banner by Meghan Carlton

Trip to Treatment

by Liam McFadden

Ecstasy, acid, magic mushrooms — these are the street names of three potent, and currently illegal, psychoactive substances. For those that recognize them, these monikers might conjure mental images of 60s counter-culture of hippies “making love, not war” and ravers thrashing to happy hardcore. Yet for most, this imagery is met with misgivings. After all, these are drugs, and come hand in hand with a few other unsavory D’s: dark, dangerous and perhaps the most threatening, the DEA.

The United States Drug Enforcement Agency (DEA) leads federal efforts in domestic drug law enforcement. This Department of Justice agency identifies and classifies potentially dangerous and addictive drugs according to illegality through a process called scheduling. Hoping to combat his “all-out global war on the drug menace,” President Richard Nixon signed the DEA’s existance into law in a 1973 Executive Order — and so it came that the gentle drugs of once-hippies evolved into the forbidden fruits they are in today’s public eye.

Chemically, however, their long-mysterious active compounds — MDMA, LSD and psilocybin, respectively — have come under the microscope once again. Such revived publicity represents a fresh outlook that has reemerged for the first time since Nixon’s massively unsuccessful “War on Drugs.” Counteracting Nixon-era taboos, this renewed scientific exploration paints another picture of these compounds: with the help of MDMA, war-torn veterans are able to revisit traumas to cure irrational stress, LSD induces a hyper-connective entropic brain state which could shed light on the emergence of ordered consciousness and psilocybin combats crippling treatment-resistant depression. There are no dark drug forests here, no broken laws nor jailed perpetrators; there is only the potential to revolutionize the pharmaceutical industry and dramatically improve lives.

Three researchers are boldly going where no scientist has gone before, leading the march of progress into the regulatory abyss. At the Multidisciplinary Association for Psychedelic Studies (MAPS), Dr. Rick Doblin is heading clinical trials to treat post-traumatic stress disorder (PTSD) using MDMA and psychotherapy. At the same time, former chairman Dr. David Nutt at the UK’s Advisory Council on the Misuse of Drugs (ACMD) is using crowdfunding to support research into the unprecedented effect of LSD on neural connectivity. Nutt has also demonstrated that psilocybin can help alleviate symptoms of severe depression with no long-term adverse effects and sustained efficacy.

The first drug of our discussion: lysergic acid diethylamide (LSD), or “acid,” is perhaps the most widely researched psychedelic. First synthesized in 1938 by chemist Albert Hofmann, LSD’s hallucinogenic effects were not discovered until he accidentally consumed the substance seven years later. Once its potential was realized, LSD was popularized in psychiatric research throughout the 40s, 50s and 60s. Following widespread experimentation LSD was found to dramatically alter human consciousness at microgram-level doses, conjuring colorful fractal-like visual hallucinations, an eclectic mental state and a dissolution of ego, our sense of self. During early research uncovering LSD’s therapeutic utility, some psychiatrists began using it to treat alcoholism and depression. Yet as with every psychotropic drug, its potency and effects soon broke free of scientific circles and sparked the psychedelic era that made LSD infamous. It's golden age was short lived: acid was illegalized in California in 1966, and then federally banned in 1968. Soon after, the Comprehensive Drug Abuse Prevention and Control Act of 1970 placed LSD in Schedule I along with most known hallucinogens, effectively ending potential for any productive research.

That is, until 2014 when the first government-approved experimental study since the late 1980s explored the effects of LSD on dying patients in therapeutic contexts. This first credible experiment showed that the administration of the drug reduced patient anxiety. Then in 2016, Nutt published a study utilizing functional magnetic resonance imaging (fMRI) to peer into the brains of 15 volunteers under the influence of LSD. Under the effects of acid, the visual cortex explodes with self-organized patterns, which may result in the geometric visual hallucinations characteristic of the drug. Furthermore, LSD dissolves neural connections to the default mode network of interacting brain regions, an area associated with a sense of self, which is activated when remembering the past or planning the future. Nutt hypothesizes that this disconnection results in the loss of self or “ego,” accompanied by dissolution of boundaries and a sense of “oneness.”

As growing evidence supports the therapeutic potential of LSD, neuroscientific studies such as Gasser’s and Nutt’s are crucial to understand how these drugs function in the brain. Nutt hopefully concludes, “In many psychiatric disorders, the brain may be viewed as having become entrenched in pathology… Consistent with their ‘entropic’ effect on cortical activity, psychedelics may work to break down such disorders by dismantling the patterns of activity on which they rest.”

