Key Takeaways About the Future of Psychedelic Treatments for Mental Health Conditions From ‘How to Change Your Mind’
If you or a loved one is affected by addiction, the following post could be triggering. You can contact SAMHSA’s hotline at 1-800-662-4357.
I grew up in the era of the so-called “War on Drugs.” Day after day, we had the dangers of illicit drug use pummeled into our minds both in school and with commercials of frying eggs in a pan standing in for our brains on drugs. All drugs, regardless of any evidence to the contrary, were bad, and they would all render us incompetent human beings… end of story. So, to say that I have been socialized to view drugs with deep skepticism would be an understatement.
It is with this skepticism that I approached the new Netflix documentary series based on the book by the same name, written by Michael Pollan, entitled “How to Change Your Mind.” This series takes a deep dive into four drugs: LSD, psilocybin, MDMA, and mescaline — and explores the history of their potential medical applications as well as how they went from being considered useful to becoming illegal. Having witnessed the efficacy of certain schedule one substances, like cannabis, upon many friends with varying ailments and the devastation caused by other completely legal substances upon others, I was keen to gain greater awareness on this topic. While I will mention key takeaways of all four substances included in the documentary, I will focus most intently on the use of MDMA in healing treatment-resistant post-traumatic stress disorder (PTSD) as this is the substance most likely poised to obtain FDA approval within the next couple of years and because it is the one that might potentially be a game changer for me personally.
Episode 1: LSD
The word “psychedelic” comes from the Greek “psychos” or “mind,” and “Delos” or “manifestation,” and indeed there is evidence of the use of mind-altering substances as early as the Ancient Greeks and throughout history among indigenous cultures throughout the world. These rituals were generally performed in groups as part of sacred-codified activities conducted by a shaman or medicine man, either as a means of expanding consciousness or of healing members within the group. In other words, none of this is particularly new or novel.
What is new or novel is the rekindled interest in the research of psychedelics as potentially helpful for treating a wide range of illnesses and conditions ranging from depression to addiction to PTSD. According to Pollan, who considers himself a “psychonaut” or “someone who seeks to expand their consciousness through the use of plants,” between 1950 and 1965 there were 1,000 scientific articles written on the use of psychedelics involving 40,000 research subjects and six international conferences on LSD alone.
In fact, even the CIA was secretly conducting research on LSD as a potentially effective bioweapon when the substance was inadvertently placed in the wrong hands, making it widely available to the general public where it began to be used in quantities that could pose potential hazards to some members of the population, inducing a form of psychosis. It could be said, therefore, that the cultural upheaval of the 1960s began with a CIA experiment gone horribly wrong. This led to the substance becoming illegal in 1970 and classified as a schedule one drug having zero medical use, effectively ending and indeed erasing any prior research on the substance from historical records.
In the early 2000s, researchers in Switzerland began to revive scientific experiments using LSD to treat medical conditions ranging from anxiety and cancer to cluster headaches. And of the participants with depression, 80% reported that microdosing lifted their depression differently than traditional antidepressants without the common numbing or muting side effects experienced with SSRIs.
Pollan himself decided to try a dose of LSD and he confirms that the greatest asset of an LSD-induced trip is its capacity to connect thoughts to feelings. It allows the participant to shift from what is called “spotlight consciousness” which is very focused to a more widespread childlike awe called “lantern consciousness.” It also appears to activate the ability to access implicit or preverbal memories that may be traumatic and to experience them without these memories being activated. Many, even those who don’t consider themselves particularly religious, have called it a spiritual experience or awakening, connecting them to all other creatures and things.
Episode 2: Psilocybin
Like LSD, psilocybin or magic mushrooms had been widely researched when it too was classified as a schedule one drug by the federal government in 1970. The history of the awareness of and eventual exploitation of magic mushrooms involves a quite fascinating and infuriating story of the persecution of early civilizations of the Yucatán peninsula by early Spanish colonizers, a story that will repeat itself later in our discussion about Mescaline. Quite often the demonization of and restriction of these substances corresponds to the subjugation of members of the BIPOC community.
Research on psilocybin re-emerged after the Millennium Mushroom Conference of 1999 when Dr. Roland Griffiths was able to get John Hopkins University to green light a volunteer-based study utilizing a tool entitled “The Mystical Experience Questionnaire” to scientifically document the effects of psilocybin on participants. Again, like LSD, brain scans indicated a significant change in the areas of the brain where our definitions of self occur, enabling an individual to in essence reinhabit oneself and safely process traumatic experiences that have been the root cause of their symptoms from mental illness.
