Psychedelics

What to know about psychedelic therapy

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Canadian entrepreneur gifts $5 million to help create psychedelic research centre for mental health

CTV Health News – October 24, 2021

TORONTO — Canadian tech entrepreneur and venture capitalist Sanjay Singhal was in his early 30s when he was first diagnosed with bipolar disorder. It had been a lifelong struggle — one moment feeling great, then suddenly mentally paralyzed and unable to get out of bed for three straight days.

“When I went manic, I would make bad decisions … spend money unreasonably,” he said. “Up until age 38, my life was a roller coaster.”

Today, Singhal is 56 and on a mission to transform mental health care. He is the philanthropist behind Canada’s first psychedelic psychotherapy research centre for mental health at Toronto’s University Health Network (UHN). Starting with a $5 million donation made through the Nikean Foundation that he founded, Singhal hopes researchers at the centre can unlock the potential of psychedelic medicine and find answers on how psilocybin and a so-called “God molecule” can help transform mental health care.

“I was very aware of what mental illness can do,” he said in his very first on-air interview about the subject and his personal struggles with it.

But it is not just about him. He also has a daughter, Nikki, who has struggled with anorexia since childhood that he also wants to help. She was hospitalized at the age of eight, and again when she was 16. Now a third year resident in psychiatry at the University of Toronto, she has done well but continues to navigate through her struggles.

A chance presentation several years ago by Robin Carhart-Harris, one of the world’s leading researchers on psychedelic medicine that mentioned psilocybin as a potential treatment for anorexia piqued Singhal’s interest. Carhart-Harris is the head of the Centre for Psychedelic Research, a division of Brain Sciences with the Faculty of Medicine at the Imperial College London.

“I thought, oh my God, I have to go listen to this guy and see what’s going on…I spoke to him afterwards, drove him to the airport, and then a couple of weeks later, my daughter and I both flew to London … we were amazed at the possibilities of what this could do.”

But Singhal is quick to note that at the Canadian research centre, psychedelic medicine will only be used alongside therapy in a controlled setting.

“I don’t want people to do this on their own,” he said. “I don’t want this to become recreational play.”

A POTENTIAL PARADIGM SHIFT

The potential of psychedelic therapy goes as far back as the 1950s when several pioneering psychiatrists experimented with LSD as a possible treatment for mental health disorders. Some of the earliest groundbreaking experiments and research happened in Saskatchewan. But studies into these drugs ended by the 1960s amid social and political backlash.

For scientists, the new research centre represents potential for transformational change in mental health therapies and offers new hope for many patients.

“I was thrilled beyond belief because psychiatry hasn’t had a real paradigm shift or a new opportunity at treatment in a long time,” said Dr. Susan Abbey, psychiatrist-in-Chief for the Centre for Mental Health at UHN, in an interview.

“There truly is a signal that there is something to this. And, really, every major academic center in mental health in the world is trying to begin to conduct research in psychedelic, particularly psychedelic assisted psychotherapy.”

There are many disorders, including post-traumatic stress disorder and end-of-life distress, that are treatment resistant, says Abbey.

Dr. Emma Hapke, a staff psychiatrist with UHN and lecturer at the University of Toronto agrees.

“We haven’t had a lot of new treatments in psychiatry in a long time. There seem to be more people suffering…struggling and there is an appetite for something new that might work,” Hapke told CTV National News in a phone interview.

Traditional medications prescribed for mental health care typically suppress symptoms, Hapke said. While much more research is needed, there are suggestions that psychedelics work differently and do not require ongoing use.

The centre is planning six to eight research projects, including psilocybin therapy for end-of-life grief, grief suffered by caregivers, families who have lost a child, and body dysmorphic disorder.

It also hopes to research a separate psychedelic called 5-MeO-DMT, also called “The God Molecule” due to the profound psychoactive effects on the user, as a potential therapy for PTSD. Found in a wide variety of plants, it is also secreted by the glands of the Sonoran Desert Toad. It is illegal in the United States but unregulated in Canada. BuzzFeed News once described it as “the most powerful psychedelic on the planet.”

The centre is also looking at training programs for licensed therapists to learn how to work with psychedelics, since treatments will likely also involve therapy for patients to understand the insights that emerge with treatment.

TRYING PSILOCYBIN AND THE ‘GOD MOLECULE’

Singhal grew up in a tumultuous household, and from a young age, built emotional walls around himself without even realizing. If he encountered someone who clearly needed emotional comfort, his automatic response was escape.

