Addiction

Drug addiction is indirectly and directly responsible for 11.8 million deaths each year globally.

Psychedelic Therapy for Addiction?

In 1943 a Swiss scientist named Albert Hofmann was studying medicinal plants. Or to be more specific, he was trying to purify and synthesize their active chemicals for use in pharmaceuticals.

An exciting area of research at the time, Hofmann and his colleagues spent their days looking at all kinds of plants from all over the world. Their goal was to find active ingredients that could potentially be used in a variety of medicinal treatments. So when he managed to successfully synthesize Lysergic Acid Diethyl-amide - known to the rest of us as LSD -  for the first time in 1938, it was just a small cog in a big wheel.

It wasn’t until 16th April 1943, when Hofmann returned to his LSD research after a five-year hiatus, that he accidentally absorbed a small amount through his fingertips. He described the resulting mini-trip as a “not unpleasant intoxicated-like condition, characterized by an extremely stimulated imagination”. Three days later he intentionally took a larger dose, and the very first Bicycle Day was born. It was the first time a psychedelic drug was used in a (at least partially) controlled scientific setting.

The Psychology of Psychedelics

For the next few decades scientists all over the world conducted extensive research into the psychedelic effects of plant-derived chemicals and their potential use in therapeutic treatments.

Psychedelics cause an acute change in brain activity, resulting in a profound altering of consciousness, perception and mood. To put it simply, parts of the brain that don’t normally communicate with each other forge connections in response to psychedelics. And parts of the brain that do normally communicate - known as the default mode network - are quietened during the trip.

This results in the feeling of spiritual awakening many people experience while taking psychedelics, as well Dr. Hofmann’s ‘extremely stimulated imagination’. With a person’s inner voice put on the back-burner and all these new connections sparking up, deeper feelings and experiences can come to the fore and be explored.

Scientists studying these effects quickly became convinced that when done correctly, tapping into this ‘inner insight’ could be used to treat a variety of psychological conditions like depression, addiction and anxiety.

LSD and the Birth of Psychedelic Therapy for Addiction

In the 1950s psychiatrists Humphrey Osmond and Abram Hoffer conducted one of the first large-scale experiments in relation to this. They chose over 1,000 patients with acute alcoholism across six hospitals in Saskatchewan, for whom traditional treatments like Alcoholics Anonymous had failed. After trying LSD therapy, around half of the participants reportedly became sober or significantly reduced their drinking.

More and more studies continued to show promising, if preliminary, results that psychedelic therapy for addiction could be a success. As word spread, people outside of the scientific world began to take an interest in the positive effects these psychedelics could create. By the 1960s recreational use of LSD, psilocybin (‘magic’) mushrooms and other psychedelics was widespread. But with recreational use came misuse and abuse, and with that came political pressure to clamp down.

The Downfall - and Rebirth - of Psychedelic Therapy for Addiction

In 1970 U.S President Richard Nixon signed the Controlled Substances Act into law, which deemed many psychedelics illegal due to their high potential for misuse and lack of acceptable medical use. Research in the area of psychedelic therapy was swiftly shut down, and stayed shut down until relatively recently.

In 2000 a research group led by psychopharmacologist Roland R. Griffiths at John Hopkins University School of Medicine became the first in the U.S. in decades to win regulatory approval for psychedelic research. A new age of worldwide scientific research in the area is now in full flow. But with much more rigorous regulation and rightly stringent patient welfare standards, are the results still as promising?

In short, yes.

Psilocybin Addiction Therapy

A 2012 study led by addiction psychiatrist Michael Bogenschutz administered psilocybin, the psychedelic compound in ‘magic’ mushrooms, to 10 alcohol-dependent volunteers. They were screened for any family history of mental disorders such as schizophrenia and psychosis, which psychedelics can provoke (and which they became strongly associated with during the 1960s). After their controlled and supervised ‘trip’, participants showed a significant decline in drinking that lasted through to their final follow-up nine months later.

