Psychedelic Medicine Research Articles

Indigenous Philosophies and the "Psychedelic Renaissance"

AbstractThe Western world is experiencing a resurgence of interest in the therapeutic potential of psychedelics, most of which are derived from plants or fungi with a history of Indigenous ceremonial use. Recent research has revealed that psychedelic compounds have the potential to address treatment‐resistant depression and anxiety, as well as post‐traumatic stress disorder and addictions. These findings have contributed to the decriminalization of psychedelics in some jurisdictions and their legalization in others. Despite psychedelics’ opaque legal status, numerous companies and individuals are profiting from speculative investments with few, if any, benefits accruing to Indigenous Peoples. In this paper, we suggest that the aptly named “psychedelic renaissance,” like the European Renaissance, is made possible by colonial extractivism. We further suggest that Indigenous philosophical traditions offer alternative approaches to reorient the “psychedelic renaissance” towards a more equitable future for Indigenous Peoples, psychedelic medicines, and all our relations.

Neuro‐plastic Shamanism? Towards a Political Ontology of Whiteness and the Psychedelic Zeitgeist

AbstractThis paper argues for reorienting our investigation of the psychedelic zeitgeist towards the longitudinal history of psychedelia with a committed attention to its relationship to colonialism. It demonstrates that clinical psychedelic medicine appears to sustain the reproduction of modern colonial whiteness in line with Elizabeth Povinelli’s theorization of late liberalism. It also challenges the notion of a restricted or segregated academic area for psychedelic studies. Instead, it is imperative to place discussions of contemporary plant medicine in line with broader contemporary discussions in cultural anthropology around political ontology and decoloniality. This paper attempts to demonstrate that doing so may challenge our understanding of whiteness—reinterpreting it—by recourse to the history of the psychedelic counterculture, as a form of complex trauma, and thus potentially demonstrating new implications for decoloniality and its praxis.

Mysticizing medicine: incorporating nondualism into the training of psychedelic guides

ABSTRACT Today, practitioners of contemporary psychedelic medicine are faced with a unique challenge: supporting clients in integrating transpersonal and mystical experiences within a paradigm based on a materialistic, reductionist, and dualistic understanding of reality. Operating on assumptions of pathology and problem-solving, the Western medical model often lacks the theoretical basis to make sense of and integrate the full potentiality of psychedelic medicine. Nondualism can offer an alternative guide to engaging with and transmuting the beliefs and traumas that lie at the root of paradigms based on assumptions of separation. These frames can be deeply resourcing for both psychedelic guide and client. This article explores the challenges and limitations of the modern Western paradigm, as well as possibilities for how nondualism could be incorporated into future training of psychedelic guides.

Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model.

The current standard of care in most uses of psychedelic medicines for the treatment of psychiatric indications includes the provision of a supportive therapeutic context before, during, and after drug administration. A diversity of psychedelic-assisted psychotherapy (PAP) models has been created to meet this need. The current article briefly reviews the strengths and limitations of these models, which are divided into basic support models and EBT-inclusive therapy models. It then discusses several shortcomings both types of models share, including a lack of adequate attention to embodied and relational elements of treatment, and insufficient attention to ethical concerns. The article then introduces the EMBARK model, a transdiagnostic, trans-drug framework for the provision of supportive psychotherapy in PAP clinical trials and the training of study therapists. EMBARK was designed to overcome challenges that prior models have had in conceptualizing therapeutic change in psychedelic treatment, incorporating elements of non-psychedelic evidence-based therapies, incorporating therapists’ prior skills and clinical orientations, delimiting therapist interventions for research standardization, and determining specific factors that contribute to treatment outcomes. The article explains EMBARK’s six clinical domains, which represent parallel conceptualizations of how therapists may support therapeutic benefit in PAP treatment, and its four care cornerstones, which reflect therapists’ broad ethical responsibility to participants. The article describes how these elements of the model come together to structure and inform therapeutic interventions during preparation, medicine, and integration sessions. Additionally, the article will discuss how EMBARK therapist training is organized and conducted. Finally, it will demonstrate the broad applicability of EMBARK by describing several current and upcoming PAP clinical trials that have adopted it as the therapeutic frame.

