The high road to health
New research on psychedelics shows they are helpful in treating numerous afflictions
When Eric Johnson puts a tab of LSD on his tongue or sips tea brewed with psychedelic mushrooms, the pain in his muscles is replaced by a warm, honeylike feeling and his mind finally comes to rest.
“It’s pure relief,” he said.
Johnson, 50, grew up in Reno. Now he lives alone in a small apartment in Citrus Heights, amid the suburban sprawl northeast of Sacramento. He doesn’t get out much. He can drive, but walking even modest distances is difficult because of a condition that affects his appendages most severely. His feet, like his hands, are weak and atrophied. His pinkies and big toes are useless. Gripping forks and coffee mugs can be troublesome, as can chewing and swallowing food. At times, he is too fatigued to hold his head up.
He was born with hereditary motor-sensory neuropathy, also known as Charcot-Marie-Tooth disorder, an incurable condition that damages neural tissue.
“You have to continuously say goodbye to abilities,” he said. “I’m getting better at some things, but it’s a progressive disease.”
The slow deterioration of his dexterity has resulted in a long-term grieving process, he said. Periodically throughout his adult life, Johnson has used psychedelic drugs for physical, mental and spiritual release.
A growing number of people are taking psychedelics for healing. Advocates say drugs like LSD, psilocybin, MDMA, DMT, ayahuasca and ketamine provide a kaleidoscopic array of potential applications, from treating eating disorders to helping terminal cancer patients find peace.
Most scientific research in the field is focused on the potential of psychedelic-assisted psychotherapy—more or less traditional, sit-down therapy with one or two psychiatrists, except the patient is tripping and sessions can last up to eight hours. Test results are preliminary and sample sizes are small, but the approach looks promising for treating severe depression, anxiety, PTSD and substance-abuse disorders. All of these conditions are often rooted in traumatic experiences.
Scientists still don’t know how, exactly, psychedelics help people process trauma, said Brad Burge, director of communications for the Multidisciplinary Association for Psychedelic Studies, a nonprofit organization based in Santa Cruz that is conducting clinical trials of psychotherapy assisted by MDMA.
“We do know there’s something deeper going on,” he said. “Psychedelics are not just treating symptoms. They are helping people reconfigure their emotional relationship to their trauma.”
If psychedelic-assisted psychotherapy were made legal and accessible—it’s neither—Johnson said he would be among the first to sign up for a session. As an experienced user—and someone exposed to severe childhood trauma—he believes the potential for healing and transformation is real.
“I know if I could accurately describe how brilliantly [psychedelics] make me feel, nobody would ever deny them from me,” he said.Psychedelic stars
For three days in April, more than 3,000 people attended the Psychedelic Science Conference, hosted by MAPS in downtown Oakland.
The conference was like a cross between TEDx and Burning Man: The Oakland Marriott City Center was overtaken by policymakers, advocacy groups, academics in tweed jackets, flower children, fairy-people on stilts and hippies who smelled righteously of weed and body odor. All the while, in multiple conference rooms, dozens of scientists, psychologists and other medical professionals expounded on the various health benefits of ingesting psychedelics.
It was apparent that psychedelic enthusiasts have formed a cultural subgroup complete with its own historic figures and celebrities. In one of the hotel’s elevators, a young woman, seemingly star-struck, asked a psychiatrist for an autograph. He declined.
Psychedelics are in the public eye more than ever. Earlier this year, the idea of microdosing was popularized by novelist, essayist and activist Ayelet Waldman’s top-selling memoir, A Really Good Day: How Microdosing Made a Mega Difference in My Mood, My Marriage, and My Life. Waldman, who lives with bipolar II disorder, describes taking miniscule amounts of LSD to manage her volatile moods and improve her relationships with her husband and son.
In the working world, microdosing has become a trendy practice among Silicon Valley techies and creative professionals.
“There’s a lot of research that shows psychedelics can help otherwise normal, healthy people lead more meaningful and productive lives,” said Jag Davies, a spokesman for the Drug Policy Alliance, a national organization that advocates for decriminalizing drugs and moving toward a health-based approach.
“It helps enhance creativity and problem-solving,” he said. “People are using psychedelics not to drop out of, but to engage with, mainstream society.”Into the past
Using hallucinogens to open the mind to broader vistas is an ancient practice. For thousands of years, indigenous peoples all over the world have used hallucinogenic plants, fungi and animals—like poisonous toads—in healing rituals and spiritual rites of passage.
Starting in the early 1950s, early researchers such as Timothy Leary and Humphry Osmond began looking at LSD for a variety of purposes, including treating alcoholism. (Osmond coined the term “psychedelic,” which means “mind-manifesting.”) By 1970, however, psychedelics had become synonymous with the hippie counterculture movement, prompting Richard Nixon to sign the Controlled Substances Act and put most psychedelics on Schedule I: outlawed drugs, alongside heroin and cannabis. LSD research ground to a halt. (An account of how hallucinogens became illegal in Nevada can be read in Upfront, page 8.)
