Opinion – Psychedelic Turn: Psychedelic revival faces risk of further reversal

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Psychedelic researchers fear reliving the trauma of a negative turnaround like that of the 1970s, with the declaration of the War on Drugs by US President Richard Nixon. The ban on LSD and other mind-altering drugs spread around the world and put the brakes on two decades of studies of these drugs.

At the turn of the 21st century, the field of psychedelic science began to rise again. In place of the stigmatized lysergic acid, compounds like psilocybin from “magic” mushrooms and MDMA from ecstasy have gained prominence, which have been tested with relative success against depression and PTSD, respectively.

Scalded cats, some researchers have launched a preemptive strike, so to speak, to deflate the bubble of enthusiasm before it bursts, scattering shrapnel everywhere. Two leading figures came forward to voice their fears and preach restraint: Rosalind Watts and Roland Griffiths.

Clinical psychologist Watts participated as a guide to psychedelic experiences (“trip-sitter”) with psilocybin patients in a celebrated trial by Imperial College London, published in 2016 in the medical journal Lancet. In the next study by the same group, which compared psilocybin with an antidepressant (escitalopram) and was also highly publicized, she acted as the clinical leader.

This work, as well as another article by the Imperial team led by Robin Carhart-Harris, received recent criticism in an editorial signed by experts from Australia and the USA, as reported in this blog. Watts did not, however, open fire on the two texts, focusing instead on questioning his own role in disseminating these results.

The mea culpa emerged in an unusually candid piece posted on Medium in February, titled “Can Magic Mushrooms Unlock Depression? What I’ve Learned in the Five Years Since My TEDx Talk.” The 15-minute presentation, held in Oxford, has 23,000 views on YouTube.

Watts apologizes for putting more emphasis on the psychedelic substance in mushrooms, psilocybin, than on the psychotherapeutic process surrounding its administration to depressed patients in the clinical trials in which he participated. “Watching it again today, I can’t help but feel like I’ve unknowingly contributed to a simplistic and potentially dangerous narrative around psychedelics; a narrative I’m trying to correct.”

She says that several of these volunteers faced painful experiences, which demanded a lot from her and other guides. The drug only acted as a catalyst for the psychotherapeutic process of integration, opening floodgates to a torrent of buried content and emotions that demanded interpretation and assimilation.

“Little did I know that my optimism would prove to be part of the problem rather than the solution. The reversal of the reversal around psychedelics is underway and could be as damaging to the healthy flourishing of a future that includes psychedelic healing as the first reversal was. , which took place in the 1960s and 70s.”

Watts attributes the setback to a wave of hype, exaggerated promises, magical thinking, marketing, gilding pills, simplistic catchphrases, eager investors, a gold rush and turf grabs. “This wave has been accompanied by the jettisoning of critical voices, such as those of victims of sexual harassment in psychedelic contexts rejected by countless respected professionals in the field, so as not to emanate their brilliance.”

Hype is also the subject of Griffiths, a psychedelic revival pioneer in psilocybin research, and two colleagues at Johns Hopkins University, David Yaden and James Potash. They published two months ago in a US medical association journal, JAMA Psychiatry, an opinion piece entitled “Preparing to burst the psychedelic hype bubble.”

Griffiths and co. they attribute the hype, in the first place, to the interests of the press and investors, who would be inflating preliminary results, although promising. But they also admit that researchers and doctors involved in clinical trials do not communicate with the necessary care.

“In recent years, a disturbingly high number of articles have promoted psychedelics as a cure or miracle drug, as well as potential investment in psychedelics reaching billions of dollars. These extreme shifts in perception can create impediments to rigorous science and reasonable clinical applications. “, warns the comment, alluding to the accelerated abandonment of previous prejudices.

“However, when it comes to psychedelics, the scientific data seem to show that both the super-enthusiastic and the super-skeptical are wrong.”

The misconceptions of enthusiasts would be to minimize the risks of using psychedelics and give only average results as good, such as the tie between psilocybin and escitalopram in the Imperial College study. The issue of risks, by the way, was emphasized in September, at the Horizons Northwest conference in Portland (Oregon), by none other than Carhart-Harris, as well as by Brian Anderson, from the University of California at San Francisco.

The authors of the JAMA Psychiatry text use a generic diagram of technological innovation, the Gartner Hype Cycle reproduced above, to characterize the current phase of the bubble: we have passed the peak of interest and headed for the ditch of disappointment.

Ultra-positive journalistic reports become ultra-negative, as in cases of sexual harassment. Over time, however, more calibrated assessments of evidence – such as the finding that abuses are rare and benefits common – can lead to a more productive plateau.

“If perceptions of psychedelic science change in line with this process, then we are fast approaching a dangerous time for the field of research. The potential for retaliation is real; we saw this psychedelic turnaround in the 1960s.”

Yaden, Potash and Griffiths argue that it is the duty of scientists to challenge ideas that psychedelics are a panacea for any psychiatric disorder or social calamity, such as racism and war.

“We encourage our colleagues to help deflate the psychedelic hype bubble in a measured way so that we can get on with the hard work of more accurately determining the risks and benefits of psychedelics,” they conclude.

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To learn more about the history and new developments of science in this area, including in Brazil, look for my book “Psiconautas – Travels with Brazilian Psychedelic Science”.

Be sure to also see the reports from the series “A Resurreição da Jurema”:

https://www1.folha.uol.com.br/ilustrissima/2022/07/reporter-conta-experiencia-de-inalar-dmt-psicodelico-em-teste-contra-depressao.shtml

https://www1.folha.uol.com.br/ilustrissima/2022/07/da-caatinga-ao-laboratorio-cientistas-investigam-efeito-antidepressivo-de-psicodelico.shtml

https://www1.folha.uol.com.br/ilustrissima/2022/07/cultos-com-alucinogeno-da-jurema-florescem-no-nordeste.shtml

It is worth remembering that psychedelics are still experimental therapies and certainly do not constitute a panacea for all mental disorders, nor should they be self-medicated. Talk to your therapist or doctor before venturing into the area.

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