Tune in: psychedelic drugs are back
http://www.thestar.com/news/canada/article/863182--tune-in-psychedelic-drugs-are-back
2010/09/18
By Antonia Zerbisias
No, you are not having an acid flashback.
For the first time since the 1960s, psychedelic drugs are again the
subject of legitimate research.
Doctors at top hospitals and universities in Canada, the U.S. and
abroad are experimenting with LSD, MDMA ("ecstasy") and psilocybin,
the hallucinogenic compound in "magic mushrooms," as treatments for,
variously, tobacco addiction, cluster headaches, obsessive-compulsive
disorder and suicidal thoughts as well as anxiety and depression in
people with end-stage cancer.
Other research is being conducted with the prescription sedative
ketamine, known on the street as "Special K."
Doctors are testing these drugs because effective treatments either
don't exist or simply don't work for some patients. "It's basically
an unmet need in medicine," says Dr. Pierre Blier, Canada Research
Chair in Psychopharmacology at the University of Ottawa.
He's been conducting pilot studies with ketamine which have so far
proven successful with the severely depressed who might otherwise be
subjected to electroconvulsive or shock treatments.
"A ketamine infusion is so much more benign than using ECT," he says,
adding that a small dose helps most patients, at least for seven to
10 days. Now he's seeking ways to prolong that effect.
At Toronto's Centre for Addiction and Mental Health, researchers are
also working with ketamine as well as looking at MDMA as a possible
treatment for post-traumatic stress disorder.
And at Harvard, researchers have studied the use of LSD for those who
suffer cluster headaches, known as "suicide headaches" for their
excruciating pain.
Meanwhile, in Torrance, Calif., a single "trip" on psilocybin has had
transformative psychic effects on the dying. "Psilocybin is a great
compound to study," says Dr. Charles Grob of the Harbor-UCLA Medical
Center, where he has worked with a dozen cancer patients. "It doesn't
carry the political and cultural baggage that LSD has.
"When you say LSD, everybody has this knee-jerk reaction to all the
wild times of the '60s."
His double-blind study, just published in the online version of
Archives of General Psychiatry, shows that mentally stable, end-stage
cancer patients had significantly improved moods after taking
psilocybin in a "pleasant environment" and in the company of researchers.
The results were so encouraging it's on to more research.
"We're establishing that we can work with psilocybin safely," Grob
says. "No one had an adverse medical event. No one had an adverse
psychiatric event and these were people who were highly anxious to
begin with."
What a long, strange trip it's been for psychedelic drugs.
These substances went from lab experiments to recreational drugs to
media-sensationalized killer poisons to illegal substances in one
Baby Boomer generation.
They escaped from the laboratory at Harvard, in the early '60s, when
Dr. Timothy Leary inspired countless youths to "Turn on, tune in,
drop out" a phrase he came up with after Marshall McLuhan suggested
he coin "something snappy" to promote the wonders of LSD.
That that's what many kids did drop acid and drop out rocking the
culture and the social order.
And so LSD and psilocybin were banned just about everywhere by the late '60s.
"That's the demonization of an entire tool kit of unknown potential,"
notes Wade Davis, a Canadian anthropologist and ethnobotanist, and an
explorer-in-residence at the National Geographic Society in
Washington, D.C. "The use of psychotropic substances to change
ordinary consciousness in the goal of spiritual understanding and
medical rescue and therapy has been something that our species has
been doing since the dawn of time."
Between the Second World War, when Dr. Albert Hoffman accidentally
got high with his invention LSD, and the late '60s, there were
thousands of studies conducted by medical and psychiatric researchers
looking into the therapeutic benefits of psychedelic drugs.
MDMA, for example, was being used in Germany as an adjunct to psychotherapy.
During the 1950s in Weyburn, Sask., Drs. Humphry Osmond and Abram
Hoffer had overwhelmingly positive outcomes using LSD to treat
schizophrenics and alcoholics. "They had remarkable results that
really ought to be looked at again because, to date, we still don't
have effective treatments for alcoholism," notes Grob.
But there were also tragedies, notably the CIA-backed '60s Project
MK-ULTRA conducted at Montreal's Allan Memorial Institute by Dr.
Donald Ewen Cameron.
