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Illegal Drugs Are Now Used as Medicine

For decades, research into the benefits of marijuana and other drugs has been limited, but now researchers are paving the way to a “psychedelic renaissance.”

illegal drugs as medicine

In a comfortable room on the campus of Johns Hopkins University, one that resembles a home more than it does a research clinic, study participants took a pill containing psilocybin, the active hallucinogenic ingredient in “magic mushrooms.”

In individual sessions, participants donned eyeshades and earphones. As they relaxed on a couch listening to music, they were encouraged to turn their attention inward.

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Psilocybin affects every person differently, so people in the study no doubt experienced their own versions of the euphoria, visions, or spiritual insights described by American banker R. Gordon Wasson in a 1957 article for Life magazine titled “Seeking the Magic Mushroom.”

In 1955, Wasson, along with his friend Allan Richardson, ventured to a village in the mountains of Mexico, so remote that none of the inhabitants spoke Spanish.

There, in a thatch-roofed, adobe-walled home — a far cry from the homelike university room in Baltimore — the two men participated in a ritual with an Indian family that involved consuming “divine” mushrooms in a “holy communion” mingling Christian and pre-Christian elements.

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Their colorful visions lasted throughout the night, appearing whether their eyes were open or closed. Wasson described the visions as beginning with art motifs and changing into beautiful palaces, mythological beasts, and other images.

He wrote that he felt that he was “poised in space, a disembodied eye, invisible, incorporeal, seeing but not seen.”

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These effects are typical of psilocybin and other psychedelics — a term coined by British-born Canadian psychiatrist Dr. Humprhy Osmond in a letter to author Aldous Huxley in 1956.

While some psilocybin research focuses on these kinds of mystical effects, one Johns Hopkins study took on a more practical therapeutic application — helping people to stop smoking for good.

This is one of several studies that belong to the university’s Psilocybin Research Project.

It is also evidence of what some researchers are tentatively calling the “psychedelic renaissance” — a rebirth of research after a long dry spell caused by government regulation and societal stigma about these drugs.

Mushrooms and smoking

Once ingested, psilocybin is converted by the liver to psilocin, which acts on serotonin receptors in the brain.

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Like other psychedelics, it is this interaction with the brain that causes the drug’s effects, which can last for hours.

But researchers say that these physiological effects don’t fully explain how psilocybin can help someone quit smoking.

“It’s not the drugs themselves that are producing all these therapeutic benefits. It’s usually the drug experience in combination with supportive psychotherapy,” study author Albert Garcia-Romeu, Ph.D., a psychologist at Johns Hopkins University, told Healthline.

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In the Johns Hopkins study, which was published 2014 in the Journal of Psychopharmacology, psilocybin sessions occurred as part of a comprehensive cognitive behavior therapy smoking cessation program, with weekly one-on-one counseling sessions.

Participants underwent three psilocybin sessions several weeks apart, which lasted six to seven hours each.

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psylocibin infographic

After six months, 80 percent of participants were still free of cigarettes. In comparison, the success rates for most smoking cessation programs that involve behavioral therapy and medications are below 35 percent.

The poor success of most smoking cessation programs shows how difficult it is to shift people’s behaviors, especially when it comes to addiction.

One problem with conventional methods may be with how they approach the problem.

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Public health campaigns often try to convince people to quit smoking by appealing to their logical side — such as by telling them how dangerous smoking is or showing them videos of blackened lungs.

If people were always logical, this might be effective.

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Albert Garcia-Romeu

“That’s not how it works,” said Garcia-Romeu. “Addiction is much more complicated than that. People are much more complicated than that.”

Something else is needed to reach people more deeply.

Garcia-Romeu compares it to a making a chocolate cake. If you have the instructions and right ingredients, you can easily bake a chocolate cake that tastes good. But that is not the same as the “immediate experience” of eating the cake.

“The psychedelic experience provides that kind of immediate type of experience — that direct experience — which is sometimes profound enough to really jar people out of their normal routines,” he said.

The psychedelic experience provides that kind of immediate type of experience [that] is sometimes profound enough to really jar people out of their normal routines.
Albert Garcia-Romeu, Johns Hopkins University

Garcia-Romeu said that there is another type of direct experience that helps people quit smoking — having a heart attack. This near-death experience may force people to look more closely at their priorities and choose what’s most important.

“Psilocybin functions similarly in the sense that it creates a very direct first-hand experience that can sometimes be very frightening,” he said, “but because of that, it is also much more powerful.”

Other recent research has found that psilocybin may bring about long-term personality changes — such as increased openness — or diminish depression and anxiety in people with advanced cancer.

