Psychedelic Drugs Win Growing Respect

For somebody like myself who remembers scare stories delivered by cops in classrooms about the terrors awaiting those who dabble in drugs and was subsequently inspired to try them all, mushrooming (pun intended) acceptance of psychedelics is a revelation. Not long ago, we were told that LSD, MDMA, magic mushrooms, and the like were going to make us all insane; now it turns out they may actually hold the key to treating a host of mental illnesses and enhancing life. Importantly, legal barriers to their use are finally falling away, leaving people a little more free to experiment without fear of penalty.

One Saturday many years ago, several friends and I decided it would be a fine idea to take magic mushrooms amid chaos in New York City's Central Park, and events progressed pretty much as you might expect. Some hours later, as my anxiety attack subsided, the phone in my apartment rang. One of my buddies had wandered aimlessly until his head started to clear and wanted to know if I could help figure out where he was from the street signs. It was the Lower East Side, as it turned out, and no I didn't know where the nearest subway station could be found. In better circumstances, though, such as those outlined by Reason's Mike Riggs, the psilocybin in magic mushrooms can offer very positive experiences.

"A growing body of research shows psilocybin holds promise for individuals with treatment-resistant depression and other mental health conditions," the Seattle Times noted last month. 

Compass Pathways, a British biotech company, boasts of positive outcomes from its COMP360 psilocybin preparation in a study done in partnership with Columbia University's Department of Psychiatry. "The results showed that a single 25mg dose of COMP360 demonstrated a highly statistically significant and clinically relevant reduction in depressive symptom severity after three weeks, with a rapid and durable treatment response," the company announced in December.

Johns Hopkins Medicine is now investigating the potential for psilocybin as a smoking-cessation treatment. The study is funded by a federal grant from the National Institute on Drug Abuse, which is an interesting turn of events.

Seattle decriminalized magic mushrooms last fall (following in the footsteps of Denver) and Washington state lawmakers are considering allowing legal psilocybin consumption in supervised "service centers." While that wouldn't fully allow people to make their own choices without risking legal penalties, it's similar to a measure adopted by Oregon and a step in the right direction.

MDMA, often called "ecstasy" or "molly" and known as a party drug, shows similar promise for psychological therapy. Earlier this month, in "Can MDMA Save a Marriage," Christina Caron of The New York Times described how the drug has long helped break down emotional barriers between people, which is especially important for couples therapy.

"Before MDMA was banned in the United States in 1985, psychiatrist Dr. George Greer conducted over 100 therapeutic MDMA sessions with 80 people and was an author on an informal, observational study featuring 29 of them," she wrote. "The participants didn't volunteer with the intention of trying to heal a relationship, Greer said, but interestingly, every subject except one reported improved communication in their relationships after the MDMA session, either with a partner or someone else in their life."

In an interview last year with Reason's Nick Gillespie, psychotherapist and relationship specialist Charles Wininger described MDMA as "emotional superglue for relationships." 

Such a reputation explains why, despite its illegality, some therapists continue clandestine use of MDMA in sessions with patients. The drug even won a grudging nod from the powers-that-be to allow further research. In 2017, the Food and Drug Administration quietly granted MDMA breakthrough therapy status as a promising treatment for post-traumatic stress disorder (PTSD). While that doesn't ease legal restrictions much, it at least opens the doors to clinical trials, and the results are encouraging.

"MDMA-assisted therapy is highly efficacious in individuals with severe PTSD, and treatment is safe and well-tolerated, even in those with comorbidities," found a study published last May in Nature Medicine.

MDMA has yet to break down legal barriers the way psilocybin has, probably because of suspicion about its origins in a laboratory rather than a natural source. But it's winning greater acceptance. The same can be said of LSD, the best-known of psychedelic drugs. It, too, has won growing respect from users and professionals alike, especially in small doses.

"Many who are intrigued by the promise of psychedelics—a category that includes psilocybin, lysergic acid diethylamide (LSD), ayahuasca, mescaline, and other substances that alter consciousness—are eager to reap the benefits without having to take a dose strong enough to provoke an hours-long journey down the rabbit hole," National Geographic noted last month. "A growing number are turning to microdosing, regularly ingesting five to 10 percent of the mind-bending amount in a quest to enhance well-being, improve work, or diminish depression and other psychological demons without triggering the drug's full effects."

"While preliminary findings demonstrated the therapeutic efficacy of full psychedelic doses in the treatment of depression, anecdotal reports suggest that lower doses, without the psychedelic experience, are beneficial too," found a 2020 review of research into psilocybin and LSD use published in Therapeutic Advances in Psychopharmacology.

A University of British Columbia study examining self-reported psilocybin and LSD use published in November 2021 "identified lower levels of anxiety and depression among microdosers relative to controls." The researchers concluded that "future research is warranted."

Data are hard to come by, though, given the illegal status of LSD, which largely confines researchers to anecdotes. A little more dosage control may come in the form of microneedle patches developed by Canadian pharmaceutical company PharmaTher specifically for the delivery of the drug.

While curiosity about and evidence for the potential benefits of psychedelic drugs is leaping ahead, legal reforms proceed more slowly. Magic mushrooms lead the way, but it'll be a while before we can purchase MDMA, LSD, and similar drugs without fearing arrest by people using force to (they claim) save us from ourselves. Still, decriminalization, research, and controlled usage are a big improvement over unthinking criminalization. With more acceptance and fewer penalties, we may even, someday, discover the appropriate dosage for a chaotic Saturday afternoon in Central Park.