This illegal and covert experiment, which subjected unsuspecting
patients to LSD and powerful shock therapy, inflicted permanent
physical and psychological damage
But, by then, hallucinogenic drugs already had a media-hyped
reputation for causing paranoia, "chromosome damage" and even
suicide. And, while it's true that some people suffered from "bad
trips," today's researchers insist most of those users were likely
emotionally troubled to begin with.
This bad rap now means U.S. researchers find it tough to secure
anything but private, and non-drug company, funding for their work.
"Things are starting to move but it's been excruciatingly difficult
because there's a long memory of the '60s," says Grob.
His work , as well as similar studies of psilocybin at New York
University and Johns Hopkins, have received most of their financial
backing from the New Mexico-based Heffter Research Institute.
According to its website, it is named after Dr. Arthur Heffter, a
turn-of-the century German pharmacologist who was the first scientist
to systematically study naturally occurring hallucinogens.
And there are plenty of them: some 120 known plants and at least one animal.
What's made psilocybin so attractive for research is that it works
very fast; other anti-depressants can take weeks to kick in. It also
has a lasting effect after just one dose.
In a crisis situation, that could be a lifesaver.
"The question becomes: What is the mechanism?" asks Dr. Stephen Ross,
clinical Director of New York University's Langone Center of
Excellence on Addiction. "Is it a psycho-spiritual mechanism or is it
in the biological realm, having to do with neurotransmitters and
parts of the brain that are activated or deactivated?
"Within medicine it might sound foofy to talk about mystical stages
of consciousness, but there are standardized psychometric scales to
rate the experience."
Ross's research on the matter has just begun but so far, he says, so good.
What all the experts emphasize is that these studies involve the
careful monitoring of patients and, as well, smaller doses than
recreational users might take. And they all occur in controlled
environments unlikely to provoke the kinds of negative reactions some
users might have suffered back in the daze.
Cautions Grob, "If somebody is going into this like, you know, like
we did 40 some odd years ago, in a college dormitory as a way to kick
back on a Saturday night and have a fun, recreational experience,
that's an entirely different phenomenon and I would say that's a
much riskier phenomenon.
"I remember in my dorm some people had difficulty."
Indeed, says Davis, some people simply can't cope with the
"non-linear experiences" caused by hallucinogens.
"People who would be reflexively against these substances would most
likely be people who either personally had a bad experience with them
or never had a personal experience and are judging them on what they
think they are, which are bad drugs," he says.
"Those who have experienced the wonder of these substances tend to
recognize that it's not the drug per se, but that the drug releases a
kind of ambivalent potential for good or evil, for positive or negative.
"People who have not taken these substances and have no experience of
them, it's like trying to explain to a blind man what it is to see."
Well, there's no evidence that hallucinogens can cure blindness.
But, based on what's emerging from studies and medical journals,
they're giving off good vibrations.
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Turn on, tune in … heal your head? LSD as therapy
A Swiss LSD trial is part of the latest research on hallucinogenic
drugs as possible tools in the battle against depression and other
mental illnesses
Catherine McLean
Winterthur, Switzerland
Sep. 16, 2010
In a psychiatrist's office in the sleepy Swiss town of Solothurn,
patients are taking part in extraordinary individual therapy sessions
that can last up to eight hours.
The patient can sit on a stool or lie on a mat while listening to
music or exchanging a few words with the psychiatrist. But for most
of the session silence rules as a long-time feared and banned drug
pushes them deep into a meditative state.
It's a long way from LSD's previous life as a drug of choice for the
1960s counterculture, a role that led governments around the world to
ban the substance. But LSD along with other hallucinogenic drugs such
as ecstasy, psilocybin, and ketamine are being reborn as possible
tools in the battle against depression and other mental illnesses.
"The ban on these substances was generally a political decision
because of the counterculture and hippies," said Peter Gasser, the
psychiatrist conducting the LSD trials. While he says many
psychiatrists are wary of the drug, he believes its use in therapy
could be "meaningful and good and effective." Reports coming out of
the research community in recent months have indicated these drugs
could be effective in treating mental illness.
An article in August in Nature Reviews Neuroscience, for example,
said psychedelic drugs create changes in the neural circuits and
potentially affect the glutamate transmitters that are involved in memory.
