Psychedelic research

While participating in a sacramental ceremony in the Amazon
basin of South America during the late 1980s, Dr. Charles Grob had
a moment of realization about the power of psychedelic substances
used for therapeutic purposes.

Grob, the director of the division of child and adolescent
psychiatry at the Harbor-UCLA Medical Center, was at the time
investigating the effects of the hallucinogenic concoction called
“ayahuasca” on a religious community in the Brazilian
tropics ““ a substance he had tried himself while in
Brazil.

Grob, who is currently conducting a study of the effects of
psilocybin (the chemical found in “magic mushrooms”) on
terminally ill cancer patients, said he observed the hallucinating
Brazilian congregation’s heightened receptiveness to
accepting the maestre’s (priest) sermon of leading a moral
and responsible life. Many of these congregants had “risen
from being at the bottom of society and reformed their lives”
after attending the ceremonies, Grob said, leading him to be
confident in the potential benefits of psychedelic drugs.

Grob said the scene illustrates the importance of
subjects’ states of mind and the external environment when
administering psychedelic drugs on patients ““ a philosophy
that Grob uses in his 2004 study of psychedelics on cancer patients
nearing death.

Grob’s study has attracted new attention as a predecessor
to a Harvard Medical School study approved in December by the Food
and Drug Administration that will test the effects of the
psychedelic drug MDMA also on terminally ill cancer patients. MDMA
is better known as the mind-altering drug ecstasy.

The research having taken a hiatus for over 20 years, the last
decade has seen a slow resurgence of psychedelic research exciting
the few psychiatrists that believe in hallucinogen-induced therapy
across the country.

Dr. John Halpern, the psychiatrist heading the study at Harvard,
says he embarked on the research out of a blend of curiosity and a
desire to help people. From past research and anecdotal
experiences, Halpern has confidence in the abilities of MDMA to
ease the anxiety of patients nearing death.

Halpern and a team of four doctors are currently waiting on a
special Schedule 1 license from the Drug Enforcement Agency to
begin administering the test. According to the Controlled
Substances Act of 1970, Schedule 1 drugs ““ which include
heroin, ecstasy, LSD, marijuana and psilocybin, among other drugs
““ have a high potential for abuse and have no currently known
medical use.

Though Halpern’s study has needed to undergo “many
layers of approval,” the psychiatrist says the checks are all
necessary and expects DEA approval to come within the next two
months.

Once a study is approved, the psychiatric team faces the often
difficult task of recruiting subjects.

In Grob’s case, finding suitable patients has been
challenging because of the strict screening process and reluctance
on the patients’ part to undergo a study that acknowledges
their unfortunate situations.

On the patient’s end

When a patient comes in to participate in Grob’s study,
they are taken to a Harbor-UCLA hospital room adorned with pink and
lace curtains and purple tie-dye decorations to create a comforting
atmosphere in which the hallucinogenic psychotherapy can
occur.Sitting in his cluttered office surrounded by marker-drawings
by his daughter, Grob emphasizes that the aim of the treatment is
in no way a physical cure to the disease. It is aimed more at
easing feelings of depression and anxiety as patients get closer to
death, he says.

Many in UCLA’s psychiatry community also believe in the
value of the study.

“We are all going to die. A lot of people are sufficiently
afraid of dying so that the prospects of death are
stressful,” said Mark Kleiman, director of the Drug Policy
Analysis Program at UCLA. “This is an unusually good time to
think about things that could be done to give people an easier and
mindful time of it as they are dying,” Kleiman said,
referring to the baby boomer generation reaching old age.

A patient participating in Grob’s study undergoes two
sessions of drug administration ““ taking a capsule of
psilocybin during one session and a placebo in a second
session.

Though Grob’s study allows the evaluation of 20 patients,
only three have been tested. Two more were scheduled to be studied,
but died before the screening process was over, Grob said.

In the Harvard study, 12 patients will be chosen to undergo MDMA
administration in conjunction with psychotherapy, Halpern said. The
drug may allow the patients to mobilize and talk about issues that
would otherwise induce a panic reaction.

The drug could induce “a sense of empathy, a feeling of
well-being and interconnectedness; and lack of stress will allow
the participant to deepen the effects of psychotherapy,” he
said.

A similar study conducted by Dr. Francisco Moreno at the
University of Arizona tested the effects of psilocybin
psychotherapy on patients with obsessive compulsive disorder. The
study was completed in December and Moreno hopes to have the data
analyzed and published shortly, he wrote in an e-mail.

“We are encouraged by the observations and hope to
continue this line of research to favor the development of new
therapeutics for this disabling disorder,” he wrote.

A “sleeping giant” emerges

There was a time when psychiatric therapy was at “the
cutting edge” of scientific research, Grob says, but had all
but vanished from the medical community’s radar for the last
25 years.

With its roots in Shamanistic traditions and dating all the way
back to antiquity, psychedelic drugs were discovered by Western
scientists in the 1940s ““ centuries after European conquerors
repressed their use due to fears of pagan influence, all according
to an article written by Grob.

But this widespread research experienced a blow in the 1960s and
’70s when hallucinogen use spread rampantly among the youth
of the time and law officials began to curb scientific uses of the
substances.

With the force of law against them, many researchers were
encouraged to stop their work until it eventually faded as a
legitimate science.

But, with FDA approval coming to Dr. Michael Mithoefer, a
psychiatrist in South Carolina, to test the effects of MDMA on
patients with post traumatic stress disorder in 2001, psychedelic
research seemed to be re-emerging. “As the sleeping giant of
hallucigonogen research emerges …, it will perceive that the
world of psychiatry has vastly changed from when it was put to
rest,” Grob wrote in 1998.

Most psychedelic researchers agree that with the methodology and
technology available today, hallucinogenic therapy has the
potential to be grounded on sounder evidence than in the past.

“I think the time is long overdue,” said Dr. David
Nichols, president of the Heffter Research Institute, which
sponsors Grob’s study.

“Why should psychedelics have no medical utility?”
he asks. “The question is where and how we should use
it.”

Though psychedelic research has seen a new emergence in the last
decade, Halpern says studies in psychedelic therapy are rare in the
country ““ “I can count them all in one hand.”

And there is always the skeptic who believes that the dangers
that hallucinogens pose to society far outweigh the potential
benefits.

Overall, most in academia are not opposed to the learning
opportunity psychedelic research provides.

“No body knows whether it is a good or not until the
research is done,” Kleiman said.

And in the face of several barriers, Halpern emphasizes
“you better know what you are doing,”