The key question coming out of this episode is: how do we conduct research and gain mainstream approval of a substance with the potential to eliminate symptoms with only a couple of doses in a system dominated by “Big Pharma.” This is where MDMA comes into play.
Episode 3: MDMA
MDMA, or methylenedioxymethamphetamine, commonly known as Ecstasy, is a psychedelic that works somewhat uniquely in the brain. Unlike the other three substances covered in this series which target the serotonin 2A receptor of the brain, MDMA floods the entire brain with serotonin. It also increases the release of the feel-good hormone oxytocin and injects the body with a small dose of amphetamine. This combination of features helps to turn off the amygdala and engage the prefrontal cortex of the brain, which is the complete opposite of what occurs in the brains of those with PTSD, making it especially effective for this population. And the adrenaline helps to increase motivation to participate in the therapy.
The reason that MDMA is the most likely to become FDA approved is thanks to Dr. Rick Doblin, a researcher who understood the difficulty of navigating the FDA approval process and whose doctoral dissertation was a step-by-step protocol for how to pursue FDA approval. In 2000, Dr. Michael Mithoefer teamed up with Doblin to begin research on MDMA for the treatment of PTSD. Their findings were presented to the federal government and in March 2004, the FDA granted permission for the first phase two clinical trial.
$100,000,000 and 22 years later, the final stage three clinical trial results are in and according to the study, two out of three participants no longer meet the criteria for a PTSD diagnosis. The effects appear to be long-term with participants continuing to be asymptomatic one to three years after their treatment. And most notably, all of the money needed to fund this research was obtained through philanthropic donations, a powerful example of how a “non-Big Pharma” methodology for research can be a success.
As someone who has been in therapy for PTSD for seven years and has undergone numerous different therapeutic modalities including EMDR, medication, and other more body-focused therapies, I still experience chronic nightmares which contribute to my anxiety and depression. Nothing has given me any kind of relief from these nightmares and frankly, I’ve stymied all of my health care providers with the pervasiveness and intense detail that my nightmares present with. After hearing the testimonials from those participants included in the documentary, I can see myself seeking out this treatment once the FDA has approved it. With the rigorous standards and protocols that have been established, I wouldn’t hesitate one bit as long as it was being provided by a licensed and well-trained clinician.
Episode 4: Mescaline
Mescaline, which is the active ingredient in two types of cacti — namely Peyote and the San Pedro cactus — is a similar psychedelic to LSD and psilocybin in terms of how it affects the brain. This particular episode dealt less with the therapeutic use of the drug and more with the social justice aspect of it. Peyote in particular only grows in a tiny swath of the area surrounding the Rio Grande and its existence has already been threatened by a host of factors ranging from farming to poaching.
This poses a unique challenge to the Native American tribes that have long utilized it as a ritual means of healing their transgenerational trauma. They argue that the popularization of and push to decriminalize the use of natural plants is a direct threat to their culture and way of life. This cultural appropriation could effectively end their ability to pass on their heritage to future generations so while there is a push to legalize the personal growth and use of entheogenic plants across the country, several bills have been presented and passed in legislatures across the country that deliberately excluded peyote from their list of plants to be decriminalized. From a sociological perspective, this is a meaningful conversation to have, but perhaps slightly outside of the scope of what is relevant here.
Used in a controlled environment under the supervision of an ethical and highly trained professional to facilitate the proper dosage and to monitor the process of the “trip,” these substances may be powerful weapons that could be added to the arsenal of tools a medical practitioner might consider to help treat those who have not responded to other types of treatments options or who are unable to tolerate them, for instance, those with allergies or severe side effects to medication. Furthermore, these substances, when used in small quantities, may be integral to combating the current opioid crisis.
While FDA approval is still highly anticipated for MDMA and several jurisdictions have already voted to decriminalize entheogenic plants, the use of psychedelics in the treatment of chronic and mental illness is still very much theoretical. I hope to see the fruition of this research within my lifetime as I do believe based on the evidence presented in this documentary that there are legitimate safe uses for psychedelics that could potentially change the quality of life for millions of people.
Interested in learning more about the use of psychedelic drugs for psychiatric use, as discussed in this article? Check out some of our great articles from around The Mighty, shared below.
Image via Netflix/Youtube