“I was afraid of other people’s emotions,” Singhal said. After three psilocybin sessions, everything changed.

“Now, my instant thought is, I need to sit down with this person and comfort them, find out what’s going on. That has been tremendously beneficial for my relationships.”

Singhal’s original intent when he decided to try psilocybin as a therapy was to find out why he sometimes drank too much and to get a handle on that aspect of his life. He had already been seeing a therapist for 20 years, and while it has helped him get through some of the most depressed periods of his life, psilocybin was different. Suddenly, he felt liberated, he said.

“The psilocybin took me on this circuitous journey of, no, let’s explore what’s really going on here,” he said.

But Singhal is perhaps even more interested in the potential of 5-MeO-DMT, which is still in the drug development process phase and likely years away from clinical trial use.

One of the challenges with psilocybin and MDMA is that they are expensive treatments, Singhal explained. It takes four to six hours in a room with one or two trained therapists, licensed professionals, so a single treatment can run upwards of $2,000 or more.

5-MeO-DMT lasts just 15 minutes, which makes potential treatment significantly more affordable, he said.

”You’re not aware you’re conscious, but you’re not aware of what’s going on so when you come back from that trip, all you know is something beautiful happens. And all of a sudden you feel better,” Singhal said.

While much of the new research involving these psychedelics are still considered very early stage, Singhal’s experience and newfound peace gives him hope.

“The apparent lack of adverse effects is reassuring and consistent with what we know about these compounds more generally – that when administered in a responsible manner, to suitable and prepared individuals, they are almost invariably well-tolerated,” according to a research commentary on 5-MeO-DMT published in 2019 in The American Journal of Drug and Alcohol Abuse.

But it also added that “any conclusions pertaining to the antidepressant efficacy of 5-MeO-DMT must wait until the appropriate clinical trials are conducted.”

UHN doctors agree all the compounds need rigorous scientific study.

“We need to take a very careful approach… so that we don’t just get so swept away with potential excitement, but that we’re really understanding how medications work what they do for people,” said Abbey.

Singhal acknowledges that much of the evidence that psychedelics could be used to help with anorexia or other mental disorders is anecdotal, but it is enough that he is willing to write a big check to fund the research necessary.

“We’re all traumatized children running around in adult bodies, and these medicines can help us all,” Singhal said.

“I would say, now, three years later, my daughter has tried various treatments, and she’s still struggling, but she has hope. And if … this gives somebody hope, that’s a tremendous gift.”

Correction:

In the second last paragraph under “A potential paradigm shift” subhead, the legal status of 5-MeO-DMT was corrected to unregulated and a reference to Health Canada exemptions was removed, as it was in reference to a different type of DMT.

Story from CTV Health News

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Can Psychedelic Drugs Treat Physical Pain?

LSD and psilocybin increasingly show promise as mental health treatments. Now universities and companies are exploring their use in pain management

By Troy Farah on September 30, 2021

When Kevin was just 11 months old, he was diagnosed with type 1 diabetes, which led to other health problems as he grew up: loss of vision in his left eye and peripheral neuropathy, a painful condition caused by nerve damage. Then, in 2019, a colonoscopy revealed he had colon cancer.

Feeling anxious and depressed, Kevin (a pseudonym) decided to try self-medicating with psychedelics, including psilocybin-containing “magic mushrooms.” Twice a week, the now 28-year-old delivery driver takes about half a gram of the outlawed fungi. This amounts to too little psilocybin to induce a full-blown trip, and Kevin says he quickly noticed an improvement in his mental health—a result that is in line with a handful of recent studies about the drug’s clinical potential. And he was pleasantly surprised to find that his physical pain seemed to decrease as well, even on the days he was not taking anything.

“A lot of the anxiety and depression I was dealing with started to fade away—and then the pain in my legs started to go away,” Kevin says. “I’m feeling the lasting effects from the psilocybin on my stomach and colon pretty much all the time.”

Vivid colors, warped textures and sounds, and intense introspection are famously associated with the psychedelic experience—and now, increasingly, so are improvements in mental health conditions such as anxiety and post-traumatic stress disorder. But what about pain relief? That is the question a growing number of researchers are asking, based on anecdotal reports that drugs such as LSD or psilocybin can help with this. Both drugs are currently illegal under federal law, though medical studies on them are now being officially cleared with increasing frequency.

