding our subsequent feasibility study into using psilocybin-assisted psychotherapy for patients with treatment-resistant depression. This study, when published in 2016, generated a global wave of interest, and paved the way for the clinical development of psychedelic-assisted therapy for the treatment of depression, and eventually the creation of the first psychedelic ‘unicorn’ company (ie a company valued at over $1Bn).

As part of our feasibility study, 20 participants were recruited, all of whom had previously tried at least 2 other treatment methods without success, and who had suffered from depression ranging from moderate to severe for an average of 18 years. All patients showed some reductions in their depression scores at 1-week post-treatment, and these were sustained in the majority for 3–5 weeks. At 5 weeks, 21% were in complete remission and 47% of patients had their depression scores reduced by half or more (which is called a ‘clinical response’). Remarkably, results remained positive 6 months later, with 31% of patients still maintaining clinical response. The drug was also well tolerated by all participants, and no patient except one sought conventional antidepressant treatment within 5 weeks of the psilocybin intervention.

This feasibility study remains a landmark in the history of psychedelic research and has proven to be extremely influential, confirming, as it did, that psilocybin is safe and largely effective as a treatment for depression in patients who were unable to find relief elsewhere.

In 2019, the team at Imperial College undertook a larger study, which represents the much-anticipated follow-up to our initial 2016 feasibility study, expanding the scope of the research in order to directly compare the efficacy of two psilocybin sessions with that of conventional antidepressant medication – in this case, 6 weeks of escitalopram – in 59 patients with Major Depression (30 on psilocybin vs 29 on escitalopram). Both groups received similar psychological support.

The results, published recently in the New England Journal of Medicine, show that while depression scores were reduced in both groups (without significant difference), the reductions occurred more quickly in the psilocybin group, and were greater in magnitude, with fewer side effects.

Reflecting the success rates of our earlier study, in this new study, after 6 weeks and two psilocybin doses, 70% of people in the psilocybin group saw their depression scores reduced by more than half, compared with 48% in the escitalopram group. In addition, remission of symptoms at six weeks was seen in 57% of the psilocybin group, compared with just 28% in the escitalopram group.

However, the main results may, at first glance, be cause for some disappointment. Indeed, both groups showed a similar level of improvement in their depressive symptoms, as measured with the QIDS-SR-16 depression scale. But this lack of significant difference should not be interpreted as a lack of advantages of psilocybin over traditional antidepressants. It must indeed be kept in mind that the psilocybin group only received 2 doses of 25 mg, whereas the other group received 63 doses of 10 mg of escitalopram, and experienced many more side effects.

It is also worth noting that in this study, both groups benefited from extensive psychotherapeutic support, which is not normally the standard of care for depressive patients on SSRIs.

These results undeniably confirm the benefits and safety of psychedelic-assisted therapy, and now an issue of primary importance is how best to begin providing access to these therapies to those in need.

At the same time, of course, we need to reform our outdated regulatory system, and to reschedule psychedelics to a lower level of restriction, which recognises their medical potential, and permits doctors to prescribe them where appropriate.

Next step: the provision of access

As a growing number of studies, whether clinical or observational, collectively demonstrate the safety and efficacy of psychedelics in helping manage multiple mental health conditions, many people in need are now seeking access to these treatments . The Beckley Foundation regularly receives emails and phone calls from individuals desperate to get access to psychedelic-assisted therapy. They have often tried everything and the little hope they have left lies in the therapeutic promise that this new approach may afford. Unfortunately, at the moment, we cannot provide any form of guidance; but it feels utterly wrong that these people are left so hopeless, while we know that psychedelic-assisted therapy’s potential benefits, in all likelihood, far outweigh its risks. For these individuals to gain access to psilocybin, they are therefore forced to either break the law, or travel abroad to places like the Netherlands.

Thus the next major problem which needs solving is the provision of safe, legal, and affordable access to high-quality psychedelic-assisted therapy.

My aim when I established the Beckley Foundation was two-fold: to carry out the best research in order to explore and expand our understanding of psychedelics; and to get psychedelic compounds rescheduled and legally available to those in need.

It was, and indeed is, my belief that these two aims can work in synergy, with research informing policy reform, which in turn facilitates more research, and in time leads to expanded access. This has proven to be the case, as positive findings from research into psychedelic-assisted therapy for depression, and other conditions, have led to a greater movement towards providing access, including grassroots-led campaigns for reform across North America, and more recently Australia. Colorado was the first city to decriminalise psilocybin in 2019, followed soon after by municipalities in California and Massachusetts. I was also glad to be an early supporter of the successful ballot initiative in Oregon (which I discuss in more detail below). Meanwhile, in Canada and Switzerland, exemptions from drug regulations have been granted to certain individuals suffering from depression and end-of-life distress, allowing them to legally receive psychedelic-assisted therapy (although, it must be said, for the vast majority of those in need, these efficacious treatments are still not available).

In 2016, I presented at the UN in New York a Beckley Public Letter calling for the abandonment of the 1961 Drug Convention, and for every country to be permitted to implement the drug policies which their governments consider best for their citizens: policies that are effective, harm-reductive and respect human rights. This obviously requires the rescheduling of certain psychoactive compounds which were originally mis-scheduled due to ignorance, or political expediency.

Perhaps the most notable recent drug policy reform success has come in the US state of Oregon, which became the first state to decriminalise psilocybin and legalise it for medical use, after Measure 109 was passed in November 2020, with the approval of 55.75% of voters. In addition to decriminalising and legalising, it specifies a number of provisions aimed at ensuring competency of facilitators, appropriate screening of patients, adequate preparation and integration for participants, and a high quality of medicine. It is also intended to open up psilocybin therapy to all adults who can safely benefit, not merely those suffering from treatment-resistant depression.

