The movement to relax ban on psychedelic drugs
By Lisa Brody
When many people hear the words “psychedelics” or “hallucinogenic drugs,” they think of the 1960s, of LSD and Timothy Leary, who coined the infamous phrase, “Tune in, tune out, drop out,” at a Human Be-In in 1967 in San Francisco's Golden Gate Park before 30,000 hippies. A clinical psychologist, in the early 1960s when LSD and other drugs in that classification were popular, Leary came to believe that psychedelic drugs had great therapeutic uses in psychiatry – and he was not alone.
Fast forward 60 years, and medical science is finding its way back to Leary's initial hypothesis – if not his legendary slogan. Even some scientific skeptics are interested in studying the potential of psychedelics to break through the mental health morass some are burdened with by depression, PTSD, eating disorders and other conditions which may be helped by utilizing a more natural treatment course than the current pharmaceutical antidepressants. Classified as Schedule I drugs, it is difficult for scientists and medical practitioners to research psychedelics, or to have scientific trials as mushrooms and other psychedelic drugs are illegal.
A burgeoning movement is afoot to decriminalize psychedelic drugs, primarily for therapeutic use and scientific study, and in some cases for recreational use. In less than two years, four cities around the country, ranging from Oakland, California to Ann Arbor, Michigan, along with Denver, Colorado and Santa Cruz, California, have voted to decriminalize possession of some or all psychedelic drugs, which is a category that includes mushrooms, LSD, mescaline, peyote, ayahuasca and MDMA – popularly known as Ecstasy or Molly. In November 2020, voters in the state of Oregon approved statewide ballot Measure 109, becoming the first state in the country to legalize the therapeutic use of psilocybin – the chemical compound that creates the “magic” in magic mushrooms. Clients will only be able to buy and consume psilocybin at specific facilities and only under the supervision of a licensed facilitator.
The movement to decriminalize psychedelic drugs – as in Oakland, California and Ann Arbor – generally involve resolutions stating that law enforcement should not prioritize arresting or investigating adults who possess or use the substances, and that the counties should not prosecute people involved in their use. But these efforts do not get people caught driving under the influence of these drugs off the hook, and they do not create marketplaces or commercial sale mechanisms for distribution of natural plants, the drugs are barred from being distributed at schools and often times the sale of these drugs still remains illegal.
The decriminalization drive comes on the heels of a growing successful movement to legalize cannabis across the country, many experts point out. And it's not just in traditionally “liberal” communities. The founder of the Decriminalize Nature Ann Arbor said they are actively looking to decriminalize psychedelic drugs in the cities of Detroit and Grand Rapids. And an Iowa Republican lawmaker unsuccessfully introduced an amendment to a budget bill in 2020 which would have removed psilocybin from the list of Iowa's prohibited substances. While the amendment was shot down, Iowa state Rep. Jeff Shipley said he was seeking to legalize psilocybin and MDMA for medical and therapeutic use.
“Psilocybin, I sincerely believe, could open up Iowa to a whole new world of health and healing, revolutionizing our healthcare, revolutionizing mental health, where right now we have a system of treatments where a person has to take a pill, a synthetic pharmaceutical for an indefinite period of time, maybe for the rest of their life,” Shipley said during a speech on his amendment. “These treatments, at best, make a person’s symptoms manageable.”
Across the United States, psychedelic drugs are classified as Schedule I drugs, meaning that according to the U.S. Drug Enforcement Agency (DEA), they have a high potential for abuse and the potential to create severe psychological and/or physical dependence, and there is no currently accepted medical use. Schedule I drugs include heroin, marijuana, LSD, ecstasy and peyote.
