Can Hallucinogens Help the Mentally Ill?

Could ’shrooms or LSD help the mentally ill?

At Harvard, a psychiatrist is studying whether the hallucinogenic cactus peyote creates any long-term memory or attention problems in the American Indians who take the drug as part of religious rituals.

A University of Arizona psychiatrist is poised to begin researching whether taking the hallucinogen psilocybin under controlled circumstances may help people suffering with obsessive compulsive disorder.

And another Harvard psychiatrist is in the beginning phases of designing a protocol that may employ LSD or another hallucinogen to see if it helps terminally ill people suffering from depression and pain.

With some support from the private New Mexico-based Heffter Institute, these researchers, along with others in the United States and abroad, represent a small movement of scientists looking at the possible medical benefits of hallucinogens for some psychiatric conditions.

Hallucinogens Among Oldest Drugs

Hallucinogens are among the oldest known group of drugs that have been used for their ability to alter human perception and mood, according to the Drug Enforcement Agency. They have been used for medical, social and religious practices.

More recently, synthetic hallucinogens have been used recreationally, with hippies from the '60s, such as the now deceased ex-Harvard psychology professor Timothy Leary, first promoting their use with the famous slogan, “Turn on, Tune in, Drop Out.”

Today, hallucinogens are deemed drugs of abuse by the DEA, with no known medical benefit. Approximately 8 percent to 10 percent of high school seniors tried a hallucinogen in the past year according to a University of Michigan study of drug use.

It remains unclear how these drugs exert their action in the brain, but anecdotal evidence and some earlier studies indicate they may help a variety of psychiatric conditions, says David E. Nichols, founder of the Heffter Institute, in Santa Fe, and professor of medical chemistry and molecular pharmacology at Purdue School of Pharmacy in West Lafayette, Ind.

Nichols says there is some indication these drugs work on the serotonin pathway in the brain, the same target of the selective serotonin reuptake inhibitor drugs Prozac, Paxil and Zoloft, used to treat depression, anxiety and obsessive compulsive disorder.

He founded the institute in 1993 to help give scientific credibility to medical research on hallucinogens. After years of fund-raising, the institute now has enough money to help scientists do serious research.

Trials Must Be Rigorously Designed

“Since opinions are so strongly held about hallucinogens, it is essential that any studies in this area be performed with the most rigorous modern methods and great care to have an impartial approach,” says Dr. Harrison Pope, professor of psychiatry at Harvard Medical School, who is leading the four-year peyote study in American Indians.

Funded largely by the National Institute of Drug Abuse and Heffter, Pope’s group will be comparing three populations of American Indians — peyote users in religious ceremonies, alcoholics, and local tribespeople — to see if peyote use is associated with cognitive problems.

Pope is also developing a trial to follow up on studies from the '60s and '70s suggesting that hallucinogens helped ease anxiety and depression in the terminally ill and also reduced their need for pain medication.

“The challenge is to design the study in such a way that if the drug shows benefits, skeptics are convinced, and if it doesn’t help, proponents of hallucinogenic use don’t challenge the research as inadequate,” Pope says.

These studies take time to develop to get that scientific imprimatur. They also need to get review, by local medical institutions and governmental regulatory authorities. The DEA and the FDA is still reviewing a protocol by Dr. Francisco Moreno, an assistant professor of psychiatry at the University of Arizona in Tucson, hoping to study a chemically synthesized psilocybin for obsessive-compulsives. His hospital gave him permission to start the study.

A protocol of psilocybin and depression in Switzerland also is undergoing revision before it is submitted to the government authorities there, Nichols says.

Critics: Risks Outweigh Benefits

Some scientists, however, question the potential risks of these studies.

The problem with this kind of research is that when average people hear or read about them in this preliminary stage they might think these drugs could be good for them now, says Una McCann, associate professor of psychiatry at Johns Hopkins School of Medicine. “But it remains unknown until the studies are finished,” McCann says.

Dr. Gregory Collins the director of the Alcohol and Drug Recovery program at the Cleveland Clinic, in Cleveland, Ohio, believes the risks outweigh any benefits.

“Some of these drugs have been shown to have long-term consequences in healthy people,” Collins says. “ I would be reluctant to try them in the mentally ill.”

Nichols, however, defends the research. “I think we will find some medical benefit of these drugs,” Nichols says. “There is no other drug class that doesn’t have some medical utility.”