I, and many others, will be watching with interest to see whether or not Measure 109’s proposed model is a success. If it is, it could provide inspiration for subsequent legislation and regulation around the world.

Currently, the establishment of clinics, retreat centres, and certified lists of therapists, which could provide the psychedelic-assisted therapy for those in need, is blocked by the current scheduling of psychedelics as Schedule 1 (indicating no medical benefits, the highest level of potential harms, and therefore the highest category of restriction). However, it is ever clearer, as study after study has shown, that these compounds are low in harms and high in potential benefits.

The time for change is long overdue.

The Medical-Pharma approach

The global move to develop this therapy as a new, more efficacious treatment for many mental health disorders such as depression, anxiety, addiction, PTSD, among others, was initially based on research motivated by a handful of passionate, non profit-motivated pioneers.

However, what started as a purely philanthropically-funded field of research is now attracting a new wave of interest from investors, as the winds of the cannabis gold-rush blow over to the psychedelics, which are becoming the latest darlings of the pharmaceutical investor.

Lessons must be learnt from some of the failures of the cannabis movement, and while there is most certainly a place for for-profit investment in this new sector – as the costs of clinical trials and scalable care-delivery, not to mention the social and political pressure needed to bring about policy reform, will most likely be beyond the resources available to the non-profit sector on its own – I am mindful of the risks that come hand in hand with this new type of money: the need to satisfy the ‘hunger’ of some investors, the willingness of some to cut corners, the competitive spirit overwhelming the sense of cooperation and collaboration, plus the temptation to hoard intellectual property, and claim exclusive private ownership over what rightfully belongs to the commons, thereby depriving the patient of the treatments they desperately need. These are all very real risks, each of which could set back the Psychedelic Renaissance, which I and many others have spent so long labouring for.

We must encourage conscientious and responsible investors, together with mission-aligned entrepreneurs, so that ethical principles of reciprocity, stewardship, equitable access, and putting the good of society above maximum profit, are the cornerstones of psychedelic businesses.

It is with these values in mind, that since 2019 I have co-founded two new Beckley organisations, in order to help carry out my long-held mission of integrating these amazing compounds into the fabric of society. I realised that the modest, non-profit philanthropic donations that funded the Beckley Foundation were insufficient to bring about the radicalA changes needed in order to make these compounds legally regulated and widely available to those in need.

The first is Beckley Psytech, which is a drug development company, committed to putting patients first, and focused on taking various psychedelic compounds through clinical trials so that they can become regulated pharmaceutical medicines to treat various neurological and psychiatric disorders. The second is Beckley Waves, which is a venture studio that will build and invest in start-ups devoted to expanding safe, legal, and affordable access to psychedelic-assisted therapies and other altered states of consciousness that can improve mental health and wellbeing.

These new companies will complement the vital non-profit work that I will continue to lead on at the Beckley Foundation.

However, despite the influx of for-profit money and skills into the psychedelic field, there is still a vast amount that must be done by the non-profit sector, especially in terms of the most cutting-edge and exploratory scientific research, particularly in those cases where there is little or no profit potential.

Indeed, just as this new for-profit ecosystem has been built on the foundations laid by non-profit research done by institutions such as the Beckley Foundation, MAPS, Heffter, Imperial College, Johns Hopkins, and others, so I am sure that many of its future areas of opportunity will also be based on the breakthrough studies of these same non-profit organisations.

For this reason, it is critical that we don’t forget the great need for continued philanthropy in this sphere.

The new challenge for philanthropy is that their good will can be undermined by the fact that, next door to them, the investor is investing similar money with the potential of high return, and thus the philanthropists rightly have the sense that the fruits of their non-profit contribution is maybe helping provide profit to the investor. This thought can understandably be putting off for some philanthropists, thereby making the raising of philanthropic donations even more difficult.

Nevertheless, without the support of generous private donors and institutional funders, the essential work of non-profit psychedelic organisations, which continue to push the limits of our knowledge by conducting the best possible independent research and dare to explore new and taboo territories without consideration of profit, would not be possible.

For more info or to support the Beckley Foundation’s Research, visit:

https://www.beckleyfoundation.org/

Longread: Psilocybin-assisted Therapy for Mental Health: A New Paradigm? - Volteface

Pioneering psychedelic research, by Amanda Feilding We are living through a mental health crisis. Existing treatments barely scratch the surface of the problem, and have not translated into real world benefit for a huge number of people. An estimated 1 billion people worldwide now live with a...

volteface.me

 

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More people self-medicating with psychedelics, study

by Kristi Pahr | LUCID | 30 Mar 2021

The world's largest drug survey has found that some people are using psychedelics on their own to address mental health concerns.

Survey participants reported using LSD, MDMA, psilocybin, and other drugs to combat mental health issues ranging from depression, which was the most common disorder cited, to grief and relationship problems.

In the last six years, psychedelic usage has increased worldwide, according to data from the Global Drug Survey, the world’s largest drug survey. The 2020 Global Drug Survey has now found that many people are not only using psychedelics recreationally, but are self-medicating with psychedelics to address mental health concerns. Of the 110,000 respondents, almost 6% used psychedelics as a mental health treatment.

Survey participants reported using LSD, MDMA, psilocybin, and other drugs to combat mental health issues ranging from depression, which was the most common disorder cited, to grief and relationship problems. The survey ran for two months in 2019 and included people from countries around the world. Of the 6500 respondents who said they self-medicated with psychedelics, 72% identified as male, 25% as female, and 2% as non-binary or different gender identity.

Numerous studies and research projects have shown that psychedelics use is increasing and that they hold promise as effective and safe mental health treatment. However, a lack of access to these therapies may have caused self-medication to proliferate.

