Australia should be initiating a psychedelic research program: What are the barriers?

Summary

A renaissance in psychedelic drug research is underway in North America and Europe, overturning a 30-year embargo driven by political reactions to the 1960s counterculture. Randomized controlled trials at Johns Hopkins using an active placebo found that psilocybin can occasion spiritual experiences leading to long-term positive personality changes. Multiple trials show that one or two doses of psychedelic medicines within a psychotherapeutic program reduce anxiety and depressive symptoms in advanced-stage cancer patients, sustained for 6 months.

Study at a glance

Abstract

Australian & New Zealand Journal of Psychiatry, 50(11) A recent review in Pharmacological Reviews highlights that over the last decade, a renaissance has occurred in psychedelic drug research in North America and Europe as investigators at Johns Hopkins School of Medicine, University of California, Los Angeles (UCLA), New York University and Imperial College London have embarked on studies that could be paradigm-changing for psychiatry (Nichols, 2016). These developments overturn a 30-year embargo on psychedelic research that followed political reactions to the 1960s counter-culture movement in the United States and elsewhere, as disgraced Harvard Professor Timothy Leary told the world to take psychedelics to ‘turn on, tune in and drop out’. Promising research was halted, not for lack of theoretical interest and clinical applications but due to political pressure (Nutt et al., 2013). Serotonin was discovered in the course of understanding the mechanism of action of lysergic acid diethylamide (LSD), while clinical research by psychiatrists showed the drug’s promise for treatment of depression, anxiety, psychosomatic disorders, autism, alcohol dependence, existential angst among the dying and in reducing criminal recidivism (Grinspoon and Bakalar, 1979). The neologism ‘psychedelic’ was coined by psychiatrist Humphry Osmond in correspondence with Aldous Huxley. From its Greek roots, psychedelic means ‘mind-manifesting’, describing the profound, unique effects on human conscious experience elicited by these drugs. Naturally occurring psychedelics have been ingested safely by humans from premodern times for diverse medicinal, social and spiritual purposes (Nichols, 2016), some of which—notably ayahuasca in South America, peyote in North America and ibogaine in West Africa—have survived within their traditional contexts into contemporary times. LSD, undoubtedly the most widely recognized psychedelic compound, was discovered by Albert Hofmann when he resurrected his research into the effects of ergot derivatives on uterine contractions and accidentally ingested a small dose. This soon led to his self-experimentation with the drug, experiences he described as extraordinary (Hofmann and Ott, 2013). In 1947, the first research paper was published on LSD in the Swiss Archives of Neurology and Psychiatry. Hofmann remained interested in psychedelic research until his death; interviewed shortly before his 100th birthday in 2006, he called LSD ‘medicine for the soul’ and expressed his deep frustration at its prohibition, even demonization, worldwide (Hofmann and Ott, 2013). The current renaissance in psychedelic research in North America and Europe demonstrates that science can come before politics. The methodological flaws oft-cited in critiques of the first wave of clinical research largely have been overcome (Nichols, 2016). Randomized controlled trials (RCTs) at Johns Hopkins, in which an active placebo (methylphenidate) was utilized in efforts to address issues of double blinding, found that psilocybin can occasion spiritual and transcendental experiences that elicit longterm positive changes in personality. Multiple open-label and RCTs are now complete, with more in progress, that aim to study the capacity of psychedelic medicines such as psilocybin and LSD to reduce anxiety in patients suffering from advanced-stage cancer (Nichols, 2016). The results thus far have shown that the use of a psychedelic medicine on just one or two occasions within the context of a psychotherapeutic program of preparation and integration leads to a reduction in anxiety and depressive symptoms, sustained 6 months post-intervention. Research over many years has also indicated that psychedelics can be effective adjuncts in treating substance use disorders. Recently, an open-label trial of psilocybin-assisted psychotherapy for the treatment of tobacco addiction showed much higher rates of abstinence at 6 months follow-up Australia should be initiating a psychedelic research program: What are the barriers?

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