top of page

Psychedelics: Taking a Trip

Updated: Aug 15, 2022

Psychedelics are a class of drugs which has the effect of triggering non-ordinary states of consciousness (known as psychedelic experiences or "trips"). This causes specific psychological, visual, and auditory changes, and often a substantially altered state of consciousness. Psychedelics seem to be everywhere lately, Silicon Valley is all fanatical about Microdosing with LSD to improve creativity, and new documentaries on psychedelics seem to launch almost every month, captivating this resonance. But with so much information available on psychedelics, It's effortless to be lost in its realm, even to be found blinded with incorrect information about them.

Image Credit: Julia GR


The word psychedelic quite literally means "mind revealing," which is one way to describe the powerful effects of these drugs, they're also sometimes referred to as hallucinogens. They cause a profound shift in your sense of self and consciousness. Psychedelics have been used for thousands of years as part of religious and cultural rituals to induce mystical experiences. And it is this uncanny effect that may be part of what helps with so many mental health conditions. Most of the medical research on psychedelics has examined two drugs; Psilocybin, which is the active ingredient in magic mushrooms, and MDMA, which you may know better as ecstasy or Molly. There's also growing research on LSD, mescaline, DMT, and other psychedelics. Several universities, including Johns Hopkins, NYU, UCSD, and Imperial College London, are doing in-depth research on these medicines. And early results, while limited in size, have been impressive.


Psychedelics have always been there, although it became popular first back in the 1950s and 1960s. It was being used by medical professionals world-over to treat mental health conditions and the results were quite promising back then too. But studies at that time lacked the stringent methods of clinical trials, that precision medicine now requires to approve a drug's efficacy. Research largely halted in the 1970s when President Nixon launched the Controlled Substances Act in the US as they at that time perceived psychedelics to be a threat to the public's health welfare, placing substances like MDMA and LSD under schedule 1: substances which have no medical use and have a high risk of abuse. Henceforth research came to a stand-still in the US and that effect rippled world over.


At that time, Harvard was also one of the universities researching on Psilocybin; but it has had a troubled past with it. A psychologist and psychedelic advocate Timothy Leary was a Harvard professor who partnered with his colleague Richard Alpert (Ram Dass) to launch the Harvard Psilocybin project although it came under the limelight of the university administration when they provided a student with Psilocybin off-campus, subsequently leading Harvard to fire him, and shutting down the project.


There are many popular psychedelics, and agreed some of them might not have any medical use and might be at a high risk of abuse but appended below is a chart of some of the most popular psychedelics that present potential and prospect, as of now, in medicine.


A psychedelic renaissance is upon us from a commercial standpoint, too, According to one analysis, the market for psychedelics could be worth $7 Billion by 2027. The Journal of American Medicine (JAMA) reported that as of January 2022, there were more than 50 publicly traded companies in this space, with at least three companies valued at more than $1 billion. And bills are being introduced in state legislatures across the country- from Washington and California to Pennsylvania and Maine- to legalise medical psilocybin, decriminalise it, or both.


Mental health professionals are more than ever, ready to administer and prescribe psychedelics as long as they see promising results consist alongside a low number of cases where these drugs have been rather abused. Janssen Pharmaceuticals received the FDA approval in 2013 for, Esketamine, An isomer of Ketamine, for Treatment-resistant depression when they presented their promising findings. Their Ketamine Nasal spray called as Sparvato is the first and only approved antidepressant medication that showed to begin improving depressive symptoms with the first dose itself, in this challenging to treat patient population. Making it a Rapid-fast acting antidepressant.


From history, we've learnt that psychedelics may have a therapeutic use, only when it's administered by professionals, its not uncommon to hear of so-called bad experiences or "bad trips" when people have attempted to self-medicate themselves with psychedelics, and in some extreme cases it has even caused death.


John Krystal, MD, chairman of the psychiatry department at the Yale school of medicine is very optimistic about the use of psychedelics in his practice although he worries that we shouldn't push for a FDA approval too quickly without any substantial Research on them. As previously stated research has happened with short sizes. Researching psychedelics is difficult as these researches have to be a double-blind, randomised controlled trial where both the doctors and the patients are unaware of the treatment they are going to receive and it's difficult to hide this because of the peculiar effects of these substances that differentiate each of them, from one and another. Nevertheless, his optimism stays afloat when he notices how much hope psychedelics give to patients and clinicians for severe mental health conditions, like treatment-resistant depression that could shorten one's lifespan by 5 years.

That's why he applauds psychedelic research, even when it pushes the limit with studies that might be politically unpopular or hard to administer--just as long as there's no rush to approve.


There is significant hope--now that big-shot investors have gambled their money on this industry-- for regulative bodies to change policies regarding psychedelic use. For example, Peter Thiel, one of the investors of Facebook and a venture capitalist has invested heavily in a psychedelics startup called Atai Life Sciences, which is listed publicly on the New York Stock Exchange. Three years after its founding, Atai Life Sciences has 10 therapeutic programs in its pipeline, each at various stages of clinical trials.