While the majority of study respondents reported recreational use to enhance a feeling of well-being, the number of those self-medicating is larger than previously thought. “The outcome may be quite similar between self-medication and recreational use, but the intent is different,” explains Monica Barrett, professor at Australia’s RMIT University and a co-author of the study.

“Where self-medication psychedelic use is done with the intent to alleviate a mental health condition, recreational use may have a broader intent which could also include enjoyment or changing one’s conscious state for fun or curiosity. Ultimately, though, many similar experiences may occur – including mystical and life-changing experiences – regardless of intent.”

Because of the lack of access to these compounds in a clinical setting, many people who self-medicate use alone or with a trusted friend or partner – but the lack of pre-treatment assessment or oversight by a psychedelics trained clinician can introduce unexpected challenges during the experience. Of the survey respondents who reported self-medicating, 3.7% revealed that they required emergency medical care as a direct result of their experience.

“Having a trained supervisor (ideally a health professional) who can provide care before, during, and after is critical to help reduce negative effects,” said Barrett. “Ensuring that the person is able to relax and is not anxious about impending responsibilities, as well as use within a relaxing and safe environment, are all critical. If things do go wrong, the willingness of supervisors to seek medical help is important, but it is also, unfortunately, the case that many first responders are not well trained to support people in this situation, and may make the situation worse.”

According to Dr. Barrett, the most important takeaway from the survey is the need for safe access to psychedelics. “Given the context of lack of access to psychedelics as medicine via formal channels, people are already using psychedelics as a DIY mental health treatment, and that we need to address that reality. We need to recognize the demand for them is increasing and this demand may end up being filled outside of the medical setting. We can help bridge this gap between the current situation and a future where psychedelics as medicine are more accessible by creating accredited courses for people who work in the mental health space to help support this group.”

More People Are Self-Medicating with Psychedelics, Says New Study - Lucid News

The world’s largest drug survey has found that some people are using psychedelics on their own to address mental health concerns.

www.lucid.news

 

[mr peabody]

Ships in Distress in a Raging Storm c1690 by Ludolf Backhuysen

Psychedelics associated with lasting improvements in mental health

by Nicole Wyatt | University of Alabama at Birmingham

Classic psychedelics, such as LSD, psilocybin mushrooms and mescaline, previously have been shown to occasion lasting improvements in mental health. But researchers led by University of Alabama at Birmingham School of Public Health investigators wanted to advance the existing research and determine whether classic psychedelics might be protective with regard to suicidal thoughts and behaviors.

Approximately 30,000 lives in the United States are claimed by suicide every year, and more than 90 percent of victims have been diagnosed with mental illness, according to the National Alliance on Mental Illness.

Using data from more than 190,000 respondents of the National Survey on Drug Use and Health from 2008-2012, the researchers found that those who reported ever having used a classic psychedelic drug in their lifetime had a decreased likelihood of psychological distress in the past month, and decreased suicidal thinking, planning and attempts in the past year.

"Despite advances in mental health treatments, suicide rates generally have not declined in the past 60 years. Novel and potentially more effective interventions need to be explored," said Peter S. Hendricks, Ph.D., assistant professor in the Department of Health Behavior and lead study author. "This study sets the stage for future research to test the efficacy of classic psychedelics in addressing suicidality as well as pathologies associated with increased suicide risk (e.g., affective disturbance, addiction and impulsive-aggressive personality traits)."

Hendricks says "the take-home message from this study is that classic psychedelics may hold great promise in the prevention of suicide and evaluating the therapeutic effectiveness of classic psychedelics should be a priority for future research."

Classic psychedelic use found to be protective with regard to psychological distress and suicidality, study finds

Classic psychedelics, such as LSD, psilocybin mushrooms and mescaline, previously have been shown to occasion lasting improvements in mental health. But researchers led by University of Alabama at Birmingham School of Public Health investigators wanted to advance the existing research and...

medicalxpress.com

 

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Mental health issues that don’t mix well with psychedelics

by Karla Ilicic | Healing Maps | 22 Jan 2021

Mental health issues are common these days, especially in the age of COVID-19, where psychedelics treatment has become more popular. Even before the pandemic, researchers and psychotherapists studied how these alternative drugs could help with things like depression, anxiety, PTSD, and addiction. It’s only natural to question whether or not there are some conditions that don’t mix well with these healing methods. Let’s find out.

Psychedelics are classified as hallucinogens, and, therefore, are a subject of legal disputes that are preventing future studies. Since the greatest problem is not knowing for sure how they’ll affect someone who’s dealing with serious a mental health condition, it’s hard to make a case for testing it on human subjects.

Existing studies mostly target depression, anxiety, PTSD, and addiction, and have shown promising results in all areas. This has led to the approval of multiple Phase 2 and Phase 3 trials, as well as legalization of the first psychedelics drugs-assisted treatment in the U.S.

Since even these studies and trials have been scarce, it’s hard to find a lot of information on other mental health issues, and whether or not any studies have been conducted or at least considered. Here are a few we know of.​

Psychedelics and Schizophrenia​

Schizophrenia is one of the most serious mental health issues. It affects a person’s thinking, mood, and social functioning, and usually leads to an episode of psychosis. The changes in behavior can be gradual or abrupt and its symptoms generally fall under psychotic (hallucinations, delusions, thought disorders), negative (loss of motivation, willpower, reduced speech and emotional expression), and cognitive (problems in attention, concentration, and memory).

Symptoms can exacerbate, turn into something more persistent than episodic, and become disabling when left untreated. This makes it hard to function in everyday life. Schizophrenia is most prominent in the late-teen years to the early-thirties, and often emerges earlier in the male population.

Research

When it comes to psychedelic therapy, there have been several promising studies. That’s because hallucinogenic drugs have high affinity for serotonin 5-HT2A receptors, which is also the target of psychedelics.

