Facts About and Perspectives on Medical Use of Psychedelics

What are your thoughts on the supposed benefits of psychedelics for medical use? Do you think it should be legalized? I don’t know how to wade through all the information out there.

ANSWER:

Questions like yours are becoming more common as the media reports on potential medicinal benefits of psychedelic drugs. Several states have already legalized or are considering legalizing psychedelics for medical and even recreational use, and federal restrictions are loosening as well.

What this ultimately means is that psychedelic drugs can gain approval by bypassing careful, thorough scientific scrutiny, and instead appealing directly to voters at the ballot box. However, much research still needs to be done to verify the therapeutic usefulness of psychedelics, and we believe extreme caution is in order as people consider legalization in their state.

What are psychedelics?

Psychedelics are one category of a broader group of drugs known as hallucinogens, drugs that can induce hallucinations and alter perception or moods. And so sometimes the term “psychedelic” is used to include dissociative drugs (such as the anesthetic ketamine); drugs such as ibogaine that induce a “visionary,” dreamlike state; and drugs that can give users an intense sense of emotional bonding (such as MDMA, or “ecstasy”).

Technically, however, “psychedelics” refer only to a class of hallucinogens that act on a specific set of serotonin receptors. This subset of hallucinogens produces sensory distortions, a sense of detachment from reality, and a feeling of “expanded” consciousness — experiences often described informally as “trips.” For our purposes throughout this article, we use the term “hallucinogen” mainly to refer to psychedelics.

The effects of psychedelics range widely, from euphoria to panic, anxiety, and disturbing hallucinations. Other effects include impaired judgment and difficulty thinking and concentrating.

Common psychedelic drugs

• Lysergic acid diethylamide (LSD). Also known as “acid,” LSD is the best-known psychedelic. It was first synthesized in the late 1930s but came to prominence in the public consciousness in the 1960s as a recreational drug used by the hippie subculture.

• Psilocybin. This psychedelic compound is derived from a variety of mushrooms (“magic mushrooms” or “shrooms”) and has gained more attention in recent years. Much of that attention stems from reported therapeutic benefits of psilocybin for a number of mental health conditions, including post-traumatic stress disorder (PTSD), depression, and opioid addiction.

• Peyote (mescaline).

• Ayahuasca.

Do psychedelics have therapeutic value?

Initial studies suggest psychedelics might help with PTSD, depression, opioid addiction, and other mental health conditions. Unfortunately, the potential benefits are so appealing that some states and advocacy groups are pushing hard for legalization as though there is already scientific consensus on safety and effectiveness — yet there isn’t.

Possibility isn’t the same thing as proof

It is the somewhat promising but still preliminary data, and the publicity associated with it, that fuels much of the commotion around psychedelics. A few very small studies indicate that patients with major depressive disorder experienced clinically meaningful improvements. Similarly, several studies suggest psychedelics may help treat PTSD when paired with psychotherapy from a highly skilled therapist.

But claims that psychedelics are ready for prime time are overstated. The American Psychiatric Association agrees, stating, “There is currently inadequate scientific evidence for endorsing the use of psychedelics to treat any psychiatric disorder except within the context of approved investigational studies.” Early data that suggests possibility should not be taken as incontrovertible proof of efficacy and safety. Instead, it’s a signal that further, rigorous study is needed.

Data on safety and therapeutic effectiveness is limited

While studies might imply legitimate mental health uses for psychedelics, much of the fanfare is based on studies involving small numbers of participants. Very few studies have been conducted that track long-term safety and efficacy. Furthermore, test subjects are, by the nature of psychedelics, left in a very vulnerable state, which can leave users open to mistreatment or abuse.

One of the biggest complications in studying psychedelics is that researchers currently lack an effective way to meet the gold standard for clinical trials: the double-blind placebo-controlled study. This methodology is designed so that neither the researcher nor the test participant knows whether a subject is receiving the drug being tested or a placebo (a substance that does nothing). Unfortunately, a double-blind placebo-controlled study is especially hard to accomplish with psychedelics because a person will obviously know whether they’ve taken a drug that causes hallucinations.

