Unpacking Psychedelics and Their Place in Mainstream Medicine
What Are Psychedelics?
When we hear the term psychedelics, many of us think back to stories from the 1960s when people took (or tripped) on these drugs and had mind-altering experiences. But did you know that there are several drugs that fall under this umbrella of psychedelics, each with its own promising benefits for those suffering from conditions such as PTSD and depression? We have entered a new and very promising time in the treatment of mental wellness.
According to Wikipedia, psychedelics are a subclass of hallucinogenic drugs whose primary effect is to trigger non-ordinary mental states (known as psychedelic experiences or "trips") and/or an apparent expansion of consciousness. The "classical" psychedelics, the psychedelics with the largest scientific and cultural influence, are mescaline, Lysergic acid diethylamide (LSD), psilocybin (aka magic mushrooms), and N-dimethyltryptamine (DMT). There are, however, additional substances beyond this list. The psychedelic experience is often compared to non-ordinary forms of consciousness such as those experienced in meditation, mystical experiences and near-death experiences, which also appear to be partially underpinned by altered default mode network activity. The phenomenon of ego death is often described as a key feature of the psychedelic experience.
The term psychedelic was coined by the psychiatrist Humphrey Osmond during written correspondence with author Aldous Huxley and presented to the New York Academy of Sciences by Osmond in 1957 with the intended meaning "mind manifesting," the implication being that psychedelics can reveal unused potentials of the human mind.
What Are the Different Types of Psychedelics?
MDMA
MDMA is best known as the party drug or by its street name Ecstasy or Molly. Although not one of the classical psychedelics, because of recent clinical trials of its potential to treat PTSD, I included it in this blog. According to The National Institute for Health (NIH), MDMA is a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions). It is chemically similar to both stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception.
MDMA increases the activity of three brain chemicals:
Dopamine—produces increased energy/activity and acts in the reward system to reinforce behaviors
Norepinephrine—increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems
Serotonin—affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.
Psilocybin
According to Wikipedia, psilocybin is found in over 200 species of fungi (or mushrooms). It is biologically inactive but is quickly converted by the body to psilocin, which has mind-altering effects similar, in some aspects, to those of LSD, mescaline, and DMT. In general, the effects include euphoria, visual and mental hallucinations, changes in perception, a distorted sense of time, and perceived spiritual experiences. It can also cause adverse reactions such as nausea and panic attacks. Interestingly, imagery found on prehistoric murals and rock paintings of modern-day Spain and Algeria suggests that human usage of psilocybin predates recorded history.
LSD
According to Drug Policy Alliance, lysergic acid diethylamide, commonly referred to as LSD, or “acid,” is considered the best-known and most researched psychedelic drug. LSD is active at exceptionally small doses (around 20 micrograms) and is taken orally, sometimes as droplets or more commonly on blotter paper and absorbed on the tongue and then swallowed. LSD is currently in Schedule I of the Controlled Substances Act, the most heavily criminalized category for drugs. Schedule I drugs are considered to have a “high potential for abuse” and no currently accepted medical use – though when it comes to LSD there is significant evidence to the contrary on both counts.
According to Australian Government’s site Healthdirect, the short-term effects of LSD may include:
seeing, smelling, hearing or touching things that aren’t real
more intense senses
a distorted sense of time and space
strange feelings in the body, like floating
rapidly changing or intense emotions
altered state of thinking
Mescalin/Peyote
The Oxford Treatment Center describes mescaline as a naturally occurring chemical compound that is found in a number of species of cacti, most notably the peyote cactus.The peyote plant has played a role in Native American ceremonial and medicinal rituals for as far back as 5,700 years ago. This longstanding tradition of use among indigenous peoples is why mescaline is legal for use in religious contexts in tribal nations. Like most hallucinogens, mescaline is a serotonin receptor agonist; the drug stimulates the production of the serotonin neurotransmitter, which boosts positive moods and relaxation.3Researchers suggest that mescaline excites certain neurons in the brain, leading to the well-known psychedelic effects. Mescaline is thought of as one of the milder hallucinogens; it is as much as 3,000 times less potent than LSD and about 30 times less potent than a similar naturally occurring psychedelic like psilocybin. Taking mescaline might negatively affect those who are prone to anxiety.
They share that users’ experience may include:
time passing more slowly
“seeing” sounds and “hearing” colors
feeling weightless or extremely heavy to the point of immobility
thought processes that become easily and vividly derailed
drastic and unpredictable mood swings
Ayahuasca (DMT)
Healthline describes Ayahuasca, also known as the tea, the vine, and la purga, as a brew made from the leaves of the Psychotria viridis shrub along with the stalks of the Banisteriopsis caapi vine, though other plants and ingredients can be added as well. When combined, these two plants form a powerful psychedelic brew that affects the central nervous system, leading to an altered state of consciousness that can include hallucinations, out-of-body experiences, and euphoria. This drink was used for spiritual and religious purposes by ancient Amazonian tribes and is still used as a sacred beverage by some religious communities in Brazil and North America.
According to GoodRxHealth, the effects can include:
hallucinations
intensified feelings and sensory perceptions
mixing senses where you feel colors or see sounds
distorted sense of time
increased energy
hallucinations that could include heavenly experiences or hellish visions.
How Do Psychedelics Work?
According to the National Institute on Drug Abuse, classic hallucinogens (LSD, psilocybin, peyote, DMT, and ayahuasca) are thought to produce their perception-altering effects by acting on neural circuits in the brain that uses the neurotransmitter serotonin. Specifically, some of their most prominent effects occur in the prefrontal cortex—an area involved in mood, cognition, and perception—as well as other regions important in regulating arousal and physiological responses to stress and panic.
