What are psychedelics?
Psychedelics are powerful psychoactive chemicals that alter perception, mood and numerous cognitive processes. They should not be confused with legal medicinal mushrooms or supplements, which do not have psychoactive effects. They work by affecting our serotonin receptors and so they can also be known as serotonergic hallucinogens. The chemicals have a chequered past, which predates written history and has seen them both revered socially, spiritually and psychologically whilst being outlawed and demonised politically. Throughout this article we will be discussing; the history of psychedelic use, the effect a blanket ban has had on research and the recent psychedelic renaissance. Despite the name hallucinogens, most people do not experience true hallucinations when taking these chemicals, but rather perceptual distortions or illusions. One exception to this rule is found in DMT and DMT containing ayahuasca brews, which usually offer users deep and profound hallucinations.
The use of hallucinogen-containing plants has been documented for millenia. Ancient American civilisations have a detailed history of using mescaline and ayahuasca in spiritual ceremonies, whilst around 100 of the 1200 Sanskrit texts that make up one of the four ancient Hindu texts (written over 5000 years ago) detail the mythical ‘soma’ brew, which allowed the consumer to ‘become immortal, come to the light and find gods’. This brew has largely been accepted, by archaeologists, to have contained psilocybin based mushrooms. At this time in history the mechanical action of psychedelics were still unknown, however the chemicals were respected for their ability to help bring the consumer closer to the earth and spirits, which were worshiped in these civilisations.
LSD becomes influential
Whilst working at Sandoz Pharmaceuticals, in 1943, Albert Hoffman discovered the hallucinogenic properties of the world’s most potent psychedelic, lysergic acid diethylamide (LSD), after accidentally ingesting a minute amount of the chemical. Intrigued about the introspective effects of LSD, Sandoz began extensive experiments on the chemical, eventually distributing it to psychologists throughout the world, once its relative safety and toxicity levels were documented.
Before it’s illegal status, some 40,000 patients were treated with LSD and over 1000 papers were published on the overwhelming beneficial effects of the drug. It was clearly noted that the drug should be taken in a controlled setting, with psychological follow up sessions aimed to allow the patient to understand and process the emotional experience that they had gone through. This would ensure safety for the patient, along with a lower likelihood of negative side effects. Unfortunately as LSD’s recreational popularity grew, with users becoming increasingly disillusioned with and outspoken against the government in power, the chemical was banned in the USA in 1966, with the rest of the world soon following suit. Once placed on the prohibited drugs list, not only is recreational use made illegal but also research into the therapeutic uses of the drug. What followed was a half century blanket ban on psychedelic research, which is only starting to unravel today.
How do psychedelics work?
Classic psychedelic drugs strongly bind to specific serotonin receptors, known as 5-HT2A receptors. Although they do not bind exclusively to this receptor, this is something that more traditional psychotherapeutic drugs, such as SSRI’s are unable to do and is the reason for the current interest in psychedelic drug treatments. It is their action on these receptors that is thought to result in the drug’s psychological effects, dampening our “default mode network”, which is important in formulating our sense of self in the world, something which often becomes lost in sufferers of anxiety and depression.
Why the current interest in psychedelic treatment?
It is no secret that we are currently experiencing a mental health crisis throughout the world, with the UK certainly not being exempt. In the UK, prescriptions for antidepressants have more than doubled in the past decade. It is estimated that only one-third of people suffering with depression actually benefit from their prescribed antidepressants, which are usually a type of SSRI (Selective Serotonin Reuptake Inhibitors). These drugs are also serotonin agonists, however, unlike psychedelics, they do not directly work on the 5-HT2A receptors and are known for dampening the effects of anxiety and depression, effectively placing a plaster over the issue, instead of actually dealing with the root cause of it head on. The health crisis has been made even worse due to the pandemic causing a lack of access to treatment, with mental health charity Mind reporting that more than two-thirds of adults with mental health problems have reported worsened conditions since the lockdown started.
Psychedelics, along with guided therapy have been shown to positively affect sufferers of PTSD, depression and anxiety with just a single session. Traditional medications can instead be life long, costly and still ineffective and since Prozac was released over three decades ago, developments have largely been variations of the same drug. The NHS currently spends £650,000/day on pharmaceutical antidepressants, which could be totally transformed with a therapy requiring just one or two doses per year. Dr. Carhart-Harris, who heads up the centre for psychedelic research at Imperial College London and is co-author of the current phase 2 clinical trial on psychedelic mushrooms said that “after psychedelic therapy, participants reported feeling recalibrated, reset like they haven’t for years and enjoying life.” Instead of just plastering over or muting their symptoms, with a psychedelic it’s more about “a release of thought and feeling that, when guided with psychotherapy, produces positive outcomes.” The patient is able to better come to terms and deal with the root cause of why they are depressed/suffering from anxiety. Patients are able to re-find their place and purpose in the world and have even reported feeling emotions, such as joy, which their lives have been devoid of for many years.“ It’s this internal psychological and spiritual experience that people describe as transformative … they describe being transported back to childhood or back to where they can have conversations with people and resolve situations.”
What has changed?
There has certainly been a shift in public opinion to psychedelic therapy. Recent YouGov polls show that more than half of Brits (55%), including majorities in every region of the UK, support moves to make psilocybin-assisted therapy available to armed forces veterans suffering from PTSD, depression and anxiety, with less than 1 in 7 (13%) opposed, and 32% not sure.
Both clinical trials and law changes throughout the world, including some US states, who have decriminalised psychedelic chemicals, are slowly starting to sway the minds of the public, who can now see real world evidence of the potential benefits of psychedelic treatments.
Two trials in the US have shown that just a single dose of the active chemical of psychoactive mushrooms, psilocybin, can help palliative care patients suffering from anxiety and depression. Some patients, even four years later, “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”.
Further clinical trials, based in Australia are exploring whether psilocybin treatment can be effective in the treatment of addiction. The trial will involve 15 participants who are already being treated for addiction at St Vincent’s. “These will be people who may have tried to achieve their goals but have not had success,” Lead Researcher, Dr Jonathan Brett said.
What is currently being trialed for psychedelic treatment?
- Treatment of Depression
- Treatment of PTSD
- Treatment of Addiction
- Treatment of Short-Lasting Unilateral Neuralgiform Headache Attacks (SUNHA)
What does the future hold for psychedelics treatments?
It is clear that there is currently a great increase in scientific, cultural and even commercial interests in psychedelic use. Clinical trials are underway or complete and really we have only scratched the surface of what psychedelic therapies may be able to treat. In what is already being dubbed as a paradigm shift in public and legal opinion, investors are heavily supporting new mycological start ups, looking to take a hold on the emerging psychedelic healthcare market. In our next psychedelic editions we will explore, in more depth, the ongoing clinical trials, along with the financial developments in the world of both psychedelic and medicinal mushrooms.