This hints at why it’s a problem to legalize psychedelics for therapeutic purposes at the state level before careful testing has been completed. In the absence of good data on the safety and therapeutic effectiveness of psychedelics, we should actively resist their use as a quick fix or do-it-yourself treatment for conditions that should be evaluated carefully and treated over time with a wide variety of available approaches.

At Focus on the Family, our hearts go out to those dealing with PTSD, depression, or addiction, especially those whose conditions are resistant to other treatments and who might look to psychedelics for answers. But those suffering men and women deserve more than anecdotal evidence and claims.

Any research conducted with hallucinogens must be done rigorously and cautiously. Medications should be approved by appropriate authorities and be subject to proper regulatory oversight for safety, purity, and dosage uniformity. Otherwise, when states legalize psychedelics in hopes of helping people with mental health conditions, those same people — individuals who are desperate for such help and hope — may end up the losers.

Downsides and risks of psychedelics for therapeutic use

While much more investigation is needed to establish the safety of psychedelics, here’s a rundown of what we do know.

Psychedelics can have adverse effects

Psychedelic mushrooms are often thought of as a harmless way to trip. But while some trips are reported to be pleasurable, some are horrifying. For those with cardiac disease, the accompanying rapid increase in blood pressure and heart rate may be dangerous.

Of course, foraging for “magic mushrooms” carries the added danger of accidentally picking and ingesting a potentially fatal toxic mushroom. (On a separate note, many people assume that because “magic mushrooms” and their derivatives are natural, they must be harmless. But tobacco, arsenic, and radon also are “natural,” yet they are not harmless. Just because something can be found in nature doesn’t mean it’s safe.)

Ibogaine is another hallucinogen getting a large share of media coverage. Ibogaine has been shown in some studies to have adverse, even fatal, effects on heart rhythms.

Psychedelics can lead to problematic usage

Psilocybin does not appear to have the same dire physical safety risks as illicit drugs such as heroin and cocaine, nor does research suggest it leads to physical dependence the way those drugs do.

Still, the pleasurable experiences some users have with psilocybin can create a psychological attachment to the drug that can lead them to seek it out repeatedly. And any time a person turns away from God and reality and relies instead on drugs, alcohol, or other substances to cope with their problems — or even just everyday life — more problems inevitably follow.

Psychedelics can cause psychotic episodes

In individuals with a history of psychosis, using hallucinogens may make subsequent psychotic events more likely. These events can be brought on by substance use, alcohol, stress, trauma, and other triggers.

Psychedelic use can result in hallucinogen persisting perception disorder

Hallucinogen persisting perception disorder (HPPD) is a condition where a person continually re-experiences visual distortions or other perceptual anomalies from a past trip. Such flashbacks can be random and brief, or they can be persistent and deeply disturbing.

Could microdosing be a solution?

One dosing approach marketed as a way to avoid disturbing trips and HPPD is microdosing — taking amounts low enough that the user doesn’t notice any psychedelic effects. These low doses supposedly trigger physiological brain changes that promote healing even without a noticeable high. So far, research linking microdosing of psychedelics with improvements in depression or PTSD symptoms is suggestive but inconclusive.

Notably, in Colorado — the one state (at the time of this writing) where “magic mushrooms” are legal for both medical and recreational use, and where microdosing was used as a selling point to voters — the law actually places no limit on how much a person can own or consume.

Some advocates for legalizing psychedelics in various states may also pitch the idea based on microdosing. However, if the proposed legislation is anything like Colorado’s, it will do nothing to limit a user’s possession or consumption only to microdoses. In other words, microdosing would simply be a ploy to legalize psychedelics.

The dangers of approving drugs by ballot measures

When drugs are approved by ballot measure, investigations into safety and efficacy are bypassed, and responsible clinical study can be short-circuited. This is exactly what happened when states rushed to legalize marijuana for medicinal and recreational use.

