Psychedelics, such as LSD and mushrooms, are expanding beyond their reputation as experimental social hallucination drugs. Often described as “mind-manifesting” because some believe they make the mind visible, these substances are becoming tools for medicine and therapy. MDMA and psilocybin, in particular, might become FDA approved as trauma treatments soon. In fact, the Biden administration said it “anticipates” that the drugs will be approved by regulators within the next two years.
With this development, these mind-altering drugs are buzzier and more relevant than ever, so we’re taking a look at six things you need to know about them.
1. What Exactly Are We Talking About?
The classic psychedelic drugs—the ones you likely think of first—are compounds that have been used to produce non-ordinary states of consciousness, says Sharmin Ghaznavi, MD, PhD, associate director of Massachusetts General Hospital’s Centre for the Neuroscience of Psychedelics. That includes LSD, psilocybin, mescaline—the substance found in peyote—and DMT (N,N-dimethyltryptamine), a major ingredient of ayahuasca. Along with these drugs, there is a class of psychedelics called empathogens. Ecstacy and Molly are the most commonly known drugs that fall under the empathogen umbrella. Ketamine, while not a psychedelic, is often grouped with these drugs because of its dissociative properties, meaning you might feel a sense of detachment from your surroundings when you take it.
2. How Can These Be Used As A Therapeutic Treatment?
Both psilocybin and MDMA have received FDA breakthrough status, which means they’ve been labelled as drugs that could therapeutically treat a serious or life-threatening condition. This label from the FDA indicates that preliminary evidence points to the drug demonstrating a substantial improvement compared to other available therapies. For now, signing up for and participating in one of these trials is the most effective—and only legal—way to use psychedelic drugs in a therapeutic setting.
Psilocybin was specifically given FDA breakthrough status for treatment-resistant depression. There are ongoing trials testing the drug’s efficacy for depression treatment, including a phase III trial that is set to begin soon. The Johns Hopkins Centre for Psychedelic and Consciousness Research is invested in this discovery and potential breakthrough, committing $17 million of funding to expand research on psychedelics for illness and wellness.
MDMA, on the other hand, has been given breakthrough status for its potential use in treatment-resistant post-traumatic stress disorder. A phase III trial is currently underway to evaluate whether the drug can be effective in treating treatment-resistant PTSD. It could get approved as early as this year.
David Hellerstein, MD, a researcher and professor of clinical psychiatry at Columbia University Medical Centre, is optimistic about these trials proceeding and eventually resulting in legalization for therapeutic use. Oftentimes, the people who participate in these trials failed to respond to several previous treatments, he points out, so the legalization of psilocybin and MDMA for therapeutic use would be a massive development. “It’s definitely an active effective drug for some percentage of people,” he says.
3. What Are The Risks Associated With Psychedelics?
These drugs are not medically or federally approved, and psychedelics can have incredibly powerful—and sometimes negative—outcomes, especially in recreational and unsupervised settings. (LSD and psilocybin have been labeled as illegal under United States federal law for more than 50 years, but they have been decriminalized in a few states and cities.)
“The promising findings from clinical trials are under very controlled conditions with trained therapists and cannot be extrapolated to recreational settings,” Hellerstein emphasizes.
Often, bad psychedelic reactions or experiences are connected to using a high dose, which is why it’s important to connect with an expert. “Psychedelics are powerful drugs, and that means they have the potential for great good as well as great harm,” Ghaznavi said.
4. How Do Psychedelics Affect Your Brain?
When it comes to neuroscience, psychedelic drugs cause a massive discharge from transmitters in the brain, which can cause a reset of sorts for a lot of circuits, Hellerstein says. Popular psychedelics like LSD and psilocybin activate the serotonin receptors on brain cells in a way that reduces the energy needed for your brain to switch between different activity states, according to Weill Cornell Medicine researchers. You might feel like you’re hearing colours or seeing sounds when the drugs kick in because a connection is being facilitated between brain regions that don’t normally interact very much, Hellerstein points out. Along with these feelings, you might also feel sensations that seem real but actually do not exist. The effects can last long past one day. In fact, psilocybin treatment for major depression can be effective for up to a year for most patients, according to studies by Johns Hopkins Medicine researchers.
5. What Is The Right Way To Take Psychedelics?
Given the fact that psychedelics are Schedule I drugs—which means they aren’t currently accepted for medical use and have a high potential for abuse—Ghaznavi, as a psychiatrist, recommends that people use them only in the context of a controlled clinical trial. When it comes to treatment-related environments, the experience often begins with a therapist getting to know the patient. With psilocybin, for example, after the patient meets the therapist at an office, the next step involves receiving a dose of the drug in a capsule. For a fully immersive experience, the patient will listen to a curated playlist and wear an eye mask to promote focus. This whole process could last up to eight hours.
6. Who Should & Shouldn’t Consider Treatment With Psychedelics?
There isn’t a definitive. The people participating in the therapeutic trials underwent extensive screening before beginning the experimental treatment process, and they are being monitored very closely. People who have a personal history or family history of bipolar disorder or psychosis are currently being excluded from the clinical trials for psychedelic drug treatments, Ghaznavi says.
Views expressed in this article are the opinions of the author and do not necessarily reflect the views of Collective Spark.
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