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Whether they show up in your aunt's stories from the '80s, your cousin's tales from last weekend, or a new endeavor from Stark Industries' CEO (aka, Gwyneth Paltrow), psychedelics are getting plenty of play lately. Researchers have long been interested in the potential healing effects of drugs like MDMA, LSD, and psilocybin, also known as molly, acid, and mushrooms. Recent studies show that psychedelics may have an impact on mental health, but there's so much more we need to know.
In How To Change Your Mind, Michael Pollan's 2019 book examining the history of this field, he writes that LSD and psilocybin in particular "change[d] the course of social, political, and cultural history, as well as the personal histories of the millions of people who would eventually introduce them to their brains." He describes how research into these compounds' effects on mental health were underway well before their role in counterculture led to their criminalization. This legal status makes it difficult to conduct this research today, but the tide is changing.
On Jan. 17, the U.S. Food and Drug Administration (FDA) announced a new program, called Expanded Access, that will provide medical-grade MDMA to patients with treatment-resistant PTSD, VICE reports, under a doctor's supervision. Molly or ecstasy (two of the more common names for MDMA) has been shown in studies to help patients can feel safe accessing and processing traumatic memories in therapy.
The Expanded Access program begins amidst increasing research demonstrating the potential effectiveness of psychedelic drugs at improving mental health. CNN reports that cancer patients have been shown to benefit from the "magic mushroom" compound psilocybin, which a 2020 study suggested can reduce depression and anxiety. Studies are also finding that the tranquilizer ketamine can reduce treatment-resistant depression, a protocol the FDA approved in 2019.
Even though recreational psychedelic use still has risks, including legal ones, these kinds of studies show how, with professional supervision, there are potential mental health benefits. The most current research, outlined here, suggests that medical-grade psychedelic drugs might be a helpful part of making treatment more accessible to people with severe mental health issues.
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MDMA And Psychotherapy May Treat PTSD
A 2017 study, published in the journal Neuroscience Letters, tested the impacts of two or three treatments with 3,4,-methylenedioxmethamphetamine (AKA, MDMA) in patients with severe PTSD. Combining traditional therapy and MDMA doses, participants used MDMA to help safely recall traumatic memories. For people with PTSD, remembering traumatic events is often fraught with overwhelming sensations of unsafety associated with the experience, and MDMA can help ease those sensations.
In a similar 2019 study, published in the journal Psychopharmacology, researchers also found that MDMA may be useful for treating PTSD. Using MDMA let participants access and process trauma without experiencing the terror associated with PTSD symptoms. These kinds of treatments were being explored in the 1980s (before the "War on Drugs" made ecstasy illegal), but the recent studies pointed out that medical-grade MDMA administered in a clinical setting isn't as risky as recreational ecstasy (which can cause increased anxiety, depression, muscle cramping, and memory problems).
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MDMA May Be Helpful For People With Alcohol Use Disorder
In 2019, the journal BMJ Case Reports published the first study to investigate the safety of using MDMA to treat alcohol use disorder. Though this study only included results for four people undergoing treatment for alcohol-use disorder, none of these participants had negative reactions to their eight weeks of treatment combining MDMA doses with traditional therapy. Because treatment with MDMA didn't put participants with alcohol-use disorder at an increased risk for dangerous drug use, researchers plan to expand their trials to find out if MDMA can be effective at treating alcohol-use disorder in the long-run.
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"Magic Mushroom" Compound Eases Depression And Anxiety
Patients experiencing cancer-related depression and anxiety may benefit from treatments with psilocybin, which is the compound that makes shrooms trippy, according to a 2020 study published in the Journal of Psychopharmacology. The study found that the majority of patients who received psilocybin treatment along with talk therapy experienced reduced depression, anxiety, and hopelessness as long as four years after treatment.
The potential benefits of the psychedelic compound are not limited to treatment for cancer patients, however. A 2018 study published in the journal Psychopharmacology suggested that patients with severe treatment-resistant depression benefited from treatment with psilocybin and therapy for as long as six months after treatment.
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A Patient Reported Her Mental Illness Was "Over" After A High Dose Of LSD
A case report published in the Journal of Studies on Alcohol and Drugs in February 2020 described three women's experiences accidentally taking extremely high doses of LSD. One of these women had been diagnosed with bipolar disorder, and had lived with hallucinations since she was 12; after taking more than 10 times the typical dose of acid, CNN reports, she reportedly told her father "it's over," referring to her mental illness. She continued to not experience any symptoms of mental illness until giving birth 13 years later, when she went through postpartum depression.
"There appear to be unpredictable, positive sequelae [effects] that ranged from improvements in mental illness symptoms to reduction in physical pain and morphine withdrawal symptoms," the study concluded. Still, David Nutt, director of the Neuropsychopharmacology Unit in the Division of Brain Sciences at Imperial College London, told CNN that these results should be taken with a grain of salt. "They don't really show the benefits of LSD, rather they show that in some people exceptionally high doses don't lead to enduring harms and may do some good."
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Medical-grade psychedelic drugs, when combined with good, old-fashioned talk therapy, may well be able to ease painful symptoms of severe mental health issues like PTSD and depression. As research expands its scope and improves in quality, these drugs may, like medical-grade marijuana, become more widely approved and accessible for mental health treatment.
Studies Referenced:
Sessa, B. (2017) MDMA and PTSD treatment: "PTSD: From novel pathophysiology to innovative therapeutics." Neuroscience Letters, https://www.sciencedirect.com/science/article/abs/pii/S0304394016304906.
Mithoefer, MC. (2019) MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology, https://www.ncbi.nlm.nih.gov/pubmed/31065731.
Sessa, B. (2019) First study of safety and tolerability of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in patients with alcohol use disorder: preliminary data on the first four participants. BMJ Case Reports, https://www.ncbi.nlm.nih.gov/pubmed/31308191.
Agin-Liebes, G.I. (2020) Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer. Journal of Psychopharmacology, https://journals.sagepub.com/doi/abs/10.1177/0269881119897615?journalCode=jopa.
Carhart-Harris, RL. (2018) Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology, https://www.ncbi.nlm.nih.gov/pubmed/29119217.
Haden, M., & Woods, B. (2020). LSD Overdoses: Three Case Reports. Journal of Studies on Alcohol and Drugs, 81(1), 115–118. doi: 10.15288/jsad.2020.81.115
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