Interest Grows in Using Psychedelic Drugs for Psychiatric Disorders

An adult psychiatry expert in the U.K. is calling for psychedelic drugs to be re-examined for their potential benefits for people with psychiatric disorders.

Dr. James Rucker of King’s College London, U.K., believes that psychedelic drugs such as lysergic acid diethylamide (LSD) “should be legally reclassified so that researchers can investigate their therapeutic potential.”

In the United States, LSD is a schedule I controlled substance under the Controlled Substances Act. This means that the federal government believes LSD to have high abuse potential, a lack of accepted safe use when taken under medical supervision, and no current medical use.

But Dr. Rucker calls on authorities to downgrade the “unnecessarily restrictive” legal status to allow trials of these “physiologically safe and non-addictive drugs.”

“Psychedelic drugs, especially LSD and psilocybin, which is found in magic mushrooms, were extensively used and researched in clinical psychiatry before their prohibition in 1967,” he writes in the British Medical Journal.

“Hundreds of papers, involving tens of thousands of patients, presented evidence for their use as psychotherapeutic catalysts of mentally beneficial change in many psychiatric disorders, problems of personality development, recidivistic behavior, and existential anxiety,” he adds.

This research “abruptly ended” when psychedelics were legally reclassified. “But no evidence shows that psychedelic drugs are habit forming; little evidence shows that they are harmful in controlled settings; and much historical evidence has shown that they could have use in common psychiatric disorders,” he writes.

Rucker said psychedelic drugs do not induce dependence, and have been linked in studies to recovery from alcoholism, anxiety associated with advanced cancer, obsessive compulsive disorder, tobacco addiction, and cluster headaches.

“However, larger clinical studies are almost impossible throughout the Western world because of the practical, financial, and bureaucratic obstacles imposed by schedule 1 classification or its equivalent,” he writes.

The “self-reinforcing cycle of stigma” generated by schedule 1 classification means that almost all grant funders are uncomfortable funding research into psychedelics, and similar problems are encountered with ethics committees, Rucker believes.

He said almost all grant funders are uncomfortable funding research into psychedelics, and prohibition as a condition of UN membership is “arguably causing more harm than it prevents.”

“I call on the UK Advisory Council on the Misuse of Drugs and the 2016 UN General Assembly Special Session on Drugs to recommend that psychedelics be reclassified as schedule 2 compounds to enable a comprehensive, evidence based assessment of their therapeutic potential,” he concluded.

Commenting on the article, Dr. Woody Caan, editor of the Journal of Public Mental Health, says he has studied the actions of hallucinogens both in the laboratory and the community. “Some patient populations may be more, or less, vulnerable to psychedelic substance use,” he warns, and some hallucinogenic substances have clear “cumulative toxicity.”

He believes, “Unlike our present conventions on drugs, a good system of legislation and regulation would balance risks and benefits and comprehend some individual variation among patients.”

Although LSD does not cause dependence, Caan states, “users become sensitized to repeated doses, progressing to disturbances of perception that are spontaneous, uncontrollable, and potentially distressing.”

He agrees that politicians in the 1960s and ’70s manipulated public perceptions of many drugs for political advantage, but points out that in the Vietnam era, the U.S. Air Force had a genuine problem over the use of LSD.

“Understanding hallucinogens requires a completely different perspective to understanding the risks and benefits of addictive drugs like heroin,” he writes. “I never call LSD ‘safe.'”

Replying to these comments, Rucker said it is important to emphasize the risks of recreational use of psychedelics. But, “The current legal framework encourages unsafe use in recreational settings and discourages safe use in medical research settings. The government’s current approach maximizes harm and minimizes benefit.”

Only one manufacturer in the world produces psilocybin for trial purposes, Rucker said, at a cost of 100,000 UK pounds for one gram. To hold such drugs, institutions also require an expensive license which comes with regular police or home office inspections and onerous rules.

Also in response to the article, Teri Suzanne Krebs of EmmaSofia, a nonprofit company based in Oslo, Norway, said, “rules should be changed or re-evaluated to make it easier to use psychedelics in research and in medical practice.”

Said Krebs, also a research fellow at Norwegian University of Science and Technology, “In my experience there are very few people who are actively opposed to psychedelics, although there are some misunderstandings to clear up. The old opposition to psychedelics was based on an outdated worldview that valued conformity over self-expression and was skeptical to anything remotely ‘mystical’ or ‘spiritual.’

“Today, the situation is very different than 50 years ago; for one thing, meditation and mindfulness now are accepted by psychiatrists, scientists, and the general public. There is a lot of curiosity and interest in psychedelics.”

Reference

Rucker, J. J. H. et al. Psychedelic drugs should be legally reclassified so researchers can investigate their therapeutic potential. British Medical Journal, 27 May 2015, doi: 10.1136/bmj.h2746