On November 3, the citizens of Oregon, in addition to electing the new president, voted for a referendum asking them to comment on the introduction of a new therapy for depression. The majority of the voters (55%) answered yes. After the approval by the FDA of a drug (the first) in the same category – a ketamine derivative called esketamine, which arrived in March 2019, for suicidal depression – the Psylocibine Services Act of Oregon represents a further, significant step forward, because for the first time it authorizes public health to give life to real therapeutic programs based on the use of substances hitherto prohibited: psychedelics.
Psilocybin is in fact the active ingredient of some mushrooms of the psilocybe family, and has characteristics very similar to those of the progenitor of the category, the diethylamide of lysergic acid 25 or Lsd, but it is slightly less active and, consequently, more manageable.
Medical cannabis, the letter from patients to Draghi: “Cure for our suffering”
by Matteo Grittani, and Valeria Pini
In the previous months there had been other very strong signals of the concreteness of what has been called the psychedelic Renaissance: among others, both the Ichan School of Medicine at Mount Sinai Hospital in New York and the California Berkeley University had opened research centers. and dedicated information, which had been added to those of other equally renowned universities, from Johns Hopkins in Baltimore to Imperial College in London. All accompanied by a growing number of publications on LSD, psilocybin, ketamine, ibogaine, Dmt (active ingredient of ayahuasca), Mdma (ecstasy), salvinorin and more, both in patients and on cell models and cultures.
It is not surprising, therefore, that Nature also devoted a long article to psychedelic psychiatry: it is indeed coming. Fifty years after the global ban (the inclusion in table 1 of drugs by the WHO dates back to 1971), the LSD and its peers are thus taking a good revenge, and are candidates to fill a void for which, for decades, no one has been able to provide convincing alternatives. Because psychedelics are extraordinarily effective in the treatment of addictions to alcohol, tobacco and drugs of abuse, depression (including those – very serious – of the terminally ill and those resistant to classic therapies), post traumatic stress, cluster headache, anorexia, and there are indications that it may also play a role in dementia.
Not all in the same way, and not all without risk. But they often heal, are low in toxicity, and are not addictive when used correctly. There is a fundamental rule: they must be used only after a careful psychiatric evaluation that excludes psychotic syndromes and schizophrenia, which could be aggravated by these drugs; thanks to this preventive selection, today the so-called “bad trip” has disappeared in the therapeutic field.
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Furthermore, all those who are studying them and starting to use them insist that they must always be considered tools in a program that includes psychotherapy, to accompany the triggered change, and to process it in the right way.
For this reason, for the dissociative effects and for the alteration of conscience, psychedelic psychiatrists are all in agreement: these are treatments to be done in a day hospital, and with the supervision of duly trained personnel. In short, we are very far from mass trips, and not only for fear that the genius, who has come out again from the lamp in which he remained for 50 years due to indiscriminate and incorrect use, may be forced to return to it even before having shown what can do. But also and above all because such powerful substances require careful and scrupulous use, and because there are still several aspects to be clarified.
There are currently about twenty clinical trials underway around the world: the next few months will tell if psychedelics, as Nature speculates, are really back: to change psychiatry.