The psychedelic renaissance is on the brink of a schism: the outdated dichotomy between chemistry and subjective experience is now reincarnated in the opposition between newcomer investors obsessed with neurochemistry and traditionalists who worship the alteration of consciousness and the dissolution of the ego as foundations of the treatment of mental disorders such as depression.
These are not just philosophical beliefs or competing explanatory models for the healing potential of psychedelics, but rather disparate approaches to how the emerging alternative therapy will be incorporated into the healthcare market. Or, if you like, a clash of parapsychedelics against psychedelics as we know them.
On the one hand, the mainstays are patents, startups, regulation by health authorities and coverage of new treatment protocols by health insurers. In this case, the profitability would greatly increase if they used short-acting drugs, preferably without the risk of causing complicated psychedelic trips or even without involving prolonged psychotherapy.
On the other hand, heirs of a long tradition of underground shamanic practices and alternative clinics work to preserve, in partnership with the reborn psychedelic science, the emphasis on care and psychic elaboration bequeathed by the traditional use of psychedelic substances.
In the field here dubbed parapsychedelic, three business models are outlined to explore in the market the potential to treat conditions ranging from drug-resistant depression to migraine, including post-traumatic stress, chemical dependency, anxiety, OCD, anorexia and, perhaps, Alzheimer’s.
The first model is still moving towards maintaining the psychotherapeutic component in the treatment, restricted, however, to a dozen meetings with facilitators. The process would start with patient preparation meetings about what to expect from the psychedelic experience, then dosing sessions, then integration sessions (conversations to interpret emerging content and obtain useful clues for conduct in everyday life).
Companies like Compass Pathways plan to patent the entire package, from their purified psilocybin variety of “magical” mushrooms dubbed COMP360, to the care protocol. Intellectual property over ancient substances and practices, however, has come under intense resistance.
Even this modality would face some obstacles in the usual context of care services, due to the long duration of the effect of psilocybin, MDMA, LSD and ayahuasca and other psychedelic compounds under study (4 to 12 hours). The ideal would be to have short-acting drugs such as ketamine (or ketamine), a dissociative substance with different action from classic psychedelics such as LSD and psilocybin.
Ketamine has been used with some success in the rapid treatment of depression. It has the advantages of being manageable in 1-2 hour consultations and being legal, including with the recent authorization for psychiatrists to administer the ketamine variant in the form of a patented antidepressant spray.
In this quest for short-term psychedelics, Bryan Roth, from the University of North Carolina (USA), was awarded US$ 27 million (R$ 150 million) from the American agency Darpa (Projects in Advanced Defense Research). He will lead a group of laboratories in the effort to design effective drugs against depression, anxiety and substance abuse “without serious adverse effects”.
Due to this temporal limitation, a second strategy emerges, still as an experimental proposal, to place psychedelic therapies on the market: to develop molecules with a psychedelic effect whose effect does not exceed two hours. This is one of the lines being studied by the shareholders of Atai Life Sciences, which is also a major investor in Compass, and by Field Trip Health, in Canada, according to an article by Will Yacowicz in Forbes.
The third way to explore psychedelics in mental health goes further and seeks to completely get rid of what is called travel, the dissociative and hallucinogenic effect of these compounds. This is the plan, for example, of David Olson of the University of California at Davis.
Olson has already published a study on a drug analogous to ibogaine that he developed with the aim of offering an alternative to this derivative of an African plant to treat drug addicts, but lacking the prolonged and intense oneiric effect triggered by the substance originating in Gabon. founders of Boston company Delix Therapeutics, who also have depression and dementia in their sights.
No one is yet making money from one of these three technoscientific business models, but they have already allowed them to raise considerable amounts of capital. They are countered by at least three other strategies to bring the therapeutic potential of psychedelics to the public today unattended by the psychiatric pharmacopoeia.
The three are characterized by non-profit making, claiming to be heirs to the tradition of healing and self-knowledge of the counterculture times, and for not relying on intellectual property to support themselves, although they do not exclude it. The alternative trio has been featured on this blog more than once, so it would not be the case to elaborate on them:
- The non-profit corporation model followed by the Multidisciplinary Association for Psychedelic Studies (MAPs) in its decades-long effort to regulate the treatment of post-traumatic stress disorder with MDMA-assisted psychotherapy, which could happen in 2023;
- The open science strategy spearheaded by the Usona Institute in competition with Compass in clinical trials of psilocybin for depression, including sponsoring a repository of studies and traditional knowledge on “magical” mushrooms and other ritual-use psychedelics, Porta Sophia, for questioning of patents due to the existence of prior knowledge;
- The innovative ongoing experience in the US state of Oregon for licensing psilocybin therapies, certification and source control of the compound and training of specialized therapists, in parallel with the progressive decriminalization of the adult use of various so-called “entheogenic” drugs (alternative term, less stigmatized, to designate psychedelics).
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