A ‘Magic Mushroom’ Strategy for America’s Opioid Crisis

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Illustration by sirin tanritar via Flickr

Since the adoption of the Controlled Substances Act (CSA) in 1970, cannabis has been outlawed by the federal government.

But it’s not the only drug on that list.

It may be time to move it and other drugs onto a less restrictive schedule.

Schedule I of the CSA is reserved for drugs and other substances that are judged to have a high risk of abuse, and no safe or prescribed medical use. But the evidence doesn’t always support that judgment.

Not only is marijuana neither physically addictive nor generally harmful, but it may have numerous health benefits. There’s a disconnect between what the government says and what most people experience, and it has led to contempt for the federal law, as well as the passage of laws permitting the medicinal use of marijuana in more than 29 states, and recreational use in nine states, as of last month.

Canada is set to legalize recreational cannabis from coast to coast later this year, and the United Nations’ World Health Organization (WHO) will consider revising its cannabis policy in June.

The consequences and benefits of these measures will be tallied and argued for years and decades to come. But a clearer sense of the medicinal use of marijuana could have been discovered earlier, if studying its effects had been made less difficult.

Currently, there’s only one limited source for the legal study of marijuana: the University of Mississippi. which hosts the nation’s only stockpile of pot available to researchers for U.S. Food and Drug Administration-approved tests on the medical properties of cannabis.

In fact, politics rather than objective science has largely determined our approach to marijuana. Some analysts track the more recent criminalization of pot to John Ehrlichman, the domestic policy advisor to former President Richard Nixon, who defended it as a strategy to weaken and disrupt the 1960s anti-war youth movement.

He and other authorities applied the same approach to other Schedule I substances, namely psychedelics.

Sometimes cannabis is considered a hallucinogenic, too, although hallucinations are not their main or intended effect. Some strains of cannabis, if taken in high enough doses, may cause hallucinations, but the primary motivation for consuming the drug is usually euphoria.

It also is taken for medical uses, including pain control.

Ketamine, which is on the WHO’s Model List of Essential Medicines as an anesthetic, also is sometimes labeled a hallucinogenic.

See also: Opioids: Chasing the Wrong ‘Epidemic’

Hallucinogenics are not addictive, at least not physically, and don’t cause lasting impairment. The reason they are outlawed is most likely because they cause hallucinations. As a society, we don’t like that. (Alcohol also can cause hallucinations, auditory and visual, but usually only during withdrawal.)

Psychedelic, psychoactive or hallucinogenic drugs, such as lysergic acid diethylamide (LSD), ayahuasca, ibogaine, psilocybin and methylenedioxymethamphetamine (MDMA or Ecstasy), to one degree or another, cause hallucinations, but that’s not all. Preliminary research suggests they may help treat anxiety, depression, and other mental health disorders including addiction.

In 1962 Howard Lotsof reported being cured of his heroin addiction after taking ibogaine—a drug derived from the iboga tree—and taking a single 36-hour “trip.” He wasn’t trying to get cured; it just happened. Some of his addict friends had the same experience.

Given the opioid epidemic, further research seems warranted.

Other researchers say ibogaine resets the brain to a pre-addiction state but isn’t an actual cure. Some have tried to create an hallucination-free version of the drug, but Lotsof believed the hallucinatory experience was an integral part of the cure.

Other psychedelics being studied include:

From a law enforcement perspective, hallucinogenics seem to hold promise for making society safer. From a policymaker perspective, they may improve society’s mental health. There’s not enough scientific evidence to be sure because testing and studying their effects is nearly impossible.

A recent study of LSD was limited to only 10 people. That tells us nothing. Better studies are needed.

I’m not arguing that ibogaine or any psychedelic should be distributed over the counter without a prescription. Any experience that lasts up to 36 hours, especially one involving hallucinations, ought to be monitored for safety, complications, and simple hydration. Currently, there are unregulated ibogaine clinics around the world—though not in the US—of varying safety and efficacy.

Psychedelics, in particular, have a risk of causing or exacerbating mental health disorders. This risk has been overstated, but that doesn’t mean there’s no risk involved.

Use of these drugs can lead to mental illness, or a user might take them as an attempt to self-medicate for an existing mental illness. Either way, when the conditions co-occur, it’s called a dual diagnosis, and it becomes necessary to treat both conditions simultaneously, such as at Chapters Capistrano Dual Diagnosis Facility.

Even counterculture author Philip K. Dick was no fan of LSD. In 1974 he told an interviewer that LSD and the visions it inspired “didn’t seem more real than anything else; it just seemed more awful.”

He also told another interviewer, “I used to beg people not to take acid.”

At least some illegal psychedelic drugs seem to inspire therapeutic hallucinations. Other drugs, often legal, also can produce hallucinations, but not helpful ones, including nootropics (reputed cognitive enhancers) and stimulants prescribed for attention deficit hyperactivity disorder (ADHD).

Misuse of the methylphenidates Ritalin and its extended-release formulation Concerta, or the amphetamine compound Adderall–often by students who think it will improve their grades, or at least let them stay awake to study more–can cause hallucinations as part of a psychotic break from reality.

Stephen Bitsoli

Stephen Bitsoli

These stimulants are physically and psychologically addictive and, if stopped suddenly, can lead to a crash that makes it harder to concentrate because your body no longer manufactures enough dopamine or norepinephrine on its own.

We can debate whether these stimulants have been overprescribed or should be further limited.

But there should be no debate that the epidemic of opioids, and increasing incidences of chronic pain and PTSD require that we explore every promising treatment, including psychedelics.

Stephen Bitsoli, a Michigan-based freelancer, writes about addiction, politics and related matters for several blogs. He welcomes readers comments.

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