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Psychedelics: Treatment or Terror?

By Mrudul Nagapurkar

Over the past few decades, the line between danger and treatment has been fading in medicine, particularly when it comes to psychedelics. Many substances that were previously thought to be harmful to the body are now more frequently being prescribed as therapeutics for all kinds of diseases, a noteworthy example being medical marijuana. Psychedelics, or hallucinogens, are another substance whose use has a long-disputed history in medicine. While they have their adverse effects, psychedelics can also be helpful for those with certain mental health illnesses, making them potential alternatives for medication-based treatments. 

Psychedelics have been a part of medical research for hundreds of years. In fact, there are murals in Spain and some Saharan regions of psychedelic mushrooms and people wearing those mushrooms. There is evidence of peyote, which contains a potent psychedelic, being used later, around 3700 BC. Over decades, the practice of ingesting natural psychedelics traveled around the world, showing up in journals and conversations, and eventually entered the Western world. It was a common practice in the late 1800s for scientists to try the substances they presumed to be psychedelic so they could confirm or deny their peers' observations about the experience. Over time, scientists recognized the substances as therapeutic, even recommending the drugs to patients for issues such as PTSD and depression. In 1943, Albert Hofmann created the first synthesized hallucinogenic: lysergic acid diethylamide (LSD). LSD is made from ergot, which is grown on rye grain, and is the most commonly known psychedelic. LSD became increasingly used as a therapeutic and started the everlasting controversy over the classification of such drugs, making it difficult for scientists to fully understand the therapeutic benefits of psychedelics.

It’s important to know how psychedelics work to understand why they may be a beneficial option for treating mental health disorders. Psychedelics, as a group of mind-altering drugs, change your brain chemistry and often produce hallucinations of varying levels. They increase serotonin levels in the body, producing feelings of euphoria by ligating with particular receptors in the brain — specifically 2A serotonin receptors. Such serotonin-inducing effects are why scientists believe psychedelics could be useful as therapeutics, despite backlash from the past. 

 Besides LSD, there are many other drugs that are considered psychedelic, including dimethyltryptamine (DMT), mescaline, ololiuqui, ketamine, psilocybin, and ecstasy/MDMA. DMT is found in plants from Central and South America. It’s commonly used for short-lived experiences, which is why it’s referred to as a “businessman’s trip.” Then we have mescaline, which is extracted from the peyote cactus. This substance was commonly used in ancient civilizations for otherworldly experiences and is still used by some Native American tribes for rituals. Next, there is ololiuqui, which is found in the morning glory flower’s seeds in Central/South America. It was also used during rituals in some indigenous civilizations. The main difference between this substance and mescaline is that it isn’t a controlled substance, so it’s more widely available and used. Another common type of psychedelic is psilocybin. It’s found in many wild mushrooms, popularly referred to as magic mushrooms, that grow around the world but can be highly toxic (even lethal), raising ingestion concerns. The next type of psychedelic is ketamine. It can be used as an anesthetic, though it becomes hallucinogenic in moderate amounts. Finally, there is ecstasy, or MDMA, which is less of a hallucinogenic and more of a stimulant. In high quantities, though, it can cause hallucinogenic delusions. Overall, these substances can have severe effects if taken in excess quantities, posing the question of if they should be used in medicine or not. 

There are many steps that can (and must) be taken to address the dilemma of using psychedelics as treatment. This is mainly because therapists and other medical professionals who may prescribe psychedelics for medical use have an ethical duty to reduce harm to patients. Prescribing these substances may do the opposite of that, rendering their vow to “do no harm” void. Even so, in some countries, therapists can “provide psychotherapy before and after a client has a psychedelic experience on their own.” While there are risks involved with using psychotherapy and psychedelics together, there are some benefits too. If a patient wants the treatment, prescribing it increases patient autonomy and supports their choice to maximize their benefits while reducing overall risks. Additionally, educating patients about the benefits and risks of psychedelics increases the incidence of fully informed consent, and may further help a patient understand misinformation about psychedelics. 

As for reducing societal stigma surrounding drug use, changing overly strict policies is a huge step that can be taken. Current policies contribute to the societal diminishment of mental health as psychedelics are commonly used to treat mental health disorders. Many countries have regulations (Controlled Substances Acts) that categorize (or “schedule”) substances based on their liability, safety, potential medical purposes, and possibility for abuse. Depending on a nation’s scheduling system, a higher or lower number could mean a more/less potent substance. According to Australian researchers Eleanor Andrews and Dr. Alana Roy, psychedelics should be reduced from a category 9 to a category 8 (controlled substance) drug, which would increase their availability. In other countries, this should be adapted according to their own drug scheduling system. In the U.S., this means moving psychedelics from a Schedule I classification (the most restricted of substances) to Schedule II or lower (meaning it has some medical use). Overall, if research restrictions are re-evaluated and the media is informed by the scientific elements of psychedelics rather than their stigma, the future of psychedelic-supported therapy is bright.