Case study / by Corinne Lamoureux of Mental Health Switch
Please note, this article is in no way intended to suggest that anyone should ever attempt to self-medicate with drugs. In the studies of these drugs, the drugs themselves are pharmaceutical grade and carefully measured. With some of them, treatments are performed as ‘guided trips’ with a therapist present throughout.
All drugs are bad!... Right? Corinne Lamoureux analyses the history of psychedelics and their potential for treating mental health issues.
Drugs + mental illness = BAD! That’s right isn’t it? It's what I've always believed and been taught. After all, Mental Health First Aid states that drugs can increase the likelihood of developing mental ill health and worsen existing conditions.
Hippies of the 1960’s and 70’s were synonymous with drugs. “Turn on, tune in, drop out” was popularised by Timothy Leary in 1966 when he urged people to embrace cultural changes through the use of psychedelics by detaching from the existing
conventions and hierarchies in society.
But the tide against drugs had been changing since 1961 when the International Single Convention on Narcotic Drugs was introduced. It was formed during the era of McCarthyism, the Berlin wall was being built, and there was a fear of communism spreading throughout the world. As the Hippie culture was more accepting of other beliefs and values, it was easy to equate being a hippie with being a communist. We have also long associated abstinence (drugs and alcohol) with moral rectitude, which still continues now. If you want to imply that someone is bad, just say that they take drugs.
But recent research is now challenging this belief, offering a potential paradigm shift in our view of psychedelics. All of which begs the question: did the hippies get it right?
The history of psychedelics in medicine
Hallucinogenic substances are among the oldest drugs used by human kind. They naturally occur in mushrooms, cacti and a variety of other plants, and yet, in most developed countries today, the possession of many hallucinogens – even those found commonly in nature – is considered a crime punishable by fines, imprisonment or even death.
President Richard Nixon once described Leary as "the most dangerous man in America". Contrary to what you might think though, Timothy Leary was not some far-out radical – in fact, he was a clinical psychologist at Harvard University!
Leary worked on the Harvard Psilocybin Project from 1960 to 1962 and, after leaving his position, continued to promote the use of psychedelics. His work led to multiple arrests and stints in multiple prisons (36 to be precise!).
After the Single Convention on Narcotic Drugs was introduced, the authorities began to move against the counter-culture and by 1973, even research on psychedelic drugs for medical purposes was banned.
Non-profit organisations like the Association for Psychedelic Studies and Beckley Foundation, as well academic researchers like Roland Griffiths at John Hopkins University or David Nutt at Imperial College London, refused to be deterred, and by the 2010’s had amassed a body of evidence that has led to a resurgence in the study of these drugs. The Psychoactive Substances Act was passed in 2016
which exempts approved scientific research.
In 2018, the world started to see a dramatic change in its attitude to these drugs. Thirty-three states in the USA legalised the use of cannabis for medical purposes. This was followed in 2019 by the approval of esketamine nasal spray for adults suffering from treatment-resistant depression – the first major breakthrough in the treatment of depression since the late 1980’s!
(Currently, esketamine is approved for people with treatment-resistant depression. That means you’ve tried at least two other antidepressants for at least six weeks each and haven’t experienced remission or at least a 50% improvement in mood).
What does this mean for mental health?
Ketamine (a Class B drug under UK law) was originally approved as an anaesthetic. If you watch programmes like “Air Ambulance,” you will see it being used for people with severe injuries, but it is proving to be an effective treatment for a variety of different mental health conditions.
Unlike conventional anti-depressants, which can take 2–4 weeks to reach a therapeutic dose, esketamine immediately impacts brains cells, often offering relief from depressive symptoms within hours. Esketamine is also the only drug besides lithium that’s proven to decrease suicidal thoughts.
In addition to being an effective treatment for depression, esketamine is accumulating an evidence base as being effective for an array of anxiety disorders, including post-traumatic stress disorder (according to Dr Masand of Centers of Psychiatric Excellence).
Other drugs like psilocybin (from magic mushrooms), LSD and mescaline (which occurs naturally in some cacti) are also starting to show signs of promise as a way to treat challenging disorders. This has led to a new landscape of pharmaceutical companies, including Champignon Brands (no surprises about their interests), ATAI Life Sciences, Field Trip Health and Eleusis, all of which are working on developing and trialling psychedelic drugs.
Srinivas Rao, chief scientific officer of ATAI, stated in an article for Pharmaceutical Technology that “there is a recognition that existing therapies [for mental health] are limited. They work well for a subset of the population, but there’s recognition that there’s a subset who really do not benefit.”
In an interview with Psilocybin Alpha (which defines itself as “the definitive resource for investors in the emergent psychedelic medicine sector”) in May 2020, Roger McIntyre, CEO of Champignon Brands said: “For most adults with treatment resistant depression, only about 10 to 20% respond to any type of treatment. With ketamine, we see response rates occurring in about 60 to 65%.
"Importantly, with conventional treatments, it takes 6 to 8 weeks to work, but with Ketamine people can see benefits, usually, within a week.”
MDMA (ecstasy) is also showing promise, being effectively used to treat PTSD according to trials at Cardiff University, while CBD, one of the compounds found in cannabis, has been shown to have good anti-psychotic effects equalling those of antipsychotics already available, but with fewer side-effects.
There is even ongoing research into how psychedelics could be used to help people heal from sexual trauma.
On July 14th 2020, the UK’s leading independent scientific body on drugs launched the Drug Science Medical Psychedelics Working Group. Their aim is to provide “an evidence base free from political or commercial influence, creating the foundation for sensible and effective drug laws, by delivering, reviewing and investigating scientific evidence relating to psychoactive drugs.” They are a consortium of drug science experts, leading academics, researchers and policy specialists, supported
by industry partners.
With depression now one of the leading causes of disability worldwide; stress, anxiety and depression accounting for 54% of all working days lost in the UK; and 16 people a day dying by suicide (with many more making suicide attempts), this new research could quite literally save lives.
Beyond mental illness
The potential benefits of psychedelics may also extend beyond mental illness.
London-based Eleusis is researching how medications based on psychedelics could be used to treat a variety of chronic inflammatory diseases, such as asthma, cardiovascular disease, arthritis and back pain. It already has a drug in pre-clinical trials to treat diabetic retinopathy (a leading cause of vision loss in adults)
and is hoping that trials of LSD micro-dosing to treat Alzheimer’s disease will follow in 2023.
There are also studies taking place into the use of CBD not only as a treatment, but also as part of palliative care for cancer patients.
It would appear then that there are many potential benefits for drugs that, for the past 50 years, have been viewed as intrinsically bad.
The future is bright
George Harrison once said “When you’ve seen beyond yourself, then you may find, peace of mind is waiting there.”
Perhaps by going on a “trip”, people with a variety of mental illnesses will be able to find a peace of mind that currently eludes so many. As someone who teaches Mental Health First Aid and has heard many stories of struggles, I sincerely hope so.
Judging by the above it would appear that maybe the hippies got it right after all and the next few years could see significant breakthroughs in the treatment of mental illness. I shall be watching with interest.