Unfortunately, the number of studies is still extremely low, and the connection between the two is still difficult to fully understand. Therefore, the current mental health space needs more research to prove that treating depression and anxiety is a responsive strategy.​

Psychedelics and Bipolar Disorder​

Bipolar disorder is another one of the more serious mental issues. By definition, it involves extreme shifts in mood, energy, activity levels and behavior. This results in manic episodes (a euphoric high), before crashing down into a depressive episode.
It exists in three most common types:​

• Bipolar I Disorder. The most severe, with manic episodes lasting up to a week, and depressive up to two weeks.​
• Bipolar II Disorder. Milder than the first category, and lasting for only a few days.​
• Cyclothymic Disorder. Mood shifts in this category aren’t as extreme as those with bipolar disorders. People with cyclothymic disorder often function in daily life, though it can be difficult.​

Research

With its deep connection to depression and anxiety, it doesn’t come as a surprise that there’s a genuine interest in whether or not psychedelic-assisted treatment would help. The world’s first clinical trial relating psilocybin to Bipolar II disorder is commencing in 2021. It is under the guidance of researchers from the University of California in San Francisco and CREST.BD.

Scientists have shown interest in other studies using psychedelics for depression. However, more research is necessary to compare how psilocybin therapy benefits those with bipolar disorder.

Still, the biggest problem of psychedelics for bipolar disorder is the concern of “high” energy activity. This occurs when hallucinogens in the system, potentially, trigger mania or mood episodes. So, until further research comes with some definite conclusions, it’s hard to know whether the results will be positive or negative.​

Psychedelics and ADHD​

One of the more common mental health issues, ADHD (or Attention Deficit/Hyperactivity Disorder), is having the problem of paying attention. However, it also may include the inability to control impulsive behaviors, or have unusually high levels of activity. It is most prominent during childhood, and often lasts into adulthood.

With the help of behavior therapy and medication, ADHD can be kept under control. However, the use of psychedelic intervention could potentially change these current treatment methods.

Research

A company called MindMed is exploring the impact of LSD and MDMA on ADHD, with Phase 1 trials beginning soon. The reason for combining the two instead of trying each one for themselves comes after a thorough research on how one’s negative effects can counteract the other one’s, especially as LSD’s stimulatory impact can potentially exacerbate the hyperactivity in ADHD.

Once again, we’re in a situation where we don’t know much due to lack of research and current findings. Hopefully, studies will yield results to further trigger exploration into the effectiveness of psychedelics for ADHD.​

Mental health issues & risks with psychedelics​

Mental health issues are a large group of different illnesses that oftentimes have similar symptoms. However, treatment varies in each. It’s why thorough psychedelic studies and trials need to continue, so researchers can identify what is and isn’t working. Unfortunately, due to current lack of funding, it’s hard to work on simultaneous studies — even with some known side effects of psychedelics.

Therefore, currently, no one knows for sure which mental health issues don’t mix well with certain psychedelics. With more research, that will change. So, hopefully, the next decade will show the true promise of the future of psychedelics against common mental health issues. This will further highlight ways that these alternative drugs can be an efficient and effective tool for millions of people.

Mental Health Issues That Don't Mix Well With Psychedelics

Psychedelics have shown promise treating mental health issues, but some existing conditions don't mix well with the alternative medicine.

healingmaps.com

 

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Researchers are racing to understand the power of psychedelics to treat mental illness*

by Meagan Miller | ABC-7 | 29 Jul 2021

SOUTHWEST FLORIDA — Once associated with hippies in the 60’s or club drugs, but now doctors are racing to understand the power of psychedelics to treat mental illness.

One thing Florida researchers are looking into is the hallucinogen in “magic mushrooms.” They’re joining others across the country to learn more about that compound, which is called psilocybin.

In 2019, the FDA granted “breakthrough therapy” status to psilocybin treatments, clearing the way for a U.S.-based study, conducted by the nonprofit, Usona Institute.

“We have seven sites in seven states but are about to onboard two more sites. Some of these sites are very well-known universities and others are private clinical research centers well versed in studying medications for depression,” said Dr. Charles Raison, the Director of Clinical and Translational Research at Usona Institute.

On Florida’s east coast, Segal Trials is participating in the study. The goal is to find out if the impacts of psilocybin last six weeks after the treatment, which Raison said is a standard time frame for antidepressant studies.

In this case, they are only taking the medication once.

“We are exploring the potential of psilocybin, which is a psychedelic, as a single dose to see if that would be enough to alleviate patients who are suffering from depression,” said Dr. Rishi Kakar, Principal Investigator and Medical Director for the Center for psychedelic and cannabis research at Segal Trials.

Dr. Kakar is one of the leaders at the study site near Fort Lauderdale.

At all of the locations for this study, half the participants, selected at random, are taking a capsule with psilocybin that’s synthesized in a lab. The other half of the participants are taking a placebo.

First, in order to qualify, patients must have moderate to severe depression. They go through a screening to rule out certain factors that could interfere with the study or cause any potential harm.

“That screening criteria does assess for any symptoms of psychosis, any symptoms of schizophrenia, for example, any family history for example. Out of abundance of caution, these patients are usually ruled out of the study at this time,” Dr. Kakar said.

Then, they go through a preparation session before taking the dose.

“The dose day itself could be 7-8 hours, sometimes more depending on the patient’s needs,” said Dr. Julia Mirer, a facilitator for study and Chief Education Officer at Mr. Psychedelic Law.

The participants are monitored that entire time.

“The two facilitators will stay there with them and the role of those facilitators, whether they’re highly trained physicians or psychologists, is to provide a support system for them,” Dr. Kakar said.

The participants can listen to music, color, or journal during that time. They’re also offered headphones and a blindfold.

