07 Sep Psychedelic drugs: An Approach to addressing mental health issues
TEISI TAMMING, BRADLEY FRANKS: PSYCHEDELIC DRUGS: AN APPROACH TO ADDRESSING MENTAL HEALTH ISSUES – Aug 20th 2018
An increasing amount of research has shown that psychedelic substances could be of major use for more successful forms of psychotherapy. This research has converged at a similar conclusion – psychedelic substances such as Psilocybin, MDMA, LSD and DMT have a medical value in that they can be used to treat mental health issues such as, but not limited to, addiction, anxiety, depression and post-traumatic stress disorder (PTSD)    .
Despite the growing amount of evidence for the usefulness of psychedelic substances in psychotherapy, modern policies reflects outdated social misconceptions. This results in the stagnation of medical research and the application of psychedelic substances to therapies. Considering the potential of psychedelics drugs to reduce the human, social and financial costs associated with the growing prevalence of mental illnesses worldwide, policies need to be renewed . Policy makers must recognize the medical value of psychedelic substances, so that researchers can prioritize further research and begin the process of making psychedelic-assisted therapies available to the public. The following report will therefore outline three major reasons the current policies need to be changed and suggests three steps that policy-makers need to take.
Faulty rationales of the current policies
The most commonly used classification system by the United States Drug Enforcement Agency lists cannabis, LSD, MDMA and psilocybin as Schedule 1 drugs. Schedule 1 drugs are characterized as having a high potential for abuse, no medical value and no accepted safety for use. Drugs listed as Schedule 2-5 are acknowledged to have some medical value, but differ in ranking depending on their potential for abuse. Schedule 1 drugs are under the greatest legal scrutiny and have the most regulatory restrictions on research. As will be shown below, the pitfalls of the widely utilized classification system are hindering scientific advances and slowing the process of addressing the emerging mental health crisis around the world.
The current classification system is faulty in three major ways. Firstly, the current system historically stems from societal and cultural, rather than scientific considerations. This results in the continuous hindering of scientific, and through that, societal, progress. Research since the discovery of LSD in 1938 until its prohibitions, showed the potential of the substance to reduce anxiety, depression and pain in patients with advanced cancer, to treat addictions, obsessive-compulsive disorder, and other psychotic disorders  . However, the effects of LSD, like of many other psychedelic substances, is dependent on several factors, such as the mental state of the individual, and the physical, social and cultural environment in which the substance is ingested. Whether or not the use of the substance is supervised can also have a large influence. When the recreational use of LSD became widespread it was a lot of people were genuinely concerned that it would threaten the wellbeing of society. This resulted in the war on drugs and new classification system that has largely remained to this day. This resulted in a major drop in research on psychedelic substances and pharmaceutical progress.
Second, the current system of classifications has failed to adapt itself to an influx of new findings, which confirm that psychedelic substances have medicinal value. The new findings bring into question whether or not these substances should be classified as Schedule 1 drugs. Clinical trials have shown the safety and efficacy of LSD-assisted therapy in treating anxiety related to terminal disease and treatment-resistant alcoholism . Additionally, research on MDMA-Assisted psychotherapy has shown significant long-term reductions in PTSD symptoms, even in patients previously unresponsive to existing treatments. Finally, Psilocybin-assisted psychotherapy has shown to aid smoking cessation, whilst a chemically related substance DMT, found in the Amazonian folk medicine ayahuasca, has shown reductions in alcohol and cocaine addictions in a 6-month follow-up with no lasting adverse physical or psychological effects .
The abundance of evidence for the medical potential of the Schedule 1 drugs has however been ignored consistently. In 1978, an advice to downgrade the classification of cannabis in the UK was rejected. More recently, in 2009, UK government’s Chief Drug Advisor’s, Professor David Nutt, criticized the toughening of the laws on cannabis. He argued that drugs should be rightfully classified according to the harm they cause, noting that alcohol and tobacco caused more harm than LSD, ecstasy and cannabis. In light of this David Nutt was dismissed and the classification of the substances remained unchanged .
Finally, the misclassification of drugs can be used to legitimize the consumption of harmful and addictive legal substances, such as alcohol and tobacco. Both alcohol and tobacco are not classified due to their thorough embedment in Western cultures and historical contingencies, yet the harm they cause is well known. Considering both legal and illegal drugs, alcohol has been shown to be the most harmful drug overall, with seven times more harm caused to self and others than LSD, and over twice the harm caused by cannabis. Reports from 2012 show that almost 6% of global deaths can be attributed to alcohol and 12% worldwide can be attributed to tobacco . Both alcohol and tobacco are also associated with significant costs to healthcare systems. This was exemplified in the Global Drug Survey (2017), which showed that alcohol consumers have greater chance of seeking immediate drug-taking related medical treatment than cannabis, LSD, cocaine and MDMA. However, all of the latter, which have also been shown to have medical benefits as argued above, are currently ranked as schedule 1 drugs whilst alcohol and tobacco are not classified at all. This underlies the need for a thorough review and alteration of the entire classification system in order to reflect the reality of medical benefits as well as the reality of potential harms of different drugs.
In summary, drug classifications must better respond to the overwhelming evidence presented in favour of the potential of psychedelics in therapy. Indeed, this would not only speed up the conduction of larger scale studies, but would also allow treatment in the future.
Policies need to encourage and prioritize innovative high-potential psychedelic-assisted therapy research, which has been conducted safely and in a scientifically rigorous manner.
1) The classification system needs to be adjusted to reflect the medicinal value of several substances currently listed as Schedule 1. This includes the rescheduling of MDMA, LSD, psilocybin, DMT. This will make it easier to conduct large-scale clinical trials and begin the process of addressing the mental health crisis.
2) Advocacy efforts need to be made to break down the misconceptions about the relative risks and harms of the medical use of psychedelic drugs. The campaigns could use conventional channels of national television and radio, but also build upon existing social media channels to reach different audiences.
3) Several substances, which have shown to be effective, should be available for medical subscription and used in hospitals.