by Julia Peavey
It was 1943, and Albert Hofmann was in the midst of a bike ride that would change the world. Three days earlier, the Swiss chemist had accidentally ingested a small dose of a presumed-to-be inactive chemical compound, unsuccessfully synthesized years prior as a treatment for headaches. But in the hours that followed, he discovered that this substance did indeed have a striking effect. He described experiencing a state of dizziness, highly stimulated imagination, and distinctly distorted consciousness. Further intrigued about these evocative effects and deeming himself an adequate test subject, Hofmann took a larger dose of the substance seventy-two hours later, right before biking to his home after work. The chemical compound was lysergic acid diethylamide (or LSD) and it was then, pedaling through the streets of Basel, Switzerland while cars were prohibited due to wartime restrictions, that Hofmann experienced the world’s first intentional acid trip.
Hofmann’s experience - vivid hallucinations of kaleidoscopic shapes and colors, disorientation, and intense paranoia - were aspects that came to define the counterculture and recreational rave culture of the 1960s and are what most of us still associate with psychedelic drugs today. What commonly gets overshadowed are the ideas that not only have psychedelics been celebrated by Mesoamerican and Andean cultures for thousands of years due to their mystical and medicinal properties, but throughout the 50s and 60s, psychedelics were touted as a revolutionary psychiatric treatment.
LSD and its fellow hallucinogens, including mescaline (derived from peyote cacti) and psilocybin (a chemical found in certain mushrooms), had their psychopharmacologies studied in depth for the first time and had remarkably promising early trials on human test subjects. Psychedelics were found to be non-addictive, and many psychiatrists believed that they possessed incredible therapeutic potential for treating mental disorders, inducing a new sense of self-awareness in patients, and reversing alcoholism.
Yet almost all groundbreaking research was effectively halted by 1970 when the possession of psychedelics in the US became criminalized (for both recreational and research purposes) by the Controlled Substances Act. President Nixon’s War on Drugs only further served to brew public fear of psychedelics as drugs tied to abuse, and ended all government-sanctioned psychedelic studies. Even today, there’s a clear disconnect between scientific evidence and the DEA’s classification of most psychedelics as Schedule I drugs, their most severe and penalizing rating. This deems them more dangerous than highly addictive stimulants and opiates, including cocaine, methamphetamine, and fentanyl. Further, this distinguishes psychedelics as having no accepted medical use, being unsafe under medical supervision, and having the highest potential for abuse - statements that are not supported by current medical research.
It's clear to see how versatile these drugs can be and how much potential they hold when looking at one of the most broadly used hallucinogens in the medical world: ketamine. Recreationally, ketamine is most notable for its dissociative effects, in which high doses cause a total disconnection between the mind and body complete with numbness, disorientation, and, of course, hallucinations. But on the other hand, anyone who's experienced a fractured or broken bone has likely been given ketamine, being that it’s currently the primary analgesic used for children. It’s also on the World Health Organization’s list of essential medicines, is used as a surgical anesthetic, and is an extremely common, off-label emergency treatment for severe panic. Most interesting of this wide variety of uses, however, is the 2019 FDA-approved nasal spray esketamine, which is prescribed to patients with treatment-resistant depression.
To fully understand why this is such a breakthrough, it’s crucial to know that of the over 20 million people in the U.S. who experience major depressive episodes, about one third of them are resistant to traditional SSRI medication. Of this one-third, over 70% experienced reduced symptoms with ketamine. This drug’s therapeutic properties are so significant that ketamine IV infusion clinics have been established across the globe in the past decade, notably treating depression, PTSD, addiction, OCD, and trauma. There's even one of these clinics in Point Loma!
Specifically, ketamine’s unique mechanism of action accounts for its many-faceted success. Within the brain, it binds antagonistically to receptors on GABA neurons, which are the primary inhibitory neurons of the brain. Ketamine actually suppresses these neurons’ inhibitory effects, causing the disinhibition of surrounding excitatory (or glutamatergic) neurons. This causes a burst of the neurotransmitter glutamate in the brain, which in turn increases neuroplasticity and synapse formation; in simple terms, it actually triggers the growth of new, normalized neural pathways. Dendrites physically grow within hours of receiving ketamine, and neurons increase their functions and connections to such a point that depressed and traumatized brains regain the electrical activity level of normal ones.
It has taken decades of research and extensive safety protocols to ensure that clinical settings can offer this life-changing treatment to people in need, but even so, it’s only possible because ketamine is a Schedule III drug - meaning it’s considerably less legally hindered than other psychedelics that can have just as powerful effects.
But there is hope in that organizations like the Multidisciplinary Association For Psychedelic Studies (or MAPS) continue to fight for and pursue groundbreaking research on other hallucinogens which still have Schedule I designation. MAPS was founded in 1986 as the first non-profit research and education organization revolving around psychedelic therapy. This allowed it to keep researching the potential of MDMA (or ecstasy) to treat post-traumatic stress disorder - after the DEA refused appeals for legalization of research and banned all possession of the drug in 1985. The work of MAPS sets international protocols for the integration of psychedelic drugs into therapy sessions in order to provide the most healing experience possible.
MAPS has also ignited what is now known as the “psychedelic renaissance,” a modern rebirth of the promising research that was first stifled in the 1960s. The organization’s clinical trials for MDMA gained FDA approval in 2014, the same year that they held the first study on therapeutic usage of LSD in over 40 years. Their work has found that MDMA-assisted therapy produced clinical reduction of PTSD symptoms in 88% of patients after just three sessions. Their LSD therapy has also shown a lasting reduction of anxiety symptoms in test populations without causing adverse effects. Last year there was more good news, as the U.S. government funded the first therapeutic psychedelic research in over 50 years, with the National Institutes of Health granting Johns Hopkins Medicine four million dollars to study how psilocybin can help people overcome nicotine addiction.
So clearly, change is happening, though slowly, and thousands of new medical studies are finally able to progress our understanding of how far psychedelics can go when it comes to revolutionizing the idea of trauma therapy and clinical recovery. The reason, though, that it's important to share this story of the birth and rebirth of hallucinogenic science is because what will determine its ability to become accepted isn’t remarkable statistics and boatloads of research, or even further government funding of large-scale investigations. Instead, it’s important to share because the up-and-coming generation will determine if our mainstream perceptions will have the capacity and maturity to see psychedelics in a different light, despite the cultural stigma and skepticism they continue to generate. Having open-mindedness is crucial when examining how therapeutic strategies are evolving, and how transformations in mental healthcare are emerging, especially as the pioneers of psychedelic study (like Albert Hofmann) are replaced with young scientists taking research further than ever before. More than anything, we should all seek to understand the unexpected places that the human brain can find healing, and celebrate the capacity we have to change our own minds and accept all of the exceptional possibilities within our reach.