Early psychedelic research

The success of these psilocybin studies show that psychedelic research is having some resurgence, but there are still many roadblocks.

In part, this is the result of how society views these drugs, something that has shifted since Wasson’s early experiments with psilocybin in the 1950s.

The profound nature of the experiences produced by psychedelics like psilocybin and LSD increased their popularity during the height of the hippie and counterculture movements of the 1960s.

It also led to intense scientific efforts to understand how these drugs worked and whether they had therapeutic benefits.

By 1961, researchers had published more than 1,000 papers on LSD, another hallucinogen. This included research by Harvard psychologists Timothy Leary, Ph.D., and Richard Alpert, Ph.D. (later known as Ram Dass), who studied both LSD and psilocybin.

This early cultural and scientific flowering was helped along by the lack of public concern over drugs at the time, something that may sound surprising given our current focus on illegal drugs.

John Caulkins

“In 1960 people were not that worried about drugs. So if you wanted to use some think-outside-the-box really creative experimentation, you weren’t really bumping up against taboos.” Jonathan Caulkins, Ph.D., a professor of operations research and public policy at Carnegie Mellon University's Heinz College, and co-author of “Marijuana Legalization: What Everyone Needs to Know,” told Healthline.

The media and cultural craze surrounding psychedelics, though, would soon come to a crashing halt, possibly because of the intense popularity of these drugs.

“There were concerns and fears about these drugs being used in a much more liberal context — such as people taking it wherever and not knowing what they’re taking, and all of these things with black market acid and counterculture use of acid,” Erika Dyck, Ph.D., a professor of history at the University of Saskatchewan, who has been studying the history of LSD for about 15 years, told Healthline.

Erika Dyck

In the early 1970s, some countries had labeled psilocybin and other psychedelics as Schedule 1 drugs — a classification for compounds that the government deems to have a high potential for abuse and no medical use.

As a result, recreational use of these drugs shifted to the black market. And research on the potential therapeutic applications of these drugs effectively shut down.

Scheduling of drugs does not automatically prohibit research on them or their use for medical purposes. Nor is it illogical for researchers to study them for possible benefits.

“There’s no problem with the idea that something can be completely banned for recreational use — and in fact subject to substantial penalties — even though it has recognized medical use,” said Caulkins.

In fact, cocaine and methamphetamine are both Schedule 2 drugs that have limited medical uses.

The rise of medical marijuana for the treatment of pain, HIV, addiction, and other health conditions also hints at progress being made in reopening illegal drugs for research.

“The federal government actually does fund research, on cannabis in particular, trying to understand its potential,” said Caulkins.

Long-term stigma

In spite of that, the stigma surrounding psychedelics remains even today. Researchers have differing opinions on why.

“In 1990, we were coming off of a decade in which many cities in America seemed to be falling apart,” said Caulkins, “with massive levels of street violence associated with crack cocaine.”

This may have had a spillover effect on how other illegal drugs — including marijuana and psychedelics — were perceived by the public, even if these drugs caused fewer deaths than the thousands of people killed each year by prescription opioids.

Garcia-Romeu said that the current political climate may mirror what was around in the 1960s, when backlash against psychedelics began — a large left-leaning counterculture against a backdrop of conservative society.

marijuana infopgraphic

Today there’s a lot of interest in these drugs from the public, he said, “but there’s obviously a huge conservative base — in politics, in particular — that sees drugs like cannabis or the hallucinogens like psilocybin or LSD as drugs of abuse.”

There are signs, though, that these attitudes are shifting, along with a growing openness about these drugs.

Dyck recently hosted an “evening of psychedelics. It was off campus, but it was a bunch of historians talking about the history of these drugs.”

The event was “packed,” with attendance by writers, social workers, nurses, students, and others.

“It was interesting because it didn’t descend into a discussion into why these [drugs] were so dangerous,” said Dyck.

lsd infographic

“I don’t think it would have happened 10 years ago,” she added, “because the reputation of [psychedelics] was still that these are incredibly dangerous, possibly addictive — even though that’s been disproven.”

Although Dyck is hesitant to speculate so soon on why attitudes are shifting, she suggests that society has grown more comfortable with having certain kinds of drugs around.

“Sixty years ago, more often than not, the norm would be to not take any kind of pharmaceutical substances,” said Dyck. “Now, people have often been exposed to pharmaceutical substances, and many people take them for the rest of their lives — in a very sanctioned way.”

Are psychedelics mainstream?

Does that mean psychedelic research has gone mainstream?

“I don’t think that we would say they’re quite mainstream at this point, but I do think that there’s a possibility that they could become mainstream in the next 10 or 20 years,” said Garcia-Romeu. “If we’re able to continue doing research carefully and we don’t have any major hiccups.”

