Alec MacDonald
Aug 24, 2017 · 5 min read

The Long, Strange Trip Ahead: Reviving Psychedelic Medicine

Attendees at the Psychedelic Science 2017 academic conference in Oakland last April

“This is the age of big pharma,” said Albert Garcia-Romeu, “so how many people do you know who are on anti-depressants, anti-anxiety medications, sleeping pills, drugs to get off other drugs for addiction?” Far too many, he would imagine. As the 36-year-old clinical researcher observed, “Our generation is starting to become a little disillusioned with the idea that we can be sold mood-enhancing drugs on a daily basis for a whole lifetime.” He proposes an alternative solution, one which the previous generation embraced and then rejected: psychedelics.

During Psychedelic Science 2017, an international academic conference held recently in Oakland, California, Garcia-Romeu and his colleague Fred Barrett took a break to discuss the medical applications of hallucinogens and other drugs affecting sensory perception. The pair serve as junior faculty in Johns Hopkins University’s Behavioral Pharmacology Research Unit, one of just a handful of laboratories across the country where psychedelics receive rigorous examination.

Fred Barrett and Albert Garcia-Romeu

Their field has not always been so sparsely populated. In the decades following 1943 — the year that Swiss chemist Albert Hoffman famously discovered the psychotropic properties of LSD by accidentally dosing himself — researchers churned out thousands of studies involving tens of thousands of human subjects. Momentum ground to a halt, however, after psychologist Timothy Leary got himself booted out of Harvard University for conducting unprofessional LSD experiments; his subsequent exploits helped popularize the drug within the burgeoning counterculture movement, contributing to the Nixon administration’s move to outlaw psychedelics under the Controlled Substances Act of 1970.

“It really got sensationalized,” Barrett said, “and when you sensationalize something like that, to that degree, it really becomes a difficult thing for more objective scientists or more conservative medical researchers to endorse or engage in.”

Hopkins lab cofounder Roland Griffiths was one of the first to revive the study of psychedelics, nearly 30 years later. His team’s less ostentatious efforts have served to normalize this kind of inquiry, especially because they work at a prestigious academic institution and follow strict DEA and FDA guidelines. Furthermore, they usually eschew the now-stigmatized LSD in favor of synthesized psilocybin, the mind-altering compound contained in so-called magic mushrooms. Psilocybin has the practical benefit of inducing effects that last roughly six hours (an LSD trip can span more than 12), allowing for experimental sessions that fit within the course of a standard business day.

Although the intense sensations of psilocybin fade before long, it appears to summon up enduring personality changes. This is one reason why Hopkins researchers want to further investigate the drug’s potential for alleviating depression, anxiety, and substance dependency; instead of continually popping short-lived pills to tweak their mental state, people may be able to find and maintain balance with vastly less frequent pharmacological interventions. As Garcia-Romeu explained about those who have been through the lab’s psilocybin-facilitated smoking cessation study, “The drug experiences seem to help clarify what your priorities are, such that after a really powerful experience, people can walk out and say, ‘Oh, here’s my family and here’s the rest of my life; and here’s this pack of cigarettes. And this is what matters to me; and this is not really important.’ So they’re much more comfortable with making that change.”

The study looked at 15 smokers who averaged nearly a pack a day and had been smoking for about three decades. Garcia-Romeu and his collaborators put them through a 15-week treatment schedule that incorporated two or three psilocybin sessions within a broader regimen of behavioral therapies. One year later, 10 of the participants tested nicotine-free. This two-thirds success rate more than doubles what prescription anti-smoking medications have demonstrated in other studies. Detailing the results in The American Journal of Drug and Alcohol Abuse, Hopkins researchers concluded that “psilocybin holds considerable promise in promoting long-term smoking abstinence.”

Seeing that promise fulfilled, however, won’t be quick or easy. Fifteen smokers represents a tiny sample size; the burden of scientific proof demands that future studies significantly scale up the test group. Yet the cost of running these experiments is high, and the funding for them is limited — at least for university-based labs like at Hopkins.

Pharmaceutical companies may have greater capacity to handle this kind of research, but psychedelics offer them little commercial value. “There’s not a profit motive,” Garcia-Romeu pointed out, because “they can’t patent psilocybin — it grows out of the ground.” Industry giant Pfizer has more reason to invest time and money in a proprietary drug such as Chantix, a pill that helps only 30 percent of users quit cigarettes but still generates huge returns.

Besides the advantage of a trademark, Chantix and other prescription meds benefit from the fact they must be ingested on a regular basis for a long time — that’s a solid capitalist model for earning revenue. Psychedelics stand to disrupt this cycle of pill-popping, but that may actually diminish their market viability, especially given the necessity of combining them with extensive interpersonal support activities. They certainly won’t provide the convenience of simply reaching for a bottle in the bathroom cabinet. “None of the models of therapy at this point that I’m aware of seem to have these as take-home drugs,” said Barrett, explaining that if the medical use of psychedelics catches on, “it’s very likely to be in a specially licensed clinic, administered by specially trained individuals.”

And even that scenario, if it ever comes to pass, lies much further down the road. Steering clear of the zealotry that consumed and ultimately derailed past psychedelics investigation, Hopkins researchers are proceeding with diligence and discernment. “There’s the potential to view this whole class of drugs as a panacea,” acknowledged Barrett. “I think they do have incredibly remarkable effects — otherwise we wouldn’t be studying them — but that’s not to say they’ll have those effects for everyone, and it’s not to say they will be appropriate for everyone.”

So for now, the slow and steady grind of gathering evidence continues in hopes of illuminating how psychedelics may heal the mind.

“I think we’re in a good position because so many people are just interested to see what the data have to say — even critics,” Barrett said.

As Garcia-Romeu added, “They’re curious, they’re open to the possibility that it might be useful and therapeutic, and so they’d like to know more.”

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Alec MacDonald
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