How Psychedelic Drugs Can Be Used For Mental Health
Oregon legalizes mushrooms. Ketamine can be delivered to your home. People microdose LSD to treat pandemic anxiety, and Wall Street is pouring billions into companies that sell mind-altering drugs. It seems psychedelics – although for the most part still illegal – are everywhere.
Although the federal government does not recognize the medical use of most of these drugs and claims they have the potential for abuse, some of the world’s leading universities are studying four substances in particular: psilocybin, ketamine, MDMA and LSD. Much of the available research suggests that these substances hold promise as part of larger treatment plans.
There is also growing evidence that psychedelic drugs work differently in the brain than addictive drugs, and advocates have consistently called for legalization. But psychedelics are still expensive and difficult to access legally, unless you participate in a research study for mental health purposes.
These medicines are not all the same and carry risks. One quality they share is the ability to create an altered state of consciousness, commonly referred to as travel. This effect can either give a hint of perspective or be downright terrifying.
“You are not likely to overdose, but you can have negative life changing experiences,” said Katharine Neill Harris, drug policy researcher at Rice University in Texas.
To avoid these experiences, while still getting the benefits these drugs can offer, people have started microdosing small amounts at regular intervals – but they often do so without professional advice, and some remain uninformed of the significant drawbacks with very little. evidence of benefits.
Here’s what researchers are learning about the psychedelic drugs most involved in mental health research.
As an active chemical in magic mushrooms, or “mushrooms,” psilocybin is the most studied of the psychedelic chemicals found in plants and fungi, and it is most likely to become an accepted mental health therapy soon. After Oregon was legalized last year, entrepreneurs began investing tens of millions in psilocybin research, and other cities and states are following suit.
Potential uses for mental health: Research over the past decade suggests that psilocybin, typically taken in pill form, has the potential to treat substance use disorders, including alcoholism and nicotine dependence, as well as depression.
This research is not yet conclusive, said Paul Hutson, a professor at the University of Wisconsin-Madison who studies psilocybin and heads the school’s psychedelics research center. But he predicts that there will soon be enough evidence for the Food and Drug Administration to approve psilocybin capsules to treat at least some of these disorders – most likely within the next five years or so.
In the meantime, clinical trials of psilocybin for various ailments are underway across the country, although they may be hard to find or have long waiting lists. Still, it’s safer, Dr Hutson said, to try psilocybin in a study than on your own or at one of the treatment clinics that have popped up. In these trials, patients attend appointments to prepare for and treat their psychedelic trip with a professional in an environment where side effects can be managed.
What he does: According to users who participated in the trials, a mushroom trip can induce euphoria and heightened awareness of parts of their environment. For example, solid objects can appear to inhale and exhale. A trip can last more than six hours, and some people describe a positive “afterglow” that lasts for months.
Risks: Psilocybin can cause distressing hallucinations or feelings of panic and anxiety in some patients, especially in large doses. Safety standards cannot be guaranteed – having a trained professional who can reassure you, protect you, and even administer medication to you on a bad trip – in therapy outside of a research trial, Dr Harris said. .
One use of psilocybin that should not be confused with the standard treatment described above is microdosing. By taking small doses – maybe 10 percent of a standard dose – every few days, some people might experience mental health benefits without the high. But microdosing psilocybin can be harmful, and there is some evidence that it can damage the heart over time. Recent research also suggests that the positive impacts of microdosing in humans may be largely caused by the placebo effect.
First synthesized in 1956, ketamine, sometimes called Special K, is now used as an anesthetic by veterinarians and in emergency and combat medicine. Because it’s the only psychedelic that’s never been illegal, researchers have been able to explore ketamine’s potential as a mental health treatment – and build a case for its use in humans.
Potential uses for mental health: Many brain disorders, such as schizophrenia, depression, and anxiety, are characterized by atrophy of the prefrontal cortex. The evidence is strong, but not yet conclusive, that ketamine helps people with psychiatric disorders by promoting regrowth over time in neurons in this area. It might help explain the almost immediate feelings of relief reported by users, which is one of the reasons it has been used in the treatment of suicidal patients.
Ketamine has shown so much promise for treating major depression, often faster than other drugs, that the FDA approved its limited use in early 2019.
What he does: Ketamine can create euphoria and provide a sense of detachment from reality. Users taking a low dose may feel like they are floating or their body is numb. Higher doses can temporarily make people clumsy and forget where they are or even who they are. Blurred vision or hallucinations are common.
Ketamine works differently from other psychedelics. Most psychedelics – like LSD, MDMA, and those derived from plants – work by affecting receptors for serotonin, which alter mood and happiness. Ketamine affects a different class of receptors in the brain that are important for learning and memory. Both types of receptors are found in the brain’s prefrontal cortex, which could explain why ketamine and other psychedelics appear to have similar effects on mental health.
“The prefrontal cortex is a region of the brain that is really critical,” said David Olson, professor of chemistry at the University of California, Davis, who studies chemicals that affect brain function. “It speaks to a whole bunch of areas of the brain that regulate things like mood, emotions, fear, reward.”
Risks: Ketamine is also known for a specific and frightening side effect known as the “k-hole”. This is rare in a clinical setting, but users may feel estranged from themselves and their surroundings and panic or feel paranoid.
“Turn on, connect, give up. “Lucy in the sky with diamonds.” Microdosing from Silicon Valley. Suffice it to say that LSD, also known as Acid, has a historic place in American popular culture.
Potential uses for mental health: It has shown promise for the treatment of alcohol dependence and has been studied for other conditions like depression. As with psilocybin, some new LSD followers microdose for mental health benefits without the trip.
What he does: LSD users have reported feelings of happiness during their trip, being able to see sound and have mystical experiences as well as a sense of closeness to others.
Risks: Some people experience lasting psychological trauma from a bad trip, especially when they take higher doses or frequently use LSD.
Microdosing LSD can also have physical risks. In a study in rats, microdosing LSD had the opposite effect of a trip; this caused the rats to show signs of psychiatric illness, such as aggression and poor grooming. Similar to microdosing psilocybin, it can also strain the heart by overworking the neurons around the organ.
“If you constantly stimulate these neurons, even with a small dose of these compounds, the neurons just can’t handle it,” Dr. Olson said.
A well-known club drug, also known as ecstasy or molly, MDMA has been the subject of intermittent research for decades for its potential mental health benefits. Although the drug remains illegal, the FDA is clearing its use in research and treatment of life-threatening diseases.
Potential uses for mental health: In 2010, the results of a study on treatment-resistant PTSD renewed interest in MDMA research. Since then, it has also been explored as a treatment for other conditions like substance use disorders or social anxiety in people with autism, although it has more potential to cause harm than some others. psychedelics.
What he does: MDMA is often known by its street name – ecstasy – because of the feeling of euphoria and connectedness it promotes in users.
Risks: MDMA can cause long-lasting kidney and organ damage as well as cardiac arrhythmias while traveling, especially in patients with related pre-existing conditions.
Psychedelic drugs are not just substances. More time and research will provide answers on their effects on the brain and whether it is possible to use them for medical treatments. For now, Dr Hutson has warned that the evidence supports psychedelic treatments only in cases where other forms of treatment have not worked.
“This is not a panacea that everyone is going to react to,” he said.
Kat Eschner is a Toronto-based science and business journalist. She is editor-in-chief for Popular Science and a contributor to Fortune magazine.