Understanding the use of psychedelic drugs as medicine

DUSTIN WALSH

ere’s a psychedelic renaissance afoot. In clinical research settings around the world, scientists are investigating the use of psychedelic drugs to treat illness, such as depression, addiction, anxiety, post-traumatic stress disorder and much more.

e renewed interest is a continuation of research mostly conducted between the 1950s and 1970s, before most psychedelics were classied by governments as illegal narcotics with no medical value. e research capitalizes on improved methodologies and the public’s increasingly greater awareness and tolerance of these drugs.

Psychedelics are generally classied into two categories: classic psychedelics, like LSD or psilocybin, that mimic or contain chemicals found in plants or fungi; or entactogens, like MDMA, that acts as an agent for the body to release serotonin.

Ketamine isn’t technically classied as a psychedelic, but it produces much of the same euphoric and sometimes hallucinogenic e ects of classic psychedelics.

Ketamine was approved for therapeutic use in 2019. e other drugs remain in clinical trials only.

Below is a list of the most common psychedelics being tested or used for therapy.

 Ketamine: Categorized as a disso- ciative anesthetic, it’s primarily used in anesthesia. But about a decade ago, doctors began using the drug “o -label,” or not for its intended use, at clinics across the country. e FDA only in 2019 approved a form of the drug to treat depression and only in cases where traditional methods have failed. Ketamine-assisted therapy most often involves use in a clinical setting with therapists who guide the patient through the experience and break down meaning behind the experience.

 Psilocybin mushrooms: A classic psychedelic, “magic mushrooms” have been used recreationally for nearly 70 years. However, changing attitudes and new research point to legitimate uses in therapy settings. Clinical trials have been ongoing at major research institutions, like

Johns Hopkins, for a few years. A new national clinical trial will begin this summer at other institutions such as the University of Michigan.

 3,4-Methylenedioxymethamphetamine (known as MDMA, ecstasy or molly): MDMA medical research is also ongoing. e synthetic drug alters awareness and perception and produces an increase in dopamine, norepinephrine and serotonin in the body and is being tested for use treating severe PTSD.

 N,N-dimethyltryptamine (DMT): DMT is a naturally occurring psychoactive molecule that can by synthesized in a lab. e molecule is similar to serotonin, a neurotransmitter in the body that regulates happiness, optimism and satisfaction. DMT would mimic in a more natural way modern anti-depressant drugs called selective serotonin reuptake inhibitors, or SSRIs, to increase serotonin. Studies are ongoing across the U.S., including at the University of Michigan, to see if DMT can be used correctly in a clinical setting to treat chronic depression.

 Lysergic acid diethylamide (LSD): LSD remains a Schedule 1 narcotic in the U.S., but is under clinical trials to treat alcoholism, depression and PTSD in Europe. e drug can alter perception and cause hallucinations.

Contact: dwalsh@crain.com; (313) 446-6042; @dustinpwalsh