Psychedelic Health Care: The Hope and Perils

Several recreational drugs that are known for providing the user with a mind-altering trip are now being studied for the treatment of depression, substance misuse, as well as other disorders. Here are the important details.

Oregon is in the process of making mushrooms legal. Ketamine can now be brought right to your home. And people are taking microdoses of LSD to treat anxiety related to the pandemic as Wall Street feeds billions of dollars into the companies selling these mind-altering substances. It looks like psychedelics, although mainly still illegal, are everywhere.

And although the Federal Government does not recognize the medical benefits of these drugs and still maintains that they have the potential for abuse, some very prominent universities have begun to research four of these substances: LSD, ketamine, psilocybin, and MDMA. Most of this research points to the fact that there is hope in the use of these substances as part of a larger treatment plan.

Evidence also continues to grow that psychedelic substances work differently in the brain compared to addictive drugs, and some advocates have also been calling for the legalization of these substances. However, psychedelics are still expensive and pretty hard to get through legal means, unless you are part of a research study using these substances for mental health purposes.

These drugs are quite different from each other and they all have their own risks. However, one thing they have in common is the ability to create a warped state of consciousness, that is widely referred to as a “trip”. This effect can provide the user with a whole new perspective, which can be very terrifying in some cases. 

Katherine Neill Harris, who is a drug policy researcher from the Rice University in Texas says that although you are unlikely to overdose on these substances, you can still have some pretty life-changing bad experiences. 

To prevent these experiences from happening, as they enjoy the benefits that these drugs provide, people have begun to microdose small portions at regular intervals, although this is widely done without any guidance from professionals, and some people stay uninformed about the very real risks that come with this along with only a little evidence of advantages.

Here are the details of what researchers are learning about these psychedelic drugs that are mainly involved in the research of mental health. 

Psilocybin

As the main active compound in magic mushrooms, psilocybin is the most studied out of all the psychedelic substances found in fungi or plants, and, likely, it will soon be accepted for use in mental health therapy. After the recent legalization in Oregon, entrepreneurs started to invest a lot in the research of psilocybin, with other states also doing so.

Possible mental health uses: Studies in the last couple of years have shown that psilocybin, which is usually taken in pill form, can be potentially used in the treatment of depression and substance abuse, including nicotine addiction and alcoholism. 

Although those studies are yet to be concluded, says Paul Hutson, who is a professor at the University of Wisconsin-Madison who has been performing research into psilocybin and also leads the center for psychedelics research in the school. However, he believes that there will soon be enough evidence to make the Food and Drug Administration approved the use of psilocybin pills for treating some of these disorders, at least in the next five years. 

Right now though, clinical trials of psilocybin for several different conditions are taking place in many parts of the country, although they can be pretty difficult to find. Still, it is safer, says Dr. Hutson, to try the psilocybin as part of a study instead of on your own or in a treatment clinic, of which many have recently popped up. In these studies, the patients go for appointments to prep for their psychedelic trip in a place where any potential side effects can efficiently be managed.

What it does: The people who have participated in these studies say that the mushroom trip might bring euphoria as well as an increase in awareness of their surroundings. An example is how solid objects seem to change form. A trip could last about six hours or more, and some people even say they feel an “afterglow” effect on them for months.

Risks: Psilocybin can cause some pretty terrifying hallucinations, anxiety, or panic, especially when taken in larger doses. You can not get a guarantee of safety unless you have a trained professional that can reassure you, protect you, and help you through a bad trip. 

One of the uses of psilocybin that you should not confuse with the standard treatment referred to above is microdosing. This is essentially taking tiny doses, about ten percent of a standard dose, every few days. Some people can get mental health benefits through microdosing without getting high. However, microdosing psilocybin can be pretty harmful and there is evidence that proves it can cause damage to the heart when done over a period. Recent studies have also pointed to the fact that the benefits of microdosing in humans may be primarily produced by the placebo effect. 

