Psychedelic medicines may well change the basic nature of psychiatry. They have been shown to effectively treat conditions like PTSD, depression, and substance abuse with just one or two doses. This is in stark contrast to medicines like antidepressants that need to be taken daily for weeks, months, or even years. Psychedelics appear to make long lasting and perhaps permanent changes in how the brain is “wired” via neuronal connections. Thus, people who are successfully treated stay better for years without further treatment. Many people have used psychedelics for the spiritual experience or “trip.” Now, the question that researchers are asking is if psychedelics without the trip will work as well.
Why Do Psychedelics Work?
Research shows that when a person takes psychedelics, neurons in their brains grow new branches. These are called dendritic trees and their branches. These branches connect to neighboring neurons. This increased intensity of interconnected wiring reduces depression, increases a sense of wellness, and improve mood. The physical increases of dendritic branching happens within days of taking psychedelics and has been shown to last for months.
Why Do People Use Psychedelics?
People use psychedelics for the effects that they experience. These effects can include outright hallucinations or simply an enhanced sense of connection with other people. People who have used psychedelics commonly report after the fact that they felt less stressed or depressed. However, improving their depression, etc. is typically not why people seek out a ayahuasca ceremony in the Northwestern Amazon River basin where ceremonies have strong spiritual overtones.
Medicines Work without Bad or Good Side Effects
Nobody gets addicted to penicillin, insulin, or ulcer medicines. They just get better. Researchers are looking for ways to obtain the nearly spectacular benefits of psychedelics without any side effects. As psychedelics move into the mainstream of psychiatric treatment, there need to be cost effective and efficient ways to deliver medicines. For example, ayahuasca is made from plants that grow in the upper reaches of the Amazon basin in Colombia, Peru, and Ecuador. It will not be practical to use fresh plants every time this medicine is used for treatment. Rather it will need to be produced as a pill or shot that has a acceptable shelf life as well as being safe and effective.
Is the High Necessary for Psychedelics to Work?
One of the things that will have to be worked out going forward with psychedelics is if the high or state of altered consciousness is necessary for psychedelics to work as adjunctive treatment along with coaching or psychotherapy in treating PTSD, depression, or substance abuse disorders. Is it enough to grow more neuro branches? Can the necessary coaching work without the patient experiencing the usual state of altered consciousness that goes with medicines like psilocybin or MDMA?
The fact of the matter is that we do not know at this point. We have probably only scratched the surface of understanding how psychedelics work on a biomolecular level. How specifically do psychedelics affect the brain and which changes in the brain are essential for effective treatment? Efforts are underway to make psychedelics in cream form. How safe can these medicines be made. Can they be made safe enough for over the counter use like with aspirin or cold pills?
How Long Do the Effects of Psychedelics Last?
There are no long term controlled studies regarding the use of psychedelics in treatment. We know from surveys that psychedelic use in a recreational setting can help depression, anxiety, and a person’s sense of community. But no one has done studies where people were treated with psychedelics and followed for ten, twenty, or thirty years. This is the sort of work that was done with medicines that reduce cholesterol to see if they also helped heart disease which was the point of inventing those drugs. We do not know if with time more treatments are needed or if those treatments will need to be more frequent.
As research continues and the promise of treatment with psychedelics becomes clearer, we expect to see synthetic variations on psychedelics that target specific psychiatric conditions and aim to work with minimal side effects and maximum safety. In the meantime, we expect to see MDMA be approved for standard treatment within a year!