Conditions such as depression "are serious, debilitating,
life-shortening illnesses, and as the currently available treatments
have high failure rates, psychedelics might offer alternative
treatment strategies that could improve the well-being of patients
and the associated economic burden on patients and society," Franz
Vollenweider and Michael Kometer of the University Hospital of
Psychiatry in Zurich wrote in the article.
These medications aren't without risk, however, with potential side
effects ranging from nausea and weakness to psychotic reactions. Last
year in Germany, two patients reportedly died during a therapy
session in which psychedelic drugs were used. Indeed, experts caution
against their use in people with conditions such as schizophrenia,
borderline personality disorder and serious addiction.
Despite such concerns, the aim for many of these researchers is to
remove some of the restrictions on hallucinogenic drugs. They
envision a day when doctors would be able to prescribe them to
patients, albeit under very controlled circumstances.
"It would be nice to emerge from the dark ages, superstition and
paranoia, and have these substances available in responsible use,"
says Vancouver-based psychologist Andrew Feldmar, who plans to study
the impact of MDMA, also known as ecstasy, on post-traumatic stress disorder.
The Swiss are among the most active in probing the little-understood
world of hallucinogenic drugs. Along with the LSD trial, there is
another looking at whether MDMA aids those suffering from
treatment-resistant post-traumatic stress disorder, and other
research examining the use of ketamine for depression.
Hallucinogenic drugs have a long history in Switzerland. The alpine
country is the home of chemist Albert Hofmann, who first created LSD
in a Basel laboratory in 1938 and discovered its hallucinogenic
properties five years later.
As well, Switzerland tends to be more flexible when it comes to using
drugs for treatments. The Swiss, for example, allow heroin addicts to
receive that substance on a prescribed basis in special clinics as
part of efforts to reduce crime. Mr. Feldmar is turning to
Switzerland to provide MDMA for his study because it's the only place
where he could procure a reliably pure form of that substance. He is
currently waiting for an import permit.
While drugs such as ecstasy or LSD are illegal in Switzerland, the
authorities are willing to approve their use for trials on a
case-by-case basis.
Dr. Gasser's study started to probe the effects of LSD on patients in
2008. The use of LSD in therapy is not new. In the short period
between LSD's discovery and eventual ban in the 1960s, it was used in
many therapists' offices and included such converts as film star Cary Grant.
"This substance was intensively researched," Dr. Gasser says. "And
then there was that long interruption so we don't know much more
today." The treatment under Dr. Gasser's study consists of two
therapy sessions with either LSD or a placebo containing traces of
LSD. After the sessions, the patients stay at the clinic overnight in
case there are complications.
So far, the trial is halfway through with six patients treated. There
were no adverse reactions observed, such as bad trips, according to
Dr. Gasser. Those who took the LSD reported feeling better, although
as Dr. Gasser observes they still have serious illnesses and don't
feel 100 per cent again after therapy. The LSD proved more effective
than the placebo as patients who received the latter felt there was
little improvement in their condition.
The challenge has been finding people willing to participate in the
study. Few doctors sent patients his way to be treated with LSD.
Instead, trial volunteers contacted Dr. Gasser themselves after
hearing about the study in the media. Five more patients are
currently being prepared for the trial.
Dr. Gasser is aware the study's small size will provide more of a
hint than concrete statistical evidence. Still, he is optimistic it
is a first step in bringing LSD back from its forbidden land.
Over at the University Hospital of Psychiatry, researchers are
probing ketamine, an anesthetic that is also illegally sold on the
street as "special K." Using healthy volunteers rather than sick
patients, they are measuring the effect that drug has on the brain.
There are plans to start offering ketamine to patients with
treatment-resistant depression.
Erich Seifritz, a director at that hospital, believes ketamine is a
good drug to study as it is already well known because of its
current, regulated use as an anesthetic. He says little is known
about other hallucinogenic drugs, such as LSD, because they have been
banned for so long. Even when they were actively used, studies from
that time were not well designed, according to his colleague, Dr. Vollenweider.
As a result, Dr. Seifritz is concerned other researchers may be
pursuing their exploration of hallucinogenic drugs too quickly. He
would prefer such tests start with animals, proceed to healthy people
and later to actual patients.
"Of course we must bring progress into medicine," Dr. Seifritz said.
"But in psycholytic research, if you want to do it in a scientific
and sound way, you have to do it following the highest physical and
psychological safety standards."
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