One step forward two steps back

Don Wyeth

One step forward two steps back

2 min.
January 11, 2022

My very first job, after I graduated from NIU in 1970, was as a psychiatric social worker at Elgin State Hospital in Illinois. Looking back, I have to say that it was one of the most difficult and challenging jobs I have ever had. 

Having survived the 60s, I knew what psychedelic drugs were, but I had absolutely no idea that things like LSD and psilocybin mushrooms had any clinical value. After all, it was common knowledge that psychedelics were labeled as Schedule I drugs.

Schedule I drugs are those that have the following characteristic according to the United States Drug Enforcement Agency (DEA): the drug or other substance has a high potential for abuse; it has a lack of accepted safety for use under medical supervision; according to federal law, no prescriptions may be written for Schedule I substances, and they are not readily available for clinical use.

My assumption, however, turned out to be false. One of the doctors on the unit that I worked, a Cuban refugee from the Batista regime, often spoke of programs in the US in the 50s and 60s that, in fact, were used by clinicians to ameliorate some psychiatric conditions such as schizophrenia, bipolar disorder and alcohol addiction.

I checked the hospital archives and discovered that these programs had actually been in place and appeared to have phenomenal success rates.

The first peer-reviewed study that I looked at, “Taking Psychedelics Seriously,” stated that, “Psychiatric research in the 1950s and 1960s showed potential for psychedelic medications to markedly alleviate depression and suffering associated with terminal illness. More recent published studies have demonstrated the safety and efficacy of psilocybin, MDMA, and ketamine when administered in a medically supervised and monitored approach. A single or brief series of sessions often results in substantial and sustained improvement among people with treatment-resistant depression and anxiety, including those with serious medical conditions.”

The conclusion of this study proposed that, “...even with an expanding evidence base confirming safety and benefits, …political, regulatory, and industry issues impose challenges to the legitimate use of psychedelics. The federal expanded access program and right-to-try laws in multiple states provide precedents for giving terminally ill patients access to medications that have not yet earned FDA approval. Given the prevalence of persistent suffering and growing acceptance of physician-hastened death as a medical response, it is time to revisit the legitimate therapeutic use of psychedelics.” 

I came away not understanding the logic of the DEA placing these drugs as schedule I. So, I did some research of my own and discovered what set these bans in motion: The War on Drugs. There classification of LSD as recreational use and its perceived connection to the anti-Vietnam war movement resulted in all psychedelics being banned in the U.S. But, there exists a plethora of peer-reviewed research studies using psychedelics to treat psychiatric and addiction conditions. The federal government elected, nevertheless, to consequently disregard these studies, which crippled any new research on the topic.

In another peer-reviewed article, “Classical psychedelics for the treatment of depression and anxiety: A systematic review,” it notes that, historically “…classical psychedelics like ayahuasca, psilocybin and lysergic acid diethylamide (LSD) are potential therapeutic options for patients that are not effectively managed by conventional treatment.” 

The paper supports these claims by adding, “Seven studies were analyzed, and it was found that classical psychedelics produced significant and sustained anti-depressant and anxiolytic effects. Psychedelic treatment was well-tolerated with no persisting adverse effects; when occurring, the most common included transient anxiety, short-lived headaches, nausea and mild increases in heart rate and blood pressure. The paucity of data currently available on the subject calls for further research in the field. Though further evidence is required, psychedelics appear to be effective in significantly reducing symptoms of depression and anxiety and are well-tolerated.”

Have we not have been down this road before? Chemist Albert Hofmann working for Sandoz, a Swiss pharmaceutical company, discovered LSD and the active psychedelic component of Magic Mushrooms: “By the 1960s, these drugs had caused a revolution in brain science and psychiatry because of their widespread use by researchers and clinicians in many Western countries, especially the US. Before LSD was banned, the US National Institutes of Health funded more than 130 studies exploring its clinical utility, with positive results in a range of disorders but particularly anxiety, depression, and alcoholism.” 

Until recently, in the face of a worldwide ban on psychedelics, no company has been legally able to produce these potentially life-saving substances. The consequence of this ban is that it made it next to impossible for research groups to obtain pure, medical-grade samples of agents such as LSD.  

I have to conclude, based on existing evidence, psychedelics do not belong in the Schedule I classification: No. 1, high potential for abuse would be in check if the substance is used in a clinical setting; No. 2, has no currently accepted medical treatment has become a circular argument, and is patently untrue; A treatment cannot be accepted until all agencies and parties are on board, No. 3, lack of accepted safety argument should be questioned on the same grounds as high potential for abuse. The clinical setting provides substantial protocols and appropriate safety procedures. No. 4, based on existing data, in order for psychedelics to help those that are suffering, these substances must be readily available for doctors to prescribe. 

Why has progress been taking one step forward and two steps back for quite a while now? I think the whole process needs to be re-thought and reevaluated.

This article was orginally reported by
Don Wyeth

Passionate and intelligent columnist from Madison, WI.