Julie Barron, the president and founder of the Michigan Psychedelic Society in Ann Arbor, is also the executive director and founder of Decriminalize Nature Ann Arbor. A trained therapist who explains she has worked with “non-ordinary states of consciousness,” said she moved to Ann Arbor from the west coast and saw “lots of people wanting to talk about psychedelics and their experiences, and there wasn't a group here. Decriminalization efforts started out of the Michigan Psychedelic Society – it's part of our mission statement to first decriminalize Ann Arbor, and then bring it statewide. Whether people are using them recreationally or therapeutically, they're profound drugs. They're very transformative by their very nature.”
She said Ann Arbor's efforts focused strictly on decriminalizing “natural specimens that came out of the ground. How do you criminalize nature? That was the foundation. Whether it's going to be used medicinally or recreationally, we have to educate people to help with safe and responsible use.”
Ann Arbor City Council decriminalized psychedelic mushrooms and other natural plants September 21, 2020, taking immediate effect. Included in the resolution is ayahuasca, ibogaine, mescaline, peyote and psilocybin mushrooms. LSD and MDMA are not included as they are created in laboratories.
On January 12, 2021, the Washtenaw County Prosecutor Eli Savit announced his office would not charge anyone for use, possession or small-scale distribution of marijuana or psychedelic mushrooms, and would look into expungement of old criminal records for those offenses.
While psychedelic drugs are not a significant law enforcement issue, Robert Stevenson, executive director, Michigan Association of Chiefs of Police, said, “We always look through the eyes of public safety, and the question is public safety improved or diminished if psychedelics become more available? – and common sense says no. There are no common doses; they're not regulated. You don't know where they come from. We know the more drugs out there – including marijuana and alcohol – the more impaired driving there can be. We don't have a chemical test to determine if we stop an individual, so we have to have a DRE – a drug recognition expert – to come and determine it, which needs extensive training, which most departments don't have.
“Decriminalization makes it appear that it's less dangerous,” Stevenson continued, who said he hopes it does not gain more traction across the state.
Psilocybin is a naturally occurring psychedelic drug compound found in more than 200 species of fungi. In the body, it quickly converts to psilocin, acting on the serotonin receptors of the brain, which can cause mind-altering effects that can include euphoria, visual and mental hallucinations, changes in perception, a distorted sense of time, and for some, spiritual experiences. Some users can have adverse reactions which can include nausea and panic attacks. The mind-altering effects of psilocybin can last for two to six hours, although anecdotally, to individuals under its influence, the effects may seem to last much longer.
Scientists and psychiatrists assert that psilocybin has a low toxicity and a low harm potential, and there is no documentation for addiction or abuse. For centuries, indigenous cultures have used psilocybin mushrooms in traditional religious or spiritual contexts. Peyote, a small, spineless cactus, known for its psychoactive alkaloids, particularly hallucinogenic mescaline, has a long history of ritualistic and medicinal use by indigenous North American Indians.
“From the earliest recorded time, peyote has been used by indigenous peoples, such as Huichol of northern Mexico and by various Native American tribes, native to or relocated to the southern plains states of present-day Oklahoma and Texas. Its usage was also recorded among various southwestern Athabaskan-language tribal groups,” according to Carl Lumholtz, a Mexican and Native American scholar. He noted the religious, ceremonial and healing uses of peyote may date back over 5,000 years.
While a Schedule I drug, as part of the American Indian Religious Freedom Act of 1978, the listing-of peyote as a controlled substance in Schedule I does not apply to the use of peyote in bona fide religious ceremonies of the Native American Church.
Mescaline, derived from peyote, has a wide array of suggested medical uses, including for alcoholism, depression and other conditions linked with serotonin deficiencies. But, since the 1970s and its listing as a Schedule I drug, few human studies have been conducted to determine its medical efficacies.
Ayahuasca is a brew made from the leaves of two different plants, and has also been used for centuries by indigenous tribes for spiritual and religious purposes. It is enjoying a renewed interest in some circles for its naturally occurring hallucinogenic chemicals. According to the National Institute of Health (NIH), the hallucinogenic substance, DMT (dimethyltryptamine), is broken down quickly in the liver and gastrointestinal tract, “which is why DMT must be combined with MAO inhibitors which allow DMT to take effect… when combined, these two plants form a powerful psychedelic brew that affects the central nervous system, leading to an altered state of consciousness that can include hallucinations, out-of-body experiences, and euphoria,” said Jillian Kubala, MS, RD.
