Legalising Hallucinogenics to Treat Mental Illness
This week
I came across a blog post on ‘Vox’ entitled: ‘The most convincing argument for legalizing LSD, Shrooms and other psychedelics’.
As drugs are an interest of mine, I tend to follow their news trends quite closely
in the UK. Now, don’t mistake that to mean I take drugs: I sincerely do not condone drug use, I merely work with them. In
fact, that’s my entire job: to analyse drugs. I see it almost every day, death, violence and destruction from the use
of drugs. I don’t mean that to sound overtly poetic, it’s simply the truth. Imagine my
surprise to see an article in support for the legalisation of lysergic acid
diethylamide (LSD), Psilocin (magic mushrooms) and Ibogaine - complete with evidence. Let’s look at the
article, the papers and the evidence we have to support the use for these
substances for treatment purposes.
The Article and the Sources
The
article is written by German Lopez. He seems to write a lot on drugs from what
I can gather, I don’t know what his stance on the issues, but I can take an
educated guess from this article. The article talks more about the enrichment
of life through psychedelic drug use as opposed to them being used as a cure
for anything. Nevertheless,
he does mention the use of drugs for cure of mental illnesses such as anxiety,
its hard to see what the focus of the reason for legalisation is, he states
this:
‘This is the case for legalizing hallucinogens. Although the drugs
have gotten some media attention in
recent years for helping cancer patients deal with their fear of death and
helping people quit smoking, there's also a similar potential boon for the
nonmedical, even recreational psychedelic user. As hallucinogens get a renewed
look by researchers, they're finding that the substances may improve almost
anyone's mood and quality of life — as long as they're taken in the right
setting, typically a controlled environment.’
The
words ‘Typically in a controlled environment’ is what is getting me here. How do you control for that?
What would be deemed the ‘right’ setting for hallucinogenic drugs? There are arguments for legalising drugs to take down the illegal market, I don't think that's what this post is is aiming at. But here is my take on that segment: Let’s
take LSD for example and hypothetically say that these drugs work as cures for
mental illnesses. Legalizing something such as LSD doesn’t mean that the
illegal market will dissipate, far from it: there will be competition. Especially
in America and places where people pay for medical care, the black market will
look a whole lot better and ultimately cheaper - does that not make it more dangerous? Anyway, getting back to it.
Looking
at this guys 'backing up' with evidence is a little strange. He states:
“….why preliminary, small
studies and research from the 1950s and '60s
found hallucinogens can treat — and maybe cure — addiction, anxiety, and
obsessive-compulsive disorder”
I
looked at these studies, well, I say studies. Links to articles that back up
the point he is trying to make, which in turn link to the studies. I can find a million and one articles for the
use of psychedelics to treat anxiety and I can find the same for against the
use. Choosing favour over one is called Confirmation Bias. I am more focused on what the science says, rather than a jaded
reporters take on the interpretation of a study.
Pilot study of the 5-HT2AR agonist Psilocybin in the treatment of tobacco addiction is a study published in the Journal of
Psychopharmacology and linked in the article, published in 2014 and
concluded:
Although the
open-label design does not allow for definitive conclusions regarding the
efficacy of psilocybin, these findings suggest psilocybin may be a potentially
efficacious adjunct to current smoking cessation treatment models
The
research doesn’t appear to be have been picked up after that. The study used
only 15 subjects dosed with varying levels of psilocybin and looked at the efficacy of the drug to wean smokers off of cigarettes, with a 80% success rate. Those of you that
have followed this blog and know me, know that sample size is the crux of any
study. I think you know what I am going to say on the ethics, the results and
the tediousness in which this applies in the grand scheme of things. I’ll save
you from it and allow you to infer it for yourselves - thinking is fun isn't it? I will say this though; I came across a study describing the synergism of tobacco and psilocybin. Tobacco exposure
decreases the amount of an enzyme called monoamine oxidase inhibitors (MAO)
within the body. Psilocybin has been known to have prolonged effects with the
presence of MAO after binding to hydroxytriptamine receptors (HT), which in turn, can be effected
by MAO. It is little reckless to study this as a therapeutic avenue, considering the active ingredient can potentially synergise, is it
not?
The
second study linked to is from a research centre called the Heffter Research Institute, but published in JAMA Psychiatry. The institute itself is set up in order to see if psilocybin is
effective in treatments. That’s the whole research foundation. As far as I can
tell, the research is mostly in therapeutic treatments to ease symptoms in
advanced stages of cancer. This is far from the word ‘cure’ which is used twice
the in article. The study appears to focus more on the ‘psychospiritual experiences’. It is quite evident that there is a little science in the study, none of which can be measured, with exception of physiological effects (heart rate and blood pressure). The measured effects to make the study 'significant' are the account of people feeling better
after taking hallucinogens – which they say correlates with the therapeutic outcome,
within the 12 subjects used, within a those, there was a placebo group - the study does not state any numbers for the subjects in each group. The basic consensus is: their mood changed after taking drugs - which is probably good considering they had terminal cancer.
The
third study linked me to a page that was unable to be found. The fourth linked
me to an article he wrote previously expanding on the first study published
in Journal of Psychopharmacology. I decided not to read that particular article. The
rest of the article focuses on studies linked to cancer and easing the patients
into a ‘better quality of life’. After all, that is the whole point of the
article, to inform you on the ‘cure’ for (the word he uses twice) depression and
improve the quality of life. There is a lot to be said on the easing of the
pain of terminal cancer patients, but are hallucinogens the answer? The links
provided to studies to centre around one place: the Heffter Research
Institute. Most of the studies published by them are not empirical and are more anecdotal
with very the few patients used in the studies - again, infer from that what you will.
