Exploring the Potential Health Benefits of Psychedelic Drugs
Once taboo, psychedelics are being rethought as possible remedies for PTSD, depression and addiction.
NICHOLAS SAND WAS 75 when he died in his sleep in his Lagunitas home after a heart attack. These details don’t seem very notable — a heart attack at that age isn’t unusual, and the circumstances surrounding his death weren’t suspicious — yet his obituary ran in the Los Angeles Times, The New York Times and countless other publications the world over.
Born in Brooklyn in 1941, Sand was 23 when his life took a pivotal turn. A voice spoke to him, one that didn’t come from the heavens. In the 2015 documentary The Sunshine Makers, he talked about that experience — his first with the drug LSD, back when it was still legal. As he sat naked in front of a fire, the voice permeated his body and presented him with a mission: “Your job on this planet is to make psychedelics and turn on the world.”
Sand rose to the challenge with zeal. The numbers are often contested, but it’s safe to say he produced upwards of 250 million hits of Orange Sunshine — Timothy Leary’s LSD of choice — often while on the lam, earning him the epithet “clandestine chemist.” The day before his death, he spoke at the Psychedelic Science 2017 conference in Oakland; his last words to the audience were a question he believed LSD could provide answers to: “Who are you, who are we, what are we doing here, are we here to make war or are we here to make love?”
Sand was hardly alone in his thinking. The Bay Area is historically ground zero for the psychedelic movement. From the Summer of Love on, the image of tie-dye-clad kids turning on, tuning in and dropping out is a legendary part of San Francisco history. But the face of psychedelics is no longer a long-haired hippie on Haight Street. Silicon Valley’s Supreme Being Steve Jobs extolled the virtues of LSD and said it helped his creativity. He also praised marijuana. Author Michael Pollan has picked up from there in his recent book How to Change Your Mind, arguing that psilocybin “magic mushrooms” and LSD don’t make people crazy, but instead can actually make them more sane. Government entities are taking note: Oakland recently became the second U.S. city to decriminalize use of psychedelic mushrooms, as well as of psychoactive plants. And a Santa Cruz–based organization is pursuing the possibilities for therapeutic and even legal use of MDMA. Yes, Ecstasy, aka Molly, the drug embraced by glassy-eyed festival-goers, may soon appear in a psychotherapist’s office near you.
DISCOVERING POTENTIAL BENEFITS
Originally synthesized in 1912 by the pharmaceutical company Merck, MDMA was not known to have psychoactive properties until more than half a century later, when Berkeley chemist Alexander Shulgin developed a new method of synthesizing it and then tested the drug on himself. MDMA, short for 3,4 methylenedioxymethamphetamine, is derived from safrole oil, a compound found in sassafras. Ingested orally, usually in powder, pill or crystal form, it has effects similar to those of stimulants and psychedelics but marked by feelings of euphoria, warmth and at-oneness with other people and surroundings. It’s also become famous for an ability to reduce fear and promote a sense of empathy. After his discovery in 1976, Shulgin gave MDMA to a handful of psychotherapists, and it soon found its way into practices throughout the Bay Area. The joyride came to an end in 1985 when the federal government classified MDMA as a Schedule I drug, right alongside other substances considered the most dangerous, like heroin. As a result, use and distribution went underground, and the “party drug” became a fixture at clubs and music festivals around the world. Meanwhile, scientists kept researching therapeutic benefits.
One of the strongest advocates for such research is Santa Cruz–based Multidisciplinary Association for Psychedelic Studies (MAPS). Started in 1986 by Harvard-educated public policy doctorate Rick Doblin, MAPS helps scientists get regulatory approval and funding for studies about the effectiveness of many controlled substances, including MDMA, psilocybin and LSD. Performed in collaboration with government entities around the world, the work adheres to clinical drug research guidelines. The biggest study now underway is a Phase 3 (the final required step required to prove safety and efficacy before approval for prescription use) human clinical trial of MDMA-assisted psychotherapy for treating post-traumatic stress disorder (PTSD).
