New studies are testing whether psychedelic drugs such as LSD and MDMA can treat OCD, post traumatic stress and cancer related anxiety.
On September 19 this year, 12 people gathered in the suburban Hermsdorf district of Berlin for a group psychotherapy session that allegedly involved illegal drugs. A day later, two of the participants were dead and another in a coma. The substances used and exact cause of death have yet to be confirmed. Local newspaper reports have claimed that heroin and MDMA (ecstasy) were taken, but other drugs may have been in circulation.
Garri Rober, the therapist who led the session which included his wife, Elke, is facing possible charges in connection with the deaths and on suspicion of supplying illegal drugs. The other nine participants were released from hospital the next day.
This tragedy, which received international coverage, threatens to derail a fledgling renaissance in legitimate research using psychedelic drugs in the management of common disorders from migraines to obsessive compulsive disorder, post-traumatic stress disorder and anxiety associated with life-threatening illness.
LSD, the drug that was to fuel the Sixties counter-culture, was first explored as a treatment for conditions ranging from neurosis to alcoholism during the Fifties, the "golden age" of psychedelic research. As its use spread from the consulting room to the street, concern about its misuse grew, and it was banned in 1968. MDMA was first used by American therapists in the Seventies before it was adopted by "rave" culture and subsequently banned in 1987.
At the time, little medical evidence of worth had been accumulated about the effectiveness of these drugs in therapy, but now studies using MDMA, LSD, and psilocybin, another tryptamine, are under way in several countries including Britain and the States.
Underground psychotherapy sessions, such as that which took place in Berlin, are already making practical use of them. I have joined in two such sessions myself. I was invited to participate because I have written about hallucinogenic drug research for many years for scientific media such as Nature and New Scientist.
Both sessions involved taking illegal substances – MDMA in one, ayahuasca, a plant-brew from South America which contains the intense and short-acting illegal hallucinogen DMT, in the other.
The first took place over a weekend in 2005, in a smart apartment in a European city and was hosted by three legitimate psychotherapists who organised these special classes for treatment-resistant patients. I was one of 13 people there, aged 20-40, who'd paid 300 euros.
The session started with exercise, discussion and resuscitative breathing, which involves taking deep breaths very quickly to achieve a state of relaxation, before taking the MDMA. I spent most of the next eight hours in a sleeping bag trying to focus on my chosen theme for the "journey" – my relationship with my alcoholic father – while listening to bad music through headphones. When you wanted to talk, you raised your hand.
Brain-imaging studies from the University of Chicago show that MDMA reduces activity in the left amygdala – part of the brain responsible for the fear response. Some researchers believe that the reduced fear between the patient and therapist can catalyse the psychotherapeutic process and leads to positive results in a shorter time frame than usual.
For me, though, the session ended without any doors being opened. I found the drug, which I'd taken on an empty stomach, was overpowering, which made it hard for me to express my thoughts.
Three months later my father died from a sudden but not unexpected heart attack. It was in the difficult months that followed, that my half-constructed conclusions from the session about how I "managed" his demanding behaviour took on extraordinary new meaning. As an alcoholic he often wasn't a very nice person, but I'd been a good son and stood by him when he needed it. These thoughts had made me feel only marginally better when he was alive but a lot better after he had died.
My second session was in 2008, after I was introduced to a middle-aged shaman in London for an article I was writing. He'd spent years in Peru learning the craft of spiritual-healing.
First we smoked raw leaf tobacco in a pipe, to "cleanse" the room of evil spirits or negative energies, before imbibing the ayahuasca, a viscous, scarlet red brew, out of a bowl using both hands as you would traditional Japanese tea. We sat in silence, in the dark, for six hours as the shaman sang songs in the language of the Aztecs.
My visual field was soon dotted with the whirling kaleidoscope of fractal polygons, typical of the psychedelic experience. Soon, I saw two interlinked golden rings with a diamond atop, interlinked. Then a giant eyeball clenched by a green, goblin-like fist scrutinised me for a second before it vanished. The drug had abruptly stopped working. I'd been warned that ayahuasca didn't work for some people and, given the high dose I had taken I must have been one of them.
At present there is a fragile understanding between scientists, government regulators and the public that has enabled legitimate research to resume to determine the medical value of these drugs. Tryptamines such as LSD and psilocybin work by binding to the same receptors on nerve cells as the naturally occurring neurotransmitter serotonin which is involved in the regulation of mood, sleep, and emotional reactions such as fear and anger.
MDMA belongs to a different family of chemicals, but also works on the serotonin system by promoting its release and inhibiting its uptake. MDMA also releases the hormone oxytocin, "the love chemical", which is produced after hugging, childbirth and orgasm, and which facilitates trust or promotes bonding.
So what exactly is the evidence so far? The American journal Neurology recently reported that LSD and psilocybin can be more effective than conventional migraine drugs in controlling cluster headache attacks, preventing new cycles of attacks, and extending remission periods. Meanwhile, a study at the University of Arizona, Tuscon, used psilocybin to treat obsessive compulsive disorder (OCD) and showed a positive but temporary reduction in OCD symptoms.
At last year's annual convention of the International Society for Traumatic Stress Studies in Chicago, Dr Michael Mithoefer, a psychiatrist, showed that 92 per cent of people in a group taking MDMA (under legal trial conditions) experienced a significant drop in their post-traumatic stress disorder scale. And in Solothurn in Switzerland, psychotherapist Peter Gasser, is undertaking legal, controlled clinical trials at his private practice to test whether LSD-assisted psychotherapy can help people with the anxieties related to terminal cancer. Similar experiments in the Sixties showed positive results.
Dr Ben Sessa, a psychiatrist from the Department of Psychopharmacology at Bristol University, is among those who have endorsed the return of psychedelic research. "Recent trials are now demonstrating positive results using the same modern protocols as demanded for other conventional drugs," he says. "I totally support research that explores the therapeutic possibility of these drugs. As a doctor, not to so would be to turn my back on my patients."
But the controversy continues. According to Dr Ken Checinski, a consultant psychiatrist at St George's, London, psychedelic drugs should have no place in psychotherapy. "The benefits are short-term, and the risks are not inconsiderable. It would also give a message that people can easily get in touch with their feelings through the use of mind-altering drugs, which is not a message I would want to give."
But what is the opinion of those who have tried them? Most that I have spoken to claim to have found their underground sessions useful. Interest is growing across Europe, helped by easy access through the internet. It appears that, legal or not, in a search for reflief, more and more people are willing to take the risks.
By Arran Frood
November 16, 2009
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Can mind-altering drugs have mental health benefits?