The Worldview-Changing Drugs Poised to go Mainstream

September 8, 2021

The growing legitimacy of psychedelics as therapies promises to transform how we view the extraordinary.

It was 1971 when Rick Doblin first took LSD. A Saturday afternoon in Florida, a few weeks into his freshman year. Four years had passed since the Summer of Love – when millions of young people descended on San Francisco, London and beyond in a haze of music and drugs – but the psychedelics still flowed through campus.

LSD, or Lysergic Acid Diethylamide-25, is a chemical trickster. Mimicking the morphology of serotonin, it locks in the synapses of the brain’s 5-HT2A receptors to trigger a manifest wave in cognition: extraordinary ruptures in vision, patterns of thought, belief, and emotion.

Within an hour, the trickster’s games make themselves known. A sense of strangeness hard to put in words descends. Shapes and kaleidoscopes may appear and dance in synchrony. Synaesthetic connections – when you can hear or taste colours – could emerge. Depending on one’s dose, by the drug’s peak you may be thrown into an entirely altered dimension: a weird place filled with entities, snakes, designs behind-the-eyes, DNA strands, and a radically enhanced appreciation for art and aesthetics. Or something far darker.

Doblin’s world hummed, throbbed, droned. After floating through the campus dining hall, he made his way back to a private dorm for an inward-facing trip. Glancing at his friend – also surging on LSD – Doblin was struck by a fresh vision. Not merely deducing his co-pilot’s thoughts and emotions, Doblin could see them plain as day. His friend’s comfort, benefaction, warmth, were visible like arms and legs.

Transformative experiences aren’t like most experiences, even our most dramatic ones

Doblin wished he could feel so free. He was decomposing. In his own LSD rotoscope, Doblin had become a boy again – no longer the man – and the imbalance of emotion and intellect that drove his life in the everyday were sensible. Yet he was this way for a reason, Doblin realised. And this meant it wasn’t set in stone. He could change things. He could be free.

For the philosopher LA Paul, what Doblin experienced can be described as a “transformative experience”. These aren’t like most experiences, even our most dramatic ones. What makes them distinct is how they change a person: their preferences, ideas and identities are turned upside-down. When Doblin entered his first trip, he perhaps hadn’t realised that the next day he would not be the same.

Afterwards, Doblin knew he was on to something. He’d take more trips – many of which were destabilising – but the essential promise was clear. Evangelising the therapeutic potential of psychedelic drugs became his life’s mission.

Doblin is today the founder and executive of a non-profit organisation called the Multidisciplinary Association for Psychedelic Studies (Maps), which aims to bring psychedelic drugs closer to mainstream use in medicine and beyond. It advises scientists how to conduct trials and win funding, as well as working closely with regulators.

Now the efforts of Doblin and others are finally paying off. In the last 10 years, psychedelic drugs like LSD, magic mushrooms, DMT, a host of “plant medicines” – including ayahuasca, iboga, salvia, peyote – and related compounds like MDMA and ketamine have begun to lose much of their 1960s-driven stigma.

Promising clinical trials suggest that psychedelics may prove game-changing treatments for depression, PTSD and addiction. The response from the psychiatric community, far from dismissive or even sceptical, has been largely open-armed. The drugs may well mark the field’s first paradigm shift since SSRIs in the 1980s.

The “psychedelic renaissance” promises to change far more about our societies than simply the medical treatments that doctors prescribe

In 2017, for example, the US Food and Drug Administration designated MDMA a “breakthrough therapy”, which meant it would be fast-tracked through to the second stage of Phase-3 trials. Doblin, whose organisation was instrumental in achieving the designation, hopes it will achieve FDA approval by 2023.

Psychedelics remain Schedule-1 drugs federally in the US and Class-A in the UK, but rules are relaxing. Along with Austria and Spain in the EU, psilocybin mushrooms have been decriminalised in Washington DC and a host of other US cities, and legalised for therapy in Oregon, where LSD has also been decriminalised. A California bill to decriminalise LSD and psilocybin passed several crucial committee stages and will be decided next year. A vote to federally sponsor psychedelic research recently made its way to Congress.

In anticipation of this shift, psychedelic drug developers and clinical providers are attracting significant investment. Business reports describe “psychedelic euphoria” and a “Shroom Boom”.

This phenomenon is known as the “psychedelic renaissance” – and it promises to change far more about our societies than simply the medical treatments that doctors prescribe. Unlike other drugs, psychedelics can radically alter the way people see the world. They also bring mystical and hallucinatory experiences that are at the edge of current scientific understanding. So, what might follow if psychedelics become mainstream?

Across some 6,000 studies on over 40,000 patients, psychedelics were tried as experimental treatments for an extraordinary range of conditions: alcoholism, depression, schizophrenia, criminal recidivism, childhood autism. Participants included artists, writers, creatives, engineers and scientists. And the results were promising. From as little as a single LSD session, studies suggested that the drug relieved problem drinking for 59% of alcoholic participants. Experimenting with lower, so-called “psycholytic” doses, many therapists were amazed by LSD’s power as an adjunct to talking therapy.

It wouldn’t last. By October 1966, LSD was banned in California, with federal restrictions to follow in 1970 under the Controlled Substances Act. Several alarming myths made their ways into government campaigns: claims of LSD-induced chromosome damage, mutant babies, that tallying five, six (or seven) trips made you “legally insane”, were propagated to school kids just like Doblin (although he’d only shirk the warnings in time).

This affected science, too. Apart from a handful of remnant groups in Canada and the US, the entire field of psychedelic science would dry up for decades. Regulators restricted access. Funders lost appetite. At the height of the crackdown from the 1970s to the 1980s, Doblin’s attempts to launch psychedelic research led to closed doors and real difficulty securing jobs.

Conventional narrative traces the crackdown to the career of Timothy Leary, a Harvard scientist who became the counterculture’s biggest proponent of LSD in the mid-to-late 1960s.

A scandal at his Harvard Psilocybin Project in 1963 – in which his co-director was accused of dishing out psilocybin to undergraduates – would mark the first shots of a more sensationalist reaction in the media. Soon after, regulators would grow distressed by LSD’s black market currency “outside the lab”, which Leary’s post-Harvard advocacy – including claims that LSD could give women “thousands of orgasms” and excite revolution against the establishment – did much to furnish.

That’s not the whole story, though. Some medical historians pin the blame for the backlash on the rise of the Randomised Controlled Trial (RCT) methodology. This is now the standard way to run clinical trials, and its introduction raised questions about just how scientific “psychedelic science” really was among regulators.

RCTs involve comparing two groups of people: one which has taken a drug, and another which has not. The participants aren’t meant to know which group they are in, but that’s difficult with psychedelic substances.

The Good Friday Experiment of 1962 – a session held in a church with seminary students to test psilocybin’s capacity for inducing mystical experiences – provides an illustrative example. One half of the subjects were given the active drug, the other a placebo (and all double-blinded), yet within 30 minutes it was plainly obvious who’d got which. Those dosed wandered around the grounds in a daze envisioning God, one of the participants told me – while the placebo group (including him) just “twiddled their thumbs and read the hymnal”.

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