MAPS has been researching MDMA since 1992. In 2015 a team of therapists led by San Anselmo–based psychiatrist Philip Wolfson began a yearlong 18-person study in his center overlooking Mount Tamalpais, combining MDMA with talk therapy to investigate whether the drug could reduce anxiety for people with life-threatening disease. This study was competed in July 2018, results are yet to be published. After this, MAPS shifted focus to PTSD. “PTSD is an epidemic; it is a life-threatening condition,” says Brad Burge, MAPS’ director of strategic communications.
That point is reinforced in a TED talk Doblin gave about the future of psychedelic-assisted psychotherapy in July 2019. “According to the Veterans Administration, there’s over a million veterans now disabled with PTSD. And at least 20 veterans a day are committing suicide, many of them from PTSD,” he noted. He described an instance when experimental psychedelic drug treatment helped one veteran overcome PTSD symptoms and opiate addiction. Psychedelic psychotherapy “is an attempt to go after the root causes of the problems,” he emphasized, “with just relatively few administrations, as contrasted to most of the psychiatric drugs used today that are mostly just reducing symptoms and are meant to be taken on a daily basis.”
In 2017 he gained important recognition when the U.S. Food and Drug Administration granted MDMA “breakthrough therapy” status for PTSD, paving the way for further study of the drug’s disease-treatment potential and affirming there’s clinical evidence it might improve existing therapies. The designation also indicates the FDA will continue to work closely with MAPS on developing Phase 3 research and will help make that program as efficient as possible.
“The Phase 3 trials are going on in two places in San Francisco — UCSF and a private practice in the Castro,” Burge says. When that work is completed, MAPS will submit the findings to the FDA, which if approved will then require additional studies with adolescent subjects who have PTSD. Burge is optimistic that MDMA-assisted psychotherapy for PTSD will be approved by the end of 2021.
How, and where, are the research drugs obtained? “MDMA for the studies is made in a lab in the United Kingdom — once you have an FDA license and approval from the DEA, any (medical testing organization) can consult a lab to have it made and shipped legally,” Burge says. MAPS had two kilograms of the substance produced for the trials; “lots more will be needed for future treatment after approval.” Post-approval, sourcing, public health care plans and insurance details would also need to be worked out.
MAPS’ ultimate goal is to establish a network of clinics where psychedelic treatment can be administered alongside other therapies under the guidance of trained and licensed therapists. “These clinics can also evolve into centers where people can come for psychedelic psychotherapy for personal growth, couples therapy or spiritual, mystical experiences,” Doblin says.
CHANGING LAWSBeyond the labs, the legal landscape is shifting. Last May, a ballot measure approved in Denver decriminalized possession of psilocybin mushrooms; the following month, Oakland’s city council ruled similarly for both mushrooms and psychoactive plants, directing law enforcement and government spending away from investigation or prosecution of cultivation, noncommercial distribution, use or possession. The prospect of therapeutic value was what guided the Oakland decision: The FDA has declared psilocybin a breakthrough therapy for treatment-resistant depression, and “for millennia, cultures have respected entheogenic plants and fungi for providing healing, knowledge, creativity and spiritual connection,” states a report by the resolution’s sponsor, council member Noel Gallo. “This initiative aims to empower the Oakland community by restoring their relationship to nature.” Similar decriminalization efforts are underway in Oregon and Iowa.
Meanwhile, ingestion of psychedelic mushrooms and drugs made from psychoactive plants remains illegal under federal and state law. Concerns persist that legalization would encourage more experimentation with potentially harmful substances, and there’s certainly no shortage of horror stories: last Fourth of July in Bodega Bay, a 32-year-old software engineer took four doses of LSD, became delusional and started punching, choking and stabbing his friends before speeding off in a stolen car. Police shot him in pursuit, and while he survived his injuries, he now faces criminal charges that include attempted murder and carjacking.