Psychedelic Psychiatry

The last decade has seen a remarkable resurgence of interest in psychedelic drugs such as psilocybin (from magic mushrooms) LSD and DMT (dimethyl tryptamine – the active ingredient of ayahuasca). This has been driven by the discovery that these psychedelics all act agonists of 5-HT2A receptors. Human imaging studies have revealed this action leads to profound alterations in brain measures of activity particularly in terms of increased entropy of EEG MEG and fMRI signals and reduced within-network, but increased between-network, connectivity. In addition they all can increase synaptic growth and brain plasticity. These findings not only explain the subjective nature of the psychedelic experience but also have implications for the treatment of internalising disorders such as depression addiction anorexia and OCD that are characterised by increased within network connectivity especially of the default mode network. Subsequent trials, particularly of psilocybin, in these disorders has revealed significant clinical benefits from even just a single administration. A number of companies have now been set up to extend these discoveries with regulatory-level trials that could result in market authorisations within a few years. My talk will explore these brain mechanisms and clinical data and discuss the potential place of psychedelic medicine in the future of psychiatry.DisclosureI am an advisor to Compass pathways and Beckley Psytec two companies that are developing psychedelics for depression and other psychiatric indications. Several members of my research group receive support from these companies and also from Small Pharma.

Psychedelic Medicine: Creating an Introductory Course for Mental Health Professionals and Trainees.

Psychedelic Medicine: Creating an Introductory Course for Mental Health Professionals and Trainees.

Traditional Amazonian medicine in addiction treatment: Qualitative results

Traditional Amazonian medicine, and in particular the psychoactive substance ayahuasca, has generated significant research interest along with the recent revival of psychedelic medicine. Previously we published within-treatment quantitative results from a residential addiction treatment centre that predominately employs Peruvian traditional Amazonian medicine, and here we follow up that work with a qualitative study of within-treatment patient experiences. Open-ended interviews with 9 inpatients were conducted from 2014 to 2015, and later analysed using thematic analysis. Our findings support the possibility of therapeutic effects from Amazonian medicine, but also highlight the complexity of Amazonian medical practices, suggesting that the richness of such traditions should not be reduced to the use of ayahuasca only.

The Pharmacology and Clinical Applications of Psychedelic Medicines Within Midwifery Practice.

The research and use of psychedelic medicines to treat common mental health disorders has increased substantially in the past 2 decades. At the same time, knowledge is relatively uncommon among midwives regarding (1) the relative benefits of psychedelic‐assisted therapy, (2) best practices associated with the delivery of psychedelic‐assisted therapy, and (3) responsible integration of this potentially useful intervention into mental health treatment plans. The purpose of this review is to describe current applications of psychedelic medicines to treat common mental health disorders, to describe the current legal status of these medicines used in this context, and to explore the potential for midwifery practice in this area with further training. This article also addresses the disparities regarding LGBTQIA+ and BIPOC populations in relation to this topic and their historical exclusion from research and treatment access in this field.

Interest in receiving psychedelic-assisted therapy among marginalized women: Implications and findings from a community-based study in Canada

BackgroundPsychedelic-assisted therapies are receiving mounting attention for their therapeutic potential. However, little is known about interest among women who experience elevated risk of mental health and substance use disorders. This study examined interest in receiving psychedelic-assisted therapy and socio-structural factors associated with interest among marginalized women. MethodsData (2016–2017) were drawn from two community-based, prospective open cohorts of >1000 marginalized women in Metro Vancouver, Canada. Bivariate and multivariable logistic regression examined associations with interest in receiving psychedelic-assisted therapy. Among women who used psychedelics, additional data were collected to describe ratings of personal meaningfulness, sense of wellbeing, and spiritual significance. ResultsOf 486 eligible participants (aged 20–67 years), 43% (n = 211) were interested in receiving psychedelic-assisted therapy. Over half identified as Indigenous (First Nations, Métis or Inuit). Factors independently associated with interest in psychedelic-assisted therapy in multivariable analysis included: daily crystal methamphetamine use in the last six months (Adjusted Odds Ratio [AOR] 3.02; 95%Confidence Interval (CI) 1.37–6.65), lifetime mental health conditions (depression, anxiety, post-traumatic stress disorder) (AOR 2.13; 95%CI 1.27–3.59), childhood abuse (AOR 1.99; 95%CI 1.02–3.88), lifetime psychedelic use (AOR 1.97; 95%CI 1.14–3.38), and younger age (AOR 0.97 per year older; 95%CI 0.95–0.99). ConclusionsSeveral mental health and substance use-related variables that have been demonstrated to be amenable to psychedelic-assisted therapy were associated with interest in receiving psychedelic-assisted therapy among women in this setting. As access to psychedelic-assisted therapies continues to expand, any future approaches to extend psychedelic medicine to marginalized women should integrate trauma-informed care and broader socio-structural supports.

