One of the newest frontiers in mental health care is psychedelic drugs — like MDMA or psilocybin in magic mushrooms. But, for now, those drugs are illegal and can’t be prescribed.
Efforts across the country to decriminalize psychedelics are gaining steam in some places, including western Massachusetts, but some people want to slow down the process.
Those of a certain age will remember psychedelic drugs were a mainstay of the 1960s counterculture — the part that focused on exploration of the soul.
Thousands of young people followed the call of eccentric Harvard professor Timothy Leary – a Springfield, Massachusetts, native – who became famous for his anthem: “Turn On, Tune In, Drop Out.”
But amid the spiritual expansion, there were many out-of-control acid trips, some people jumped off buildings, and others reported flashbacks and long-term cognitive effects.
By the late 1960s, most hallucinogens were banned. The Nixon administration shut down research into psychedelics as mental health treatment and moved them into the Schedule 1 category of illegal drugs, the same as heroin.
As a result, psychiatrists like Tom Insel think many people lost out on an effective way to reduce their suffering.
Psychedelics work less like a medication, he said, and more like a portal to better insight.
“When you talk to people in the field, pretty quickly they talk about the experience of taking the drug,” he said, “and the way in which that experience leads to behavioral, cognitive, affective change.”
Insel is former director of the National Institute for Mental Health. Now he’s an advisor and investor in Compass, a company seeking to develop psychedelic-assisted mental health treatment.
“It’s almost as if what the drug is trying to do is to get you to where you get in five years of psychotherapy,” Insel said, “but to do that in five weeks through a very structured set of experiences.”
The FDA has recently approved some clinical trials involving psychedelics, including for Compass. Insel said scientists still aren’t sure of the exact biological mechanisms for psychedelics, though two recent studies show they can reduce symptoms of depression and PTSD.
Psychedelics are often described as dissolving the ego — obliterating the division between oneself and the world.
“You’re just delighted with yourself, you’re just in sort of rapture. There’s a total joy and then mix that with a total loss of fear,” said Emily Howard, a psychotherapist in Amherst, Massachusetts. “So it means all of your usual defenses, all the little tiny, subtle ones that guard your heart are just gone.”
Howard first experimented with hallucinogens in college in the 1990s. More recently, she’s tried MDMA (also called ecstasy) and psilocybin – mostly, she said, for professional reasons. She works with patients who use psychedelics to help treat depression, anxiety, PTSD and other problems they could not resolve in more traditional ways.
But since most psychedelic drugs are illegal even for medical reasons, Howard has to be careful how she incorporates them into her practice.
“I knew I didn’t want to be in jail, because I’m a mother,” Howard said, “I was like, ‘I’ve got to figure out a way to do this legally.’”
She tells clients she can’t help them find the drugs or even the psychedelic “guides” who stay with people for the hours they’re hallucinating. As she states in her public profile, she will only work to prepare clients for their drug experience, or help them make sense of it afterwards.
“What did you listen to? What was hard about it? What were the themes, what are you literally going to do differently in your life to integrate this?” she said.
To protect her license, Howard doesn’t accept health insurance for psychedelic therapy. But she said this work would be a lot easier if psychedelics were legal. She’d feel more secure about the quality of the drugs and it wouldn’t be so hard for therapists and guides to find each other.
“We could actually create more of a professional network and support each other,” she said.
Last November, Oregon passed a ballot measure to legalize psilocybin. Across the country, cities and towns are moving in a similar direction.
In April, Northampton, Massachusetts, passed a resolution in April – one of three in Massachusetts, along with Cambridge and Somerville – calling on the local police to deprioritize psychedelics as a reason for arrest.
“We’ve devoted our energies to demonizing people who are affiliated or associated with drugs in any way, at our own peril,” said Northampton City Councilor Bill Dwight, who co-sponsored the resolution.
Decades ago, in his 20s, Dwight used hallucinogens himself.
“I consumed everything at some point,” he said. “LSD, psilocybin, peyote, MDMA, DMT.”
While Dwight never found them particularly transformative, he knows many others have, which is why he wanted to make them more accessible, especially as mental health treatment. Granted, the Northampton resolution is mostly symbolic, and Dwight said there’s been little local pushback.
“It doesn’t particularly impact what we’re doing here,” said Northampton’s police chief, Jody Kasper.
Kasper said the police rarely arrest anyone for simple drug possession anyway, and even less often for psychedelics.
“I understand there’s large national issues that the council may want to weigh in on,” Kasper said, “and I think they’re more making a statement to our local community and the broader community about what they believe should be the priorities of our systems.”
Even if the police aren’t speaking out against legalization, some people one might not expect are – including Insel, the psychiatrist who considers psychedelics a promising treatment.
“There’s a risk here if the drugs are used by the wrong people, at the wrong time, in the wrong way,” he said.
Insel thinks psychedelics should stay out of the public domain until there’s more medical research into their effectiveness, which is the argument made by some companies developing psychedelics for market.
Insel worries that — like in the 1960s — too many people would use them irresponsibly, leading to injuries and deaths. And if that happens, the government could again shut down research.
“Because the FDA will be spooked, as will the public, in the same way that happened in 1972 or 1970,” Insel said. “We’ve been there before. That’s exactly how this went off the rails.”
Proponents of legalization, however, consider those worries unfounded.
For one, they say the legalization of marijuana in Massachusetts and elsewhere did not cause the sky to fall. And many people already use psychedelics, just where the authorities can’t see them. They’d rather the options be aboveboard — for recreation and for mental healthcare.
This article was reported by New England Public Media.