Beyond ceremonial purposes, those who try ayahuasca today are seeking to heal previous traumas, open their minds or help treat addiction, anxiety, treatment-resistant depression and PTSD, Kubala said. Because it is so powerful, it is advisable only under the supervision of an experienced shaman, who takes care of the effects and needs until it has worn off, anywhere from two to six hours later. Those who take ayahuasca can experience vomiting, diarrhea, feelings of euphoria, strong visual and auditory hallucinations, mind-altering psychedelic effects, fear and paranoia.
“Some adverse effects, such as vomiting and diarrhea, are considered a normal part of the cleansing experience,” Kubala said.
LSD (lysergic acid diethylamide), colloquially known as “acid,” is a hallucinogenic drug first made by a Swiss chemist named Albert Hofman from lysergic acid, a chemical related to the fungus ergot. Hofman created LSD in 1938, but did not realize its hallucinogenic properties until 1943, when he accidentally ingested an unknown quantity.
LSD typically can alter a user's thoughts, feelings and awareness of their surroundings, and many users have visual and auditory hallucinations. Effects can begin within a half-hour and last up to 12 hours. It has primarily been used as a recreational drug, although some practitioners believe there are medical benefits, and is not addictive, although a tolerance can be achieved for some users. An overdose is believed to be unheard of – although some users have had what are known as “bad trips.” According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDR), adverse psychiatric reactions can occur, such as paranoia, anxiety and delusions. Hallucinogenic persisting perception disorder, or flashbacks, can occur at any time, according to the National Institute on Drug Abuse, and as of 2017, at least 10 percent of the people in the United States had tried LSD at some point in their lives, and .7 percent had used it in the last year, with it increasing among adults in the U.S. by 56.4 percent between 2015 and 2018. Early studies indicated that a single dose of LSD was effective in reducing alcohol consumption in alcoholism, and it is being studied for depression, anxiety and drug addiction, with preliminarily positive outcomes.
If psychedelics seem to have a high upside with minimal downsides for most adventurists – much less the potential for medical and psychiatric use – many wonder why it is classified as a Schedule I drug. For a long time they weren't – the U.S. government actually utilized LSD and some other drugs clandestinely in mind control efforts against enemy combatants. It appears only when psychedelics became the choice of counterculture youth in the 1960s and 1970s that the drugs were reclassified as dangerous drugs.
When Hofman first discovered the hallucinogenic properties of LSD, five years after he developed it in a lab, he was working for a Swiss chemical company, Sandoz. His “accidental” discovery in 1943, during World War II, during a ride home from work when motorized vehicles were banned. April 19 – when he took a large dose and rode home – has become known as “Bicycle Day” by recreational users of LSD to celebrate Hoffman's discovery. Hofman later wrote that he took 250 micrograms of LSD, and that should be the threshold for dosages.
In 1947, Sandoz Laboratories introduced LSD as a psychiatric drug, according to Drug Enforcement Agency records, and as a psychiatric panacea for schizophrenia, criminal behavior, 'sexual perversions,' and alcoholism.
The U.S. government discovered LSD was beneficial and useful – with the CIA, using the code name “Project MK-Ultra” in the 1950s and '60s. Beginning first as a research program in the early 1950s, the CIA introduced LSD to the United States by purchasing the world's entire supply, for a price tag of $240,000, and propagating LSD via CIA fronts through U.S. hospitals, clinics, research hospitals and prisons. In a report in the congressional Rockefeller report in 1975, it was revealed that experiments were conducted on CIA employees, military personnel, doctors, other government agents, prostitutes, mentally ill patients, and members of the general public – all without their knowledge – in order to gauge and study their reactions.