The public was told that marijuana was helpful for a staggering assortment of ailments, that it was safe, and that it was not addictive. However, after a few years of watching things play out, an extensive body of research has dashed most of those promising declarations. Data proving marijuana would help everything from glaucoma to chronic back pain either never materialized or was woefully underwhelming.

Instead of proving to be a remedy for PTSD, depression, and anxiety as promised, marijuana has been shown to be unhelpful, or even to aggravate symptoms. Indeed, it worsens mental health in individuals vulnerable to schizophrenia and other psychotic disorders. And, unsurprisingly to many, it was quickly shown to be addictive. What was touted to heal only exacerbated our current mental health crisis.

Legalizing any illicit drug for medicinal use is almost invariably a steppingstone to recreational legalization. The problems associated with cannabis may not be the same as those of psychedelics, but they should prompt us to think long and hard about how we approach the topic. Because if psychedelics are prematurely legalized for medical use, vulnerable individuals with serious mental illness will effectively be experimenting on themselves.

Without doubt, many people have good motives to see psychedelics legalized for medicinal use because they genuinely hope it will result in healing for those with mental health conditions like PTSD and depression. But there are fortunes to be made in psychedelics, and legalization is part of the business plans of a well-funded few.

An assortment of venture capitalists, Silicon Valley moguls, and institutional investors are pushing for legalization in hopes that it will lead to drug development. While there’s nothing wrong with the enterprising development of helpful medications, voters should understand that much of the money funding pro-legalization campaigns is not intended for the common good. Instead, it’s aimed at profit — even if that means easier access to these drugs for young people and turning the public into test subjects.

Other concerns about psychedelic use

Apart from concerns about testing the safety and therapeutic effectiveness of psychedelics, and concerns about issues surrounding legalization, four points stand out to us as being specifically important for Christians to consider: availability of psychedelics to minors, psychedelic intoxication, pseudo-spiritual experiences, and disruption of healthy coping skills.

Availability to minors

Whenever an illicit substance is legalized, whether for medicinal or recreational purposes, it eventually gets into the hands of children and young people. (Again, marijuana is a clear example.)

Biblical perspectives on psychedelic intoxication

The psychotropic effects of psychedelic drugs raise legitimate moral concerns. The Bible forbids drunkenness. And while this mandate, in context, refers specifically to alcohol, the underlying principle extends to other substances. For that reason, using hallucinogens simply for a psychedelic experience is morally prohibited.

Pseudo-spiritual experiences

Another concern from a faith perspective is the “mystical” or “spiritual” experiences many psychedelic users report. These emotionally powerful experiences can involve feelings of transcending the boundaries of time and the physical body — a sense of oneness with the universe, or instances of profound meaning that some describe as “an encounter with the divine.”

For believers, this should be especially troubling. Any true encounter with the divine starts with God Himself — not a mushroom. When people open themselves to counterfeit spiritual experiences, they open themselves to spiritual deception.

Disruption of healthy coping skills

People with dissociative disorders (conditions that involve a disconnect with identity or perception of reality) can experience improved mental health when they become grounded in reality and perceive reality more clearly. In fact, therapists try to help people correct distorted thoughts and perceptions in order to ease fear, depression, and anger so they can move toward wholeness.

But psychedelics, by definition and application, disrupt reality. They might bring temporary relief for certain issues but by themselves don’t deliver the healthy coping skills needed for long-term healing.

Final thoughts and where to find more help

As we’ve shared here, Focus on the Family offers many cautions and caveats about legalizing psychedelics for medical purposes. And we categorically oppose the legalization of psychedelics and hallucinogens for recreational use.

That said, we realize you might have more personal reasons for asking your questions. If you’d like to talk more, call our counseling staff for a free consultation at 1-855-771-HELP (4357). Our team can suggest next steps and refer you to qualified counselors and Christian professionals in your area for ongoing support. In the meantime, we urge you to look through the resources and referrals listed below.