A New Kind of Acid Test
Can psychedelic drugs be brought into the medical mainstream?
Posted September 6, 2014
In the past decade, after thirty years in the deep freeze, research into the medicinal use of psychedelic drugs, ranging from psilocybin to Ketamine, and from MDMA to LSD, has begun to accelerate. FDA-approved pilot studies and clinical trials using the drugs under controlled conditions and in combination with talk therapy have shown they could be used safely, delivering promising results in a wide range of tough-to-treat maladies, including opiate and tobacco addiction, alcoholism, autism, anxiety, depression and Post Traumatic Stress Disorder.
These developments are not surprising to some who remember the first wave of research and even widespread clinical use of psychedelics in the quarter century after the accidental discovery of LSD in 1943. A global review of psychedelic studies and clinical results in 1963 concluded: “Some spectacular, and almost unbelievable, results have been achieved by using one dose [of the drugs].”
In 1960, a psychiatrist named Sydney Cohen surveyed the results of 44 physicians who had administered 25,000 doses of LSD or mescaline to 5,000 subjects under widely varying conditions. Cohen found “no instance of serious or prolonged physical side effects” in either those 25,000 sessions or in the wider literature on psychedelic drug studies. Adverse psychological reactions, he found, were rare, and mostly related to pre-existing mental illnesses.
But the powerful drug that was proving surprisingly safe to use in the clinic was creating a panic when used on the streets. The mushrooming popular abuse of psychedelics in the late 1960s, particularly by unscreened young people taking it in uncontrolled environments, struck such a sensitive cultural and political nerve that it left the drugs, and the scientists who worked with them, severely stigmatized for more than a generation.
“It was if psychedelic drugs had become undiscovered,” one researcher recalled.
Ironically, the criminalization of the possession of psychedelic drugs in 1970 and the attendant passion of the authorities’ anti-drug crusade did little to slow the spread of recreational abuse, but effectively shut all research into possible beneficial uses down cold.
In the three decades that followed, an underground network of therapists continued to use the now illegal compounds in treatment of psychological maladies. In the late 1970s, with the rediscovery of the psychoactive effects of the synthetic psychedelic 3,4-methylenedioxy-N-methylamphetamine, or MDMA, these underground therapists found a compound many felt was even more useful in combination with therapy than the classic psychedelics – avoiding the unpredictable effects and anxiety-provoking visions that sometimes arose, as well as creating an almost instant bond with the therapist. MDMA also had the advantage of not yet being illegal.
As the government prepared to rectify that in 1985, a coalition of credentialed doctors and scientists allied with those in the psychedelic underground to attempt to rehabilitate the drugs and bring back the hope of the 50s and 60s that they could become a powerful tool in psychotherapy. They sued the Drug Enforcement Agency (DEA) to prevent them from placing MDMA on Schedule I of the Controlled Substances Act, the most restrictive category reserved for highly dangerous drugs with no medical benefit.
After months of hearings and volumes of testimony, the presiding judge ruled dramatically in the plaintiffs’ favor – MDMA he declared, was neither particularly dangerous when used in a clinical setting nor without medical value.
The DEA simply ignored the ruling, which was not legally binding, and MDMA therapy went back underground. But some of those behind the challenge refused to surrender. If they couldn’t prove their case in court, they would do it in the lab. It took more than a decade and a slowly changing culture, but as the 20th Century came to a close, the Food and Drug Administration began to once again approve clinical human trials testing everthing from whether psychedelics could reliably produce a profound spiritual experience to assessing their ability to help people stop smoking.
One of the most noteworthy and advanced efforts has been using MDMA-assisted psychotherapy to treat chronic, treatment-resistant PTSD. A completed and published trial inSouth Carolina, and additional ongoing trials there and in a half dozen other places, are showing very promising results. In the completed study of 24 subjects, primarily female victims of rape and sexual abuse, all but three subjects experienced lasting remission of their symptoms after just a handful of sessions in which the drug appeared to allow them to examine the roots of their trauma without fear, and generate insights that released them from the disorder’s vicious cycle of avoidance, rage and hypervigilance.
Even if all goes smoothly, the path to the point where MDMA becomes a tool available to all those in need is long, and very expensive. It could take more than a decade, and tens of millions of dollars to generate the final phase studies involving scores of therapists and hundreds of patients that must precede approval of a drug for prescription use. At a time when half a million veterans have returned from wars in Iraq and Afghanistan with PTSD, contributing tragically to the average of 22 veterans each day who commit suicide, that seems like a long time to wait.
The cost to the American taxpayer of giving these vets the medical care they’ve earned will be in the range of a trillion dollars over the next 30 or 40 years. If PTSD could be reliably cured with a short-term treatment using an inexpensive drug like MDMA, those costs could be slashed dramatically. And yet, though the Department of Defense is spending lavishly on speculative development all sorts of untested therapies – including planting microchips in veterans’ brains – it has yet to budget a dime for MDMA research, in part, clearly, because the cultural wars of 1970 continue to hold the image of psychedelics hostage.