‘Psychedelics renaissance’: new wave of research puts hallucinogenics forward to treat mental health | Mental health

Out of desperation, Michael Raymond finds himself sitting in a remote haven in the Peruvian Andes, sipping a cup of bitter tea.

Raymond has reached a breaking point. His 16-year career as an electrical engineer in the high-security situations of the Australian Air Force has seen him deal with near-death experiences, accidents, injuries and ‘traces of human remains’.

Michael Raymond overlooks Machu Picchu in Peru
Michael Raymond, an Australian Air Force veteran, traveled to South America for drug-assisted treatment

“I was going to kill myself at some point,” he says. “I couldn’t go on.”

After medically discharged from PTSD, anxiety and depression, Raymond was prescribed antidepressants and underwent psychotherapy, to no avail.

Taking ayahuasca tea, which contains the psychoactive compound N, N-Dimethyltryptamine (DMT) and San Pedro cactus, was a last resort.

After early psychiatric experiments in the 1950s and 1960s, followed by decades of prohibition – sparked in part by a backlash against hippie counterculture – dope is experiencing a renaissance. A new wave of research has returned hallucinogenic drugs as potential candidates for treating psychiatric conditions.

It has also led to more people, frustrated with drugs that don’t work, looking for illegal drugs. Experts are quick to warn of the dangers of self-treatment of mental health conditions with psychedelic drugs.

But therapeutic uses for illegal substances — including MDMA, DMT and psilocybin, the active ingredient in magic mushrooms — are now being explored in clinical trials.

Dr. Martin Williams, executive director of Sassydelic Research in Science and Medicine, says the tide is finally turning after decades of it being linked to “functional suicide.”

Magic mushrooms grow
Therapeutic uses for illegal substances, such as the active ingredient in magic mushrooms, are being explored in clinical trials. Photo: Westend61 GmbH / Alamy Stock Photo / Alamy Stock Photo

Williams, who is also a research fellow at Monash University, co-leads a clinical trial at St Vincent’s Hospital in Melbourne in psilocybin-assisted psychotherapy to treat anxiety and depression in terminally ill people.

The trial, which will run until 2023, includes 40 people with chronic obstructive pulmonary disease and motor neurone disease who receive one or two 25 milligram doses of psilocybin in conjunction with treatment.

It follows successful US studies of the drug in patients with anxiety and depression linked to life-threatening cancer. At follow-up four and a half years later, participants “significantly attributed positive life changes to the psilocybin-assisted therapy experience and ranked it among the most personally meaningful and spiritually significant experiences of their lives.” A similar experience with LSD has also found beneficial effects.

For anxiety and end-of-life depression, evidence suggests that standard drug treatments with antidepressants such as SSRIs — selective serotonin reuptake inhibitors — aren’t particularly effective, Williams says.

“Anesthetic…by any mechanism, it appears to be a significant improvement over standard treatments.”

Meanwhile, another clinical trial involving psilocybin, at St Vincent’s Hospital in Sydney, is investigating whether the compound might help treat methamphetamine addiction.

brain chemistry

Conventional psychedelic drugs — DMT, LSD, mescaline and psilocybin — act on the brain by binding strongly to specific serotonin receptors known as 5-HT2A receptors. Their effect on these receptors is thought to lead to the hallucinogenic effects of the drugs, as well as changes in perception and sense of ego dissolution.

The drug is also thought to suppress the “default mode network,” a system of interconnected brain regions that activate in a resting, unfocused, waking state — like daydreaming. The area is believed to be important in forming our sense of self, and it can become very rigid when people suffer from anxiety and depression.

Cultivated magic mushrooms.
Cultivated magic mushrooms. Photography: Nigel Dodds/Almy

By quieting the default mode network, Williams says, psychedelics appear to enable different connections in the brain, such as “crosstalk,” resulting in an altered sense of perspective and greater psychological resilience.

Professor Jerome Sarris, one of the directors of the newly established Psychae Institute in Melbourne, says the potential of psychedelic drugs is a kind of “paradigm shift for traditional psychiatry”. The research center plans to conduct clinical trials of ayahuasca in 2022 to treat depression and alcohol use disorder.

It’s one of the few trials in the world: a Brazilian study showed promising results for treatment-resistant depression, while a UK trial of DMT was approved by regulators.