The renaissance of psychedelic science started a little more than a decade ago, as researchers started focusing on psilocybin, a compound found in more than 200 types of psychedelic mushrooms. Like LSD, psilocybin is listed as a Schedule I drug, but is considered less controversial to study. Researchers must get a special license from the U.S. Drug Enforcement Agency to do so.
In 2006, Roland Griffiths, a professor of neuroscience and psychiatry at Johns Hopkins University, published a landmark article titled “Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance.” Of 36 volunteers who participated in the double-blind study, half were given a pill containing psilocybin and half were given an active placebo. More than two-thirds of the participants who took the psychedelic ranked the ensuing trips to be among the most spiritually significant experiences of their lives.
“When administered under supportive conditions, psilocybin occasioned experiences similar to spontaneously occurring mystical experiences,” Griffiths concluded.
Now there’s a whole field of research focused on peak mystical experiences. Leor Roseman is a Ph.D. student of neuroscience at the Beckley/Imperial Research Program in London. During the Psychedelic Science Conference, he presented the results of his research on fMRI brain-imaging before and after patients underwent psilocybin-assisted therapy for depression.
Roseman monitored patients who were given 10 milligram and 25 milligram doses of psilocybin during therapy sessions separated by one week. He found that strong trips and low levels of anxiety predicted positive clinical outcomes. In those cases, patients reported alleviated symptoms of depression several months after their last treatment.
How is it that just two doses can influence long-lasting changes in thought patterns and behaviors? Again, researchers aren’t sure. A working theory is that acute psychedelic experiences make changes to the brain’s functional connectivity, linking previously disconnected areas and allowing it to “become more entropic, more flexible,” Roseman said. That may allow rigid, treatment-resistant conditions to loosen and break free.
Here is where science and spirituality intersect and the mystery goes deeper. Patients often report losing their sense of self during peak mystical experiences, Roseman said. The ego dissolves, and patients’ sense of individuality is replaced by “oneness” with the universe.
By way of example, conference speaker David Lukoff—a licensed psychologist and professor at Sofia University in Palo Alto—described his first LSD trip, which he took more than 30 years ago at Ocean Beach in San Francisco. As he watched the waves roll in, hypnotized, he was overcome by a sense of connection to everything. “The ocean’s is me; I am the ocean; the waves are me,” Lukoff recalled thinking. “I experienced past, present and future as unity.”
To put it nonscientifically: The patient’s mind is blown, sense of self is shattered and it all comes back together as a stronger whole—recalibrated.
“This relates to Eastern philosophies,” Roseman said, “that losing oneself momentarily allows for a kind of stronger self.”Facing fears
Johnson took mushrooms for the first time during a Crosby, Stills & Nash concert in 1983, when he was 16 years old. It was a blast. Colors were more vivid; the air smelled sweeter; the music became transcendent. The experience led to experiments with LSD and Pink Floyd, to equally dazzling effect.
“It was just incredible, the way they made me feel,” he said. “Whenever I heard mushrooms or LSD was around, I wanted to get some because they made me feel so good.”
At the time, they provided a much-needed respite, he said.
Johnson’s childhood in Reno had been difficult. As his body grew, his musculature did not develop accordingly, and he became clumsy. He couldn’t keep up with the kids who played sports, rode bicycles and went hunting and fishing, and his physical limitations made him vulnerable to bullying—and more damaging abuse. In the summer of 1974, when he was 7 years old, Johnson was raped multiple times by a 15-year-old boy in his neighborhood, he said.
“Unfortunately, when you’re in my position, what you are is prey,” he said.
Johnson’s experiences have reverberated throughout his adulthood, manifesting later as anxiety and depression and interweaving with his chronic pain.
He describes two kinds of pain—an ache in his bones and another sensation “that feels like being crushed inward from all directions.” To manage both, he wears a patch on his shoulder that time-releases fentanyl, a strong opioid painkiller, and he takes 64 milligram doses of ketamine twice a day. Ketamine is commonly used for sedation and treating chronic pain, and it also has strong psychedelic effects that make it a sought-after recreational drug.
Johnson doesn’t find ketamine to be as beneficial—or as fun—as LSD or psylocybin, but he doesn’t seek out those drugs because they’re illegal.
“I’m afraid of the cops,” he said.
For his psychological distress, he’s tried traditional treatments. He’s seen a psychotherapist for years, and he’s been on and off various antidepressant medications, otherwise known as SSRIs (selective serotonin reuptake inhibitors). The drugs have been effective at times, he said, but they have limitations.
“Prozac, for example, can put you in a place where you’re psychologically muted,” he said. “It’s great not to experience the real lows, but it also keeps you from experiencing the super-highs. It narrows the range of psychological states you might be in.”
