Sunday, April 29, 2012

Fascinating New Uses For Psychedelics

Scientists are looking into various medical and psychiatric uses for psychedelics.
Could the taboo be ending?


By Sarah Seltzer, AlterNet
Posted on April 26, 2012


On last week's episode of the drama "Mad Men," set in 1966, Roger Sterling, the embodiment of the classic old-boys club figure, accompanies his younger wife to a dinner party where the guests "turned on" to LSD.

After a night of laughing fits, tears, dancing and hallucinations, the couple have a profound conversation about their marriage's failure. Sterling wakes up the next morning feeling that he's been given an entry into "the truth" and in a shockingly sincere tone, declares that it's going "to be a beautiful day."

The sequence represents a surprisingly positive portrayal of acid, staying away from cliches and demonstrating how a stuck-in-the-mud character might actually, at least temporarily, be jolted out of despair and complacency by an experience on drugs.

In some ways, Roger's fictional night embodies the quintessential mid-'60s "long, strange, trip." For a brief period before LSD became synonymous with the youth-led counterculture, hippies and burnout, it was taken seriously among elites--it was even legal. The drug, originally being tested for various physical and psychological institutions, began to be recreationally used by professionals like the therapist who encourages the Sterlings to "turn on" as aiding personal development and enhancing insight.

But when LSD became a street drug and was criminalized, it moved out of laboratories, and the stigma carried over through the end of the century.

Hallucinogens like LSD and psilocybin were added to the 1970 Controlled Substance Act as Schedule I substances, which defines them as having no medicinal value and makes getting federal funding (or the actual drugs necessary) for research nearly impossible. That is why, even now, many studies of pot and hallucinogens are conducted in other countries. Scientists wanted to conduct the research, but they couldn't, and for the most part, it's still very difficult.

It's taken decades for American scientists, doctors and patients to have the chance to take a closer look at the uses of psychedelic drugs, not just recreational but medical, personal and therapeutic. Even now, doctors who do this work are eager to distance themselves from Timothy Leary and his ilk.

And yet the shift has happened. The profession is back to exploring the various positive effects of these drugs, and their work is being covered by the mainstream media. Here are some examples of ways psychedelics are being explored in medicine today.

1. Alcoholism. This year, a group of Norwegian scientists went back into medical archives to reexamine previous LSD studies to help recovering alcoholics. When they crunched the data, what they found was not only evidence that LSD is useful in treating addiction, but also circumstantial evidence that the culture wars may have derailed the progress of this line of inquiry. From HealthDay's story last month:
In a new analysis, Norwegian researchers examined six studies of LSD and alcoholism that were conducted in the United States and Canada between 1966 and 1970. 
The analysis of data from the 536 patients in the studies showed that a single dose of LSD helped heavy alcoholics quit and reduced their risk of resuming drinking, according to the meta-analysis appearing online March 8 in the Journal of Psychopharmacology
Patients who received a full dose of the controversial drug did the best. On average, 59 percent of those patients showed a clear improvement, compared with 38 percent of patients in other groups, the Norwegian University of Science and Technology researchers said.
Kristen Gwynne has pointed out on AlterNet that this study is particularly promising as there are currently very limited options for those who suffer from alcoholism, and 12-step programs, which rely on a loosely religious framework, can be discriminatory and leave people out.

The implications of these studies are huge. As the authors said, "Given the evidence for a beneficial effect of LSD on alcoholism, it is puzzling why this treatment approach has been largely overlooked." In fact, the kind of radical new perspective portrayed on "Mad Men" is the kind of jolt that could help break the hold of the disease. 

2. End-of-life issues. That change in perspective may also help those who are dying or at risk of dying, and in the throes of psychological crisis. The New York Times Magazine recently ran a comprehensive cover story by Lauren Slater describing new trials for patients suffering from terminal or severe disease, and the attendant anxieties.

One patient profiled in the story had a profound emotional catharsis during her controlled use of psilocybin, and described it for posterity on video:
“I felt this lump of emotions welling up...almost like an entity,” Sakuda said, as she spoke straight into the camera. “I started to cry....Everything was concentrated and came welling up and then...it started to dissipate, and I started to look at it differently....I began to realize that all of this negative fear and guilt was such a hindrance...to making the most of and enjoying the healthy time that I’m having.” Sakuda went on to explain that, under the influence of the psilocybin, she came to a very visceral understanding that there was a present, a now, and that it was hers to have.
Slater's piece contains other compelling personal anecdotes from deeply ill patients, taking part in similar or parallel studies. After the directed, controlled administration of psychedelics, their fear of death decreased, their feeling of transcendence increased. Most importantly their anxiety was lessened, an alteration which positively affected their health and well-being.

