Using Psychedelics in Medicine

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Psychedelic drugs, or hallucinogens, have been investigated for possible use in treating mental illness as far back as the 1950’s, when LSD was manufactured and distributed to researchers by Sandoz Labs. There is little doubt this class of pharmaceuticals are powerful agents, but no one has been able to discover any clear benefit and they never gained traction in the medical community. Now, with new instrumentation and techniques to find out exactly how these compounds create their effects, researchers are taking another look at psychedelics.

A report on Medline (available with free registration) discusses the pros and cons of psychedelic research and what scientists hope to find.

Psychedelics have certain advantages over other substances of abuse. While they are classified legally in the same category as heroin and methamphetamine, they are usually not thought to be addictive. Physical dependence hasn’t been documented and users typically have no trouble moderating use. Many try them only once. Psychedelics are also considered quite safe from an overdose standpoint. No fatal dose has been found for the classic drugs of this type.

Overlap in Categories

“Pure” hallucinogens, like LSD and psilocybin, share attributes with other drugs which aren’t considered psychedelics. Drugs like Ketamine, an anesthetic related structurally to ecstasy,can cause hallucinations as well. Other drugs, like methamphetamine or even alcohol, can cause delusions and have profound, negative, mental effects.

The trick then is to find something with wanted effects at a safe, non-addictive dose. As an example, Ketamine is being investigated as a treatment for addiction, as well as for treating acute depression. It has been tested with OCD (obsessive compulsive disorder) and in one study with 15 patients, a single dose showed a 50 percent response rate a week later (falling to 40 percent after two weeks). While not a cure, this shows promise as a way to treat a disease that has so far remained very resistant to pharmacotherapy. The available drugs can take months to have an effect and all come with a suite of unwanted side effects. Interestingly, the other drugs used in OCD are anti-depressants.

“True” Hallucinogens

Drugs like psilocybin (in “magic” mushrooms) have been used for millennia for their spiritual effects. Humans have been interested in the visions they produce, as well as the profound cognitive changes. This is a true hallucinogen, in that there is no other known purpose for taking the drug.

Researchers find that a single psilocybin experience can have lasting, and positive effects. According to the Medline piece,

… administration of pure psilocybin resulted in meaningful personal experiences with spiritual significance. Moreover, they reported sustained positive attitude and behavior changes consistent with evaluations by community observers. A follow-up study 2 years later found that at 14 months out, participants considered their psilocybin experience among the most spiritually significant and personally meaningful of their lives.

Pathways Forward

Researchers are intensely interested in find ways to get the positive effects of hallucinogens without the sometimes negative “trips.” A case in point is ibogaine, a South American hallucinogen that was once touted as an addiction cure. Recent studies show it is effective for both cocaine and opiate withdrawal, but it comes with a significant downside – patients are transported mentally into an altered state many find very disturbing.

The way forward is then to examine the structure of the compound and how it acts in the body. The goal is to find other, chemically related compounds which can fight drug withdrawal without causing the overwhelming hallucinations that come with taking the native plant compound.

Most of the inroads are happening outside of the United States. Because these compounds are highly restricted in the US, research is difficult – the paperwork and licensing makes it so. However, as more research is published, investigators will continue to push for more exploration of these powerful compounds.

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