Controlling
After
laying out the evidence, he circles back round again to that word: control. How
can this be carried out in a controlled setting? He asks. And then he (or he is possibly quoting someone, it is unclear) lays out
the plan (N.B. the numbers are added by myself for clarity below):
“Here's how it
would work: A psychedelic user would go through some sort of preparation period
to make sure she knows what she's getting into [1]. Then she could make an
appointment at a place offering these services. She would show up at this
appointment, take the drug of her choice (or whatever the facility provides),
and wait to allow it to kick in [2]. As the trip occurs, a supervisor would
watch over the user — not being too pushy, but making sure he's available to
guide her through any rough spots. In some studies, doctors have also prepared
certain activities — a soundtrack or food, for example — that may help set the
right mood and setting for someone on psychedelics [3]. Different places will
likely experiment with different approaches, including how many people can
participate at once and how a room should look.[4]”
1) We call this consent; in a clinical
trial a person is wholly informed on the ins and outs of the study. What they
are taking, the effects, the upsides, the downsides, what they must do, what
they mustn’t do. Everything. This would include any previous medical trials
carried out. Including information of efficacy and deaths. The same applies to
any drugs you take from a pharmacy, that’s what the pamphlet is that nobody
really cares to read. What faced with the consequences in a 'controlled' setting, how likely are you to consume the substance?
2) Any drug of your choice.
This, right now is starting to sound less like a legalization scheme and more
like a drug enhancement scheme.Which one of these psychedelics exactly is he saying has the evidence to help? Psilocybin is heavily featured in the article - but i cannot find any actual trials featuring this drug with enough evidence for legalisation. This Review (PDF) pretty much sums up Psilocybin, its effects and evidence for therapeutic use.
3) Say this was legalised in the
U.K – Do we have the funding? No. Doctors and medically trained professionals
do not want to spend their days watching someone off their face on drugs, they
see that enough. In the U.S.A – how much will this cost? Who is going to be
able to afford this?
4) I hardly think this is the
time to start suggesting studies on the efficacy of different rooms, I think we need actual hard evidence with peer reviewed research prior to this.
My
final point on this is a point I made earlier in this post. Drug users would be
all over this legalization, but drug dealers will be on it faster – they
literally own the market for this (sad, but true). Drug users don’t want
controlled environments. LSD and other hallucinogens are essentially partydrugs – you take them at friends houses with friends to have a ‘good time’. Not
sat in a room on your own whilst a doctor is staring at you, but each to their
own.
Is this worth legalising?
To
this guys credit, he clearly lays out the facts on the two big risks of hallucinogens:
the fallout and the ‘bad trips’. Drugs have consequences, despite the debate
over them, they are on banned lists for a reason. They are dissociative drugs,
essentially meaning that they alter perceptions by acting on receptors
responding to serotonin. The experiences themselves can vary and are often
unpredictable. The long term effects of hallucinogens are very well documented,
paranoia, mood swings, confusion, hallucination and constant visual
disturbances. Mood swings and paranoia huh? This article is a defiance within
itself. It is proactively talking about legalising something that it claims ‘cures’
depression with something that has a very real side effects that cause
depression, the very definition of counterproductive. How is a trained
professional to deal with a ‘bad trip’? Just because they are in the confinements
of a ‘controlled’ environment, doesn’t mean the bad trip will be eased. A bad
trip is referred to when the drugs cause anxiety or panic attacks, which again,
counterproductive. Lets think about costs: Drug use is said to cost (PDF) a good £15,400,000,000. That is a lot of money on people blindly taking drugs. Lets consider that it is legalised, it could be argued that as it is more controlled, the costs will be less, yes? But will more people not be inclined to take drugs? They are legal after all, and if they are legal, they should be fine to use? More users, more issues, more money, logically speaking.
LSD
users develop and high degree of tolerance to the effects of the drugs. This
means repeated uses require larger doses to get repeated effects. In turn,
frequent uses if legalized will quickly diminish in the benefits that are being
propagated. For example, say I am depressed or anxious and I attend one of
these ‘controlled’ settings for a hit. I get a dose. I have a trip, I feel
better. I attend again a week later. A month later I am chasing a high. I am
paying to feel no effects.
Conclusion
The
market for psychedelics is renownedly small in the grand scale of drug
use, they have arguably less effects on people than narcotics. But should they be legalised? In my opinion, the benefits do not outweigh the harm. Infact, I have researched into this and I am still yet to find any benefits that have been well documented. Seemingly, the author of the post on VOX has information I don't and concludes with saying:
‘But if we know the benefits to public health and well-being are real,
it's irresponsible to let the potential go untapped’.
As stated, am
really struggling to see what the benefits to hallucinogens like LSD are. In his post there is nothing substantiating the claim. In the literature there
are only small scale pilot studies that never get picked back up. There’s a
reason; the studies don’t conclude much, don’t have high statistical
significance and lack solid foundations for future research. Using hallucinogenic
to treat depression and anxiety is highly counterproductive, considering their
side effects, including the risk of harm and death. Psychedelics do tend to have a good record of safety in terms of clinical research, I am not questioning that, I am questioning the efficacy of such studies - for now, I am not convinced. For an article entitled: ‘The most convincing argument for
legalizing LSD, Shrooms and other psychedelics’ there really isn’t much in
the way of convincing.
Note: This is by far not the only post out there, there are many more, with many other suggestions on how to legalise drugs and why (mostly built on a unsubstantiated medical foundation)
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