While patients on SSRIs often report a general emotional blunting, it’s just the opposite with psilocybin, Roseman said. In his research, a day after patients took mushrooms—in the “afterglow” period—brain scans showed a notable increase of sensitivity in the amygdala, the brain’s emotional processor, which suggested that patients were experiencing and tolerating a wider range of emotions.
As MDMA is an entirely different compound, the amygdala’s response to it is different, Burge said, but it does share an important quality with psilocybin.
“They both encourage a greater awareness on the part of the patient,” he said. “For example, one of the hallmarks of PTSD is that people try to repress the memory; the memory is something they are unable to face because it causes such fear activation. In the context of psychedelic-assisted therapy, people can talk about their difficult memories of sexual assault, military battles or natural disasters, or whatever event the trauma is based in.
“They can face their fear more directly.”
Roseman offered a quote from a patient:
“I see … my dad abusing me again—something that has flashed into my head now and again ever since it happened—but rather than pushing the image to one side and avoiding the situation, I look him in the eyes and move through the discomfort and fear. … With my demons fully revealed and presented to me, having looked my deepest fears directly in the eye, I enter a state where I feel completely elated, at peace, absolutely euphoric—the most relaxed and content I have ever been.”Push for policy
Psychedelic-assisted psychotherapy remains inaccessible to the general public, but putting it into clinical practice may not be so far out. Thanks to private donors and an enormously successful crowdfunding campaign, MAPS is entering the final phase of a roughly $25 million plan to make MDMA a federally approved prescription medicine by 2021.
In June, the U.S. Food and Drug Administration is expected to approve the protocol for MAPS’ last series of clinical trials, which will involve more than 200 patients at 12 sites around North America. Interestingly, the FDA does not require the researchers to determine how psychedelics actually work before giving them the OK, Burge said.
“For approval, the FDA doesn’t need to know anything about mechanism of action,” he said. “They only need to know that a treatment works and that it’s relatively safe, that the ratio of benefit-to-risk is sufficient.”
Davies, the spokesman for the Drug Policy Alliance, said the future of psychedelic therapy depends on public opinion and political will. Though attitudes are shifting, polls show the public currently favors legal access to hallucinogens only slightly more than methamphetamine.
“There are these myths, these vestiges of the drug war, that if you take a hit of acid, you’re going to go crazy,” he said. “The evidence does not bear that out.”
Davies pointed to a meta-analysis conducted by the Norwegian University of Science. After combing data on more than 130,000 Americans who participated in the 2001-2004 National Survey on Drug Use and Health, the study’s authors concluded that lifetime use of LSD, mushrooms, mescaline or peyote was not associated with an increased risk of developing mental health problems. Other big data studies have found just the opposite.
This is not a consensus. The National Institutes on Drug Abuse, for instance, says that “little is known about the long-terms effects of hallucinogens” and warns of rare cases of drug-induced psychosis and flashbacks.
Even if the treatment is approved, Davies said, it will remain inaccessible to most people.
“With the way everything is going with health care,” he said, “it’s unlikely that health insurance is going to cover psychedelic-assisted psychotherapy.”
Burge agreed that the health care landscape could be much different in four or five years, but said MAPS is already considering strategies for getting insurance companies to cover the treatment. One point in their favor is that, in the long run, psychedelics would be less expensive than antidepressants.
“With MDMA-assisted psychotherapy, you’re looking at just a couple of sessions, and then you don’t need the treatment anymore,” he said. “So, insurance companies might prefer to pay for that rather than pay for ongoing [SSRI] treatment.”Learning from the trip
Psychedelic therapy is not a miraculous cure-all, Burge emphasized. If patients have a seemingly life-changing epiphany during a session, it’s still up to them to put it into practice.
“Oftentimes, the participants in the studies say the therapy itself did immediately help reduce symptoms, but a lot of the work came after that,” he said. “Which is to say, the drug is not doing the work for people. Rather, it’s providing a window for people to make changes.”
Johnson knows healing isn’t found only in a substance. Lately, he’s been trying to retain dexterity by practicing yoga, and he’s tapered off his regimen of antidepressants. At the encouragement of his psychotherapist, he recently went to a meeting of the Psychedelic Club of Sacramento. It was his first social outing in some time.
Reflecting on his experiences in the psychedelic state, Johnson said they provided different perspectives on his condition, his trauma and the traditional life markers he felt he was missing out on—getting married, having children, buying a house and pursuing a career.
“Everything opens up and flows out,” he said. “You make connections and see things in a way that you might not otherwise. You have experiences that change your outlook in a positive way.”
He doesn’t know when he’ll take his next psychedelic trip, but he knows what to expect when the occasion arises, he said: “When pain is replaced by a sweet, candylike feeling in your muscles and you get that relief—that absolute relief—you want more of that.”