“If they want to talk about something we’re there, but really they are encouraged to go inward and this becomes an inward journey,” Dr. Mirer said.

It’s a double-blind study, which means until it’s over, neither the participants nor the experimenters know if they got 3.5 grams of psilocybin or the placebo.

“We don’t know if they have the active drug, but what we always tell them is take these hours to yourself regardless,” Dr. Mirer said.

Many previous studies show how psychedelics can create new connections in the brain and how this helps with processing trauma. However, the trip within isn’t the final destination.

“After the dose one time, we are just following the patients and doing assessments on them for up to a month or two later to see if the effect is still being maintained for the patient,” Dr. Kakar said.

The follow-up includes both visits and phone calls.

“With any of the psychedelics, the experience is only as valuable as what you do with it afterward,” said Dr. Julia Mirer.

They’re trying to find out if one dose done mindfully can come in and help where other medications can’t.

“One of the biggest things we see in our current drugs, there’s still 30-40 percent of the patients that have either no response to current medications or inadequate response,” Dr. Kakar said.

As more states start to legalize psychedelics, the interest in Florida keeps growing.

“We want to meet people where they’re at and people want to see the evidence, so let’s make that easier,” Dr. Mirer said.

That’s where studies like this one come in.

“The way to really define that, the way to roll it out to the masses, is to collect as much information as we can,” Dr. Kakar said.

That’s why some Florida lawmakers want to pave the way for more research, answers, and access to find whatever magic is in these psychedelics. Contrary to what other states have done with recreational cannabis, the goal is to keep this at the medicinal level.

“The whole path for psilocybin legalization is really about treatment. It’s really about therapy, it’s truly about medicine,” said Florida Representative Michael Grieco, a Miami Beach democrat.

Rep. Grieco introduced a psilocybin bill during the most recent legislative session, but it didn’t pass. He said he knew it wouldn’t.

“I spent the whole legislative session talking with folks, mainly across the aisle about the viability behind this and the reasons why,” he said. “It’s funny in the interim, even Texas passed a bill on this.”

Now, instead of focusing on decriminalization and creating widespread clinics for these treatments, Grieco is working with groups like Mr. Psychedelic Law, law enforcement, and veterans’ advocates to pass a bill, which has a bigger focus on research, similar to what Texas passed.

“In the state of Texas, there are ways now through pilot studies, through the university systems in which they’re studying this now and you can have it available. I don’t want Florida to be the last one on the list doing this,” Grieco said.

With Florida being a state highly populated with veterans, they believe this will help people who need it most and that’s who the bill aims to focus on.

“There’s not much we can do for PTSD. As much as we try, we’re masking symptoms and at the end of the day, the trauma that they experienced is so deep. That’s so devastating because these people risked everything for us and we can’t do anything to help them,” Dr. Mirer said.

Grieco said he plans to draft up the new bill by this fall to continue the conversation, then introduce it when the next legislative session starts in March 2022.

Usona said the current study is expected to end sometime in 2022.

Dr. Kakar said anyone interested in participating in a psychedelic study can look for more information by clicking here and for more information on Usona’s psilocybin trial, click here.

*From the article here :

Florida researchers work to understand power of psychedelics to treat mental illness

As more states start to legalize psychedelics, the interest in Florida keeps growing.

abc-7.com

 

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Mescaline may improve several psychiatric conditions, study

by Eric Dolan | PsyPost | 26 Jun 2021

The use of mescaline, a psychedelic substance derived from the peyote cactus, appears to be associated with improvements in depression and anxiety, according to a new preliminary study published in the journal ACS Pharmacology & Translational Science. The research provides evidence that the clinically beneficial effects of mescaline are related to specific facets of the psychedelic experience.

A growing body of research suggests that use of classic psychedelics can have lasting positive effects. But, despite its centuries-long ceremonial use among Native American tribes, mescaline has received relatively little attention in comparison to other substances, such as psilocybin.

“Contemporary research involving classic psychedelics has shown promise in treating a variety of mental health conditions including major depression, existential distress associated with a serious illness, post-traumatic stress disorder (PTSD), and addiction,” the researchers said. “The psychiatric benefits of certain classic psychedelics (e.g., psilocybin) have been well studied in recent years, paving the way for more research into other classic psychedelics.”

For the study, the researchers used internet advertisements to recruit 452 adults from around the world who had used mescaline at least once. The participants completed a wide-ranging questionnaire about their experience with mescaline. They also completed a mental health assessment, in which they reported symptoms of depression, anxiety, PTSD, alcohol misuse or alcohol use disorder, and drug misuse or drug use disorder.

About one-third of the entire sample reported that their mescaline experience was among the top five most personally meaningful or spiritually significant experiences of their lives. Many participants also reported improvements in psychiatric conditions.

Nearly half the participants indicated that they had depression or anxiety at the time of their mescaline use. Among those who had depression, 86% reported improvements in their condition after using the drug. Similarly, among those who had anxiety, 80% reported improvements in their condition after using mescaline. The vast majority of participants did not take mescaline with the intention of changing these conditions.

The researchers found that psychiatric improvement was associated with particular features of the psychedelic experience. Specifically, participants who reported improvement tended to experience more mystical-type phenomenon, greater psychological insight, and more ego dissolution effects while under the influence of mescaline.

The results are line with with previous research, which has found evidence that experiencing more psychological insights from psychedelic drugs is associated with increased psychological flexibility. Increases in psychological flexibility, in turn, appear to be linked to decreases in depression and anxiety. Other research indicates that psychedelic drugs can improve mental health by making individuals more accepting of distressing experiences.

But the research on the long-term psychological effects of mescaline use is still in a very early stage and the study has some important caveats to consider.