The stigma surrounding these drugs, though, continues to hamper efforts to find funding for new research.

“Legislatures, federal agencies, major scientific grant funding agencies are still hesitant to financially support the research despite its promise so far. That’s simply because of the stigma associated with the drugs for so long,” Brad Burge, director of communications and marketing at the nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS), told Healthline.

Brad Burge

Tight federal regulation and the Schedule 1 classification also make it difficult for researchers to study these drugs, even if they have funding. Complicating matters, a drug can only be moved from Schedule 1 if enough research shows a medical benefit.

Dyck says that some even argue that “this has created a bit of a paradox, because you can’t demonstrate value [of a drug] because you can’t actually investigate the drug and therefore you can’t demonstrate that it has value.”

In spite of those challenges, some research continues to move forward.

MAPS is working with the FDA to complete phase III clinical trials of MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD).

MDMA, also known as 3,4-methylenedioxymethamphetamine, acts like both stimulants and hallucinogens. This compound is found in ecstasy and molly, although when sold on the street, these drugs may be laced with other chemicals or not contain any MDMA at all.

MAPS is using pure MDMA to reduce PTSD symptoms and keep them reduced over the long term, without the need for ongoing treatment.

In the phase III trial, people with PTSD will take pure MDMA two or three times in conjunction with 12 weeks of psychotherapy.

mdma infographic

“These are people with chronic and treatment-resistant PTSD,” said Burge. “They’ve had PTSD for a number of years. They’ve tried other treatments and they haven’t worked for them.”

Earlier smaller studies included military veterans and sexual assault victims with PTSD, with results promising enough to move forward with the phase III trials through the Food and Drug Administration (FDA).

“We found that a single 12-week course of MDMA-assisted psychotherapy, during which participants ingested MDMA on two occasions separated four weeks apart, two-thirds of participants didn’t qualify for PTSD anymore,” said Burge.

These early MDMA trials in people with PTSD included only 103 participants. However, multiple clinical trials across more than 1,200 participants did not find any sign of lasting MDMA abuse or cognitive damage.

MAPS expects to get formal approval from the FDA in February and start the study in June.

If all goes well, they expect to have approval in the coming years, said Burge, “assuming that we get results that are remotely close to the results that we saw in phase II, and assuming that we get the funding that we need to complete those trials.”

The total cost of the phase III trial will be between $25 and $30 million. So far, MAPS has raised $10 million, all from small foundations as well as thousands of individual donors. Burge thinks that raising the additional funds over the next three to four years is “reasonable.”

Compared to the billions of dollars that pharmaceutical companies spend on research and development each year, this is a small cost, especially for a drug that will have long-lasting impact.

“Unlike conventional pharmaceuticals, which are often taken every day for years or decades by people — that’s just to control their symptoms,” said Burge, “we’re developing a treatment now that may be able to dramatically reduce those symptoms over the long term after just a few treatments.”

Addressing major concerns

Even with the successes of MAPS and other groups of researchers, moving forward with research into the therapeutic benefits of psychedelics will mean addressing two major concerns — the risk of abuse and the chance that drugs will end up where they aren’t supposed to be.

These can both be alleviated by how treatment programs with psychedelic drugs are set up.

“If the proposal is ‘I want a doctor in a hospital to be able to administer a single dose of LSD in a controlled setting,’ logically the risk that this is going to increase LSD use by 17-year-old kids is near zero,” said Caulkins.

Burge said this is how MAPS envisions MDMA-assisted psychotherapy for PTSD working. The drug would be administered in a specialized clinic, with doctors, nurses, and mental health professionals on staff.

People would have the drug administered to them on site and stay overnight or longer, which would reduce the risk of someone giving — or selling — the drug to someone else.

The small number of doses given to a patient during their treatment would also reduce the risk of abuse.

“The abuse potential with pure MDMA, given a limited number of times — two or three times in a clinical context — doesn’t seem to be very concerning at all,” said Burge.

In spite of the successes of practical treatments for conditions like anxiety, depression, and addiction, the mystical effects of psychedelics have not been forgotten.

Researchers at Johns Hopkins are starting a new study to see if psilocybin can deepen the spiritual lives of religious leaders.

This type of research may complement Western science, which tends to steer clear of big questions like spirituality.

“It’s very difficult to ask these big abstract, philosophical or spiritual questions,” said Dyck, “but it may be also that there is a growing appetite for bringing scientific techniques back to ask these kinds of more humanist questions.”

Read more: Ketamine gaining traction as a treatment for depression »

Read more: Has approval of marijuana reached a tipping point? »

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