The challenges ahead for psychedelic 'medicine'.

With the extensive public, commercial and scientific interest from what has been widely termed the psychedelic renaissance, it is important that the scientific practices and results obtained from its implementation into medicine are put under a critical microscope. While there are numerous works on the potential benefits and applications of psychedelics as medicines, relatively little has been written about the challenges this field will face when incorporated into modern medical practice. Indeed, as a new or at least revived area of investigation, psychedelic medicine has a particular set of challenges which need to be addressed. In this viewpoint, we identify a number of these challenges. First, challenges related to the design of individual research studies are discussed, particularly focusing on current practices surrounding blinding, expectancy, the use of therapy and sources of bias. Second, the broader context of the research environment is considered, including how medical science typically establishes evidence, funding bodies and the impact of psychedelics being scheduled at odds with their risk profile. Finally, we describe challenges relating to the implementation of psychedelic therapies into modern medicine, considering the social and economic context. Alongside, we provide suggestions for what could be included into current research protocols to mitigate these challenges.

Disruptive innovation in psychiatry.

Disruptive innovation is a cornerstone of various disciplines, particularly in the business world, where paradigm‐altering approaches are often lauded. As a construct, disruptive psychiatry can be considered to embody such an approach by the pursuit of innovations within the field which test boundaries and shake up the status quo. Given the importance of addressing the current mental health pandemic, and the deficit of highly effective pharmacological treatments for various conditions, innovative disruptive thinking is required. Significant promise exists via the provision of potentially more effective innovative therapeutic options, including digital interventions, psychedelic medicines, microbiome‐altering treatments, brain stimulation technology, and nanotechnology‐based delivery systems. These approaches may be further advanced by individualization of the treatments using computational technology (including quantum computing, machine learning, and artificial intelligence) and genomics.

Psychedelic Psychotherapy: Building Wholeness Through Connection.

BackgroundWe are confronted with dire statistics that document our current mental health crisis. New treatment modalities are desperately needed to address escalating mental suffering and trauma. Psychedelic medicines are attracting increased attention in psychiatry as effective treatment for a range of conditions. The mechanisms of actions and context necessary to maximize their full healing potential represent a radical departure from current psychiatric frameworks and present an opportunity to reimagine psychiatry as a healing art.ObjectivePsychedelic psychotherapy leverages biological, psychological, and spiritual domains to harness innate healing potentials. A novel psychotherapeutic methodology utilizing psychedelic medicines as catalyzing agents is presented, one that provides a developmental model to promotes self-actualization. The paper outlines transformational psychotherapy, the therapeutic process and corresponding practice implications.ConclusionPsychedelic psychotherapy represents a paradigm shift in healing, one that promotes self-integration and whole health. These shifts in internal health are correspondingly reflected in enhanced empathy, improved relatedness, and increased capacity for social connection. Much of human suffering and disregard for the planet is a reflection of our own collective inner impoverishment, fundamental disconnects, and unaddressed trauma. Psychedelic psychotherapy offers a healing approach to restore beauty and health to both the inner and outer worlds we inhabit.

The frontiers of new psychedelic therapies: A survey of sociological themes and issues

AbstractPsychedelic compounds are on the cusp of being approved by medical regulators for treatment‐resistant mental health disorders. Following promising clinical trials, and as rates of mental ill health rise globally, psychedelic medicine presents a new paradigm for treating depression, anxiety, addiction and post‐traumatic stress disorder. The novelty of psychedelic therapies, the cultural stigma they elicit, and the challenges of regulation and implementation urgently call for a sociological lens onto this emerging field of psychiatry. This article identifies key sociological issues related to the medicalisation of psychedelic‐assisted therapies. It begins with a brief overview of the field's history and current treatment approaches. We then identify and critically examine three areas of sociological interest: the of role advocacy in the advancement of scientific research and the destigmatisation of psychedelics; issues related to the medicalisation and pharmaceuticalisation; and integration into healthcare systems. The challenges and affordances of psychedelics to existing therapeutic models, regulation and monetisation are highlighted, and the socio‐political context of the pharmaceutical industry, research, investment and implementation is examined. Drawing on health science literature in this field, the article offers a sociological lens on clinical psychedelic medicine as an emerging and potentially paradigm shifting field of psychiatry and psychotherapy.