“It is important to note the methodological limitations of our study and to urge caution when interpreting these findings,” the researchers said. “As this was a cross-sectional study, we cannot infer causality regarding the impact of mescaline on psychiatric conditions. Results are also limited by possible self-selection by individuals favorably disposed toward psychedelic experiences.”

“Nevertheless, the results from our study indicate that when administered in a naturalistic setting, mescaline may facilitate unintended improvements in self-reported depression, anxiety, PTSD, and substance use disorders,” they added.

Use of mescaline may facilitate unintended improvements in several psychiatric conditions, study suggests

The use of mescaline, a psychedelic substance derived from the peyote cactus, appears to be associated with improvements in depression and anxiety, ...

www.psypost.org

 

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79% of those microdosing psychedelics report improvements in their mental health, study*

by Beth Ellwood | PsyPost | 28 Oct 2020

A study published in Psychopharmacology suggests that people may turn to microdosing with psychedelics in an attempt to improve their mental health. According to most self-reports, these attempts may be effective.

Interest in psychedelic drugs as a potential treatment option for mental health disorders has been steadily increasing. One reason for the upsurge in interest might be the lack of effective treatments for certain psychiatric disorders, such as depression and post-traumatic stress disorder (PTSD).

Study authors Toby Lea and his team were motivated to examine a particular gap in the research by focusing on something called “microdosing.” The practice of microdosing refers to the consumption of very small, routine doses of a psychedelic drug, such as LSD or psilocybin, for reasons other than achieving hallucinogenic side effects.

“To date, most quantitative microdosing studies have excluded people with a history of mental illness, have not reported microdosing motivations, and no study has examined the sociodemographic and other correlates of microdosing as mental health and substance use therapies, nor the sociodemographic and other correlates of perceived improvements in mental health that people attribute to microdosing,” Lea and colleagues say.

An international, online survey questioned 1,102 individuals who were either currently microdosing, or had tried microdosing in the past. The average age of respondents was 33, and 57% had at some point been diagnosed with a mental health disorder.

When questioned about their motivations for microdosing, 39% indicated that improving their mental health was their main motivation. Of these, 21% were microdosing to improve their depression, 7% for their anxiety, 9% for other mental disorders including PTSD, and 2% for drug or alcohol use.

Importantly, 85% of those practicing microdosing to improve their mental health had previously received either medication or counselling therapy. Moreover, among those who had received prescriptions for medication, “half (51 percent reported having ceased antidepressants and 40 percent reported having ceased other psychiatric medications). This suggests that respondents may have been microdosing as a way to replace traditional forms of therapy.

“Respondents who had been microdosing for a longer duration were also more likely to be motivated to microdose for mental health. This may suggest that microdosing is working for these people, and that they are continuing to microdose as an ongoing therapy to replace or supplement psychiatric medications, some with the knowledge of their doctor and/or psychotherapist,” Lea and associates note.

The results indicated that, at least from the perspective of respondents, the practice of microdosing elicited positive mental health effects. As the researchers report, “Forty-four percent of all respondents perceived that their mental health was much better and 36% perceived that it was somewhat better because of microdosing.

Nineteen percent of respondents perceived no changes to their mental health.” Only 1.3% indicated that their mental health was somewhat worse since microdosing, and 0.2% said it was much worse.

Lea and colleagues acknowledge that several key limitations limit the inferences from their findings. It is not possible to discern from their study whether the reported mental health improvements were due to microdosing, or rather the result of a placebo effect or other factors like lifestyle changes.

The authors stress the importance of continued study into the effects of microdosing. “While we await the findings of clinical trials, which could take some years, people will continue to self-manage their health with microdosing. It is therefore important to monitor people’s microdosing practices and experiences in the long term in order to provide appropriate harm reduction resources and other support.”

The study, “Perceived outcomes of psychedelic microdosing as self-managed therapies for mental and substance use disorders”, was authored by Toby Lea, Nicole Amada, Henrik Jungaberle, Henrike Schecke, Norbert Scherbaum, and Michael Klein.

*From the article here :

International study finds 79% of individuals who microdose with psychedelics report improvements in their mental health

A study published in Psychopharmacology suggests that people may turn to microdosing with psychedelics in an attempt to improve their mental health. ...

www.psypost.org

 

[mr peabody]

Antidepressants and Psychedelics*

by Dr. Ben Malcolm | Spirit Pharmacist | 11 Jan 2021

Both traditional antidepressants and psychedelics work primarily on serotonin neurotransmission and have been found helpful in treating or managing mental illnesses such as depression, although they appear to leverage different sets of coping mechanisms. This finding could have major implications into our understanding of when or how we would want to use them:

Traditional serotonin blocking antidepressants (e.g. SSRIs, SNRIs) are known to produce longer term neuroadaptive changes to the brain over weeks to months resulting in an enhanced tolerance to difficult conditions. This has been termed ‘passive coping’ because it allows the user to deal with their life more effectively. This explanation aligns well with what persons tell me about antidepressants: When the effects are helping, they mention “I stopped having emotional outbursts or daily crying spells” or “I just wasn’t bothered by the little things as much.” When the effects are unfavorable, they mention “I felt numbed out, like I couldn’t experience my full range of feelings.” The commonality between the stories is that emotional sensitivity was decreased. My analogy for this type of coping is ‘Weathering the Storm.’

Psychedelics can produce almost immediate shifts in mood and are being discovered as ‘psychoplastogens’ or agents that increase the ability for the brain to re-mold itself. Used therapeutically, these effects may result in the modulation of negative core beliefs or effective processing of emotional traumas that drives psychopathology. When things work well the effects can catalyze processes of positive self-transformation. Persons may mention a peak psychedelic experience feeling like “a factory reset for my brain” or that “I was rewired.” This tends to lead to processes of identity restructuring in the time afterwards. When things go sideways the user may feel that trauma was activated without resolution, leaving the user in a hypersensitive and challenging emotional state. The commonality is that emotional sensitivity was increased. My analogy for this type of coping is “Transformation and Change” (metamorphosis).

