I do think we will find a way to fold these powerful substances into our society. Do I think they could help change consciousness at scale? In my hopeful moments, yes—they do seem to nudge people in the direction of altruism, ego-lessness, connection to nature, and to valuing nature, interconnectedness and love. Is this inevitable? Probably not—some people emerge from their experiences of ego death with a worrying ego inflation. There is also the question of how do you administer a drug to a whole society? You can’t put psychedelics in the water like flouride. We have no other precedents, so we’re really in uncharted territory here. But good research could help us decide if our hopes and aspirations for psychedelics are grounded in reality or dreams.
Michael Pollan
This is important work that remains to be done. The Oregon initiative represents one good-faith effort to design a regime under which people (in Oregon) will have regulated access to psilocybin therapy. There are surely other experiments that will be tried. But the FDA drug approval process is only one path. There will also be a religious/spiritual path, in which new churches that use psychedelics as sacraments will seek, and probably win, constitutional protection, as the Native American Church and two ayahuasca churches already have. This is an exciting time for policy and legal innovation in this area.
The distinctions between legal and illegal drugs are largely arbitrary. Alcohol and tobacco do much more damage to society and individual than most illicit drugs. A genuine risk/benefit analysis would lead to a complete overhaul of the federal schedule of illegal drugs, which cannot be justified on public health or scientific grounds. Politics and history have played a much bigger role than science.
I teach journalism, and specifically teach science journalists how to read a scientific paper, which many of them are not equipped to do. I stress the importance of fact-checking and why journalists should not be afraid of ambiguous information, ie, no need to be all positive or all negative. It comes down to personal integrity and journalistic ethics, and is no different in psychedelic coverage than coverage of any other issue.
There are movements in many places to decriminalize plant medicines and to legalize drugs. Check out Decriminalize Nature and also Drug Policy Action—both highly respectable campaigns. Philanthropic monies are flowing into policy work—Dr Bronner’s, for example, contributed quite a bit to the recent Oregon ballot initiative.
Psychedelics can have great value for people who are not clinically mentally ill and I look forward to a time when they will be available to such people in the same way we make psychotherapy available to people who don’t have a DSM diagnosis of mental illness. People seek therapy who are sad or anxious, who have relationship problems, career questions, etc etc. We’re all on a spectrum at the far end of which is clinical depression or anxiety or obsession or addiction, so we stand to benefit from medicines that alleviate these symptoms. Watch the experiment on Oregon, which has legalized psilocybin therapy for any adult who wants it, beginning in two years or so.
MDMA is farthest along and will probably be approved first, followed by psilocybin,. LSD< DMT, etc are many years away.
Not that I know of, but it’s a rich and fascinating research questions. This is exactly the sort of work that needs philanthropic support. Who else is going to support it?!
I think the history could have turned out differently. President Nixon got fixed on LSD as a critical element of the anti-war movement—why young boys were refusing to fight a war, which seldom happens. However it seems to me the researchers should have fought harder to maintain their ability to conduct research. It was never prohibited but scientists felt the government animosity and funding dried up. I can imagine a scenario where LSD was made illegal but the research continued and psychedelics were put on schedule 2 o3 3 rather than 1. This is purely hypothetical, of course.
I’m not qualified to offer advice. In general people with bi-polar are excluded from the current trials.
Compass PAthways and Usona are running large trials of psilocybin for depression—check their websites for how to participate. For underground guides, you might start by consulting the list of “integration therapists” MAPS keeps on its website.
The kinds of big often spiritual experiences people have on psychedelics could be difficult for our highly instrumental capitalist culture to absorb; such experiences are threatening to many people. This might explain why so much work is being done to develop non-psychedelic psychedelic compounds—drugs that offer the benefits without the “experience.” This strikes me as mis-guided—the experience may well be the “drug” not the compound, but we’ll have to see....
Psychiatry is a long road, but we certainly will need more psychiatrist interested in psychedelic therapy. It’s a good vantage from which to advance the field.
Yes, it looks likely that MDMA will be approved in the next two years, followed by psilocybin within five years. So far the FDA has been true to its word, treating these compounds as if they were any others, throwing up no special hurdles.
I don’t know what DP/DR is, sorry. Episodes of anxiety are not uncommon, and some people using psychedelics outside of clinical trials have panic attacks; these are sometimes mis-diagnosed as psychotic breaks, because they can present similarly, but they usually pass. I can’t stress enough the differences between using psychedelics “free range” and in a therapeutic setting, where even “bad trips” can prove so useful and constructive that they’re typically referred to not as “bad” but “challenging trips.” An experienced facilitator can divert a patient from a frightening episode, often by advising the patient to “surrender” to what’s happening in the mind. The dissolution of one’s ego can be terrifying unless you’ve been prepared to let it go, in which case it can be ecstatic. Setting and setting is everything when it comes to psychedelics.
I think we need more research on these questions. There is some preliminary indications that a single psilocybin experience increase measures of “nature connectedness” and decreases tolerance for authoritarianism. But I wonder about the samples—people positively inclined in these directions already. We need to test the drugs on anti-environmentalists and authoritarians to see if they have a reall effect or just strengthen predispositions.
I would love to see a trial of healthy normals to see if it increases altruistic behavior—how about a trial of two groups of philanthropists, one gets high dose psilocybin and the other not, and which group increases its giving over the following year? do I have any volunteers?
To say microdosing is “not doing much” is to underestimate the power of the placebo effect, especially when attached to a substance with as much psychological power as LSD.
The doses being used in most of the current trials is quite high-- 25mg of psilocybin or about five grams of dried mushroom. This may nto quite be a heroic dose but it’s close. Maybe Matt could weigh in on this.
I think the potential for using MDMA to solve conflicts is a rich area of exploration. I know Rick Doblin at MAPS has a longstanding interest in this. (In the 1980s he sent hundreds of doses of MDMA to the Russian leadership, hoping to advance arms negotiations!) I believe there are some projects along these lines underway or planned in Israel.
As mentioned earlier, training up facilitators is key. I also think we need more basic science to understand the brain mechanisms involved. Most research is focused on treating new disorders, which is important, but there’s not much on HOW psychedelics work—neuroplasticity, neurogenesis, anti-inflammatory effects, potential to re-open critical periods of development, etc. This work will lead to new treatment for new indications eventually. It will also shed light on what consciousness is. There is a young generation of neuroscientists eager to do this work, but as yet, traditional funding sources are not available to study psychedelics, which is why private philanthropy can have an outsized effect here.
Great questions. There are two ways to think about this. If you have a specific concern or focus, you can find an institution that shares it. Carey Turnbull has formed an inititive to deal with the patent issues, for instance (I don’t recall the name of it). If you’re interest in delivering and scaling MDMA therapy for trauma, MAPS is the place to donate. If interested in the treatment of other indications check out Hopkins, NYU, Yale or Mass General—they’re all working on different ones and they al do great work. If basic neuroscience or public education around psychedelics is important to you, consider the Berkeley Center (with which I’m affiliated).
The second approach to find an institution whose values accord with your own and make an unrestricted gift, allowing the institution to allocate funds as they see fit. This is incredibly valuable to an institution, as it allows them to cover vital but unglamorous things like overhead.