Psychedelics Take a Long, Strange Trip to Respectability

Whether marijuana is a gateway drug is debatable. But it has certainly opened the doors for a projected multibillion-dollar market for psychedelic drugs as treatments for a variety of mental health disorders.

Pushback against psilocybin (the active ingredient in magic mushrooms) and MDMA (3,4-methylenedioxymethamphetamine, known as ecstasy or molly) in the ’70s and ’80s culminated in their criminalization. But with the legalization of marijuana for medical use in many states in the ’90s and now a wave of legalization for recreational use, research into psychedelics for medical purposes is booming.

Author Michael Pollan wrote a book, “How to Change Your Mind,” that kick-started interest in psychedelics. Kevin O’Leary of “Shark Tank” is a big investor. The psychedelics market is projected to grow by 16.3% over the next eight years to nearly $7 billion by 2027, according to Data Bridge Market Research.

Now two recent studies published in prestigious journals are lending credence to psychedelics as a possible and entirely research-worthy way of treating mental health disorders.

In early May, Nature published the results of a phase 3 study that showed MDMA is effective in treating post-traumatic stress disorder. A few weeks earlier, British researchers reported results from a phase 2 study in The New England Journal of Medicine that showed psilocybin was considerably more effective than Lexapro (escitalopram), a selective serotonin reuptake inhibitor, in treating depression. Some of the researchers involved in that study receive support from companies developing psychedelics for medical use.

Matthew Johnson, Ph.D., associate director of the Johns Hopkins Center for Psychedelic & Consciousness Research, says to be prepared for explosive growth. “When I started 20 years ago, you knew (pursuing psychedelics) might be career suicide,” Johnson says. “Since then, it’s been a bit of a risk, but the data keep speaking for themselves.”

Researchers need to be careful. In a pilot study on smoking cessation with psilocybin that Johnson was involved in, there were four to eight hours of therapy as preparation, and two people had to be in the room monitoring the patient during treatment. “A person, even though it’s physiologically very safe compared to many compounds, can feel like they’re going to die,” Johnson says. “There has to be a trusted person to say, ‘We’re here with you; just keep breathing, trust, let go and be open.’”

Jason Luoma, Ph.D., CEO of Portland Psychotherapy, has focused his research on people struggling with shame and found MDMA effective. “MDMA tends to create the experience of feeling a sense of love, a sense of connection with other people, and that is pretty profound,” he says.

Luoma adds that despite the myths, psilocybin has no addictive potential, and MDMA’s potential is low. Approvals of psychedelics probably will need to be associated with FDA risk evaluation and mitigation strategies (REMS) to ensure no off-label uses, in Luoma’s opinion: “The big fear is people who are really, really antidrug will pick up the one adverse reaction that happened out of 10,000 patients and … blow it up and essentially harm the whole research agenda.” 

Larry Hanover is a freelance writer in southern New Jersey.