​

Keep in mind we are talking about serotonin; one of the most ancient, enigmatic, and complex of neurotransmitter systems. Any discussion we have at this stage is reductionist. For example, the paper this information was taken from focuses on comparing actions of drugs at 5HT1A vs 5HT2A receptors, yet there are a dozen other types of serotonin receptors cut out of the picture. Healthy to take with a pinch of salt. ​

Use of psychedelics to catalyze transformation and change is not new. For example, traditional cultures have utilized psychedelics during rites of passage. Placed within our model of psychedelics as agents of adaptive change, use during times of life that naturally demand a high degree of adaptation may be advantageous. Another example of psychedelic use to aid in situational transition or change are those using psychedelics for existential anxiety associated with life-threatening illness.

Psychedelics are being explored for treatment of alcohol use disorder and quitting cigarettes, which ultimately involve habitual change and reduction of behaviors negative for health. Depression and anxiety are thought of as bio-psycho-social-spiritual illnesses due to the complex interaction between persons and their environment giving rise to symptoms of illness. It is often the situational circumstances (psychosocial stressors) of one’s life that precipitates or makes illness worse. Life presents challenging circumstances and most suffer to different degrees at certain junctures: The coping mechanisms employed during times of hardship range anywhere from healthful and promoting problem solving to toxic and promoting our demise.

The neuroscientific elucidation of psychedelics as agents that foster adaptive coping has the potential for application across a diverse variety of illnesses and life situations. Psychedelics are far from panaceas or magic bullets for ‘bad habits’ and do not automatically cause any shift in behavior, situation, or psychological perspective. There is much to be said for motivation and readiness for change that is prerequisite for sustained positive change. However, effects of psychedelics could increase the probability of positive change occurring or help clarify ambivalence that creates resistance to change. Supportive psychotherapy or psychedelic integration coaching can also increase the chances of sustained positive change.

Over the past 30 years we’ve been able to observe the effects of SSRI antidepressants in clinically depressed, anxious, or traumatized populations. Overall, we’ve observed modest benefits (small effect size) and increasing chronic use without reductions in persons experiencing the mental illnesses the medications are designed to treat. There are many times when increasing emotional sensitivity may not be desirable due to toxic life circumstances, however is it an optimal strategy to ‘weather the storm’ one’s entire life? This is not supposed to demonize antidepressants, argue positive transformations cannot be made with antidepressant use, or suggest they’re numbing agents that retard personal growth. On the contrary, my hope is that we learn to apply agents that enhance the right coping mechanisms at the right times to achieve the goals and fulfill the intentions of the user.

Dr. Ben Malcolm is a doctor of pharmacy, master of public health, and Board Certified Psychiatric Pharmacist. He provides consultation services, courses focused on psychedelic healing and pharmacology.

*From the article here :

Coping with Antidepressants and Psychedelics

spiritpharmacist.mykajabi.com

 

[mr peabody]

New wave of research puts psychedelics forward to treat mental health​

In what’s been described as a ‘paradigm shifter’ for psychiatry, Australian clinical trials are exploring the therapeutic benefits of illegal substances.

by Donna Lu | The Guardian | 25 Sep 2021

It was out of desperation that Michael Raymond found himself sitting in a remote retreat in the Peruvian Andes, sipping a cup of bitter tea.

Raymond had reached breaking point. His 16-year career as an electrical engineer in high–security situations for the Australian air force had seen him deal with near-death experiences, crashes, casualties and “the aftermath of human remains”.

Michael Raymond, an Australian air force veteran, traveled to South America for psychedelic-assisted therapy.

“I was going to kill myself at one stage,” he says. “I couldn’t keep going.”

After being medically discharged with post-traumatic stress disorder (PTSD), anxiety and depression, Raymond was prescribed antidepressants and underwent psychotherapy, but with no success.

Taking the ayahuasca tea, which contains the psychoactive compound N,N-Dimethyltryptamine (DMT), and San Pedro cactus, had been his last resort.

After early psychiatric experimentation in the 1950s and 60s, followed by decades of prohibition – sparked in part by the backlash against the hippy counterculture – psychedelics are experiencing a renaissance. A new wave of research has returned to the hallucinogenic drugs as potential candidates to treat psychiatric conditions.

It has also meant more people, frustrated at medications which don’t work, have sought out the illicit drugs. Experts are quick to warn of the risks of self-treating mental health conditions with psychedelics.

But therapeutic uses for illegal substances – including MDMA, DMT and psilocybin, the active ingredient in magic mushrooms – are now being explored in clinical trials.

Dr Martin Williams, executive director of Psychedelic Research in Science & Medicine, says the tide has finally turned after decades of being associated with “career suicide”.

Williams, also a research fellow at Monash University, is co-leading a clinical trial at St Vincent’s hospital Melbourne into psilocybin-assisted psychotherapy to treat anxiety and depression in people who are terminally ill.

The trial, which will run until 2023, involves 40 people with terminal conditions such as chronic obstructive pulmonary disease and motor neurone disease, who are receiving either one or two 25-milligram doses of psilocybin in conjunction with therapy.

It follows successful US studies of the drug in patients with anxiety and depression associated with life-threatening cancer. At follow-up four-and-a-half years later, participants “overwhelmingly attributed positive life changes to the psilocybin-assisted therapy experience and rated it among the most personally meaningful and spiritually significant experiences of their lives”. A similar trial using LSD also found beneficial effects.

