Psychedelics today

TODAY

I close my eyes tightly enough, I can still remember the rush of euphoria that hit me the first time I took MDMA (a.k.a. ecstasy) at the age of 16. It was 1998, and my best friend and I had snuck out of her house in Port Credit, Ont., and taken the GO train to downtown Toronto. There, we loaded ourselves onto a magical school bus to attend our first rave.

As we arrived in the middle of nowhere, we saw a sea of bodies clad in fun fur, tightly gripping glow sticks and swaying to thumping bass lines. It was like nothing I had ever experienced before. Everyone was welcoming and inviting, happy to share a warm embrace—or some of their favourite party favours,

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Soon after we arrived, a stranger handed me a small purple pill with a tiny star detail pressed into the top, which I immediately gulped down. I should have been scared but, for whatever reason, I wasn’t. Within hours—maybe even minutes?—I felt all of the pent-up anger that I couldn’t quite place, and all of the displaced sadness I harboured for not being the perfect kid my parents wanted, slowly ease out of my body. For the first time in a long time, I felt happy and connected to myself.

This marked my introduction to psychedelics, a class of psychoactive substances—which also includes psilocybin (commonly called magic mushrooms), ketamine and LSD— whose primary effect is to trigger non-ordinary states of consciousness. Little did I know, nearly 25 years later, the party drugs of my youth would be headlining some very promising therapeutic treatments for anxiety, depression, post-traumatic stress disorder (PTSD) and more. Here’s what you need to know about the new age of psychedelics.

n the late 1930s, a Swiss chemist who worked for a pharmaceutical company synthesized a compound he hoped would stimulate the cardiovascular and respiratory systems. It didn’t, but the chemist, Albert Hofmann, always suspected that this compound, called LSD, might have other uses. After embarking on some “informal” research, he experienced LSD’s hallucinogenic effects first-hand. This discovery kicked off a global round of research into psychedelic-assisted psychotherapy. Saskatchewan’s Weyburn Mental Hospital soon emerged as a leading facility for such research. There, in the 1950s, psychiatrist Humphry Osmond—who is credited with coining the term “psychedelic” —studied how LSD, mescaline (derived from several types of cactus) and other hallucinogenic substances could be used to help transform mental health care. Around this time, a colleague of his, Colin Smith, conducted a small study on the effects of LSD treatment in 24 people with alcohol issues. About 50 percent saw some improvement; Osmond eventually treated hundreds of patients who overused alcohol with

LSD. Recreationally, the drug became incredibly popular in the 1960s and was touted by countercultural icons of the time, like the novelist Ken Kesey and the Harvard psychologist Timothy Leary.

“It’ s not about just taking psychedelics to have a lot of fun. It’ s about what is the research and what is the medicine here?”

But then came the war on drugs. Psychedelics were placed in the most restricted category in the United States Controlled Substances Act, alongside marijuana, cocaine and heroin. Canada’s Narcotic Control Act also classified them as dangerous drugs with no medical value. As a result of this criminalization, psychedelic research ground to a halt, relegating these drugs to illegal use on the party circuit. Today, after decades of advocacy, Canadian doctors and researchers are finally being allowed to perform limited clinical trials as they attempt to prove the validity of psychedelics as a treatment for PTSD, depression, anxiety, eating disorders and addiction issues. Behind much of the push to further the research that first began in the 1950s is the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit that originated in California in the 1980s; it has had a Canadian arm since 2011. MAPS, whose mandate is to advance psychedelic medicine and support legal and regulated access to it, has raised more than $130 million to fund research on MDMA, LSD and other hallucinogens, as well as cannabis. “I still think that people have it in their head that . . . this is just something you get high on, ” says Sabrina Ramkellawan, the research committee lead for MAPS in Toronto, referring to both psychedelics and cannabis. She finds it confusing that people are willing to tolerate the side effects of many pharmaceuticals yet disparage drugs that “give you pleasure and make you happy. ”

90 THE APPROXIMATE NUMBER OF EXEMPTIONS HEALTH CANADA HAS GRANTED TO ALLOW PATIENTS AND HEALTH CARE PROFESSIONALS TO USE PSILOCYBIN

scramble to pay for expensive treatments while investors cash in. Some market research suggests the sector could be worth as much as US$10.75 billion by 2027.

