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Can Psychedelic Drugs Treat PTSD?

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Kept on hold for close to half a century, especially in the U.S., psychedelic science is now coming back to life, in large part due to efforts by the Multidisciplinary Association for Psychedelic Studies and researchers it has recruited and supported and with whom it has won approvals to do legal studies here and abroad. This month, MAPS held a conference with main speakers from, for example, Harvard, Johns Hopkins, NYU, Purdue, UCLA, and leading European universities.

Gathering predominantly in navy blue and other sober hues, these scientists and hundreds from the psychedelic tribe also honored figures who had kept the flame alive during official repression. A "tribute dinner" celebrated the life of silver-haired Sasha Shulgin, chemist of a private lab who, with his wife Ann, led a Bay Area group that experimented with psychoactive molecules created (or repurposed) in that lab and described (with instructions) in their ostensibly fictional books.

As in the Netherlands for many years, attendees at the conference took for granted a sharp distinction between hard drugs such as cocaine, heroin, and methamphetamine, which are clearly destructive, and relatively non-addictive and visionary substances such as psilocybin, mescaline, lysergic acid diethylamide, and ayahuasca, as well as marijuana and MDMA (or Ecstasy).

Held in San Jose, California, the April conference was organized by MAPS in collaboration with three sister organizations. Said Rick Doblin, founder of MAPS: "While we do have an interest and are active in a range of other areas, we are focusing on MDMA and post traumatic stress disorder."

A certain division of labor in the vineyards of psychedelic science exists, with MAPS concentrating now mainly on making MDMA and marijuana into prescription medicines; the Heffter Research Institute, on exploring how psychoactives work in the nervous system; the Beckley Foundation, on doing research and affecting public policy in the U.K. and elsewhere; and the Council of Spiritual Practices (CSP), on moving beyond the medical model and exploring the uses of visionary drugs in occasioning what one research team calls "mystical-type experience."

Said Bob Jesse, who initiated CSP: our "goal is to make more available to more people a certain loosely defined category of experience" which "goes by many names." In religious studies, it's called mysticism. It's also called "Buddha consciousness, Christ consciousness, non-dual consciousness, primary religious experience." Jesse added it's "our belief" that "if more people had this kind of experience, under good and prudent circumstances, they, their neighbors, and the world would be happier."

Much of the legal research reported at the conference fits the medical model, such as using psilocybin to treat post traumatic stress disorder (PTSD) or alcoholism or the anxiety of cancer patients, using ibogaine (from an East African root) to break addictions (as to cocaine), or psychedelics to treat cluster headaches.

Against this dominant medical theme, what stood out as a complementary voice was research on spiritual uses of psilocybin in healthy volunteers. Under the leadership of psychopharmacologist Roland Griffiths, a Johns Hopkins team is picking up a theme introduced into science by the Marsh Chapel experiment of the 1960s, an experiment that gave psilocybin to subjects listening to a Good Friday service and rated their findings on a scale based on mystical or unitive experience. Volunteers in the Hopkins research are not trying to cure anything, except perhaps the confines of ordinary quotidian consciousness.

Attendees at the conference knew that psychedelic science might never have resumed without the underground efforts of often unsung heroes, who included not only chemists such as Shulgin in his early work, but also "guides" who have assisted in supporting what a scientist would call "non-trivial" trips. Whether trained in psychotherapy or just possessed of a natural talent for being supportive to folks in extraordinary states, these guides were not featured as such on the conference program but see themselves as serving quietly in society as helpers or, in some cases, even as a sort of Western version of shamans.

Many are the ways to use psychoactive molecules, from the trivial to the profound. For example, these substances can be ingested frivolously (as in excruciating YouTube videos of teenagers chortling at friends "wasted" on salvia divinorum, which in other contexts is used as a sacred herb) or as an aid to dancing all night or to making love, or perhaps to treating the widespread and otherwise intractable syndrome of PTSD, or to reducing the anxiety of dying patients, or to occasioning "mystical-type experiences," which may, to the extent that we accept self-reports and community observations, offer a glimpse of unitive consciousness and subsequently change behavior.

Unofficially, much is known about guiding psychedelic sessions so they are as deep as possible. For example, a new site called "entheoguides" contains a draft manual and links. Next year, Jim Fadiman (who did early research on creativity with Willis Harman) will publish a book, Shattering Certainty, which begins by discussing the best way to guide sessions.

Because of the official and blanket condemnation of visionary molecules, we have been deprived of research that is carefully framed, double-blind (neither the volunteer nor experimenter knowing whether the pill, when ingested, contains a drug or an inert control), and peer-reviewed (checked by other scientists as to design, execution, and the link between evidence and conclusions). Now this deficit is starting to be repaired.

Meanwhile, as the conference made clear, at least two arguments are advanced for making more available visionary and other psychoactive molecules. MAPS advocates that certain drugs should be available for prescription drugs by physicians (and in certain cases, by other professionals). In which case the threshold question is: are these substances as safe and efficacious as others already approved?

Other people have long made the libertarian argument that each individual should have the right to ingest anything he or she chooses on the basis of accurate information, so long as the experience won't harm others (as alcohol may, for example, impair driving). The International Foundation for Internal Freedom advanced a similar argument back in the 1960s , but a rattled governing elite was then not persuaded, in the face of protests against the Vietnam war and demands from blacks, feminist women, and some of the young.

At the conference many papers dealt with a visionary drug called ayahuasca, a harsh-tasting thick infusion often made by boiling Banisteriopsis caapi vine and Psychotria viridis leaves. Not a party drug, ayahausca tends to cause vomiting and diarrhea. Clearly, it must provide benefits that outweigh these physical discomforts. Traditionally used in the Amazon basin for healing, ayahausca also serves in the cause of personal growth and, in a couple of syncretic churches founded in Brazil, in the role of a sacrament.

The churches were founded there but have spread to cities such as Amsterdam and Santa Fe. The latter group gets its ayahausca "tea" from south of the border, and shepherded a case all the way to the U.S. Supreme Court claiming the right to import its sacrament, provided the tea is safeguarded against "diversion." It won the case, affording U.S. members the right to ingest an otherwise illegal drug, as with the peyote taken by members of the Native American Church.

Which has led people to ask, if the sacramental drugs are okay for these groups, what about the rest of us? Does religious freedom extend only to small or ethnically restricted groups with a Christian flavor, or also to other spiritual explorers?