From psychedelic start-ups to university labs, scientists are starting to test such drugs on various types of pain: cluster headaches, chronic pain, fibromyalgia and even phantom limb pain. This May a New York City–based, multimillion-dollar psychedelic start-up called Mind Medicine (MindMed) announced Project Angie—a series of studies using LSD and an undisclosed drug to treat chronic pain.

“We don’t really know how psychedelics work to modulate people’s long-term symptoms in any illness, let alone pain disorders, which are less studied than some of the others,” says physician Dan Karlin, MindMed’s chief medical officer. “But there is compelling preclinical evidence that they work … via psychological mechanisms … but also may have some direct effects on descending pain pathways.”

Tryp Therapeutics, a California-based psychedelic start-up, is exploring chronic pain relief using psilocybin and another, psilocybin-based drug with an undisclosed formulation that is obliquely called TRP-8803. The company has also partnered with the University of Michigan to study how these drugs might treat fibromyalgia, a complex and little understood condition blamed for pain throughout the body. Tryp has added leading psychedelic researcher Robin Carhart-Harris to its scientific advisory board, and the company says he will play a “critical role” in clinical trial design.

Earlier this year Yale University announced a trial using psilocybin for cluster headaches. And in August the Oxford, England–based pharmaceutical start-up Beckley Psytech raised $80 million for psychedelic research. Part of this will fund a phase 1b safety trial investigating low-dose psilocybin to treat a rare kind of headache called a short-lasting unilateral neuralgiform headache attack.

These efforts are in very early stages, and so far any results are far from clear. Some experts argue that the evidence for psychedelics relieving pain is weak and that these drugs are so powerful that they should only be used in psychotherapy—if anywhere. Even if psychedelics can relieve physical pain, they may not be better tools than those that are already widely available.

“Pain is this four-letter word that can mean so many different things,” says Vivianne Tawfik, an assistant professor of anesthesiology, perioperative and pain medicine at the Stanford University School of Medicine. At an outpatient clinic, Tawfik treats rare and refractory types of pain usually associated with surgery or injury, such as chronic neuropathic pain and complex regional pain syndrome. “There’s a role for opioids,” she says. “There might end up being a prescribed role for psychedelics. The jury’s still out.”

Tawfik warns that any off-target effects of psychedelics need to be carefully monitored. “I think abuse liability needs to be really closely considered, making sure that there aren’t unexpected psychiatric effects, certainly in populations at risk,” she says.

HISTORY OF PAIN AND PSYCHEDELICS

One of the earliest recorded studies of pain relief from psychedelics was conducted by Eric Kast, an Austrian-born physician who fled the Nazis with his family in 1938 and resettled in the U.S., later becoming an anesthesiologist at Chicago’s Cook County Hospital. Kast had an early interest in how to measure pain responses: in 1962 he designed an elaborate apparatus—a pneumatically operated “mechanical pain-producing device”—that used air pressure to let a subject apply a “pain-producing element” (possibly a needle) to their own leg.

Two years later his attention was drawn to the powerful psychedelic LSD, which he tried giving to 50 “gravely ill” patients afflicted by pain with causes ranging from cancer to gangrene. They first received the synthetic opioids hydromorphone (Dilaudid) and meperidine (Demerol)—and later they were given 100 micrograms of LSD as well. This would be a strongly psychoactive dose for most people.

“When compared with LSD-25, both [other] drugs fell short in their analgesic action,” Kast wrote in 1964. It was a remarkable anecdote but barely investigated further. For decades this remained some of the best research in this area, aside from a few case studies.

“I feel like most of the studies that were done weren’t done well,” says Fadel Zeidan, a neuroscientist who studies the underlying mechanisms of pain and mindfulness at the University of California, San Diego. Zeidan, who is co-leading a study on psilocybin for phantom limb pain, would like to see “higher standards, more rigor” in this area of research. In 2020 he co-authored a review that weighed the evidence of psychedelics relieving chronic pain and proposed a mechanism of action. The review noted that psychedelics act on the body’s serotonin receptors—notably the type known as 5-HT2A—which have been linked in some research to the development of chronic pain.

“Serotonin is also involved in descending modulation of pain [from the brain] down to the spinal cord,” Tawfik says. But she and others note there are currently very little data to back up the hypothesis that psychedelic pain relief acts through this mechanism. “Even though we know that some of the receptor systems that underlie pain are probably similar, there’s probably a lot of nuance that we don’t really know yet or appreciate.”

