What do we lose when psychedelics are turned into medical drugs? [PART I]

Brain

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Psychedelics have had a long history of use as sacred and ceremonial plant medicines for
thousands of years. During the cultural revolution of the 1960s in the United States, they became popular with consciousness-expanding proponents who used them to achieve unusual states of consciousness. However, in the 1970s, the Nixon administration declared psychedelics illegal, causing a backlash.

Nowadays, psychedelics are once again attracting the attention of researchers who are finding new evidence of their potential in treating mental illness. Thanks to this research, psychedelics are slowly coming out of hiding and becoming the subject of serious interest as effective treatments that can
overcome the rise of mental illness.

Funding for research and efforts to legalize psychedelics is growing across the United States. In January of this year alone, seven states implemented new legislation regarding psychedelics, ranging from decriminalization to controlled adult use and as part of psychiatric treatment.

Overseas, a historic event took place in Australia, the country being the first to legalize psilocybin (psychedelic mushrooms) and MDMA as drugs prescribed by psychiatrists. The United States may follow suit: the FDA is currently considering approving MDMA for therapy in the near future.

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This significant change in drug policy comes amid a
mental health crisis in the U.S., where traditional treatments have become ineffective. According to the World Health Organization's largest report, current intervention methods have been called «insufficient and inadequate». Turning to psychoactive mushrooms to treat persistent mental illness represents a significant turnaround, indicating a depletion of current approaches and an interest in truly new treatments.

Standard psychiatry focuses on the study of mental disorders that have clinical effects on areas essential to everyday functioning, such as emotional regulation, behavior, and thinking. However, the proper use of psychedelics can do more good than just treating disorders.
The World Health Organization's constitution defines health as «a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity». Psychedelics can help focus attention on changing the baseline level of ordinary, unchanged experience to enrich what we used to call «normal».

Full utilization of these substances, however, may require a very different approach to research and regulatory standards than currently employed traditional efforts to turn psychedelics into next-generation therapeutics. To maximize the potential that psychedelics may offer for the broader project of human well-being, medicalization alone is insufficient. Regulators should consider authorizing access to these drugs outside of physicians' offices.

But there is no consensus among researchers and policymakers on access - who gets access, where and how — in a way that maximizes the benefits of psychedelics while balancing the potential risks.

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Given the scope of the mental health crisis, policymakers should embrace new treatments to help those with mental illness. But in this embrace, we must not lose sight of what psychedelics have to offer beyond psychiatry. When used holistically, these drugs can help expand our understanding of what healthier, richer, and more flourishing states of consciousness can be. The stifled dream of those hippies and former Harvard psychology professors who urged Americans to expand their horizons with psychedelics could be revived in more intelligent, diverse, and informed ways — provided we don't box them in.

Why is the psychedelic renaissance based on mental illness?
In 1943, Swiss chemist Albert Hofmann discovered the effects of LSD, which is part of the family of «classic» psychedelics. These also include psilocybin (magic mushrooms), mescaline (from peyote catcus) and DMT. These substances are not addictive and interact with serotonin receptors in the brain. This distinguishes them from «non-classical» psychedelics such as ketamine and MDMA, which act differently and have a higher risk of side effects and abuse. For example, MDMA combined with dehydration in a warm environment can lead to death from heat stroke, while ketamine can exacerbate heart disease.
https://www.nytimes.com/2021/11/04/...AIN_CONTENT&block=storyline_flex_guide_recirc
Like the psychedelic experience itself, the story of mid-century American travel after the advent of LSD has no unambiguous narrative. It was a diverse and confusing era. LSD became popularized as psychotherapy by the Hollywood elite, the CIA used it for mind control experiments, and Jimi Hendrix brought black psychedelia to the culture. However, most of these experiments ended in 1971 when the Controlled Substances Act, signed into law by President Richard Nixon, banned psychedelics (among other drugs) and stopped psychedelic research.

