Is Psychedelic Research going down the wrong route?

Psychedelic research has had favourable results documented for over 100 years in medicine, even Bill W (the founder of AA) was spirited away in the 1930’s from his drinking by a drug made from deadly-nightshade, called the Belladonna cure. The Belladonna cure had been in use since 1909 and helped hundreds of people in the USA.  https://www.nytimes.com/2010/04/20/health/20drunk.html

The purpose of psychedelics in addiction treatment is to free up neuro-networks within the brain that can permanently offer changes in mood and functioning within the brain (Wang, 2019). This hopes to give people back their locus of control of their habitual behaviours.

You may think, if Bill W stopped drinking because of a drug why did he not become a travelling salesman of the Belladonna cure and give that out at meetings instead of the “big book” – a book that helps you learn how to stay sober, despite it not being the cause of why Bill W got sober? 

It’s very simple, Bill W’s model of recovery was one of that views addiction as being a spiritual disease – this is not a misnomer or a mistake on his part but rather an incredibly insightful progressive viewpoint that we are not simply linear machines. Personally, I don’t share all the view points but this nevertheless opened up a new take on dealing with alcoholism and addiction, it saw it existing not only within an illness but something that comes multiple aspects of a person’s being.

BIO-PSYCHO-SOCIAL MODEL

Fast forward to 1977 and George Engle introduced the “bio-psycho-social” model of health psychology, a challenge to the bio-medical model which sees disease and illnesses as being related merely to just tissues and structure and to only be treated by medicine (doctors of medicine).  George Engle saw that culture and mindset also played a big part in the make up of diseases and the spread of illness. He saw the medical community as being dysfunctional for a vast number of psychological illnesses and illnesses related psychological issues (Saraga et al., 2014).   Traditionally the bio-medical model saw changes in mood and well-being as result of being ill, not the other way round, that illness could be caused by low moods and social dysfunction.

If anyone has had the misfortune to seek help for addiction from bio-medical providers, such as hospitals, GPs’ and other medical professionals they may very well know that if you don’t respond to medication such as naltrexone, dangerous sedatives and anta-buse they simply do not know what to do with you.  Let me not get too far ahead of myself here, the bio-medical model does still serve its purpose, if I was having a heart attack I’d want to be taken to a hospital with immediate effect and treated with medicine – but even then, there are more systems at play that affect health.

ALEXANDER SHULGIN

I’ve been very fascinated with psychedelic research for many years, in 2011 I attended a conference with Anna Shulgin and Alexander Shulgin. Alexander Shulgin is a chemist and pioneer who wrote two ground breaking books called PiHKAL (1990) and TiHKAL (1997). Within these books Alexander Shulgin experimented on himself and recorded the effects of 100’s of new psycho-active compounds, phenethylamines and tryptamines (Dargan & Wood, 2013).  

Alexander Shulgin wrote detailed scientific experiences of his own accounts on these compounds, he also described what people had been sharing about anecdotally for years – That these drugs at certain levels could be controlled, were not addictive and had serious potential therapeutic value.  

Fun fact:  PiHKAL and TiHKAL were both added to the “Misuse of Drugs Act of 1971” to classify all the substances described in both books as schedule 1 class A controlled drugs – meaning they have no recognised medical benefits, and are to be considered to be particularly harmful to society and individuals who use them.  

Shulgin’s research began to give way to new wave of people ready to begin investigating the benefits of psychedelic research – even though these compounds were now more illegal than ever (Benzenhöfer & Passie, 2010).

THE 1960’s EXPERIMENTS

In the 1960’s there was a period where LSD was considered for usage in the treatment of schizophrenia and other mental health disorders, including alcoholism.  Unfortunately, this research was marred by inappropriate usage. Some patients were unwittingly tricked into taking LSD without any consent or prior knowledge of the effects of the drug (Dyck, 2005).  In the UK settlements were paid to victims of this unethical research who stated they still suffered from intense psychotic experiences from being given the drug.

These reckless practices with such a mind-altering substance, coupled with dangerous hippies handing it out like milk, gave LSD an undeserved spooky reputation.  It was viewed by the public at large in the USA and UK as something that was sinister and immoral.   This was reflected in law, with those who produced or dealt with the substance, receiving some of the harshest penalties possible under their respective legal systems. 

Photo by Chokniti Khongchum on Pexels.com

It’s taken a very long time to get the train back on the track of it being something therapeutic, even now research on these compounds is incredibly difficult. As they are classed as having “no medical benefit” (fyi, cocaine and heroin are not even in this classification!), conducting research means that you have to get the maximum clearance in order to experiment with it, also getting volunteers to be involved makes the experience slightly more precarious.  LSD in particular in the UK can leave you open for being sued and having to pay out damages, the law precedence was set due to the reckless experiments of the 1960’s. 

The law within the UK and USA has a very moralistic standpoint, even when presented with evidence, there is little change due to politicians and the general public believing that psychedelics are something to be morally outraged at and anyone considering them must face society’s retribution (Symons, 2013). 

There are various groups that deal with psychedelic research across the UK and USA, for legal reasons I will not be naming them, however there is a concern that these institutions are repeating the same mistakes of the past by viewing the treatment of disorders as incredibly linear.   

REDUCTIONIST

There are many examples emerging of psychedelic research being used as quick fix and then the patient simply leaving without any further intervention.  No psycho-educational component, no counselling, no plan, no change to lifestyle or structure.  Just a heavy dose of drugs, a handshake and make sure they sign the “don’t sue us” paperwork.