The Need for Psychedelic-Assisted Therapy in the Black Community and the Burdens of Its Provision.

Psychedelic medicine is an emerging field that examines entheogens, psychoactive substances that produce non-ordinary states of consciousness (NOSC). 3,4-methylenedioxymethamphetamine (MDMA) is currently in phase-3 FDA clinical trials in the United States (US) and Canada to treat the symptoms of posttraumatic stress disorder (PTSD). MDMA is used in conjunction with manualized therapy, because of its effectiveness in reducing fear-driven stimuli that contribute to trauma and anxiety symptoms. In 2017, the FDA designated MDMA as a “breakthrough therapy,” signaling that it has advantages in safety, efficacy, and compliance over available medication for the treatment of trauma-, stress-, and anxiety-related disorders such as PTSD. In the US and Canada, historical and contemporary racial mistreatment is frequently experienced by Black people via a variety of macro and micro insults. Such experiences trigger physiological responses of anxiety and fear, which are associated with chronically elevated stress hormone levels (e.g., cortisol and epinephrine), similar to levels documented among those diagnosed with an anxiety disorder. This paper will explore the benefits of entheogens within psychedelic assisted-therapy and their potential benefits in addressing the sequelae of pervasive and frequent negative race-based experiences and promoting healing and thriving among Black, Indigenous and other People of Color (BIPOC). The author(s) discuss the ethical responsibility for providing psychedelic-assisted therapy within a culturally competent provider framework and the importance of psychedelic researchers to recruit and retain BIPOC populations in research and clinical training.

Psychedelic medicines for existential distress associated with life-threatening illnesses

This presentation will review the history of scientific research into the use of psychedelic medicines for the treatment of existential distress due to life-threatening illnesses, it will then outline the current state of affairs in North America, and conclude with exploring the implications it will have on the future of palliative care. Despite the significant advances in the field of palliative care with regards to symptom management, and pain control in particular, we have yet to devise an effective treatment strategy for individuals facing the existential distress associated with the inevitable reality of facing death. Psychedelic-assisted therapy, which involves the use of various psychoactive substances in the right set and setting to experience an altered state of consciousness, could serve as a powerful tool to alleviate the anxiety that many face after receiving a life-threatening diagnosis.

The potential of psychedelic medicine – A personal account

In 1965, I was training in clinical toxicology in the pharmacology department of the University of California San Francisco (UCSF) and living in the Haight Ashbury. I studied various psychedelics, including LSD, mescaline, and ibogaine, in human and animal models. The psychedelics were then being used as a therapeutic drug in clinical settings and researched as a potential antipersonnel agent by the U.S. government. Then, using psychedelics became a rite of passage for the emerging countercultural movement. After adverse reactions and negative publicity, states began to criminalize these drugs, beginning in 1966. The federal government eventually moved these drugs to Schedule 1 classification, shutting down research almost entirely.

No Hallucination: The Launch of Psychedelic Medicine

No Hallucination: The Launch of Psychedelic Medicine

Teacher plants — Indigenous Peruvian-Amazonian dietary practices as a method for using psychoactives

