Recent studies are finding that drugs such as LSD and psilocybin can help to alleviate depression, anxiety and addiction—and may have profound things to teach us about how the mind works, writes Michael Pollan.
To anyone who lived through the 1960s, the proposition that psychedelic drugs might have a positive contribution to make to our mental health must sound absurd. Along with hallucinogens like mescaline and psilocybin (that is, magic mushrooms), LSD was often blamed for bad trips that sent people to the psych ward. These drugs could make you crazy.
So how is it possible that, 50 years later, researchers working at institutions such as New York University, Johns Hopkins, UCLA and Imperial College in London are discovering that, when administered in a supportive therapeutic setting, psychedelics can actually make you sane? Or that they may have profound things to teach us about how the mind works, and why it sometimes fails to work?
Recent trials of psilocybin, a close pharmacological cousin to LSD, have demonstrated that a single guided psychedelic session can alleviate depression when drugs like Prozac have failed; can help alcoholics and smokers to break the grip of a lifelong habit; and can help cancer patients deal with their “existential distress” at the prospect of dying. At the same time, studies imaging the brains of people on psychedelics have opened a new window onto the study of consciousness, as well as the nature of the self and spiritual experience. The hoary ‘60s platitude that psychedelics would help unlock the secrets of consciousness may turn out not to be so preposterous after all.
The value of psychedelic therapy was first recognized nearly 70 years ago, only to be forgotten when what had been a promising era of research ran headlong into a nationwide moral panic about LSD, beginning around 1965. With a powerful assist from Timothy Leary, the flamboyant Harvard psychology professor, psychedelics had escaped the laboratory, falling into the eager arms of the counterculture. Yet in the decade before that there had been 1,000 published studies of LSD, involving 40,000 experimental subjects, and no fewer than six international conferences devoted to what many in the psychiatric community regarded as a wonder drug.
Compared with other psychoactive compounds, these powerful and mysterious molecules were regarded as safe—it’s virtually impossible to overdose on a psychedelic—and nonaddictive. Rats in a cage presented with a lever to administer drugs like cocaine and heroin will press it repeatedly, unto death. LSD? That lever they press only once.
This is not to say that “bad trips” don’t happen; they do, especially when the drugs are used carelessly. People at risk for schizophrenia sometimes have psychotic breaks on psychedelics, and people surely do stupid things under the influence that can get them killed. But the more extreme claims about LSD—that it scrambled users’ chromosomes or induced them to stare at the sun until blind—were debunked long ago.
It wasn’t until the 1990s that a small band of researchers began to unearth what an NYU psychiatrist describes as “a buried body of knowledge” about the therapeutic potential of psychedelics. Perhaps the most promising application of the new drugs was in the treatment of alcoholism. Few people in Alcoholics Anonymous realize that Bill Wilson, the founder, first got sober after a mystical experience he had on a psychedelic administered to him in 1934, or that, in the 1950s, he sought, unsuccessfully, to introduce LSD therapy to AA.
In parts of Canada during the 1950s, psychedelic therapy became a standard treatment for alcoholism, and a 2012 meta-analysis of the six best-controlled trials of LSD therapy for alcohol addiction during that period found a “significant beneficial effect on alcohol misuse.” Early studies of psychedelics for the treatment of several other indications, notably including depression and anxiety in cancer patients, also showed promise.
These first-wave studies were, by contemporary standards, poorly controlled. That’s why many of the early experiments are now being reprised using more rigorous modern methods. The early results are preliminary but encouraging: A pilot study of psilocybin for alcohol dependence conducted at the University of New Mexico found a strong enough effect to warrant a much larger phase 2 trial now under way at NYU.
Another recent pilot study, at Johns Hopkins, looked at the potential of psilocybin to help people quit smoking, one of the hardest addictions to break. The study was tiny and not randomized—all 15 volunteers received two or three doses of psilocybin and knew it. Following what has become the standard protocol in psychedelic therapy, volunteers stretch out on a couch in a room decorated to look like a cozy den, with spiritual knickknacks lining the bookshelves. They wear eyeshades and headphones (playlists typically include classical and modern instrumental works) to encourage an inward journey. Two therapists, a man and a woman, are present for the duration. Typically these “guides” say very little, allowing the journey to take its course, but if the experience turns frightening, they will offer a comforting hand or bit of advice (“trust and let go,” is a common refrain).
The results of the pilot study were eye-popping: Six months after their psychedelic session, 80% of the volunteers were confirmed to have quit smoking. At the one-year mark, that figure had fallen to 67%, which is still a better rate of success than the best treatment now available. A much larger study at Hopkins is currently under way.
When I asked volunteers how a psilocybin trip had given them the wherewithal to quit smoking, several described an experience that pulled back the camera on the scene of their lives farther than ever before, giving them a new, more encompassing perspective on their behavior.