Rethinking psychedelics and mental health

The psychedelic drug LSD has had a long, flamboyant history, including its promotion by former Harvard psychologist Timothy Leary in the 1960s. He envisioned LSD as a way to “become sensitive to the many and various levels of consciousness” and embrace personal and cultural change.

Leary later lamented that his call to “turn on, tune in, drop out” was too often misinterpreted as “get stoned and abandon all constructive activity,” rather than as an aid to transformative change. If Leary were alive today, I’m sure he’d be fascinated by the groundswell of interest in testing psychedelics as a treatment for mental health problems such as depression and post-traumatic stress disorder.

In this issue, neuroscience senior writer Laura Sanders explores the growing evidence that mind-altering drugs — including LSD, MDMA and psilocybin — can bring people relief when combined with psychotherapy in a research setting. Recently, recreational use of psychedelic drugs has also increased, with some local governments decriminalizing their use.

But at this point, it’s unclear if the latest resurgence of scientific interest in psychedelics will bring with it the healing and growth that Leary envisioned, or end up as just more experiments that fail to live up to their promise. So many questions have yet to be answered, including how the chemicals work in our brains, who is most likely to be helped and whether treatments can be delivered safely and cost-effectively.

To help answer these questions, Sanders turns not just to scientists but also to members of Indigenous communities that have been using psychedelics in healing for centuries, typically in spiritual and ceremonial contexts. Her sources note that Indigenous communities have much more holistic approaches to the use of psychedelics than medical researchers do.

“These sacred plant medicines have been a huge part of their culture and lives for a very long time,” Sanders told me. “Their perspective is missing from a lot of these single studies, and the way people talk about these drugs [as] being ‘rediscovered.’ It’s one of those things that looks different, depending on where you’re standing.”

Psychedelics still carry considerable cultural baggage from the ’60s, when their role in the counterculture and political protests helped convince the U.S. government to classify them as illegal substances. That makes it difficult for researchers to run clinical trials and may dissuade potential patients.

To find out what it’s like to use psychedelics as medication, Sanders interviewed Kanu Caplash, 22, who participated in a clinical trial testing MDMA as a treatment for PTSD. “He spent several hours talking with me about his experience,” Sanders said. “He was so beautifully eloquent; I’m really grateful to him for being willing to talk with us about it.” The treatments helped, Caplash says. He no longer thinks of suicide, and feels more at peace with himself.

Who else might get relief from psychedelic therapies is still unclear, but what’s indisputable is that current treatments for mental illnesses fall short for many people who need help. Broadening the search for better ways may bring us unexpected insights.

Nancy Shute is editor in chief of Science News Media Group. Previously, she was an editor at NPR and US News & World Report, and a contributor to National Geographic and Scientific American. She is a past president of the National Association of Science Writers.