The second promising chemical, psilocybin, is a psychedelic compound derived from a variety of mushroom species. It causes effects similar to LSD such as vivid and colorful hallucinations, ego loss and deeply introspective mental states. “Magic mushrooms”  have been used for thousands of years in religious rituals wherever they grow. For instance, the Aztecs were known for consuming psilocybin-containing mushrooms in their holiest religious ceremonies to induce what they called “the flowery dream.” Following Cortés’ defeat of the Aztecs in 1521, the Europeans drove the use of teonanácatl (“wondrous mushroom”) underground by forbidding non-alcoholic intoxicants, a pattern which strangely parallels modern prohibitionism. On the other hand, another New World drug, tobacco, returned with the explorers and proved to be more acceptable (or perhaps simply more addictive) to the Europeans. Magic mushrooms were unfortunately not addictive enough to gain a religious pass early on, but nonetheless came into recreational use along with LSD as part of the psychedelic movement centuries later. After being similarly subjected to psychiatric and psychological research, psilocybin was summarily banned with the Controlled Substances Act that also banned LSD. Unable to contend with strict government regulation, psilocybin research also ground to a standstill during the 80s and 90s.

Recently, Nutt has also piloted a safety study for psilocybin’s treatment of severe depression. Throughout his trials, all 12 patients treated experienced an improvement in their depressive symptoms, with five displaying complete remission after three months. This is remarkable compared to a remission rate of around 20 percent for selective serotonin reuptake inhibitors (SSRIs), the current standard for depression treatment. Even more promising, psilocybin induces anti-depressive effects with only a single dose, in contrast to the daily dosage and accompanying prolonged side effects accompanying most SSRIs. While further studies are needed to uncover the drug’s therapeutic effects, Nutt’s initial experiment demonstrates the incredible potential psychiatric efficacy of psilocybin and similar psychedelics.

The third and final drug in our veritable pharmacopeia of wonders is 3,4-methylenedioxymethamphetamine, or MDMA. Although the compound was first synthesized by Anton Köllisch at Merck Pharmaceuticals in 1912, its psychotropic effects were not realized until 1976 when the pharmacologist Dr. Alexander Shulgin introduced it to psychologists. MDMA acts as both a dopaminergic stimulant, like Adderall’s active compound amphetamine, and as a serotonergic mood-uplifting ‘entactogen.’ MDMA elicits extreme feelings of love and connectedness, along with intense focus and urge to move — or dance. The intimate feelings inspired by MDMA were desirable in both party and psychiatric settings, and the drug was soon adopted into therapeutic and recreational use by the 1980s. However just like LSD and psilocybin before it, following its short freedom MDMA was temporarily banned as a Schedule I drug in 1985, and then permanently in 1988.

Thankfully another passionate researcher, Dr. Rick Doblin and his organization, MAPS, have revitalized research into MDMA. This year, MAPS has undertaken its third phase of clinical trials for MDMA-assisted psychotherapy to treat PTSD. Through his research, Doblin has already demonstrated a tremendous 83 percent recovery rate only two months into the therapy. Like psilocybin, the therapeutic effects of MDMA persist long after two dosage sessions: benefits persisted of on average 3.8 years after the initial treatment. This all comes with no detectable negative effects on cognitive function, although serotonergic cell neurotoxicity is a concern with long-term repeated MDMA consumption. The degree of this toxicity is the subject of considerable scientific debate.

Mr. C.J. Hardin, a veteran who suffered from severe treatment-resistant PTSD, gave this touching testimony after the therapy: “I just felt hopeless and in the dark. But the MDMA sessions showed me a light I could move toward. Now I’m out of the darkness and the world is all around me.” Since the trial, Hardin has remarried and returned to school after years suffering from alcoholism and depression.

To conclude this whirlwind tour: powerful mind-altering drugs can be scary, to say the least. As humans, we are accustomed to unadulterated day-to-day consciousness, and thus perceive perturbations to this normality as dangerous. Because of this ingrained fear of deviance, society has historically painted psychotropics as unarguably bad, as evils that must be banned for the better of all from those who want or need them. Luckily, our inherent human drive to learn and instinct to explore always overcomes this anxiety. Our generation stands at the precipice of a new age of exploration, not of Earth or space but into our own minds. It is by boldly pushing this inward frontier through science and passion that we stand to heal the world, others and ourselves.