For end-of-life anxiety and depression, evidence suggests standard drug treatments with antidepressants such as SSRIs – selective serotonin reuptake inhibitors – are not particularly effective, Williams says.

“Psychedelics … through whatever mechanisms, seem to represent a significant improvement over the standard therapies.”

Meanwhile, another clinical trial involving psilocybin, at St Vincent’s hospital in Sydney, is investigating whether the compound may help to treat methamphetamine addiction.​

Brain chemistry​

Classical psychedelic drugs – DMT, LSD, mescaline, psilocybin – work on the brain by binding strongly to specific serotonin receptors known as 5-HT2A receptors. Their action on these receptors is thought to result in the drugs’ hallucinogenic effects, as well as changes in perception and a sense of ego dissolution.

Psychedelics are also thought to dampen the “default mode network”, a system of interconnected brain regions that is active at unfocused, wakeful rest – such as daydreaming. The region is believed to be important in formulating our sense of self, and can become too rigid when people experience anxiety and depression.

Cultivated magic mushrooms. Photograph: Nigel Dodds/Alamy

By quietening the default mode network, psychedelic drugs seem to enable different interconnections in the brain, like “cross-talk”, Williams says, resulting in an altered sense of perspective and greater psychological flexibility.

The potential of psychedelics is something of a “paradigm shifter for traditional psychiatry”, says Prof Jerome Sarris, one of the directors of the newly established Psychae Institute in Melbourne. The research centre is planning clinical trials of ayahuasca in 2022 to treat depression and alcohol use disorder.

It is one of only a handful of trials in the world: a Brazilian study showed promising results for treatment-resistant depression, while a DMT trial in the UK has been approved by regulators.

Sarris and Psychae Institute co-director, Associate Professor Daniel Perkins previously conducted an international survey of ayahuasca drinkers. Of those who reported anxiety or depression at the time, 70% and 78% respectively reported an improvement in symptoms. (The study was observational, so cannot establish causation.)

For Raymond, taking ayahuasca was the kind of ineffable experience – an encounter with the mystical – that many who have consumed the brew describe. “I got to have these unvarnished truths come out about myself,” he said.

“Me wanting to be what I thought was a manly man, or whatever, a military man … I didn’t have tools to healthily express emotion,” he says. “Even with a psychologist I’d struggled to open up.”

One drug that has shown promise for treating PTSD is MDMA, when used in conjunction with therapy. In the US, a phase III clinical trial – the last barrier of research a drug must clear before regulators will consider approving it as a new medication – found it was “highly efficacious” and safe in people with severe PTSD.

MDMA’s mode of action differs from the psychedelics, but it also increases serotonin in the brain. Dr Stephen Bright, a psychologist and senior lecturer at Edith Cowan University, says: “That release of serotonin seems to turn on parts of the prefrontal cortex associated with language, and that might be why people are able to talk about experiences they haven’t been able to [before].”

Bright is leading a small MDMA-assisted therapy trial in Perth later this year –Australia’s first – which will treat four people with PTSD.

MDMA increases serotonin in the brain and is being used in a Perth trial to treat people with PTSD.​

Regulatory requirements​

Despite promising results to date, no psychedelics have yet amassed the required level of clinical evidence to be listed as lawfully supplied drugs on the Australian Register of Therapeutic Goods. But Prof Perkins says regulators are recognising their potential benefits. “It’s a question of how they provide access, not whether they would or not.”

Prof Perkins, who was the director of the office of medicinal cannabis in the Victorian department of health, emphasises that the psychedelics form only part of the treatment. The other is psychotherapy, and any drug approval would also be conditional upon treatment protocols that have been vetted in clinical trials.

In February, Australia’s Therapeutic Goods Administration (TGA) made an interim decision rejecting a proposal to reclassify MDMA and psilocybin from prohibited drugs to controlled substances. It has deferred making a final decision, pending an independent report into the risks and therapeutic benefits of the drugs, which is due for release next week.

The regulator already grants permission for the use of these drugs on a case-by-case basis through its special access scheme – but it is not uncommon for access to then be prevented at a state level.

Tania de Jong, founder of Mind Medicine Australia, the nonprofit that led the reclassification bid, says a change in the regulations wouldn’t result in a “floodgate of use”, but better standardise the federal and state approvals doctors would have to obtain.

De Jong says she is regularly contacted by desperate people who have exhausted all other treatment options. “They just want a chance to lead a healthy, meaningful, functional life,” she says. “The longer that it takes for these medicines to become available in clinical environments, the more people will seek them underground.”

A 2020 global drug survey found that of 1,376 people using psychedelics for self-treatment, 4.2% needed to seek emergency medical treatment – around five times as high as for people using such drugs recreationally.

Psychedelic-assisted therapies are contraindicated for people at risk of drug-induced psychosis.

“I’m seeing increasing numbers of people that are getting worse as a consequence of trying this on their own,” Dr Stephen Bright says. He is wary of the growing public interest in psychedelics, because clinical trial places are so limited, and it may be five or 10 years before treatments become widely available in Australia.

Raymond says his quality of life has improved dramatically since taking ayahuasca in South America, but recognises that the experience wasn’t a panacea. “I’ve still got things to work through,” he says.

He is now studying and working to mentor other people transitioning away from life in the military. “I’ve found more gratitude just for being alive.”

In Australia, the crisis support service Lifeline is 13 11 14. In the UK and Ireland, Samaritans can be contacted on 116 123 or email [email protected] or [email protected]. In the US, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counselor. Other international helplines can be found at www.befrienders.org

*From the article here :

‘Psychedelics renaissance’: new wave of research puts hallucinogenics forward to treat mental health

In what’s been described as a ‘paradigm shifter’ for psychiatry, Australian clinical trials are exploring the therapeutic benefits of illegal substances

www.theguardian.com