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The second wave

New research into psychedelics offers clues to curing addiction, depression, PTSD and...the fear of death

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"I sat up and spoke with Tony and Krystallia. I mentioned that everyone deserved to have this experience ... that if everyone did, no one could ever do harm to another again ... Wars would be impossible to wage ... Even the germs (if there were any present) were beautiful, as was everything in our world and universe."

- Patrick Mettes, a terminally ill cancer patient, during a medically induced mushroom trip, as told to author Michael Pollan.

There's a faint excitement filling the room as international researchers, psychologists, pioneers and policy-makers crowd into the first of a four-day conference in British Columbia.

The topic? Psychedelic psychotherapy and the potentials for these substances to offer hope for everything from addiction, alcoholism, depression, Post Traumatic Stress Disorder (PTSD) and even couples' counselling. Combined with counselling, the hope is to alleviate or even cure certain mental illnesses with one, or just a few doses—no long-term prescriptions required.

The setting—a golf and spa resort nestled into the foothills of Victoria—is indicative of the changing landscape of this once taboo topic...and there's not a long-haired hippie in sight.

Okay, maybe there are a few.

"Holy smokes," says an unassuming man as he enters the room, pausing ever so slightly to lock eyes, as he deadpans the delivery. "There's not mush-room in here." His eyes twinkle. Hey, no one said these guys had to be funny.

A changing landscape

"Psychedelics are illegal not because a loving government is concerned that you may jump out of a third-storey window. Psychedelics are illegal because they dissolve opinion structures and culturally laid down models of behaviour and information processing. They open you up to the possibility that everything you know is wrong."

- Terence McKenna

The theme of this year's Psychedelic Psychotheraphy Forum, "The Unfolding Promise," is representative of the growing momentum that's developing across Canada, the United States and parts of Europe—the resurgence of scientific research into psychedelics.

A taboo subject for more than 50 years, with little to no legal clinical research conducted since the late '60s, at least 21 international universities and organizations, including the British Columbia Centre on Substance Abuse (BCCSU), Queen's University and The University of Toronto are doing research into these psychoactive compounds. At the forefront in Canada is the PTSD research being done in B.C., followed by microdosing studies at the U of T and a Phd thesis at Queen's focusing on clinical "trips" and the methodology behind the science.

Throughout this conference and a similar one held a few weeks earlier at the University of Toronto, "Mapping the Mind with Mushrooms," everything from ketamine to ayahuasca was covered, but most large-scale research centres on the Big 3: LSD (Lysergic Acid Diethylamide), Psilocybin ("magic mushrooms") and MDMA (Methylenedioxymethamphetamine).Though the latter isn't regarded as a true psychedelic by some researchers, all are empathogens, a class of psychoactive drug that produces experiences of emotional connection and openness.

Similar in molecular structure, both LSD and psilocybin are tryptamines which, in larger doses, can cause hallucinations. They can have long-lasting benefits, as recorded by a 2011 study at Johns Hopkins, where researchers concluded that magic mushrooms produced "a lasting personality change"—known as "openness," in 51 per cent of participants. "Normally, if anything, openness tends to decrease as people get older," wrote Roland R. Griffiths, a professor at Johns Hopkins and the leading expert of psychedelics and public policy in the United States.

Experts in this now-burgeoning field say empathogens bolster emotional intelligence, communication skills, transcend barriers associated with ego, increase imagination and relatedness and evoke feelings of empathy. While the common thread linking LSD and psilocybin with MDMA is the reported ability to reduce inhibitions, lessen anxiety and eradicate fear, especially in social settings.

Current Canadian research: A primer

"Psychedelics are back!" exclaimed a grinning Mark Haden to a few hundred people at the recent Mapping the Mind conference held at the U of T. Haden is leading the MDMA research studies taking place in Vancouver and is both the Executive Director of MAPS Canada (Multidisciplinary Association of Psychedelic Studies) and an adjunct professor at the University of British Columbia. He's been a counsellor and public speaker for more than 30 years and has written extensively on the subject of psychedelics and drug policy, co-writing a 2016 paper calling to legalize psychedelics in Canada.

"In 30 years, no one has ever walked into my office and said, 'I can't stop taking LSD,'" he says. He believes the taboo surrounding the subject is a result of misinformation. "We never talk about the benefits of these drugs or how to control them ... Drug prohibition is crumbling under its own ineffectiveness," he declares, noting it does little to protect the public from the black market.