Over at John Hopkins University, psychiatrist Matthew Johnson led a similar study on 15 long-time smokers, all of whom had tried and failed to quit their nicotine habit using various other treatments. Six months after participants’ initial psilocybin dose, 80% were still abstaining from smoking.

MDMA Addiction Therapy

It’s not just psilocybin that has proven effective. An ongoing study at Imperial College London led by Dr. Ben Sessa is testing whether several small doses of MDMA, in conjunction with psychotherapy, can help patients overcome alcohol addiction. So far only one participant has relapsed, while five have stayed completely sober. A further four to five participants have had occasional alcoholic drinks since the dose, but not in the amounts that doctors would consider as alcohol misuse or abuse.

Ketamine and Addiction Therapy

Ketamine has long been touted as a therapy for clinical depression, but it can also be applied to addiction therapy. Ketamine blocks the brain receptor called NDMA, which regulates mood and is required for memory formation. Researchers believe that it could weaken or disrupt the memory triggers associated with alcohol use, or in some cases even erase them altogether. Not only would this reduce alcohol-related harmful behavior, it would also reduce depressive symptoms that commonly go hand in hand with it.

Ibogaine and Addiction Therapy

Another psychedelic that has shown potential to treat addiction is ibogaine. Derived from a plant found in rainforest environments in Africa, it is the focus of several new studies that have shown encouraging initial results. Anecdotal evidence suggests that it can lessen the intense withdrawal symptoms and cravings experienced by those detoxing from opioids, methamphetamines and even cocaine.

According to American Addiction Centers, treatment for addictive substances with ibogaine results in a 20-50% rate of abstinence at a one-year follow-up point. However, doctors have stressed that its effectiveness is in easing withdrawal symptoms, and follow-up psychotherapy is necessary to progress patient recovery.

How does Psychedelic Therapy for Addiction work?

In fact, none of the above studies (or any others for that matter) consider psychedelics as a ‘cure’ for addiction. Instead, they are an effective part of treatment that, when combined with psychotherapy, a strong support network and many other factors, can contribute to successful recovery.

Psychedelic therapy for addiction includes elements of all of the above. In many of the studies previously mentioned, doses of psychedelics were only introduced after weeks of psychotherapy sessions. These psychotherapy sessions continued for several weeks after the initial dose too, and regular follow-ups were conducted up to 12 months afterwards and sometimes beyond.  

While undergoing their ‘trip’, participants typically stayed in a secure room with psychotherapists present at all times, guiding the experience and reassuring them if any aspect of the experience provoked fear or anxiety. Participants would usually wear a blindfold and headphones which would play soothing music, to create as calming and neutral an environment as possible. They would remain in this setting until the full effects of the psychedelic had passed.

With all of these precautions in place psychedelic therapy is undeniably safer than ever before, and infinitely safer than some of the unorthodox studies conducted in the 1950s and 1960s. However researchers will be the first to admit that it is not a one-size fits all therapy. There is a reason why government authorities banned psychedelic drugs; when in the wrong hands, things can turn very bad very quickly.

However in the right medical setting, when used in a controlled and supervised manner, psychedelics can absolutely form part of an effective treatment for such issues as addiction, depression and anxiety.

Psychedelic Therapy: The Future

With more and more research adding pieces to the puzzle, scientists are finding more and more possible uses for psychedelic therapy. The neuroplasticity (or brain re-wiring) that psychedelics produce can have lasting effects on cognitive processes. So for people with forms of dementia such as Alzheimer’s, psychedelics could be an effective therapy during early stages of the disease. If research continues to be successful, who knows what other treatments psychedelics could be used for in future.

So what happened to Albert Hofmann? After the effects of his trippy bicycle ride from his lab to his home wore off, he continued his research into psychedelics with vigor. As well as LSD, he was the first to synthesize psilocybin. During the 1960s and 1970s when psychedelics were banned across the world, he continued to champion their use in supervised, controlled manners for research purposes. Mere weeks before his passing in 2008 he was still advocating their use,  and was due to speak at the World Psychedelics Forum that same year.

He continued to take occasional small doses of LSD throughout his life, calling it medicine for the soul.

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