CAN MIND-ALTERING DRUGS HAVE MENTAL HEALTH BENEFITS?

New Studies Are Testing Whether Psychedelic Drugs Such As LSD and
MDMA Can Treat OCD, Post Traumatic Stress and Cancer Related Anxiety.

On September 19 this year, 12 people gathered in the suburban
Hermsdorf district of Berlin for a group psychotherapy session that
allegedly involved illegal drugs. A day later, two of the
participants were dead and another in a coma. The substances used and
exact cause of death have yet to be confirmed. Local newspaper
reports have claimed that heroin and MDMA (ecstasy) were taken, but
other drugs may have been in circulation.

Garri Rober, the therapist who led the session which included his
wife, Elke, is facing possible charges in connection with the deaths
and on suspicion of supplying illegal drugs. The other nine
participants were released from hospital the next day.

This tragedy, which received international coverage, threatens to
derail a fledgling renaissance in legitimate research using
psychedelic drugs in the management of common disorders from
migraines to obsessive compulsive disorder, post-traumatic stress
disorder and anxiety associated with life-threatening illness.

LSD, the drug that was to fuel the Sixties counter-culture, was first
explored as a treatment for conditions ranging from neurosis to
alcoholism during the Fifties, the "golden age" of psychedelic
research. As its use spread from the consulting room to the street,
concern about its misuse grew, and it was banned in 1968. MDMA was
first used by American therapists in the Seventies before it was
adopted by "rave" culture and subsequently banned in 1987.

At the time, little medical evidence of worth had been accumulated
about the effectiveness of these drugs in therapy, but now studies
using MDMA, LSD, and psilocybin, another tryptamine, are under way in
several countries including Britain and the States.

Underground psychotherapy sessions, such as that which took place in
Berlin, are already making practical use of them. I have joined in
two such sessions myself. I was invited to participate because I have
written about hallucinogenic drug research for many years for
scientific media such as Nature and New Scientist.

Both sessions involved taking illegal substances - MDMA in one,
ayahuasca, a plant-brew from South America which contains the intense
and short-acting illegal hallucinogen DMT, in the other.

The first took place over a weekend in 2005, in a smart apartment in
a European city and was hosted by three legitimate psychotherapists
who organised these special classes for treatment-resistant patients.
I was one of 13 people there, aged 20-40, who'd paid 300 euros.

The session started with exercise, discussion and resuscitative
breathing, which involves taking deep breaths very quickly to achieve
a state of relaxation, before taking the MDMA. I spent most of the
next eight hours in a sleeping bag trying to focus on my chosen theme
for the "journey" - my relationship with my alcoholic father - while
listening to bad music through headphones. When you wanted to talk,
you raised your hand.

Brain-imaging studies from the University of Chicago show that MDMA
reduces activity in the left amygdala - part of the brain responsible
for the fear response. Some researchers believe that the reduced fear
between the patient and therapist can catalyse the psychotherapeutic
process and leads to positive results in a shorter time frame than usual.

For me, though, the session ended without any doors being opened. I
found the drug, which I'd taken on an empty stomach, was
overpowering, which made it hard for me to express my thoughts.

Three months later my father died from a sudden but not unexpected
heart attack. It was in the difficult months that followed, that my
half-constructed conclusions from the session about how I "managed"
his demanding behaviour took on extraordinary new meaning. As an
alcoholic he often wasn't a very nice person, but I'd been a good son
and stood by him when he needed it. These thoughts had made me feel
only marginally better when he was alive but a lot better after he had died.

My second session was in 2008, after I was introduced to a
middle-aged shaman in London for an article I was writing. He'd spent
years in Peru learning the craft of spiritual-healing.

First we smoked raw leaf tobacco in a pipe, to "cleanse" the room of
evil spirits or negative energies, before imbibing the ayahuasca, a
viscous, scarlet red brew, out of a bowl using both hands as you
would traditional Japanese tea. We sat in silence, in the dark, for
six hours as the shaman sang songs in the language of the Aztecs.

My visual field was soon dotted with the whirling kaleidoscope of
fractal polygons, typical of the psychedelic experience. Soon, I saw
two interlinked golden rings with a diamond atop, interlinked. Then a
giant eyeball clenched by a green, goblin-like fist scrutinised me
for a second before it vanished. The drug had abruptly stopped
working. I'd been warned that ayahuasca didn't work for some people
and, given the high dose I had taken I must have been one of them.

At present there is a fragile understanding between scientists,
government regulators and the public that has enabled legitimate
research to resume to determine the medical value of these drugs.
Tryptamines such as LSD and psilocybin work by binding to the same
receptors on nerve cells as the naturally occurring neurotransmitter
serotonin which is involved in the regulation of mood, sleep, and
emotional reactions such as fear and anger.

MDMA belongs to a different family of chemicals, but also works on
the serotonin system by promoting its release and inhibiting its
uptake. MDMA also releases the hormone oxytocin, "the love chemical",
which is produced after hugging, childbirth and orgasm, and which
facilitates trust or promotes bonding.

So what exactly is the evidence so far? The American journal
Neurology recently reported that LSD and psilocybin can be more
effective than conventional migraine drugs in controlling cluster
headache attacks, preventing new cycles of attacks, and extending
remission periods. Meanwhile, a study at the University of Arizona,
Tuscon, used psilocybin to treat obsessive compulsive disorder (OCD)
and showed a positive but temporary reduction in OCD symptoms.

At last year's annual convention of the International Society for
Traumatic Stress Studies in Chicago, Dr Michael Mithoefer, a
psychiatrist, showed that 92 per cent of people in a group taking
MDMA (under legal trial conditions) experienced a significant drop in
their post-traumatic stress disorder scale. And in Solothurn in
Switzerland, psychotherapist Peter Gasser, is undertaking legal,
controlled clinical trials at his private practice to test whether
LSD-assisted psychotherapy can help people with the anxieties related
to terminal cancer. Similar experiments in the Sixties showed positive results.

Dr Ben Sessa, a psychiatrist from the Department of
Psychopharmacology at Bristol University, is among those who have
endorsed the return of psychedelic research. "Recent trials are now
demonstrating positive results using the same modern protocols as
demanded for other conventional drugs," he says. "I totally support
research that explores the therapeutic possibility of these drugs. As
a doctor, not to so would be to turn my back on my patients."

But the controversy continues. According to Dr Ken Checinski, a
consultant psychiatrist at St George's, London, psychedelic drugs
should have no place in psychotherapy. "The benefits are short-term,
and the risks are not inconsiderable. It would also give a message
that people can easily get in touch with their feelings through the
use of mind-altering drugs, which is not a message I would want to give."

But what is the opinion of those who have tried them? Most that I
have spoken to claim to have found their underground sessions useful.
Interest is growing across Europe, helped by easy access through the
internet. It appears that, legal or not, in a search for reflief,
more and more people are willing to take the risks.