Sandoz' patent on LSD expired in 1963, and psychiatrists, psychologists, New Age writers and experimental youth began to dabble with and advocate for hallucinogenics. One of the most notable was Timothy Leary, who at the time was a clinical psychologist at Harvard who worked on the Harvard Psilocybin Project from 1960 to 1962. However, much of his scientific legitimacy and the ethics of his research became questionable because he took psychedelic drugs – LSD and mushrooms – along with his research subjects. He later became an advocate promoting the use of psychedelic drugs and the '60s counterculture.
Likely in response to the counterculture movement, in 1968 possession of LSD became illegal in the United States, and in 1970 was added to the list of Schedule I drugs, according to the Controlled Substances Act of 1970. The United Nations Convention of Psychotropic Substances, adopted in 1971, made LSD, mushrooms – of which there are over 100 with psilocybin – illegal in the countries that were party to the convention, including the U.S., Canada, Australia, New Zealand and most of Europe.
Today, small groups of scientists, psychologists and other medical professionals are looking at psychedelics once again for the claims that they can be beneficial for those suffering from severe mental health issues. The movement for decriminalization has focused primarily on those efforts, although some proponents also advocate for those who choose to safely use psychedelics recreationally.
“Unlike in the 1960s, when it was the first time they were hitting the mainstream and it would sometimes make someone crazy long-term, it's not that same level of concern, that you will break someone or destabilize society,” said Norman Farb, PhD, associate professor and psychologist, University of Toronto. “The majority of people are just fine after having a trip.”
Dr. Susanne Brummelte, professor of psychology at Wayne State University, said today the study and understanding of psychedelics is “an emerging field because it was illegal. They've been Schedule I drugs, so it's very difficult to do research, though there is beginning to be some research on the medical benefits of LSD, and they're getting some idea that with a guided trip it can help with depression and other issues.”
Dr. Scott Bowen, professor and chairman of the department of psychology at Wayne State University, said, “Decriminalization allows for some research to study depression, anxiety, mood enhancement. The question is, does it really happen? Unless there's a placebo – a negative – you don't have a scientific study to determine efficacy. There's a lot of anecdotal information that can be attributed to the placebo effect.”
Those who are studying the effects are seeing profound breakthroughs in major depression and PTSD, in particular. A small study of 24 adults with major depression published in Journal of American Medical Association (JAMA) in November 2020 found that two doses of psilocybin led to a large reduction in their depressive symptoms. Alan Davis, an adjunct assistant professor of psychiatry and behavioral sciences at John Hopkins University School of Medicine said, “The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market. Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future 'gold-standard' placebo-controlled clinical trials.”
“This is one drug that's hard to give a placebo, because you either have a trip or you don't,” noted Farb – while pointing out there are mixed reports out of the smaller studies, and randomized controlled trials with placebos are the only way to determine true usefulness.
“Many people (in the small studies) said they achieved greater stability of attention, a greater ability to focus, greater creativity, better moods. But for every two to three people reporting these effects, we get one person reporting the opposite – saying their mood is worse, they're having trouble concentrating,” he noted.
“It's different with a survey of a few thousand people,” Farb continued. “With that type of research, you can see why one person is benefitting and someone else isn't.”
“Psilocybin seems to have potential for use in the treatment of mood disorders like depression because it has profound effects on the ways the brain interacts with neurotransmitters like serotonin and glutamate,” said Adam P. Stern MD, director of psychiatry, the Berenson-Allen Center for Noninvasive Brain Stimulation, and assistant professor of psychiatry, Harvard Medical School. “While there is tremendous potential for clinical use, the field of psychiatry is still awaiting large, well-designed randomized controlled trials in order to determine if it may be a tool that we can add to our therapeutic arsenal.
“I do not, at this time, recommend it for my patients outside of the setting of a clinical trial where possible benefits and side effects can be closely monitored,” Stern continued.