He vehemently believes—as most do in this growing field—that it's not a matter of if, but when psychedelics are legalized, predicting that some drugs could be legalized within five years. In his talks, Haden often compares the prohibitions of psychedelics to the 143-year prohibition of the telescope, something that we will look back at one day and laugh at. He paraphrases the co-founder of transpersonal psychology, Stanislav Grof: "LSD is to the study of the mind what the telescope is to astronomy and the microscope to biology."

The MDMA study, conducted by BCCSU and MAPS, is entering its Phase 3 clinical trial—the last phase before a drug is sent to regulatory agencies for approval for widespread use—and is currently recruiting volunteers suffering from extreme forms of PTSD. Generally though, Phase 3 studies in the U.S. only have a 25- to 30-per-cent approval rate, so it's hardly a home run, but the previous Canadian Phase 2 study was promising, recording a whopping 68-per-cent success rate of remission from PTSD.

"It appears that MDMA assisted psychotherapy might be the best treatment for PTSD," states Haden. PTSD, however, can be extremely hard to treat, with one 2009 study on antidepressants showing only a 20- to 30-per-cent remission or "cure" rate. Oddly enough, Canada has one of the highest PTSD rates among developed nations and ranked ahead of the U.S, Australia and 24 other nations, according to a study which found that 9.2 per cent of Canadians will experience a form of PTSD in their lives. Women are four times more likely to experience it, experts say, due to sexual violence.

Haden says MDMA can cure PTSD because "...(it) gives the ability to access our unconscious minds. So if, for example, a person has had childhood trauma, they may not consciously realize the trauma is looping in their unconscious, affecting their day to day life with anxiety, fears and so on. Using psychedelics to access that part of the brain, to unearth and then treat the trauma so it ceases to loop, is the goal."

In addition, experts believe that MDMA has the ability to elevate fear, which is why conventional therapy finds it hard to treat PTSD. "It's hard to access because anyone that consciously comes near it, triggers the fear and won't allow it to be accessed," says Haden. "It takes away that fear so the tape can be reworked."

It's not such an absurd thought that Canada may be at the forefront of the push to legalize medical MDMA. With it being just the second nation to completely legalize recreational cannabis on Oct. 17, veterans suffering from PTSD used cannabis to alleviate (but not cure) symptoms and helped forge the path to medicinal, and eventually recreational use, said Ron Shore, a PhD candidate at Queen's University who spoke at the Toronto conference.

Trippy Canadian history

"At times I beheld visions of dazzling beauty—visions so rapturous, so unearthly that no artist will ever paint them."

— Sidney Katz, from a 1953 Maclean's article, "My 12 Hours as a Madman"

Think we haven't tripped before? Think again. In 1953, just 15 years after LSD was somewhat accidentally synthesized by Albert Hofmann in Switzerland, Humphry Osmond, an Englishman transplant, began treating alcoholics with LSD in Saskatchewan. Yes, you read that right.

Osmond, who actually coined the term "psychedelic," (from Greek, meaning "to make the mind manifest or to reveal the soul") is written about in Erika Dyck's Psychedelic Psychiatry: LSD from Clinic to Campus, and showcases how, along with Canadian psychiatrist Abram Hoffer, he began legally experimenting with LSD at The Souris Valley Mental Health Hospital in Weyburn, Sask.

After years of dosing dozens of individuals—including themselves and their wives—the two noticed the negative psychedelic experiences closely resembled the delirium tremens that alcoholics reported while undergoing withdrawals. So, if alcoholics had horrible hallucinations, they hypothesized, perhaps they would literally scare them into sobriety.

Out of the 700 test-patients, more than half remained sober after therapy. Not impressed? A 2014 book by retired Harvard psychologist Dr. Lance Rhodes pegged Alcoholics Anonymous' (AA) success rate at only five to 10 per cent. "About one of every 15 people who enter these programs is able to become and stay sober," Rhodes wrote. Interestingly, AA co-founder Bill Wilson credited his own sobriety to the mystical experience he observed after ingesting belladonna, a hallucinogenic plant that is also known as deadly nightshade.

And it was the same mystical, transcendent experience that was credited with the success rate of the Saskatchewan trials, not the fear that Osmond and Hoffer originally hypothesized. As cited in Dyck's book, "a transcendental feeling of being united with the world," and "to see one objectively" and "increased sensitivity of the feelings of others," were the hallmarks of this success.