One of the few double-blind, randomized, placebo-controlled studies on this topic was published last year. Researchers at the Netherlands’ Maastricht University and their colleagues trialed 24 people who were given an oral solution of ethanol containing either a low dose of LSD (too low to cause strong effects such as visual disruptions) or a placebo. Then the subjects placed their hands in almost freezing water. The longer they could keep their hands submerged, the better their pain tolerance was determined to be.

Ratings of pain tolerance from subjects who received LSD were comparable to those in studies with the opioids oxycodone and morphine, leading the authors to conclude in the Journal of Psychopharmacology that “low doses of LSD might constitute a novel pharmacological therapy.”

Again, the researchers hypothesized that serotonin receptors had a role in this effect. Two of the scientists who conducted this study, Matthias Liechti of the University of Basel and Kim Kuypers of Maastricht University, are currently working with MindMed on its LSD and pain research. And the paper’s lead author, Johannes Ramaekers of Maastricht University, says he is developing another pain study to look at psychedelics and fibromyalgia.

But Boris Heifets, a Stanford Medicine anesthesiologist who studies pain—as well as “rapid acting psychiatric therapies,” including psychedelics—says the focus on serotonin in pain relief is probably a “red herring.” Heifets (who is beginning a trial looking at psilocybin and chronic lower back pain) argues that the fact that psychedelics can also improve mood should not be overlooked, given neurological connections between pain and depression.

“If these drugs are going to help, it’s going to be much like the way we think they help for depression—[that is], changing your relationship to your pain,” Heifets says, emphasizing that psychotherapy is the core of psychedelics’ apparent effectiveness in mental health. “The revolution with this class of medicines is that it’s really not just medication alone…. This whole body of research is emphasizing the importance of therapy, psychological support and connection.”

U.C. San Diego’s Zeidan agrees. What a drug like psilocybin could be doing is helping “treat the whole person,” he says—adding that he believes this should be a greater focus of modern medicine in general.

“Chronic pain is really just this comorbid snowball of shit,” Zeidan says. “It’s not only the sensory abnormalities, but it’s also the depression, the anxiety, the sedentary lifestyle, the self-doubt, learned helplessness—it’s this whole thing.”

If psychedelics are ever prescribed for pain, it would not be the first time a drug developed for another kind of treatment has been co-opted in this way. Gabapentin and pregabalin (Lyrica) are two antiseizure drugs now commonly prescribed for nerve pain, while duloxetine (Cymbalta) is an antidepressant often used to address chronic musculoskeletal pain.

Despite the scarcity of solid evidence that psychedelics can tackle physical pain, some people like Kevin are not waiting. Three others interviewed for this article claim to use LSD to treat different types of pain, from cluster headaches to degenerative disc disease in the neck and lower back.

All say they are willing to risk breaking the law because they have tried everything else, with very little success. The steadily increasing research could shed some light on whether these long-demonized drugs can relieve physical suffering—or if they are simply placebos—while also examining long-term side effects.

“Every individual’s experience of chronic pain is unique,” Tawfik says. “Many of my patients are still looking for better treatment options…. We just always need to have these risk-benefit conversations with any of these medications.”

Story from Scientific American

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US Government issues first grant for psychedelic research in over 50 years

Kevin Dinneen – September 29, 2021

Matthew W Johnson, a professor at John Hopkins University and an expert in psychedelics, drugs and addiction announced last week that he is the first researcher to be given federal funding for over half a century to directly study therapeutics of a classic psychedelic.

Announcing the grant on Twitter, he said “It’s official. I just received a U01 grant from NIDA to study psilocybin for tobacco addiction. To my knowledge it’s the 1st grant from the US government in over a half century to directly study therapeutics of a classic psychedelic. Hopefully this starts a new era in legitimacy of psychedelic science. Hopkins will lead a multi-site trial with the other two sites being University of Alabama at Birmingham (site leader Peter Hendricks) and New York University (site leader Michael Bogenschutz). Big thanks to all the colleagues at Hopkins and the other sites, especially Albert Garcia who has been the lead co-investigator and primary session guide on the smoking research for the last decade.”

Matthew is the principal investigator in the psilocybin-facilitated smoking cessation study, and also claims to be the holder of the, “first endowed professorship on the planet with psychedelics in the title’. He told The Truffle Report “I’m extremely excited about it. The government funding for a therapeutic trial of psychedelics is something the field has been waiting on for 20 years now in the modern renaissance of psychedelic research”.