Farb pointed out that in comparison, there is decades of research on antidepressants, which millions of Americans take on a daily basis, and their side effects, “versus absolutely no research on psychedelics, despite decades of dabbling, or on their side effects. There's almost no research on micro-dosing (a new practice of giving micro doses of psychedelic drugs). There are thousands of studies, and more case studies, on full doses of psychedelics, but they're all from prior to the mid-'60s. But that is much different than randomized controlled trials with placebos.”
“At their core, all psychoactive substances – whether synthetically designed or found in nature – affect the brain through neurochemical signaling and action. The biggest differences between FDA-cleared medications and unregulated psychoactive substances – of all varieties – is primarily in our understanding about mechanism of action, dosing, pharmacodynamics, desired effects and undesired side effects, all of which can be better understood through rigorous scientific study,” said Stern.
One way scientists are studying the efficacy of psychedelics is through microdosing psychedelics – providing small doses of psychedelics, often LSD but sometimes mushrooms, in low, sub-hallucinogenic doses such as in five to 20 microgram doses, every two to three days to combat medically-resistant depression, PTSD, anxiety and other chronic mental health conditions. Farb has a lab at University of Toronto which has been studying microdosing, which he said is “not much different than the puttering that is done with dosages for antidepressants and their side effects.”
He noted the major issue is that there is almost no research on microdosing other than anecdotal reports – “case studies prior to the mid-'60s were on full doses of psychedelics, but that's much different.
“Anecdotally, when accompanied by a therapist, these drugs can really help those for whom nothing else has helped,” Farb said. “Those with deeply-entrenched depression, eating disorders, PTSD – where they get really remarkable changes they go on these trips with tight controls. With a trained therapist's care, you tend to have a really positive experience, even if you encounter really deep emotions.”
Barron of Michigan Psychedelic Society said, “Microdosing, taking small dosing to get a sub-perceptual perspective, is a very different approach versus macrodosing. There's a lot to be said, and it's advisable for some people in certain situations. There's room for both microdosing and macrodosing.”
Farb said preliminary research indicates that for higher dose interventions, “people say the trip was one of the most meaningful experiences in their life. The argument is – does it persist? We don't know if there are long-term side effects, so we need more long-term studies, and more from chronic usage. We don't see it in the literature that someone who does one or two trips with a therapist has any issues, like flashbacks, but we don't know if 10 years down the line they'll have a flashback. There needs to be more research.
“In my lab, we're doing research on microdosing, and we believe it's probably okay, but I'd like more research that there aren't adverse effects and that people are okay to drive. Right now, I think the hype has outpaced the evidence,” he said.
Bowen and Brummelte from Wayne State University believe there needs to be more research on the medical benefits of microdosing, as well.
“LSD is a powerful drug. It affects your serotonin receptors, so it will definitely change your brain,” said Bowen. “The question is, is that happening with microdosing? There are a lot of unknowns. It's just so new. LSD by itself is the most potent – you just need a teeny amount, but it is also the most effective.”
Brummelte has concerns about using mushrooms for microdosing as well, relative to the amounts ingested and the side effects.
“Some (mushrooms) work on dopamine and serotonin and would have similar effects with microdosing,” she said. But, she noted, it can be difficult to determine dosing and the amount of psilocybin in a mushroom to microdose.
“I'm not saying these drugs are bad, we just haven't had the ability to study them because of the Schedule I classification. We don't know how much psychedelics are in specific mushrooms. People think if something is natural, it must be good,” Brummelte said. “Thankfully, most psychogenic drugs are not very addictive, especially the way they're typically used – take a trip once or twice a year. With chronic microdosing, we don't have any data to make a statement about addiction.”
They both are in favor of decriminalization because of the ability for scientists like themselves to study the uses and efficacy of microdosing, macrodosing, and psychedelics for mental health.
Big business sees potential in psychedelics, as well.