Too bad then when, by 1968, LSD was banned for public use and deemed a Schedule III drug under the Controlled Drugs and Substances Act, punishable by up to three years in prison.

A light at the end of life

"You've driven quite a far distance, over many days. This tells me you're obviously here for a reason. So I'll leave you with advice my shaman once told me: 'When in doubt, take more medicine.'"

— A shaman's parting words before an ayahuasca ceremony in Taos, N.M., earlier this year.

The prevailing thinking on psychedelics seems to be slowly changing, girded by new research into how psilocybin can help with anxiety, especially at the end of one's life. "When we are dying and we are anxious about the experience and we meet our maker and we are told, 'It's OK, you can relax,' it tends to reduce the stress of that situation," says Haden. Research supports his case: a 2016 study showed that 80 per cent of cancer patients sustained changes of "mood, increased quality of life, life meaning and optimism" when given psilocybin, the effects persisting as long as six months after the initial five-week treatment.

In Michael Pollan's new book, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, he quotes one researcher as commenting, "If it gives them peace ... I don't care if it's real or an illusion."

But to get the very real effect, researchers say the doses have to be high, between 25 and 30 micrograms of psilocybin, and 100 mcg of LSD or more. In contrast, those microdosing these substances would take 0.3 grams of dried mushroom or 10 to 20 mcg of LSD.

"Our clinical basis (for dosage) is to go low and slow," Shore says. Shore is researching the effects of psilocybin, ayahuasca and shamanism at Queen's University, unpacking their therapeutic benefits. Some experts say that to overdose on a conventional medicine, a user needs about six times its recommended dose to reach toxic levels. With psychedelics, it's reported to be in the thousands. "We need to get over this (fear), because if you underdose, you may have an inhibitory effect," says Shore.

He speaks of the 22 known disorders psilocybin has been told to treat, though he has a certain disdain for categorizing patients and putting them "into boxes meant just for healthcare coverage." But he's excited just like the rest. "What we're finding here is medicine that has a generalized benefit which can be used to treat multiple disorders," he says.

Shore adds to the importance of "set and setting," emphasized often in the Pollan book. "If you go into it with any degree of anger, any degree of ill-feeling, you will have a difficult experience."

With 23 years of experience in harm reduction, Shore's background is rooted in real-world experience—he was the first federally funded AIDS counsellor and outreach worker for prisoners, pioneered the first needle exchanges and teaches about drug and alcohol issues. He is one of the few at the Toronto conference who threw caution to legalizing psychedelics into a controlled medical setting, saying that perhaps we should be careful with blending secular science with what traditionally is used in certain Indigenous communities as spiritual medicine. Though, he adds, he believes there is a way.

"My concern is that science becomes clinical practice," says Shore, and "the science is booming. We're going to lose control ... and it's going to get translated to who can make a profit, what regulatory body can license it, and that's why I'm not totally sold on the public-health model ... Bureaucracy flattens the spirit."

This capitalistic assertion may very well ring true. Earlier this year, Peter Thiel, cofounder of PayPal, announced his new biotech company, Compass Pathways, had secured $25 million in funding for research into synthetic psilocybin. The Silicon Valley billionaire says enough has been made to dose 20,000 people. It's one of the first for-profit ventures and non-academic organizations to dive into psychedelics, and it likely won't be the last.

Shore questions the use of synthetic versus organic compounds and notes that, in his experience, natural psilocybin is notoriously hard to deal with. "It has a trickster side," he laughs, adding that in the approximately 250 scientific articles he's reviewed so far, not one speaks of the "spirit" of psychedelics. "The problem with (Pollan's) book, in my opinion, is that it creates a view of the psilocybin experience as all positive, mystical and profound ... In my world, either in ceremony or with psilocybin, not everyone has these positive or mystical experiences."

So Shore is going to try and figure out the external factors that influence the research by examining the methods clinicians use while patients are under the influence of psychedelics. Common methods for treatment have patients reclining comfortably, with headphones, wearing an eye-mask—meant to reduce distractions and nudge introspection. Shore wants to dive deeper, uncovering precisely what type of music they play (some classical, some minimal, etc), how the room was decorated, what the psychologist said before and after treatment, the expectations sold, etc.

