A lengthy article appeared in the New York Times a couple of days ago about the growing scepticism of many of the studies about the use of psychedelics for various mental health issues. The title:
How Psychedelic Research Got High on Its Own Supply
is pretty amusing, because the article argues that this is literally what has happened with some researchers.
Some extracts:
If you had asked me some years ago whether the F.D.A. would and should approve this much-anticipated new drug, I would have given an enthusiastic yes. I was for a long time a psychedelic proponent, bullish on the idea that a once-illicit treatment could have widespread benefits for the many who are suffering. But through my own experience in the psychedelic community and proximity to the science of psychedelic therapy, I’ve come to realize that the field is plagued with poor clinical trial design and questionable practices that have led researchers and clinicians to premature confidence in what psychedelics can do. The recent F.D.A. decision has added to my concern that Western medicine’s promotion of psychedelics might have oversold hope to the most vulnerable among us, while fueling an industry that was once projected to be worth over $7 billion by 2029.
My personal Summer of Love kicked off in 2018, when I first dropped acid and slipped into a community of medical professionals and researchers who both promoted and used psychedelics. The excitement for these drugs seemed to be in the very air of Cambridge, Mass., where I had moved for a science journalism fellowship, auditing classes at M.I.T. and Harvard. I attended a seminar taught by Michael Pollan before he released his 2018 book on the resurgent popularity and potential of psychedelics, “How to Change Your Mind.” Society seemed to be slowly opening up to these drugs, and it felt like we were at the center of things. Taking MDMA also felt like a doorway to the purest form of love and truth I had ever experienced; it seemed obvious to me that MDMA had benefits.
In hindsight, the confidence we had in these substances before the clinical trials were finished should have been a warning sign that hype was outstripping the science.....
...the potential for researchers to bias the outcomes of these trials has become a common critique of the psychedelic research field. It is unusual for a drug under F.D.A. consideration to also be used personally and recreationally by the researchers studying it, or even for clinical trial researchers and clinicians to be encouraged to test the drug themselves. But that’s exactly what Lykos has done with MDMA. In a phone conversation after the F.D.A. decision, Dr. Doblin told me that therapists should be “strongly encouraged” to have their own psychedelic experiences, as it “really helps therapists to better understand their patients.” He says almost all of the researchers in the Lykos phase 3 clinical trials underwent MDMA experiences themselves, and many studying the drug are open about their own recreational use.
It’s difficult to disentangle the personal enthusiasm for psychedelics with the study of these drugs as therapeutic interventions.
The article notes that this has been an issue with research on the potential benefits of psychedelics from the start:
As part of a postwar pharmacological boom, psychiatrists in the 1950s explored psychedelics enthusiastically. About a thousand research papers were produced; tens of thousands of patients were prescribed LSD. But as the lines between scientific, clinical and recreational drug experimentation among researchers blurred, experts who once saw potential in psychedelics warned against their potential dangers.
“The trouble is, LSD attracts unstable therapists as much as it does the neurotic patient,” said Sidney Cohen, a leading psychedelic researcher and psychiatrist, in 1963. “It gives them an intoxicating sense of power to bestow such a fabulous experience on others.”
As you may expect with this controversial topic, the comments are very split between those who think the article is a "hit piece" (and who often cite their own positive experiences with psychedelics as reason to not believe the scepticism), and those who say "I always suspected this."
Guess which category I fall into! :)
"As part of a postwar pharmacological boom, psychiatrists in the 1950s explored psychedelics enthusiastically. About a thousand research papers were produced; tens of thousands of patients were prescribed LSD. But as the lines between scientific, clinical and recreational drug experimentation among researchers blurred, experts who once saw potential in psychedelics warned against their potential dangers."
ReplyDeleteI'll put a question mark over that because a former collaborator from NY told me that many in the field were very angry with Leary because he spooked the government into stopping the research. During the 60's the government stopped all research into illicit drugs as therapy.
It may turn out that psychedelics will be as useless as meditation and many depression drugs. We don't know yet. What we do know is that unlike MDMA LSD and psilocybin have potent effects on a key growth factor(BDNF) that was long linked to depression before the psychedelic mania set in. Even 20-30 years ago it was known that increasing BDNF was a common feature of many successful therapies(lithium, ECT, antidepressants).
“The trouble is, LSD attracts unstable therapists as much as it does the neurotic patient,”
That's true of psychology in general. Elkhonen Goldberg stated in the Moscow postgraduate psych school when assessing prospects they would interview them and no matter how good their scores if there was evidence of a psychopathology a big red tick would be placed against their name. My collaborator said a NY post grad school had the same practice.
There are obvious methodological problems with psychedelic trials. Can't use placebo, can't blind let alone double blind, and there are risks. Nor am I adverse to the idea of "spiritual awakenings" having significant psychological benefit. I'm not a materialist and I think too many scientists don't appreciate how a changed worldview can profoundly benefit some people.