“Behind the decriminalization argument is – we've gotten marijuana legal, so what's next?” noted Farb. “Marijuana was last year. It's a very lucrative market. With marijuana, they've started to run out of new ground, so they're turning to psychedelics as the next set of drugs to decriminalize, at least for prescriptions.
“My concern as someone who works at a university – I don't have a financial bone in this fight – I believe there are benefits but also side effects,” he continued. “I believe there will be a rush to get these to market. If I had a crystal ball, I'd say we'll see prescriptions for psychedelics within 10 years, and what is driving this is the decriminalization movement, because so much money is involved. But will it be done in a safe way? I'd like research policy and safety to be driving this rather than money.”
Ronan Levy, co-founder and executive chairman of Field Trip Health in Toronto believes decriminalization will occur even quicker.
“Access to psychedelic therapies is going to come much more quickly – it's about two years away for federal access for purely medical use of MDMA (ecstasy) for PTSD, and by 2023, in Oregon, there will be access to non-medical psilocybin therapies to anyone over 21,” he said. “They won't be buying mushrooms, but psilocybin therapies, still in a controlled setting with controlled oversight.”
Levy does have a dog in this fight – he and his partners previously were involved in the cannabis industry in Canada, and now, with Field Trip Health, they operate ketamine-assisted psychotherapy clinics in four cities – Toronto, New York, Los Angeles and Chicago, and soon in Atlanta, Houston and Amsterdam, with 10 to 12 locations in operations by the end of the first quarter of 2021.
Why ketamine? “In North America, ketamine is the only substance we are treating with because it is FDA-approved,” he said. “The intent is to give a substantial dose of ketamine so they don't go under but can go deep and revisit or whatever comes up and become aware.”
Field Trip Health clinic settings are almost spa-like, but Levy said instead “it is being in a safe, warm, comfortable space leads to better therapeutic treatments. The clinics are designed to be comfortable.” One therapeutic experience lasts two to three hours.
Treatments are designed for people who are stressed, anxious and/or depressed. “The research shows it's profoundly safe, inherently non-addictive and can help people get off other substances,” Levy said. “There are some risks – but there are hard trips or easy trips. A hard trip can become a bad trip without the proper support around you. Some people have very scary experiences during a trip, but a good therapist will go towards the experience. The research shows it leads to greater creativity, greater empathy, and a decrease in depression. We're bringing access to those dealing with mental health issues and those who want to expand the benefits for a better quality of life.”
Levy said Field Trip Discovery, a research and development arm of the company, is working on a synthesized molecule that will hopefully be in human trials by the end of this year.
Ketamine. LSD. Mushrooms. Localized decriminalization. Is there a real likelihood of nationwide decriminalization, or even legalization, of psychedelics, for therapeutic treatments and scientific study in the United States? Yes, if Rep. Alexandria Ocasio-Cortez (D-NY) has anything to say about it.
Ocasio-Cortez has initiated legislation twice, once in 2019 and the second time in 2020, both tied as amendments to federal spending bills that prohibits spending federal money on any activity, like research that promotes the legalization of drugs and substances classified as Schedule I.
In 2019, she noted that “psilocybin, the psychoactive substance found in 'magic mushrooms' and outlawed in the 1960s, has shown promise as a treatment for PTSD as well as end of life therapy. Psychedelics like this aren't legal for medical use, though researchers at John Hopkins hope that one day the Food and Drug Administration will reclassify them, as their analysis found it can help treat depression, anxiety and arthritis.”
On the floor of the House of Representatives in July 2020, Ocasio-Cortez advocated “to allow United States researchers to study and examine the extraordinary promise shown by several Schedule I drugs that have been shown with critical diseases, such as MDMA success with PTSD.”
She further pointed out that as many as 30 percent of U.S. veterans suffer from PTSD, so “if a substance shows promise, we have an obligation to study it.”
The wild west might be getting ready to be tamed.