Ethnopharmacological relevanceIndigenous groups of the Amazon have developed intricate methods for the application of psychoactives, among which particularly the dieta or diet method of Peruvian-Amazonian traditional medicine stands out. It is a retreat-like intervention involving lengthy periods of social, behavioural, and alimentary restrictions, while ingesting specially prepared plant substances. The interplay of the dietary conditions and plants ingested sensitizes the dieter to receive healing, strength, guidance, and knowledge. From a clinical scientific point of view, the method has remained largely underexplored, but seems more pertinent than ever given the increasing interest in Amazonian psychoactive preparations including ayahuasca (Banisteriopsis caapi) and the burgeoning field of psychedelic-assisted therapies in general. Aim of the studyThis study offers a descriptive account and emic interpretation of the Peruvian-Amazonian dieta. More specifically we document in detail the procedure, its context and purpose of application, effects, modes of action, adverse effects, and risks, from the perspectives of a sample of Peruvian traditional healers. The Peruvian-Amazonian dieta is a multi-purpose method for making use of medicinal plants, many of which (but not all), are psychoactive; the current work especially focuses on its therapeutic applications in conjunction with psychoactives. MethodsWe interviewed 16 healers working in the Ucayali, San Martín, and Loreto provinces of Peru using a semi-structured interview approach. Interviews were audio-recorded and transcribed verbatim. The extensive data derived from these interviews were analysed by means of computer-assisted manifest qualitative content analysis using a theory-advancing approach. Over 500 coded text segments were categorized, resulting in 7 main theme clusters and corresponding sub-themes. ResultsThe interviewed healers described a complex intervention with multifaceted applications (treatment, prevention, training) and effects in various domains (body, mind, spirit, energy). The process was portrayed as transformative, with benefits attributed to the effects of the so-called teacher plants in conjunction with the diet's conditions, along with the skill of the healer guiding the intervention. Further, a detailed risk assessment revealed sophisticated safety measures and tools designed to address adverse responses. The importance of adequate training of the healer that administers the diet was particularly highlighted in this context. ConclusionsThe dieta is a central therapeutic concept and tool in Peruvian-Amazonian traditional medicine and a unique method for using psychoactive plants. Multidisciplinary health research that includes traditional treatment methods from Indigenous cultures, Amazonian and other, should not be neglected in the current global interest in psychedelic therapies; such research may in the long-term contribute to a more inclusive psychedelic research paradigm as well as healthcare practice in countries where rich traditional healing systems exist, and perhaps beyond. It may also contribute to the recognition of the Indigenous healers as not only historical forerunners, but also current leading experts in psychedelic medicine.

Right-Wing Psychedelia: Case Studies in Cultural Plasticity and Political Pluripotency.

Recent media advocacy for the nascent psychedelic medicine industry has emphasized the potential for psychedelics to improve society, pointing to research studies that have linked psychedelics to increased environmental concern and liberal politics. However, research supporting the hypothesis that psychedelics induce a shift in political beliefs must address the many historical and contemporary cases of psychedelic users who remained authoritarian in their views after taking psychedelics or became radicalized after extensive experience with them. We propose that the common anecdotal accounts of psychedelics precipitating radical shifts in political or religious beliefs result from the contextual factors of set and setting, and have no particular directional basis on the axes of conservatism-liberalism or authoritarianism-egalitarianism. Instead, we argue that any experience which challenges a person's fundamental worldview—including a psychedelic experience—can precipitate shifts in any direction of political belief. We suggest that the historical record supports the concept of psychedelics as “politically pluripotent,” non-specific amplifiers of the political set and setting. Contrary to recent assertions, we show that conservative, hierarchy-based ideologies are able to assimilate psychedelic experiences of interconnection, as expressed by thought leaders like Jordan Peterson, corporadelic actors, and members of several neo-Nazi organizations.

Enhancing equity-oriented care in psychedelic medicine: Utilizing the EQUIP framework.

Psychedelic-assisted therapies are experiencing a re-emergence in mainstream medicine and mental health contexts. A wide variety of psychedelic-assisted therapy modalities are being utilized to address mental health issues such as substance use disorders, end of life anxiety, treatment-resistant depression, suicidality, PTSD and other conditions. The novel and inchoate acceptance of psychedelic-assisted therapies into mainstream medical and therapeutic realms raises questions of equity. Concerns have been raised that individuals and communities facing structural inequities are perhaps least able to access these treatments including Black, Indigenous and people of colour (BIPOC) as well as people who use drugs. Psychedelic-assisted therapies may exemplify the inverse law of care whereby services are most inaccessible to communities with the most need, especially if these therapies are regulated into the private sector. As legalization and wider implementation of these therapies appears to be imminent, now is a critical time to consider how health equity may be promoted within psychedelic medicine. This paper examines how the EQUIP Health Care approach (https://equiphealthcare.ca) may inform the development and provision of equity-oriented psychedelic-assisted therapies. The EQUIP approach seeks to reduce the effects of structural inequities on people's health, the impacts of discrimination and stigma, and the mismatches between usual approaches to care and the needs of people most affected by health and social inequities. Key dimensions of the EQUIP intervention include cultural safety, harm reduction, trauma and violence-informed care, and contextual tailoring.