Dr Fiona Hutton and Daisy Lutyens make the case for embracing psychedelic-assisted therapy to help with our mental health crisis
Many of us are only familiar with psychedelics such as LSD, psilocybin (aka magic mushrooms) and MDMA (aka ecstasy) as illicit drugs that come under the Misuse of Drugs Act. So it might come as a surprise to learn there’s a ‘renaissance’ in the use of psychedelics to treat mental health conditions.
With new evidence emerging about their potential benefits, it’s time to put aside stigma about psychedelics - reinforced and entrenched by the ‘war on drugs’ - and get behind efforts to develop psychedelic therapy, while recognising it is not a ‘magic bullet’, nor suitable for everyone.
A short history of psychedelics
Research into the use of psychedelics in Western medicine dates back to the early 1900s (although psychedelics such as ayahuasca have been used by indigenous peoples across the globe for millennia). In the 1950s and 1960s, research was even government-funded in the United States and Europe.
Early clinical research showed promising results for a range of conditions.
In the US, before LSD was banned under the 1970 Controlled Substances Act, more than 130 studies exploring its clinical use were funded. These studies showed potential for using the drug to treat alcoholism, anxiety and depression.
Early studies exploring MDMA also suggested it may be beneficial as a therapeutic tool.
So what happened to all this highly promising research and why have most people never heard of it?
Sadly, in the 1970s the moral panic around drug use and the ‘war on drugs’ meant most countries had prohibited LSD and other psychedelics. They were often categorised as Schedule I/Class A - drugs seen as having no medical use, a high potential for abuse, and as being unsafe for use under medical supervision.
As a result, research funding, drug production and the study of psychedelics as clinical agents virtually stopped.
Psychedelic renaissance
Despite the entrenched stigma caused by prohibition and resistance to the medical use of psychedelics, the results of pioneering clinical trials have been too successful to ignore and a psychedelic renaissance is underway.
Recent research includes a 2018 study suggesting MDMA is of therapeutic benefit in treating people with autism-related social anxiety. The first randomised controlled pilot study of MDMA, published in 2010, suggested it was also effective in treating treatment-resistant post-traumatic stress disorder (PTSD) - albeit based on a small sample.
Research on psilocybin indicates it’s helpful for treating addiction to nicotine and alcohol - and, when used in combination with psychotherapy, can lead to psychological improvements that are sustained over time.
In another study, a single dose of psilocybin, coupled with psychotherapy, had dramatic improvements on anxiety and depression in people with cancer. These improvements were still present after six months.
Research also indicates that, compared with conventional treatment, psychedelics may be more effective in treating depression, while having few, if any, side effects. Of note, these studies advocate for psychedelics to be used as an adjunct to psychotherapy, rather than as a stand-alone treatment.
Encouragingly, studies exploring MDMA as a treatment for PTSD have been so successful the Multidisciplinary Association for Psychedelic Studies (MAPS) is aiming for MDMA therapy to be available to the general public in the US in 2023.
Due to the sustained efforts of MAPS and others - the Beckley Foundation, Professor David Nutt and his colleagues at the UK’s Drug Science and US psychiatrist Dr Michael Mithoefer, to name but a few - a resurgence in research has been taking place over the past decade or so.
The determined activism of organisations such as Drug Science and the Beckley Foundation, alongside the mental health ‘crisis’ in many countries, means psychedelics can no longer be sidelined.
What’s happening here?
Signs of the psychedelic renaissance are also emerging in New Zealand. For example, LSD has been the subject of research at the University of Auckland.
At the grass roots level, anecdotal reports of people’s experiences of using psilocybin for mental health problems have been collected by Blue Honey, a website run by psilocybin advocates Zach and Michaela Cotogni. Some of those quoted by Blue Honey note they have to break the law to use psilocybin. One comments:
"I struggle with the fact that treatment outcomes from medical professionals had doomed me to a lifetime of pain and pharmaceuticals. Nature showed me a different path, which has forever altered my life for the better. By law, the first is legal; the second made me a criminal."
Another points to the need for law reform to enable access to psychedelic therapy:
"It is time for the law to change … drug reform advocates must listen to these stories of healing and insist on the dignity of human beings … It is time to … offer choice and provide opportunities for psilocybin-assisted wellbeing.
"Imagine what our mental health treatment system may have looked like if research into psychedelics had not been stopped in its tracks. Instead of outlawing substances such as LSD, psilocybin and MDMA, these drugs could have been incorporated into our health system and used to treat people with trauma-related conditions."
Statistics show one in five Kiwi adults suffer from mental distress and young people have one of the highest suicide rates in the OECD. Evidence-based approaches, such as psychedelic therapy, need to be given our full attention.
Let’s hope governments around the world, including our own, will stand by their ‘drugs are a health issue’ rhetoric, follow the evidence, and embrace psychedelic-assisted therapy - a much-needed tool for tackling mental health issues that could be life changing for some New Zealanders.