Jessica McKeil is a cannabis writer from Salt Spring Island, B.C., who began microdosing psilocybin—taking a tiny amount, not enough to cause a hallucinogenic effect—in 2019 to help with her panic and anxiety disorders.

The changes were subtle at first, says McKeil, who is 35. She became less anxious about deadlines, for example, and was more in the moment during daily tasks, like walking her dog. One rainstorm walk was particularly memorable: “I would stop to look over at the field in the pouring rain, and I just thought it was so beautiful and I would just have good days, ” she says. “Yes, days became good!”

While McKeil is worried about the commercialization of psychedelics, she also wishes there was more of a push to educate, train and create a structure around professionals in the psychedelics space. There are many people offering guided trips on Salt Spring Island, she says, and “it would be so much better if there were a few more safety protocols. ”

Since psychedelics remain illegal while interest in their therapeutic benefits grows, the underground industry is booming, fuelled by clients willing to take risks because they feel like they ’re out of other options. “Either we put the power into the doctors’ , health care practitioners’ and patients’ hands, and they allow for there to be medical supervision, ” says TheraPsil’s Hawkswell, “or the alternative is no medical supervision. And that’s what’s happening now. ”

The world of unlicensed psychedelic treatments has “exploded, ” says Haden, calling it the “Wild, Wild West, ” where many self-designated therapists have no medical or therapeutic training at all. He says unlicensed therapy can range from “excellent” to “abusive. ” A lack of structure means a lack of medical support in case of an emergency. A lack of medical training, meanwhile, could mean failing to know whether patients’ other pharmaceuticals might cause a bad interaction—patients on medication for schizophrenia, for example, could be at risk of setting off a psychotic episode. “We want patients and doctors to work together when they ’re using these substances, ” explains Hawkswell.

Zach Walsh, a professor of psychology at the University of British Columbia who specializes in research on cannabis and psychedelics, notes that psychedelics are less toxic than many legal drugs. He hasn’t seen significant negative mental health

$10.75 billion

“Either the government allows medical supervision or there ’ s no medical supervision, which is what is happening right now. ”

consequences from controlled psychedelic experiences in his own research, and says that while there have been concerns that frequent use could lead to symptoms similar to cannabis-induced psychosis—a rare but serious side effect of frequent cannabis use— he hasn’t seen the same pattern among psychedelics users.

Instead, like Haden and Hawkswell, Walsh worries about people who might experience a bad trip without proper medical support. “People looking to explore [psychedelics are] looking to have an experience that’s going to enhance their wellness, ” he says. “If they don’t get support, they might find the experience disorienting and unpleasant, rather than something that creates a meaningful change. ” Above all, he says choosing to use psychedelics is a big decision, and it can take time to decompress from the experience. “Like most medicines, effects vary across individuals, ” he says. “Psychedelics are certainly not a panacea that can resolve all problems. ”

Professional support is also important given the heightened vulnerability that comes with some psychedelic experiences. During his time at MAPS, Haden advised that psychedelics sessions be led by two therapists of mixed genders who would report back to a therapeutic college of psychedelic supervisors and be accountable for their behaviour. He believed this would be important in case those participating in studies (or eventually going for psychedelic therapy) needed to report an oversight or incident that occurred with a therapist.

The risk of sexual assault is a consideration with MDMA therapy in particular, since the drug increases one’s feelings of empathy as well as friendliness and playfulness with others. “It reduces people’s sense of boundaries and it increases a sense of closeness, ” explains Haden. “So people have to be very professional as a result and [respect] what those boundaries are. ” There is also a small amount of physical touch between therapists and patients that can take place, such as hand holding through an emotional session or body work using finger pressure.

“There will always be a discussion in advance with the subject, with a lot of detailed clarity that there is a difference in touching and it’s not sexual touching. ”

MAPS itself isn’t immune to issues that could compromise patient safety. In 2018, a Canadian participant in a MAPS clinical trial for MDMA accused one of the two therapists present during her sessions of sexual assault. MAPS Canada agreed to pay $15,000 to the patient so that she could obtain therapy while she sought legal action. (The patient filed a sexual assault complaint with the RCMP, but upon investigation, no charges were laid. She also filed a civil claim, which was settled out of court on undisclosed terms.) MAPS severed its relationship with both therapists and, in 2019, released a code of ethics, including a section that forbids sexual relationships between therapists and their patients. For his part, Haden says he was not involved in the hiring, training or supervising of the therapists who led the session in question. He resigned from MAPS Canada in 2021.