Ketamine

The first synthesis of Ketamine was in 1956, and this drug is sometimes referred to as Special K. It is now widely used as an anesthetic today by veterinarians as well as in emergencies or for combat medicine. It is also the only psychedelic that has never been illegal, so researchers have had the opportunity to fully explore the potential of ketamine as a mental health treatment while building the case for its use in humans.

Potential mental health uses: Several brain disorders like depression, schizophrenia, and anxiety are defined by atrophy in the prefrontal cortex. Strong evidence, yet inconclusive, has shown that ketamine can help people who have psychiatric disorders through the promotion of regrowth over time in the neurons in that area. That could also help to explain the sudden feelings of relief that the users report, and that is one of the reasons why it is used to treat suicidal patients.

Esketamine, which is a type of ketamine, has also shown its potential for treating major depression faster than other psychedelics, and even the FDA had to approve its limited use in 2019.

What it does: Ketamine can induce euphoria and detach the user from reality. A user who takes a low dose might feel like their body is numb or they are floating. Higher doses can make people forgetful or clumsy, and some people also experience hallucinations or blurred vision.

Ketamine does not work like most other psychedelics. Most others like MDMA, LSD and the ones gotten from plants work by affecting the serotonin receptors, and these alter the happiness and mood of the user. Ketamine works on a different kind of brain receptors, those that are used for memory and learning. Both of these classes of receptors are found in the prefrontal cortex of the brain, and this could explain why ketamine and other psychedelics seem like they have the same impacts on mental health. 

David Olson, who is a chemistry professor at the University of California who studies the way chemicals can affect brain function, says the prefrontal cortex is a critical region of the brain. He said it speaks to a whole other group of brain regions that regulate emotion, reward, fear, and mood.

Risks: Ketamine is also known for its scary side effect that is referred to as the “k-hole”. It is pretty rare in clinical settings, although users often feel disassociated from their bodies and surroundings, and it usually brings paranoia and panic.

LSD

LSD, which is popularly called acid, has a historic place in American pop culture. 

Potential mental health uses: LSD has shown its potential for use in treating alcohol addiction and it has been studied for use in other conditions like depression. Just like with psilocybin, some new LSD users microdose it to get the mental health benefits without tripping.

What it does: LSD users have also reported feeling blissful during their trip, as they can see sound and also have pretty mysterious experiences. They also tend to feel much closer to the people around them and their environment.

Risks: Some people end up going through long-lasting psychological trauma as a result of a bad trip, especially after using LSD often or taking large doses.

Microdosing LSD might also have some physical risks. In some research on rats, microdosing LSD had effects that were the opposite of a trip, as it made the rats display symptoms of psychiatric illness, like bad grooming and aggression. Just like microdosing psilocybin, LSD might also stress the heart by causing the neurons around it to overwork.

Doctor Olson says that if you continue to stimulate these neurons, even with just small doses of the compounds, the neurons will just not be able to take it. 

MDMA

MDMA is a drug known for its place in the clubs, where it is commonly referred to as molly or ecstasy. The research on MDMA over the last few decades has gone on and off, as scientists have searched for the potential mental health benefits of the drug. Although the drug is still illegal, the F.D.A. permits its use for research purposes as well as for the treatment of life-threatening illnesses.

Potential mental health uses: In 2010, the results of a study on treatment-resistant PTSD brought newfound interest in the MDMA research. Since then, MDMA has been explored as a potential treatment for several other conditions like substance abuse as well as social anxiety in autistic adults, although it has more of a potential to cause harm to the user than several other psychedelic substances.

What it does: MDMA, as it is often regarded by its street name ecstasy, provides its user with that exact feeling, promoting euphoria and connectedness.

Risks: MDMA has the potential to cause long-lasting organ and kidney damage as well as heart arrhythmias on a trip, especially for patients who had pre-existing health issues.

Psychedelic drugs are pretty complex substances. Although more research and time will continue to yield answers about their effects on the brain and whether they can be used for the treatment of medical conditions. For now, though, Dr. Hutson has cautioned that the evidence only supports treatment with psychedelics where other types of treatments do not work. He says psychedelics are not a cure that everybody will respond well to.