The most promising psychedelics as of now have to be Psilocybin and Ketamine, both have antidepressant-like effects that are appealing to clinicians for further research on how they affect our brain. It will take a few years for this research to continue and organise itself in medical literature, and for psychedelics to come out to the public for therapeutic use. Although a few places in the world where psychedelics are legalised, as of now, are the following:


Oregon

In 2020, Oregon residents voted on a ballot initiative to legalize psilocybin healing centres, and by the end of 2023, all adults over the age of 21 will be able to legally receive psilocybin-assisted therapy. In the interim, Oregon has decriminalized the possession of most drugs, including psychedelics.

The Netherlands

The Netherlands is perhaps best known as that place with legal marijuana and magic truffles. And while marijuana isn’t technically legal —though this is just a technicality, there is a controlled market and you can buy it in stores— psilocybin truffles are. How this came to be is a saga in and of itself. Despite psilocybin mushrooms being illegal, psilocybin truffles —the fruiting body of a fungus— are not. In short, there was a loophole in the law banning magic mushrooms which never got plugged. This resulted in psilocybin truffles being legally sold in “Smart Shops” across the Netherlands. And despite this coming to be through legislative overlook, since the law banning psilocybin mushrooms was passed in 2008, there has not been a serious effort to add psilocybin truffles to the list of banned substances. Not only does this mean individuals can buy psilocybin truffles at Smart Shops, but there is also a burgeoning psilocybin-assisted therapy and retreat scene opening up. As citizens from around the world look to try legal psilocybin-assisted therapy to improve their mental health, the Netherlands is becoming a hot destination.


The Bahamas

Going further, however, in the Bahamas not only do certain resorts offer psilocybin mushrooms-assisted healing, but many also offer ibogaine treatment for addiction. And at least one also offers 5-MeO-DMT treatment! Located only 50 miles from the Florida coast, the Bahamas are perfectly situated for curious American tourists who can’t wait until Oregon’s psilocybin centres open next year.


Brazil

Brazil takes the cake in this listicle of countries where psychedelics are legal. While psilocybin mushrooms are legal in Brazil —though their sale remains almost entirely in the informal market— the fact that the Latin American giant has also legalised ayahuasca gives them the top rank.

Ayahuasca is a brew containing DMT that can cause a psychedelic experience lasting around 4 to 6 hours. Used traditionally by many native and Christian communities in the Amazon, ayahuasca retreats in Brazil have become so popular that people from across the world make the journey.



More on Psilocybin (Extended Information for The Psychonauts)

Psilocybin is a hallucinogenic chemical in certain mushrooms that grow in Europe, South America, Mexico, and the United States. Mushrooms that contain psilocybin are known as magic mushrooms. Psilocybin breaks down into Psilocin, which further works by activating specific serotonin receptors (called as 5-HT2A receptors), most often in the prefrontal cortex. This part of the brain affects mood, thoughts, and perception.



Psilocybin itself is not thought to be very psychoactive, but soon after it is ingested it is metabolized into a substance called psilocin, which is highly psychoactive. Psilocybin is thus considered a prodrug, or a substance that is inactive until converted into an active drug after administration. Although we have some understanding of the activity of psilocin in the brain, it is not fully understood how this activity leads to the subjective experiences people have while taking psilocybin. Regardless, it is thought that psilocin’s activity at a subtype of serotonin receptor known as the 5-HT2A receptor is critical to the drug’s psychedelic effects. Psilocin is thought to act as a partial agonist at the 5-HT2A receptor, which means that it binds to the 5-HT2A receptor and causes a response that is a fraction of what the natural ligand, serotonin, does. Psilocin also interacts with other targets, like other serotonin receptor subtypes, some subtypes of dopamine, histamine, and adrenergic receptors, and the serotonin transporter. The role of these other targets in the effects of psilocybin, however, is not very clear.


References:


This Will Change Your Mind About Psychedelic Drugs, TIMES Magazine.


An Introduction to Five Psychedelics: Psilocybin, DMT, LSD, MDMA and Ketamine by Ruairi J Mackenzie. https://www.technologynetworks.com/neuroscience/articles/an-introduction-to-five-psychedelics-psilocybin-dmt-lsd-mdma-and-ketamine-355897


Inside Ibogaine, One of the Most Promising and Perilous Psychedelics for Addiction. TIMES Magazine.


Altering Perceptions on Psychedelics. Harvard Medical School. https://hms.harvard.edu/magazine/viral-world/altering-perceptions-psychedelics


Janssen Announces U.S. FDA Approval of SPRAVATO® (esketamine) CIII Nasal Spray to Treat Depressive Symptoms in Adults with Major Depressive Disorder with Acute Suicidal Ideation or Behavior By Janssen Pharmaceuticals. https://www.jnj.com/janssen-announces-u-s-fda-approval-of-spravato-esketamine-ciii-nasal-spray-to-treat-depressive-symptoms-in-adults-with-major-depressive-disorder-with-acute-suicidal-ideation-or-behavior









Comments


bottom of page