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Although legislation forced researchers interested in psychedelics to go underground, they didn't stay there for long. By the 1990s, a
new generation of researchers began to revisit the research of the 1950s, while the FDA and DEA's view of psychedelics became more lenient. Regulatory agencies no longer viewed them as exotic substances with unknown long-term effects, but increasingly categorized them as potentially dangerous drugs. By 1991, a series of legal challenges and the persistence of researchers who considered psychedelics worthy of study led to the first approval since the 1970s for psychedelic research on humans.

However, the regulatory hurdles to approval remained significant, and young scientists continued to risk their reputations by engaging in research with psychedelics. But a significant article published in the
Journal of Psychopharmacology in 2006 on mushrooms and mystical experiences, where participants described mystical experiences of high personal significance lasting for months after the trial, signaled a renaissance in scientific research that was professionally acceptable, institutionally accepted, and already underway.

This time, however, the focus was not on Timothy Leary-style broadening of the mind, but on alleviating mental illness. This shift was partly a strategic response to the
moral panic of the 1960s and the lawsuits against psychedelics in the 1970s. Through medical research, scientists decided to reintroduce psychedelics through the most appropriate and controlled channels to minimize the risk of a new negative reaction.

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The position to psychiatry also corresponded to an urgent need. By the end of 2019-2020, about one-fifth of all adults-more than 50 million Americans, up from 39.8 million in 2008-reported having a mental illness. The growing body of research using psychedelics reveals significant promise for treating the most common conditions, such as depression, anxiety, and addiction. The promise of this list may continue to expand as research in new areas, such as eating disorders, develops.

No single group of chemicals can solve complex mental health problems that transcend the individual mind and include
social and political dimensions. However, if recent research proves accurate, psychedelics may provide needed relief while inspiring new approaches to psychiatry. This is especially important given the lack of innovation in the treatment of mental disorders, as SSRI antidepressants like Prozac were approved as early as the 1980s.

There are some drawbacks to turning psychedelics into pharmaceutical drugs, however, and this is due in part to the isolation of the psychoactive molecules themselves from the larger cultural practices that have traditionally been inseparable from the experience.

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«The mainstream public learns about psychedelics primarily through the lens of medical or therapeutic purposes» — said Ariel Clark, a lawyer, representative of the California Native American Odawa Anishinaabe organization, and board member of the Psychedelics Lawyers Association. «However, the use of sacred drugs in indigenous culture is much more widespread than their medical use».

As Harvard theologian
Rachel Peterson put it, «Important wisdom is lost when methods of transcendence are taken beyond their spiritual and religious context and presented as psychological treatments». Today, a new generation of researchers seeks to reclaim a broader spiritual understanding of therapeutic and neurobiological issues.

How can psychedelics enrich your mind?
Until recently, funding for psychedelics research on volunteers without diagnosed mental illnesses, referred to as «healthy normal people», was inadequate. Roland Griffiths, director of the Johns Hopkins Center for Psychedelic and Consciousness Studies, addressed this problem by establishing the Griffiths Fund. This Fund aims to support research and professorships at Hopkins University to study the effects of psychedelics on the well-being and secular spirituality of healthy volunteers. Griffiths believes this is the most important area for future research in this area.

The Foundation's first recipient was David Yaden, an assistant professor at Johns Hopkins University working at the Center for Psychedelic and Consciousness Studies. His work focuses on experiences of self-enhancement or altered states of consciousness achieved through a variety of methods. Unlike most studies that treat spirituality as an afterthought,
Yaden intends to study the issue directly, considering it a key issue.

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«I believe it's important to keep the focus on well-being research without overriding it with a therapeutic approach» — Yaden shared with me. He describes the approach as a way to see if psychedelics can improve well-being, even in people without mental illness, and calls it a «positive program» of psychedelic research.

And while the Griffiths Foundation was the first project to deliberately study the topic among healthy volunteers, there is already a small foundation of academic research on the subject. These studies largely fall into two groups: investigating the effects of psychedelics on the brain and their subjective effects on thinking. This uncertain interaction between brain and mind is one of the many mysteries that psychedelics can help unravel.