Noting the similarities, he asks, "It seems to be that psychotherapists in clinics are using shamanic techniques to get positive results ... Are doctors and psychotherapists the new shamans?

"If you've read Michael Pollan's book, that's what he concludes on," Shore continues. Pollan dubs it white-coat shamanism and seemingly concludes: "Basically, if we're going to do this, we need a cultural container for these strong plant spirits."

Shore knows his outspoken views are atypical. "Academics get really uncomfortable around this kind of stuff—the mysticism side," he acknowledges. "We don't talk about it, but that's what changes people! So I'm told to talk about meaning-making instead. No archetypes or myth." Shore may be seen as too unconventional in a field still trying to climb out of exile imposed by late-'60s panic and a perhaps too-enthusiastic Timothy Leary.

Though his points give weight to the future of psychedelics. "We're a quick fix society ... And we want to transcend now. I think we need to tamper that with recognition that this is a spiritual journey," adds Shore.

The long, strange trip ahead

"We are disconnected with the earth. We are disconnected from each other. We are disconnected from a true sense of meaning about our lives.

Good news is psychedelics are all about connection."

- Mark Haden

So then, do psychedelics need to be medically monitored in order for users to gain the benefits? For now, yes, most experts think so. As with other substances before them, though physical addiction to psychedelics are very rare, the problem lays in users taking high doses without proper attention to set and setting, yielding potentially dangerous scenarios.

It's important to point out that any upcoming legality would happen medically and be within the parameters of supervised trips for those struggling with severe disorders. Stalled for half a century, the movement is gaining quick momentum. Just this past month, researchers from Johns Hopkins published an analysis in the journal, Neuropharmacology suggesting that psilocybin be reclassified from a Schedule I drug with no known benefits to a Schedule IV drug, the same category prescription sleeping aids are classified under. Though this, too, will take a minimum of five years.

Haden advocates for "psychedelics supervisors," trained professionals who would complete rigorous training and oversee psychedelic sessions. They would manage the dosage, the setting and the expectations of patients.

"There's some really horrible stories of what people have done with psychedelics; it's painful to read," he says. He then tells the audience to Google psychedelics and schizophrenia. "If fun means unsupervised, unskilled, no knowledge, no dosage, set or setting controls, then we have a problem on our hands."

Anne Wagner, a Canadian clinical psychologist and treatment development researcher who is leading the MAPS sponsored trial of MDMA, emphasizes the point of safety and careful deliberation. She believes the future of this fast-paced research lies in the two Ds: data and diversity.

"We're at a time of real opportunity and we have to be very careful," Wagner says. "As we see doors opening, the ability to do these studies and to answer these very important questions to help and heal so many people—we have to be very, very conscious to do that in a good way." She believes this means accurate and meticulous data. "Because there is such a risk of if we don't do it, that door will close," she adds.

Wagner also stresses the importance of having women and people of colour both in therapy and leading the work. "It would help bring legitimacy ... and encourage women to lead the therapies and not just be co-therapists with men."

A recent self-blinded U of T study on microdosing LSD and psilocybin exemplifies the too often white-male dominated stigma around psychedelics. Of the 1390 participants, more than 60 per cent were white males and 80 per cent were heterosexual. Researcher Rotem Petranker acknowledges the bias, saying it "Limits how much we can infer from the general population." Though he also points out that,"These are the people who microdose (and) who are happy to talk about it."

Still, those curious of the benefits of psychedelics who are still awaiting its legal cursor, can try alternative techniques to get a glimpse of these realms of consciousness and unconsciousness. Those who pursue long bouts of meditation and fasting can play within these layers, so too can deep breathing. Holotropic breathwork, a method developed by Grof, is said to mimic the effects of psychedelics. A quick search found several small meetups for breathwork and transpersonal counselling in British Columbia alone.

Heather Hargraves, a Canadian trauma therapist, says further challenges lay in destigmatizing psychedelics and moving away from their taboo status.

"I'm really fascinated by all these MRI studies on psychedelics and what they're teaching us about different regions of the brain," she says. "It can be reflected in this mental health diagnosis." With that knowledge, she touts, "You can reverse-engineer that and then you can reverse-engineer your life. So you can just understand your process and kind of your karmic path, whatever that may be. And then you can embrace it and move forward with it."

So then, it'll be the upcoming research that will do most of the talking.

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