Sarris and Psychae Institute co-director, Associate Professor Daniel Perkins previously conducted an international survey of ayahuasca drinkers. Among those who reported anxiety or depression at that time, 70% and 78%, respectively, reported improved symptoms. (The study was observational, so causation cannot be proven.)

For Raymond, drinking ayahuasca was the kind of indescribable experience – an encounter with a mystic – described by many who took the drink. “I must have these truths which are not embodied in appearing for myself,” he said.

“I want to be what I thought was a manly man, or whatever, a military man…I didn’t have the tools to express emotions healthily,” he says. “Even with a psychologist I was struggling to open up.”

Michael Raymond on the beach
Taking ayahuasca saw some “disembodied truths emerge about me,” Michael Raymond says. Photography: Michael Raymond

One drug that has shown promising results in treating PTSD is MDMA, when used in combination with treatment. In the United States, a phase III clinical trial – the last barrier to research the drug must clear before regulators consider approving it as a new drug – has found it to be “highly effective” and safe in people with severe PTSD.

MDMA works differently from narcotic drugs, but it also increases serotonin in the brain. “This release of serotonin appears to turn on parts of the prefrontal cortex associated with language, and this may be the reason why people are able to talk about experiences they have not previously been able to,” says Dr. Stephen Bright, a psychologist and senior lecturer at Edith Cowan University. On [before]. “

Bright is leading a small MDMA-assisted treatment trial in Perth later this year – the first in Australia – that will treat four people with PTSD.

ecstasy pills
Ecstasy pills. MDMA increases serotonin in the brain and is used in the Perth trial to treat people with PTSD. Photography: Westmacott / Alamy

Regulatory requirements

Despite the promising results to date, no psychedelic drugs have yet collected the required level of clinical evidence to be listed as legally made available on the Australian Therapeutic Goods Register. But Professor Perkins says regulators are aware of its potential benefits. “It’s a question of how they provide access, not whether or not they will.”

Professor Perkins, who was director of the Medical Cannabis Office at the Victorian Department of Health, stresses that narcotic drugs are only part of the treatment. The other is psychotherapy, and any approval of any medication will also be conditioned on treatment protocols that have been examined in clinical trials.

In February, the Australian Therapeutic Goods Administration (TGA) made a provisional decision to reject a proposal to reclassify MDMA and psilocybin from banned drugs to controlled substances. It has postponed making a final decision pending an independent report on the risks and therapeutic benefits of the drugs due to be released next week.

The regulator already grants permission to use these drugs on a case-by-case basis through its access scheme – but it is not uncommon to deny access to them at the state level.

Tanya de Young, founder of Mind Medicine Australia, a nonprofit that led the reclassification bid, says changing regulations won’t lead to a “widespread use gate,” but that clinicians should better get federal and state approvals.

De Jong says she is regularly contacted by desperate people who have exhausted all other treatment options. “They just want a chance to live a functional, healthy, and meaningful life,” she says. “The longer it takes for these drugs to become available in clinical settings, the more people are looking for them underground.”

A 2020 Global Drug Survey found that of 1,376 people who use narcotics for self-treatment, 4.2% need to seek emergency medical treatment — about five times as many as people who use these drugs for recreational purposes.

Drug-assisted therapies are contraindicated for people at risk of developing drug-induced psychosis.

“I see increasing numbers of people getting worse as a result of trying it on their own,” says Dr. Stephen Bright. He is wary of the growing public interest in psychedelic drugs, because the places for clinical trials are very limited, and it may be five or 10 years before treatments become widely available in Australia.

Michael Raymond standing in front of an Air Force plane
Michael Raymond in his Air Force days. Photography: Australian Defense / Michael Raymond

Raymond says his quality of life has improved dramatically since he took ayahuasca in South America, but he realizes the experience wasn’t a panacea. “I still have things to work through,” he says.

He is now studying and working on mentoring other people transitioning away from life in the military. “I found more gratitude just for being alive.”

In Australia, Lifeline Crisis Support is 13 11 14. In the UK and Ireland, the Samaritans can be contacted at 116123, email jo@samaritans.org or jo@samaritans.ie. In the United States, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for support. You can also text HOME to 741741 to contact a Crisis Text Line Counsellor. Other international helplines can be found at www.befrienders.org

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