We can collect objective data on how LSD affects the pattern of electrical activity in the brain using neuroimaging techniques such as
EEG and fMRI. However, we can only rely on people's memories to understand the sensation of psychedelic fusion with the world around them. The key to psychedelic research is what can be measured directly, but Yaden emphasized that subjective experience is an integral part of analyzing the long-term improvement in well-being that some psychedelic users report.

There are three groups of observed effects of psychedelics in the brain. They enhance neuroplasticity,
which helps to modify existing neural connections. They also promote neurogenesis, that is, the formation of new brain cells. Finally, they increase brain «entropy», which means increasing the diversity, randomness, and unpredictability of brain activity in different areas.
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Neuroplasticity plays an important role in the treatment of mental illness because it helps to restructure thinking patterns. It is particularly effective when combined with psychotherapy, helping to change bad habits from self-criticism to addiction to more helpful ones.

Increasing brain entropy not only offers the possibility of benefiting from greater
neuroplasticity, which declines with age, but also opens up new perspectives in the treatment of disease. Neuroscientist Robin Carhart-Harris published a paper on the «entropic brain» in 2014. He noted that the experience of states of consciousness depends on the level of entropy in brain activity. Entropy is low in states with reduced consciousness, such as general anesthesia. In altered states, such as psychedelic travel or deep meditation, entropy is higher. In the normal awake state, it remains at an average level.

According to Carhart-Harris, the brain has evolved the ability to find an optimal balance between levels of entropy. He believes that the default mode network (DMN), which is responsible for suppressing entropy in the brain, promotes environmental understanding and survival. However, he argues, it can also have a limiting effect on consciousness.

Psychedelics decrease DMN activity, reducing its control over entropy levels. This can lead to increased levels of entropy, which for our savannah-dwelling ancestors may not have been beneficial. However, for modern humans, for whom survival is not seriously threatened, these states may offer new perspectives.

Beyond simply letting go into deeper states of consciousness, high entropy states can help us see ordinary states from a different angle. Sometimes it's hard for us to imagine how different things that seem so familiar to us can look until we experience a different reality ourselves.

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After emphasizing the importance of entropy, neuroplasticity, and other aspects that can be studied through brain imaging, Yaden stresses that this is only part of the whole picture. He describes these as «low-level neurobiological processes» and notes that higher-level processes, such as the subjective content of one's own experiences, play a key role in understanding the benefits of psychedelics.

These processes become part of the more nebulous realm of effects on the mind when scientific methods cannot fully measure what is going on. We must rely on imperfect language to describe these aspects: mystical experiences, feelings of death or ego dissolution, lack of ownership, oceanic immensity. They can be either blissful or terrifying, and the quality and intensity of these experiences determine their long-term consequences.

For example,
a study found that appraisals of oceanic vastness during a psychedelic experience were a better indicator of long-term clinical outcomes than hallucinations (e.g., visions of geometric patterns). This means that in the case of psychedelics, the relationship between dose and outcome is not as straightforward as with many other drugs. Sometimes the individual's experience itself and the context in which it occurs are more important than the amount of psychedelics taken.

Although most
clinical psychedelic experiences are evaluated positively, this may be because researchers have tight control over risks. Managing these risks may, however, be limiting, as may managing entropy in the network. Clinically controlled environments and psychiatric contexts create certain conditions, favoring certain experiences and suppressing others. Many proponents of psychedelic remedies argue that greater freedom in choosing the place and company to take psychedelics can increase their benefits, especially for healthy individuals.

Psychedelics legislation being introduced in various U.S. states determines access to these remedies domestically and could be a model for global strategies.
Schwarz-Plaschg notes that the United States is a test bed from which lessons can be learned for building a safe environment for the continued use of psychedelics.
 

miner21

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Wow you really went into depth with this!
 
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