Editorial: A psychedelics revival is overdue

R. Gordon Wasson was a Manhattan banker who fancied himself a mycologist. In 1955, after decades studying the mushrooms of ancient cultures, he traveled to the remote mountains of southern Mexico to partake of what locals called the “flesh of the gods.” Wasson chronicled the experience in Life magazine - the first widely published account of psychedelic mushrooms since Spanish friars condemned their use in the early 17th century.

Wasson’s report had two ultimately conflicting results. First, it popularized recreational use of psychedelics, which induced strange and mystical experiences but also, in some cases, “bad trips,” psychotic episodes and other dangerous behaviors. At the same time, it piqued the interest of scientists, who’d been exploring such drugs as treatments for mental illnesses, including alcoholism and serious depression.

Unfortunately, concerns about the dangers of widespread experimentation quickly overshadowed the drugs’ therapeutic potential. In 1970, Congress passed the Controlled Substances Act, which, despite addressing legitimate public-health concerns, strictly limited access to psychedelics and all but extinguished a promising area of research for decades.

The White House now appears intent on a psychedelics revival. In April, the president issued an executive order that aims to boost research funding, accelerate regulatory approvals and expand access to treatments. The goal, he said, was to “address serious mental illnesses for patients whose conditions persist after completing standard therapy.”

The need for a fresh approach to such treatment is real: More than 300 million people globally suffer from depression alone, and a third of those with major depression don’t respond to conventional medications. These “walking wounded,” as one researcher calls them, face a higher risk of suicide and premature death. One in 20 Americans, meanwhile, have a serious mental illness that interferes with their daily lives.

For decades, thanks in part to the moratorium on psychedelics research, scientists believed standard medication could help alleviate such conditions. Prescriptions for antidepressants and other psychiatric drugs have climbed steadily. Yet such treatments are often ineffective - and more recent findings suggest that mental illness isn’t caused by a chemical imbalance, per se, but a breakdown in the brain’s communication pathways. What if a single psychedelic trip could reset them?

Patients who’ve spent a lifetime cycling through medications could be forgiven for their skepticism. Yet early results have been encouraging. Scientists have found that psilocybin - the psychoactive compound in “magic” mushrooms - can offer relief from major depression after one or two sessions. In some (admittedly small) studies, up to 40% of participants stayed in remission several weeks after treatment.

There are important caveats. Research remains limited and participants must be carefully screened. Psychotherapy and close monitoring are part of the process. And it’s doubtful that any trial can be truly “blinded” given the hallucinations potentially involved. A new regulatory framework will be needed to ensure patient safety. Further research likewise should be done to determine if the benefits of such drugs can be isolated without the “trip” or intensive therapy.

Another key concern is whether, like cannabis, expanding clinical access will increase recreational use. Two states (Oregon and Colorado) have moved ahead of federal regulators to allow supervised psilocybin sessions. Several others have introduced legislation that would widen access once regulators approve the first psychedelic drug, anticipated later this year. 

To state the obvious, unmonitored use of psychedelics can be dangerous. Forestalling a public-health disaster will require rigorously limiting access to licensed facilities and clinicians. Lawmakers, for their part, should consider restricting manufacturing and distribution to carefully vetted companies.

Psychedelics have vast potential for millions of suffering patients. But they aren’t without risks. A research renaissance - soberly executed - would be well worth the investment.

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The Editorial Board publishes the views of the editors across a range of national and global affairs.

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