The Potential of Psychedelics as Treatment for PTSD

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Brigid Bergin: It's The Brian Lehrer Show on WNYC. Welcome back everybody. I'm Brigid Bergin from the WNYC and Gothamist Newsroom. Often, when we think of psychedelic drugs, we think of them as illicit or only valued for their trippy and perhaps colorful side effects. In the United States, perceptions of psychedelic drugs are changing. Earlier this month, the House of Representatives passed amendments that would expand research on psychedelic drugs for therapy, perhaps most surprisingly the amendments received bipartisan support. They were authored by New York Democrat, Alexandria Ocasio-Cortez and Texas Republican Dan Crenshaw, two representatives who are at opposite ends of the political spectrum.

The bipartisan support signals a growing interest in the use of psychedelics to treat post-traumatic stress disorder in the United States, especially among service members. Joining me now to discuss these experimental psychedelic therapies is Ernesto Londoño, a staff writer at the New York Times who is currently working on a book about psychedelics and mental health. Hi, Ernesto. Welcome to WNYC.

Ernesto Londoño: Hey, Brigid. Thank you so much for having me.

Brigid Bergin: Ernesto, as I understand it you have a particular background when it comes to this topic. Can you tell us about that?

Ernesto Londoño: Sure. I became very interested in psychedelics, I think back in 2018, when I was posted in Brazil as the foreign correspondent and after a period of depression I signed up for an Ayahuasca retreat in Brazil where Ayahuasca is legal. It was a catalyst for profound change for me. On the one hand, it really helped me deal with my depression. On the other hand, it set in motion a number of changes that put me in a far stronger, more resilient place. Over the years, I became super interested in studying this field of psychedelic therapies.

There's a booming retreat industry in Latin America and increasingly in the United States, we're seeing clinicians and investors become very excited about the prospect that one day soon psychedelics will be regarded as medicine rather than drugs.

Brigid Bergin: So interesting. Callers, we would like to hear from you too, if anyone has questions for my guest Ernesto Londoño from the New York Times about psychedelic therapies, give us a call at 212-433-WNYC. That's 212-433-9692. Or have you or someone you know struggled with PTSD or depression? What do you think about using psychedelic therapies as treatment? Have you tried psychedelics to help you in this way? Veterans, in particular, we would love to hear from you. Give us a call at 212-433-9692 or tweet @Brian Lehrer.

Now, let's talk about the drugs themselves, MDMA and psilocybin are at the heart of this research, what exactly are they?

Ernesto Londoño: Sure. These are two drugs that currently are illegal. It's a really interesting time in terms of how the federal government is viewing these drugs. MDMA, which is known as ecstasy has been prohibited since the '80s. Psilocybin, which is the psychoactive compound in magic mushrooms has been illegal even longer. Currently, the DA says these drugs should be banned and that they are dangerous and that there is no therapeutic value in using them. On the other hand, over the last couple of years, federal regulators, and health regulators have become persuaded that in early clinical trials, these two drugs appear to be highly effective at treating conditions that have been very hard to treat through conventional treatments. One of these is depression and specifically depression in people who have not found help through antidepressants or conventional therapy.

The other one is PTSD, which is endemic among veterans. What's happened recently is the Veterans Affairs Administration took a big step in authorizing a number of clinical studies into both MDMA and psilocybin, essentially granting clinicians permission to enroll patients in these experimental therapies. I spoke to a handful of the clinicians who are doing this work, and they say that they've seen really hopeful signs that these could become game-changing medicines for conditions that currently lead some people to commit suicide and leave other patients in a state of perpetual suffering.

There's enormous hope, but the road ahead, when it comes to regulatory frameworks and rethinking how we classify and work with these substances in laboratories and in clinical settings is full of obstacles. The main one is that as a matter of federal law, these drugs remain prohibited, they remain illegal. This makes it very hard for people to access these drugs as medicine, and it makes it very cumbersome for clinicians to study them in official above-board settings.

Brigid Bergin: Ernesto, you noted, as you just said, these drugs are currently illegal, but I want to go back a little bit and give some historical context here. You wrote that in the 1950s and '60s, psychedelics were considered a potentially revolutionary tool to treat psychiatric conditions. Why did that change? Why did psychedelics become so controversial?

Ernesto Londoño: Sure. Back in the '50s and '60s, in fact, the federal government was a hotbed of research into psychedelics. They were studied for their therapeutic potential, but they were also studied interestingly, for instance, as tools to manipulate adversaries. The CIA specifically had a study taking a look at whether LSD could be weaponized to manipulate or embarrass foreign leaders, for instance. However, what happened during this era was that these drugs filtered out of the laboratory and entered into recreational domains and a lot of people started using these drugs very liberally in recreational settings. This coincides with a fraught political moment where there is a brewing opposition against the Vietnam War and the federal government becomes very panicky about how disruptive these drugs are in the culture and how they're galvanizing people against government initiatives, specifically the war in Vietnam.

