A look at how the War On Drugs impacted research involving psychoactive substances and their potential to treat mental illness.
The War on Drugs has not only proven ineffective in its promise of controlling the production, trafficking, and consumption of drugs but has, in turn, created many more serious problems throughout society. To name a few, it has contributed to mass incarceration, government corruption, widespread violence, enormous overspending, public health issues, and ultimately, countless fatalities. A somewhat lesser-known consequence is the effect it has had on research involving psychoactive substances and their potential to treat mental illness.
For many, psychedelics refer to dangerous Class A illicit substances, alongside heroin, cocaine, and meth. Fewer know that tens of thousands of patients suffering from a variety of mental health disorders were treated effectively with psychedelics prior to the War on Drugs. Lysergic acid diethylamide (LSD) was first synthesised in 1938 by Swiss chemist Albert Hofmann, who unknowingly dosed himself five years later and was amazed by its powerful psychoactive properties. Through the ‘50s and ‘60s, LSD was made available to the scientific community for psychotherapy research. Alongside other drugs including psilocybin and mescaline, they were trialled as potential treatments for disorders such as alcoholism, anxiety, and depression. Results were promising and psychedelic-assisted psychotherapy was regarded as the next big breakthrough for treating mental illness.
Just as psychedelic drugs neared closer to entering mainstream medicine, they slipped into public use and baby boomers began to experiment with LSD, magic mushrooms, and other hallucinogens. By the end of the 60s, psychedelic drugs were linked to the counterculture movement and U.S. President Richard Nixon launched the never-ending War on Drugs, as part of a broader political response against the liberation movements at the time. Most countries followed suit, with psychedelic drugs becoming outlawed and forced underground, ultimately halting scientific research.
New Zealand criminalised LSD in 1967, however prior to this New Zealand researchers were also legally investigating the potential of LSD. In 1966, The New Zealand Medical Journal published an article by Christchurch psychiatrist Dr. David Livingstone, titled ‘Some general observations on the usefulness of lysergic acid in psychiatry’. It contained research spanning two years, where consenting patients were administered LSD during closely supervised sessions at Calvary Private Hospital in Christchurch. Reports of use within Dunedin also exist, for example at Wakari Hospital.
After decades of suppression and neglect, psychedelic research is making a comeback and gathering momentum quickly. Building upon research from the ‘50s and ‘60s, these drugs are proving to be effective in situations where conventional treatments have failed. Current research in New Zealand is mainly focused on the use of LSD and ketamine. The University of Auckland is conducting one of the world’s first extended studies of LSD microdosing, where volunteers self-administer a low sub-psychedelic dose in an oral solution at home while continuing to go about their regular daily routines. Microdosing LSD may have positive effects on people’s mood and cognition but there have been a lack of scientific studies to back this theory up. It is thought that ingesting these small amounts of LSD may boost neural plasticity, i.e. the brain’s ability to change. Patients suffering from depression tend to have impaired neuroplasticity, and while traditional antidepressants are believed to increase this plasticity, it can take six to eight weeks. Psychedelics have been shown to increase plasticity within hours.
Ketamine is more well known as an anaesthetic or for its recreational use, however it has recently started to show promise as a treatment for those suffering with depression and anxiety. While not considered a psychedelic, it can induce psychedelic experiences and hallucinations. Due to this attribute, the substance is classified as a Class C illegal drug in New Zealand alongside the likes of cannabis and codeine. Despite this, researchers at the University of Otago and the University of Auckland have been studying the effects of ketamine on patients with treatment-resistant anxiety and depression. A single dose of ketamine has shown to have rapid antidepressant properties, with some patients experiencing remission by the following day. This is a particularly important finding for highly vulnerable patients, as suicide ideation could be treated quickly, instead of waiting the usual six to eight weeks it takes for traditional antidepressants to kick in.
Another illegal drug showing promise in psychiatric research is methylenedioxymethamphetamine (more easily pronounced MDMA). Going by many other recreational names, including ecstasy, molly, pingers, and gear, New Zealand law currently classifies MDMA as a Class B illicit substance. Also not technically a psychedelic substance, MDMA is psychoactive drug with hallucinogenic properties and is usually taken recreationally to produce feelings of increased energy, mood, and empathy. Although a large recreational demand for MDMA exists, MDMA-assisted therapy for post-traumatic stress disorder (PTSD) was recently given ‘breakthrough therapy designation’ from the Food and Drug Association (FDA) in the U.S., due to its potential of offering substantial advantages over traditional therapies. MDMA-assisted therapy is thought to enhance treatment for those suffering from PTSD as it decreases defensiveness and anxiety, and is thought to also improve the bond between the therapist and the patient. In addition to those with PTSD, MDMA is proving helpful for people coming to terms with their terminal illness, for example advanced stage cancer patients suffering from anxiety arising from their diagnoses. Currently, it seems there is little research involving MDMA here in New Zealand, although there have been some reports of researchers looking to start studies using MDMA for end-of-life related anxiety and depression in palliative care.
The psychedelic drugs being trialled in current research are considered quite safe in supervised settings. Nonetheless, the use of these substances can lead to serious negative experiences in certain cases. Impaired judgement and adverse psychological effects are two risks commonly associated with the use of psychoactive substances, however, clinical trials are beneficial in those respects. They are closely supervised and involve a rigorous screening process to exclude those who are at higher risk of experiencing adverse effects. For example, psychedelic use is generally not recommended for those with psychotic disorders or those who are predisposed to these disorders (i.e. family history).
If you, the reader, find any of this remotely interesting and are curious to hear more about psychoactive substances as a treatment for mental health disorders then you are in luck. In Part II, I will be diving into my own pensieve (look it up, muggle) and reviewing my own personal journey that has included both clinical trials and the DIY approach. On that note, I would like to add that I am not a medical professional and I would never want to influence anyone’s own journey, particularly when it involves powerful psychoactive substances. As always, try talking to a professional first.