It’s undeniable that every year millions of people take unknown psychoactive drugs, often for the first time, which, depending on setting and dosage, can lead to overwhelming, uncomfortable and dangerous experiences. To help address and prevent those hazards, in 2012 MAPS started an outreach effort called the Zendo Project. Trained volunteers, working in collaboration with event promoters, law enforcement and medical staff, attend large festivals (such as Burning Man in Nevada) and assist people undergoing a difficult drug-related episode. The idea is to promote a supportive environment for people in those situations, reduce drug-related psychiatric hospitalizations and arrests, and raise awareness about the possibility of safer, responsible substance use.
TIMELINE OF WHEN DRUGS WERE FIRST SYNTHESIZED, MADE ILLEGAL, AND LATER DESIGNATED AS BREAKTHROUGHS BY GOVERNMENT
NEW METHODS AND USES
Also being explored is an approach called microdosing — ingesting minuscule amounts of psychedelic or psychoactive drugs to benefit mental health and well-being. Author Michael Pollan discusses the method in his aforementioned book How to Change Your Mind; in the memoir A Really Good Day, Berkeley writer Ayelet Waldman attests that microdosing eased her depression and improved her marriage; and a growing number of “biohackers” praise the technique. But while it can “be helpful for depression,” Doblin says, “in general, for therapeutic purposes, we prefer macrodosing, to really help people deal with the root causes.” In his view, “microdosing is more for creativity, for artistic inspiration, for focus,” but all the evidence isn’t in. “Media coverage is in front of the findings,” Burge adds.
Beyond facilitating research, MAPS organizes conferences, sponsors lectures, and publishes books and a newsletter on scientific, legal and educational efforts on the psychedelic front. The process of researching such drugs is complex, costly and often complicated by the politics surrounding narcotics, Doblin points out. “Psychedelics are really just tools, and whether their outcomes are beneficial or harmful depends on how they’re used.”
Ironically, one new application being explored for currently illegal drugs is undoing the damage wrought by legal ones, such as prescription opiates. For instance, some MAPS-assisted research is examining the efficacy of treating opiate addiction with ibogaine, a psychoactive substance derived from the root of the iboga tree. Two clinical trials underway in Mexico and New Zealand suggest some effectiveness, Burge says, but “we want to study it more and are looking for a place to find a consistent product.” MAPS research is also investigating the potential of ayahuasca, the traditional ceremonial medicine of Amazon basin tribes (and trendy North American “retreat” drug) for treating drug addiction and PTSD. The FDA approved ketamine, typically an anesthesia medication, as an ingredient in a nasal spray targeting depression last March. San Anselmo psychiatrist Wolfson, who conducted MAPS research on MDMA and PTSD, now uses ketamine-assisted psychotherapy for some depression clients.
Psychedelic potential, to an extent, is still a wide-open frontier. Yet today it’s being explored in a new light, aimed at uncovering benefits that could relieve human suffering. It’s an enlightened new world Nicholas Sand sensed was coming, but would even he recognize the advances now blazing different trails for the years ahead?
Want to learn more about unconventional health solutions? Read our article on MDMA in Marin,
This article originally appeared in Marin Magazine’s February 2020 issue under the headline: “Free Your Mind”.
Kasia Pawlowska loves words. A native of Poland, Kasia moved to the States when she was seven. The San Francisco State University creative writing graduate went on to write for publications like the San Francisco Bay Guardian and KQED Arts among others prior to joining the Marin Magazine staff. Topics Kasia has covered include travel, trends, mushroom hunting, an award-winning series on social media addiction, and loads of other random things. When she’s not busy blogging or researching and writing articles, she’s either at home writing postcards and reading or going to shows. Recently, Kasia has been trying to branch out and diversify, ie: use different emojis. Her quest for the perfect chip is a never-ending endeavor.