The study will be one of the first studies into the therapeutic qualities of psychedelic mushrooms since the war on drugs was declared in the 1970s. The Swiss scientist Albert Hoffman, famous for being the first person to synthesise LSD, was also the first person to synthesise and name the principal psychedelic mushroom compounds psilocybin and psicolin.

The federal U01 grant, known as a ‘Research Project Cooperative Agreement’, is to fund the multi-centre high-risk clinical study into using psilocybin to help smokers quit the habit. It is being conducted by John Hopkins University, New York University, and the University of Alabama at Birmingham, USA. Global tobacco-related deaths stand at approximately 6 million per year, and that number is projected to rise to around 8 million deaths annually by 2030. Smoking is still considered to be a big public-health concern worldwide.

“This is extremely encouraging. Public funding for psychedelic science is critical” says Doctor Hendricks, professor at the Department of Health Behavior of the University of Alabama at Birmingham. “My hope is that this opens the door to further scientific inquiry, and ultimately, the advancement of a treatment paradigm that has the potential to alleviate suffering across the globe”.

Story from Leafie UK

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This is why psychedelics improve your relationship

Written by Erik McLaren – December 08, 2017

According to several studies Magic mushrooms, LSD, MDMA and other psychedelics improve relationships by inspiring empathy, communication, and self-awareness.

For the first time, psychedelics are truly being studied as medicine and not a menace. The promise of psychedelics as a treatment for PTSD seems to have no ceiling, but other findings have shown that psychedelics improve relationships. Finding a partner is one of life’s most worthwhile challenges. Magic mushrooms and MDMA and LSD might be catalysts to a deeper connection according to scientific studies.

By helping people understand the impact of their actions

In 2016, the University of British Columbia followed more than 300 men with substance abuse issues after their release from prison. Some of these men decided to take psychedelic drugs after their release, and some did not. Twenty-seven percent of The group that took psychedelics were arrested on domestic violence charges within six years. That number jumps to 47 percent for men who didn’t take any psychedelics.

This was not a clinical trial, but an observational study. The study didn’t instruct these men on dosage, or even what psychedelic drug they should take. Chance alone doesn’t explain the difference between these two groups.

Avoiding domestic violence isn’t a high bar for a partner, however, it is a shockingly common problem. One author of the study told Science Daily, “this study, in stark contrast to prevailing attitudes that view these drugs as harmful, speaks to the public health potential of psychedelic medicine.”

But this isn’t the only study in recent years to run contrary to current attitudes on psychedelics.

By inspiring meaningful conversations

When it comes to romance, finding a partner is often portrayed as the finish line. That can’t be further from the truth. Relationships require constant upkeep and discussion with mutual respect and understanding. MDMA may be able to help inspire those kinds of conversations.

The Multidisciplinary Association for Psychedelic Studies (MAPS) is currently running the third phase of their federally approved MDMA study to treat PTSD. In 2016, MAPS also sponsored a study that looked at couples therapy with MDMA, where one partner suffered from PTSD. That study is still ongoing, but plenty of anecdotal evidence suggests that it will yield positive results. A similar study in the UK also found MDMA can help couples communicate.  What may also be surprising to some is the fact that the United States only banned MDMA in 1985 and that before that, therapists often used MDMA in couples therapy.

Many couples are turning to magic mushrooms to help keep their relationships in perspective. One study concerning the affect of mushrooms on depression, also found that the shrooms improved participants’ relationships overall. LSD is becoming another tool in improving relationships. Due to the large volume of anecdotal evidence, further research is necessary.

Psychedelics improve relationships by increasing empathy and self-awareness.

Like the early days of medical marijuana studies, the results from almost every study of psychedelic medicines have positive results. Whether it’s helping people cope with death, or alleviating soldiers PTSD, psychedelics have powerful effects on the brain.

Study after study shows that experiences people have psychedelics are routinely the most powerful and meaningful in the participant’s lives. The power in those experiences comes from psychedelics ability to help people through addictions, to generally increasing mindfulness. Some studies show that psychedelics can positively influence someone’s personality, for years to come.

Psychedelics have been linked to increased empathy, and create a situation where the deep and complicated interconnectivity of life seems clear and tactile. This not only makes people better partners, it can make them better people.