3. Depression and anxiety. Slater's Times story also begins to dig into the physical reasons that psychedelics might have this effect--they may shut down over-active regions of the brain that are associated with depression:
The researchers found that the states of “unrestrained consciousness” that accompany the ingestion of psilocybin are associated with a deactivation of regions of the brain that integrate our senses and our perception of self. In depressed people, Nutt explains, one of those regions, the anterior cingulate cortex, is overactive, and psilocybin may work to shut it down. Nutt is planning a study in which he will give psilocybin to individuals with treatment resistant depression and see whether the drug can ease some of depression’s most recalcitrant symptoms.
That such an experiment would take place is logical; it seems evident that given the indications for these drugs' interaction with the depression and anxiety faced by terminal patients, they might also help those suffering from anxiety at other phases of life.


4. Cluster headaches. One interesting, more physical indication for these drugs--which arises from their non-hallucinogenic properties--is for the treatment of cluster headaches, which some call "suicide headaches" due to their extremely painful, frequent nature.

In 2009, the Daily Beast wrote about Bob Wold, a cluster headache sufferer, and the first time he took magic mushrooms (psilocybin):
The psychedelics arrived in a brown box at his doorstep from a long-distance dealer. He took one dose: about 1.5 grams. "In 15 minutes I could feel the difference,” he says. “My head was clearer than it had probably been in the past 20 years. Other medications felt like they were just covering it up.” But on acid, “All the pressure was gone."
Wold decided to help fund research into the uses of psychedelics on headaches like his:
Cluster Busters, a nonprofit advocacy group co-founded by Wold, is funding research by Harvard’s Dr. John Halpern, who recently administered a modified LSD molecule to a handful of cluster patients, successfully ending most of their headache cycles for weeks or months. Halpern thinks they may have finally found the cure for an ailment that has mystified physicians for years, and hopes to run a larger clinical trial soon.
Harvard’s Dr. John Halpern recently administered a modified LSD molecule to patients, successfully ending most of their headache cycles.
5. Post-traumatic stress disorder (PTSD). MDMA, the psychedelic ingredient in the drug Ecstasy has been studied recently to treat a specific form of depression and anxiety: that associated with past trauma. Oprah Magazine profiled several women who had been abused or raped and underwent experimental MDMA therapy. Their reactions were varied, but mostly positive. Here's one:
"I used to think, I'm a broken person. I'll never be able to do this simple thing. But after my first session, I thought, Well, it's okay not to stand in line. It's okay to go early. I stopped judging myself, and I didn't avoid my life anymore. Which was wonderful." A quarter-century after taking MDMA, Ot'alora still gets triggered from time to time, particularly in crowded places. "But it's much more short-lived now," she says. "Sometimes it's a matter of a second before I bring my body back to a safe zone."
Here's another:
In 2008 Emily did a single session of MDMA with the guidance of an underground therapist. "I took myself through the rape and I felt the trauma deeply, but I also stepped outside of it," she says. "I had what they call the 'God view' in a computer game. I saw it objectively, and with compassion. I wasn't thinking, I shouldn't have been there or I'm a piece of crap or This is all my fault."
The LA Times reported on a study being run by clinical investigator and psychiatrist Michael Mithoefer of South Carolina, the man who conducted the most recent round of MDMA therapy experiments:
Mithoefer has received FDA permission to test whether Ecstasy can help Iraq and Afghanistan veterans overcome their PTSD when used during psychotherapy sessions; six veterans have enrolled in the study. In an earlier clinical trial, Ecstasy helped 10 of 12 women recover from PTSD stemming from child sexual trauma. Only 2 out of 8 women who took a placebo had similar results, Mithoefer reported last year in the Journal of Psychopharmacology.
With MDMA as well as with mushrooms and LSD, the commonly known effects of the drug for recreational use can be seen in the way it's used to target particular psychological conditions.
Ecstasy's reputation for enhancing trust has clear roots in its biological effect. Using brain scans, Columbia University psychologist Gillinder Bedi found that subjects who took MDMA showed heightened activity in a brain region associated with processing rewards and depressed activity in the amygdala — a source of fear reactions. In animals, MDMA boosts the hormone oxytocin, which promotes trust, sociability and interpersonal attachment.
The politics of testing and studying the positive medical effects of psychedelics are marked by the politics of the drug war, the culture war, the pharmaceutical industries and academia.There may be no interest from Big Pharma to lobby the government for these studies because of the lack of profit potential; these drugs are something you take once or twice, not daily, and they are not patented.

But as all these stories in the mainstream media show, the therapeutic uses of these substances may finally be getting the kind of measured, rational attention they deserve--without the handwringing that comes from past negative associations. At least we can hope.

Here's a  National Geographic video about the return of LSD to the lab:




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