Psychedelics. What's the Fuss?

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Psychedelics have been used since the neolithic period in human history, with documented evidence of mescaline being used by civilizations in the Americas for the last 6,000 years. Pharmacologically, a psychedelic is a substance that produces profound alterations in perception, cognition, mood, and consciousness, primarily through stimulation of one of the many types of serotonin receptors in the brain. Most antidepressants in use today also target the serotonin receptors, so why the fuss? There are 14 distinct serotonin receptors, classified into seven major families, each with their own biological role.

There has been much anticipatory fanfare of the potential revolution in psychiatric care should psychedelics be made legal in the US for the treatment of depression and posttraumatic stress disorder. There are anecdotal medical reports of American military veterans going to Mexico or elsewhere in search of these ancient herbal remedies, though the ancients did not use them as remedies so much as vehicles to enhance human perception of the unseen in the ethereal realm, spirit walks in cultures from aboriginal Australia to Andes.

In the mid 20th Century, psychedelics entered the American mainstream culture through the social disruptions of the 1960’s with youth seeking intense sensory distortions and feelings of transcendence from the social ills of the day by way of mind-altering psychedelics. The term psychedelic (Greek etymology: clear, manifest mind) was coined by psychiatrist Humphry Osmond in a 1956 letter to Aldous Huxley, author of Brave New World. Interestingly, Huxley’s 1931 dystopian tale described Soma, an intoxicant used to control the masses; Huxley used the psychedelic fly agaric mushroom as his inspiration for Soma.

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The psychedelics most discussed in academic circles today are psilocybin, mescaline, and DMT (dimethyltryptamine). All three of these substances are classic hallucinogens. They have been used historically to induce religious and transformative experiences. The anecdotal reports from those who have accessed psychedelics outside of the US are that these substances induce a deep philosophical, religious type of experience outside of time and space, leaving the user with a decidedly positive mood and a sense of sacred otherworldliness. The experience can go from dissociative euphorigenic to frank psychosis. Huxley intuited the darker side of these hallucinogens, as they can subdue the ego in the service of the collective. Social psychologist Jonathan Haidt describes this as a chemical induction of the evolutionary hive switch, which allows us to switch between living for individual purpose and common purpose, as in nationalism or religious membership.

Psychedelics are substances on the DEA schedule I, meaning that they are highly controlled and not approved for medical use due to risk of addiction and unfavorable health outcomes, and yet there is a growing movement endorsing their use for compassionate care of victims of trauma with PTSD. As the US often looks to the European Union for comparison of health outcomes, it is noteworthy that the EU has similar restrictions on psychedelics. Recent EU trials, however, are demonstrating favorable safety profiles with middling efficacy for target symptoms.

The DEA and FDA are federal agencies whose mandates are to protect public health from predatory pharmaceutical practices which may be detrimental to population health. Despite the recent loss of confidence and trust by the public in these agencies, they do serve the public good, though periodic review is necessary.

Good science and ethical research ought to be inviolable for the public good. Yet, we have seen recent instances of monied interests getting a free pass on the science to claim the designation “medical”. By comparison, the public voted to make marijuana medical; marijuana did not become medical by virtue of medical research, but in spite of it. In fact, the overwhelming preponderance of medical literature demonstrates all the harm that marijuana is causing. Marijuana becomes medical by the will of the voters to allow the marijuana industry not to be subject to the investigational rigor of other pharmaceuticals. I fear the same may happen with psychedelics. While these substances are fascinating in their effects, they may also create false hope. We should continue with sound medical research, and we should accept the results. There was once a time when X-rays were a treatment for acne, but that did not work out well as radiation is carcinogenic.