If ever there was a time to talk hallucinogenic compounds, it's now. Netflix's documentary based on Michael Pollan's critically acclaimed book, 'How To Change Your Mind', has helped bring into the mainstream conversations about the use of illegal substances to help with a variety of debilitating conditions, from anxiety and depression to post-traumatic stress (PTSD).
Autumn's change in weather means hillsides around Manchester are awash with nature's own surrealist bounty, magic mushrooms, while the UK government is in the midst of a huge drug policy review after extensive consultation with the medical community that could spell big changes to come. Whether those include moving cannabis up to a Class A substance, as one doctor and several hardline politicians have suggested, is another point.
University of Manchester Professor of Psychopharmacology, Dr. Jo Neill, is an invaluable expert on these issues. In addition to work for the city's leading higher education institution, renowned for its sciences, she also chairs the Medical Psychedelics Working Group for Drug Science. That's the charity David Nutt set up, the research professor who told policymakers to decriminalise numerous psychoactive substances in an article published by renowned medical journal 'The Lancet', only to be fired from the Advisory Council on the Misuse of Drugs by the government of the day.
"I'm campaigning for psilocybin to be rescheduled, that's the naturally occurring psychedelic compound found in more than 200 species of fungi. If that happens, it means we can get on with research easier and more effectively," Neill explains. "The government asked for a drugs inquiry earlier this year, looking to understand what needs to change in terms of laws. First thing: psychedelics should never have been put in Schedule One. The decision was entirely political."
To fully grasp what Neill means, it's important to understand what this means. At the time of writing, substances like MDMA (including ecstasy), LSD, psilocybin, and cannabis fall under the strictest regulations for drugs — Schedule One. So conducting research with these requires a license, which costs around £3,000. A separate license is needed for any location where trials might be carried out, increasing the necessary investment significantly, and labs also need to spend heavily on security measures, with facilities inspected and approved by the Home Office. Among other things, Neill believes this process should actually sit with the Department of Health.
This current situation is hugely prohibitive, and essentially discourages many in the scientific community from engaging in research due to concerns they could easily fall foul of the law, the snail paced approval process (it once took Neill 12 months to receive a green light), and overall cost. One colleague, we're told, had spent £20,000 before a single patient received a dose. Putting things into perspective, Schedule 2 substances, which are far easier to license for research, include Fentanyl, now at the centre of a moral panic in America due to the prevalence of overdoses, Methamphetamine, Oxycodone, Cocaine, and Phencyclidine. That last one is also called Angel Dust.
"Changing the laws to allow better access to psychedelic substances would be massive. I mean we're missing out on so much in the UK. Patient response, compared to other medicines, is enormous from what we know. Psilocybin has over 70% efficacy for those with treatment-resistant depression. And it lasts for such a long time," says Neill.
"There were an enormous amount of studies conducted on LSD in the 1950s and 60s, before the UN Convention put it into Schedule One and made it a Class A drug, clearly for political reasons rather than any evidence of harms that it can do," she says, explaining early studies showed enormous benefits for end of life distress among those with terminal diagnoses, allowing them to live their remaining days without fear. "The other main indication was for drug dependence. Humphry Osmond treated thousands of patients for alcoholism, and the success rate was way beyond anything Alcoholic's Anonymous achieves."
While trials looking at the medical potential of psychedelics significantly dropped after the UN Single Convention on Narcotic Drugs, then the UK's Misuse of Drugs Act 1971 and America's Controlled Substances Act 12 months prior, more recent decades have seen an uptick once again. For example, Rick Doblin, Executive Director of the Multidisciplinary Association for Psychedelic Studies, has been heavily invested in MDMA research since the 1990s.
"The results of Doblin's work are extraordinary. MDMA and ecstasy for the treatment of PTSD, in the first phase three trial it led to 67% of patients no longer meeting the criteria for having PTSD. That is unheard of. 20 combat veterans kill themselves each day in the US, and here we have something that can actually heal them," Neill says. "And this is a once, twice, maybe three times dose, then lots of people will never need another. Or perhaps a top up after six months. So there is no side effect burden, you're not taking a drug every day. It's a complete paradigm shift in medicine, and works for quite a few people.
"But the stigma around is enormous, particularly LSD and psilocybin. People are frightened, they've been fed so much misinformation. They've been told it's dangerous, you'll lose control of your mind, and will do things out of control. For sure, it's a challenging psychological experience for people. You have to be in the right mindset and place," she continues. "But there's been no adverse long-term effects in any of the clinical trials."
Moving to the experiments of James Rucker, a psychiatrist at King's College London, work with psilocybin saw 89 healthy volunteers take the substance with no side effects other than increased heart rate, blood pressure, and an intense experience. By comparison, standard SSRI antidepressants regularly cause numbing of the senses and emotions, sexual dysfunction, and in some cases dependency.
"It will be expensive to administer. We're doing an economic analysis at the moment, because you need therapists to support patients post-treatment. But compared to people not being able to work and having loads of other illnesses because of long lasting side effects of medicine, this is nothing," says Neill. "Mental health is costing the UK economy £105billion a year right now.
"And this is not a vote loser. The general public have an awful lot of sympathy for people with cancer, we all know someone who has died and they've been terrified of the end coming. We did a YouGov survey and 68% of people supported access to psilocybin to help with terminal diagnoses. 55% supported combat veterans getting drugs to treat their PTSD. And the economic argument is astonishing. The market it worth $2billion, that's predicted to rise to $10billion by 2027," she continues.
"There really is no reason to keep these things as Schedule One or Class A drugs. People working with them are scared because it's so easy to wind up in jail, so the government has to make a change. They must, because we look ridiculous. And if we change the UN Convention will too," Neill adds. "I'm not sure what the problem really is. I don't understand. I'm a scientist, I see the data and how important all this is. I think, to be honest, politicians just haven't really thought about it properly."
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