This has captured the imagination of online-magazines such as vice magazine, who’ve followed people through their journey into using ketamine to resolve alcoholism – I am very sceptical of ketamine being used as a therapeutic medicine, as when given with an opioid antagonist (blocker), such as naltrexone, the therapeutic effect is severely diminished (Wang & Kaplin, 2019).  This would suggest that the therapeutic value of it is related to opioid sensor agonist (activator), meaning that it has no more therapeutic value than drinking a can of beer or taking morphine.  I could be wrong about this, but those who want to champion its benefits do seem to be more interested in the culture of ketamine than dealing with facts. 

Photo by lalesh aldarwish on Pexels.com

My main worry with psychedelic research is that it appears to be very reductionist, institutions that want to promote it seem to be only interested in two aspects of it  1). Marketing  2).  Bio-medical chemists who can research it. 

I admit that psychedelic research isn’t an easy field of work, there are laws all around the world to prevent and limit its capacity, but I do feel that those even with that taken care of, they are falling foul of emulating a bio-medical model that is outdated by almost 100 years. They are not taking enough interest into the bio-psycho-social aspects of psychedelics and certainly from what I have seen they are not supporting people in way where they are going to make long lasting changes. 

Even within the recent documentary shown on “vice”, the patient returns to drinking within a month an breaks his own abstinence boundaries almost instantly.  No one seems to even notice, which gives an indication that these probably were not even introduced as a concept of either harm reduction or abstinence-based recovery. 

My personal fear is that without the inclusion of therapy, structure and planned change that psychedelics will once again miss the mark and be cast off into the realm of “spooky”. All that will be left will be the “high water mark  – that place where the wave finally broke, and rolled back”.  

If I’m wrong and nuking your brain with psychedelics is the answer to all life’s problems, then ask yourself, why is the belladonna cure completely obsolete and Alcoholics Anonymous – which is a bio-psycho-social-and possibly spiritual solution – reign supreme over the word “recovery”? It’s a living shame that modern psychedelic research ignores this component and seems to want to bow and scrape toward ticking the boxes of just a biomedical model – which has a proven track record of being thoroughly disappointing in meeting the needs of mental health and addictive disorders.

References:

Benzenhöfer, U., & Passie, T. (2010). Rediscovering MDMA (ecstasy): The role of the american chemist alexander T. shulgin. Addiction, 105(8), 1355-1361. doi: http://dx.doi.org/10.1111/j.1360-0443.2010.02948.x

Dargan, P. I., & Wood, D. M. (Eds.). (2013). Novel psychoactive substances : Classification, pharmacology and toxicology.

Dyck, E. (2005). Flashback: Psychiatric experimentation with LSD in historical perspective. Canadian Journal of Psychiatry, 50(7), 381-8. Retrieved from https://www.proquest.com/scholarly-journals/flashback-psychiatric-experimentation-with-lsd/docview/222812056/se-2?accountid=12118

Saraga, M., Fuks, A., & Boudreau, J. D. (2014). GEORGE ENGEL’S EPISTEMOLOGY OF CLINICAL PRACTICE. Perspectives in Biology and Medicine, 57(4), 482-494. Retrieved from https://www.proquest.com/scholarly-journals/george-engels-epistemology-clinical-practice/docview/1728137634/se-2?accountid=12118

Symons, M. (2013, Nov 25). Stiffer penalties sought for drug dealing. Asbury Park Press Retrieved from https://www.proquest.com/newspapers/stiffer-penalties-sought-drug-dealing/docview/1461695744/se-2?accountid=12118

Vice magazine Ketamine experiment: https://www.vice.com/en/article/wj8qj5/vice-presents-eternal-k-hole-of-the-spotless-mind

Wang, B. (2019). JOHNS HOPKINS TO STUDY PSYCHEDELICS AS ADDICTION, ALZHEIMER’S THERAPY. InsideHealthPolicy.Com’s FDA Week, 25(36) Retrieved from https://www.proquest.com/trade-journals/johns-hopkins-study-psychedelics-as-addiction/docview/2285010317/se-2?accountid=12118   

Wang, M., & Kaplin, A. (2019). Explaining naltrexone’s interference with ketamine’s antidepressant effect. The American Journal of Psychiatry, 176(5), 410-411. doi: http://dx.doi.org/10.1176/appi.ajp.2019.19010044    

Published by Dylan Kerr BA ACAT FDAP DipHE MBABCP

Mr Dylan Kerr Addictions Counselor Bachelors in Clinical Counseling (Hons) Advanced Certified Addictions Therapist Member of the British Association for Behaviour and Cognitive Psychotherapist Member of the Federation of Drug and Alcohol Practitioners HeDip Health-care HeDip Psychology of Addiction Dip Counselling Diploma in Arts Therapy Diploma in Transactional Analysis CSAT III Dylan Kerr is a Certified Substance Abuse Therapist who is qualified in Counseling, Psychology of addiction from Leeds University and Healthcare from Birmingham City University. Dylan Kerr has been a senior Therapist at the River Rehab, Lead Therapist at Lanna Rehab in Chiang Mai and Head Counselor of Hope Rehab in Siracha. As well as working in Thailand for 7 years, Dylan has also been the on-tour counsellor for the the Rock band ‘The Libertines’. Dylan is now resident counsellor at an Asian rehab. Dylan has experience of working within the music industry supporting acts in therapeutic needs. As well as working around the world Dylan has over 13 years experience delivering substance use disorder treatment at various agencies around the UK. He is skilled in motivational interviewing, CBT, RET and guidance around 12 step philosophies. Dylan has worked with a broad client base and establish the rapport needed to effect change and sustainable progression. Dylan wishes to start this blog to help educate people on his observations within this field and debate the nature of work in the addictions field.

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