A study published by the National Institute of Health, found that psychedelics do not lead to addiction or dependence and are not considered to be reinforcing. The serotonergic hallucinogens do not have direct effects on brain dopaminergic systems, a pharmacology that appears essential for nearly all drugs that can engender dependence.
How Do Psychedelics Affect the Brain?
WebMD states, scientists already know psychedelics typically stimulate the brain's serotonin system. And that they seem to quiet the brain's default mode network (responsible for repeating thought patterns) and stimulate the creation of new neural pathways (neural plasticity). The brain’s neuroplasticity is why researchers have found that the effects of single psychedelic treatments to last for months or years compared to traditional medication which must be taken daily.
A recent article in Nature explains this finding in greater detail. Classic psychedelic drugs, such as LSD and psilocybin, disrupt neural activity by diffusing through the brain and activating a serotonin receptor known as the 5-HT2A receptor. Once stimulated, these receptors make neurons more excitable, and their blanket activation by psychedelics causes widespread changes to neural networks. There are 5-HT2A receptors throughout the brain, but they are most abundant in the cerebral cortex, particularly in areas responsible for cognition and self-awareness. Furthermore, 5-HT2A receptors are highly expressed in the visual cortex, and on the ends of axons that cortical neurons send elsewhere in the brain, such as the thalamus, where sensory information is processed. This is consistent with psychedelics causing perceptual distortions.
What Are the Medical Benefits of Psychedelics?
MDMA
According to an article in Nature Medicine, MDMA, when combined with therapy, may produce a ‘window of tolerance,’ in which participants are able to revisit and process traumatic content without becoming overwhelmed or encumbered by hyperarousal and dissociative symptoms.
MAPS lists the potential unique psychopharmacological effects to include:
Decreased feelings of fear and defensiveness
Increased feelings of wellbeing
Increased sociability and extroversion
Increased interpersonal trust
An alert state of consciousness
The Multidisciplinary Association for Psychedelic Studies’ (MAPS) latest clinical research on MDMA has achieved an important milestone: a successful confirmatory Phase 3 trial of MDMA-assisted therapy for posttraumatic stress disorder (PTSD).
Psilocybin
According to Wikipedia, studies conducted using psilocybin in a psychotherapeutic setting reveal that psychedelic drugs may assist with treating depression, alcohol addiction, and nicotine addiction.
LSD
As reviewed in a recent NIH summary of research to date, LSD was studied from the 1950s to the 1970s to evaluate behavioral and personality changes, as well as remission of psychiatric symptoms in various disorders. However, most of the studies were not performed under contemporary standards. LSD is one of the most potent classical hallucinogens available.
According to the Australian Alcohol and Drug Foundation Research is now exploring the use of LSD in developing new ways of thinking and ‘resetting’ the brain’s habitual patterns of thought.
The renewed interest in LSD is building on studies conducted 40 years ago primarily focusing on treating:
depression
post-traumatic stress disorder
drug dependency
reducing anxiety in patients with a life-threatening disease.
Ayahuasca
According to Healthline, current research shows that Ayahuasca may protect brain cells and stimulate neural cell growth. It may also boost mood, improve mindfulness, and treat depression and addiction disorders, though more research is needed to confirm these effects.
What Is the Future of Psychedelics in Mainstream Medicine?
Research into the use of psychedelics to treat mental health started in the 1950s and continued up until 1965. Unfortunately in the United States, the culture of the Nixon Administration was reactionary and stopped funding in the 1970’s in an attempt to quash the use of psychedelics for recreational purposes.
However, as the gap between traditional medical approaches and the need for effective treatments for various psychological conditions remains, dramatic changes in attitudes around psychedelic drugs are underway. According to Matthew Johnson, Ph.D., Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine, over the last 20 years, there has been a growing renaissance of research with classic psychedelics, which are the pharmacological class of compounds that includes psilocybin and LSD. These studies have been largely funded by philanthropy, resulting in impressive clinical findings for cancer-related existential distress, major depressive disorder and substance use disorders. In 2021, a landmark NIH grant was awarded to The Johns Hopkins Center for Psychedelic and Consciousness Research for a 3-year study on the potential of psilocybin in treating tobacco addiction.
In November 2022, the Congressional Psychedelics Advancing Clinical Treatments (PACT) Caucus was created. According to The Multidisciplinary Association for the Psychedelic Studies, one of the leaders in this field, the caucus will consist of bipartisan members of Congress committed to “addressing ways to alleviate the national mental health crisis through psychedelic science and research.” PACT looks to advance research into the therapeutic use of psychedelic compounds and ensure any FDA-approved psychedelic-assisted therapies are available to those in need, in accordance with the law. the goals of this caucus are to:
Increase awareness of psychedelic-assisted therapies among members of Congress and their staffs,
Support increases in federal funding for psychedelic science, and
Examine regulatory impediments to psychedelic research.
SUMMARY
The momentum supporting research on the potential benefits of psychedelics is clear. It is no longer limited to small-scale private funding. This is an opportunity to release previously held beliefs about these substances and to instead review the science with a fresh set of eyes. Given the state of our country’s mental health, especially since the pandemic, the results of these many studies combined with political will may allow us to enter a new chapter in addressing the needs of those suffering from a range of mental conditions.
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Monique Derfuss is the founder and President of SoundWellness offering gong sound therapy, Reiki, Kundalini Yoga, and meditation. Her wellness business is based in Santa Fe, New Mexico, and has helped thousands of people over the past 6+ years move beyond only taking care of their physical bodies to taking a more holistic approach to their health by integrating support of their energetic, or subtle, bodies. Check out what others have said about her services.
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