The government launches a crackdown on these drugs and takes the view that all of these drugs and especially psychedelics are extremely dangerous and sets in motion a ban that holds to this day. In recent years though, researchers have begun reopening this door and saying, the government overreacted when it classified all these drugs as extremely dangerous, prone to abuse, et cetera. It's coming at a moment where there is so much recognition that we're dealing with a big mental health crisis in the United States, that the rates of suicide and depression, and PTSD are very high, and that our current mental health system is failing too many people.

Politically, I think we're in a place where there is broad and strikingly bipartisan support to reopen this chapter of research and enable and fund the researchers who want to test whether or not these substances work and more importantly, who they are right for, what kind of patients would actually benefit for them, and what kind of safeguards need to be put in place to mitigate the risks that these could be destabilizing in certain patients, in certain contexts.

Brigid Bergin: I want to go to some of our callers. Let's start with Wesley in Ditmas Park. Wesley, welcome to WNYC. I understand that you are a veteran.

Wesley: Yes. I am a veteran of the OEF, Operation Enduring Freedom in Afghanistan. I served in 2011 and got injured twice there. I tried mushrooms once prior to the pandemic and for fear of stigma just never thought about it until I started therapy around the onset of the pandemic. Combined it with logos of mushroom chocolate and it really helped. Just helping me cope and just feel with the past without making it too hard.

It's easier to deal with the avoidance that is there with war especially. It just made it easier to deal with and I've talked to people I served with and they feel the same. Amongst the co-workers I know, it is helpful. I wish there could be a world where we would have something that is a little bit more regulated and-- [crosstalk]

Brigid Bergin: Thank you for calling and sharing your story. Thank you, of course, for your service. I'm glad that you have found something that has been helpful to you. Ernesto, I want to turn just for a moment, so that we understand a little bit about how do these drugs affect the brain, and why are they considered to be helpful in treating some of these conditions.

Ernesto Londoño: Sure, that's an excellent question. Researchers say there's a lot they still don't know about exactly what happens to a tripping brain. The fundamental theory at the heart of this research is that people who take psychedelics often experience disruptions in the way they think and disruptions in the way they make sense of memories, of traumas, and fear.

Researchers I've spoken to say that many patients feel that they're better able to reconnect with memories that had been too traumatic to really reflect on or process in real-time or in the immediate aftermath of an event. They say that patients become less inhibited and more able to drift back to moments that were shocking, and that led them to disconnect emotionally from that memory, but disconnect emotionally more broadly from life.

The thinking is that, by putting patients in that state of greater vulnerability, where they're able to re-assess how they think about this traumatic event, and maybe meet the memory with greater compassion, or with a different perspective, that helps them metabolize traumatic events more successfully than just talk therapy would. Especially on the PTSD front, what the researchers are saying is that several patients who have undergone MDMA-assisted therapy are walking away with what amounts to remission. This is very rare in PTSD currently.

Although patients find some relief in the standard treatments, which include therapy, it includes antidepressants, and anti-anxiety medicine, it's very rare for patients to actually get to the other side of healing and feel like they no longer had any of the symptoms of PTSD.

Brigid Bergin: I want to go to Amanda in Manhattan, who has a question that I think probably some other folks are wondering. We're running short on time, Amanda, you could ask your question quickly.

Amanda: Sure. Thank you so much for taking my call. It's a pleasure to be on with y'all. I just had a question for people that are just entering into this journey for themselves. I'm very interested in pursuing psilocybin for anxiety, depression, and just dealing with everything. A number of things on my plate and I don't really know resources to turn to or where to start in finding a guide. I have a family member that's been going through this, but they're not very helpful. I just wondered if you had any resources for folks that are just starting to try and find their way through this.

Brigid Bergin: Ernesto, I apologize, we only have about 30 seconds left. If you can offer some quick suggestions that would be helpful.

Ernesto Londoño: Sure. I'll keep it short. I think, unfortunately, there are very few treatment options currently, where you can access psilocybin-assisted therapy or other psychedelic therapies aboveboard. There is a vast retreat industry in Latin America and countries where these substances are illegal, but I would suggest that anybody interested in this, really do a lot of homework, talk to a lot of people who've done this, talk to their health care providers, talk to their therapists, and make sure that they avoid putting themselves in a situation where they're going to be in the care of people who may not be trustworthy. Unfortunately, the answer, for now, is until these substances are more readily available, I think it's a buyer beware marketplace.

Brigid Bergin: I can tell we could have a much longer conversation about this, but we're going to have to leave it there for today. My guest has been Ernesto Londoño, a staff writer at The New York Times who is currently working on a book about psychedelics and mental health. Ernesto, thank you so much for coming on the show.

Ernesto Londoño: It's my pleasure. Thank you.

 

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