Rick’s Blog

Mainstreaming psychedelics. Are we there yet?

November 17, 2017

In its efforts to mainstream psychedelics, the biomedical model runs the risk of proclaiming and defending particular dogmas and orthodoxies. These raise the risk of stifling inquiry into the full psychedelic experience: its mechanisms, meaning, and optimal applications. In this week’s post, I discuss the state of this mainstreaming effort, and suggest how to prevent its successes from prematurely closing the psychedelic mind. The biomedical research model has been extraordinarily successful in re-introducing psychedelic drugs to the larger scientific community and popular culture. Moderate doses, strict attention to non-drug factors, and a modest relationship with the media all have contributed to this success. However, the biomedical research model has done less to mainstream the psychedelic experience. Rather, one reads about psychedelic drug effects on drug abuse or depression, or views images of functional brain scans demonstrating mathematically significant data. The actual experience, on the other hand, is transformed into relatively...

Why Won’t DMT Go Away?

November 8, 2017

“Myth,” “arguably bullshit,” and “deserving a decent burial.” These are some of the published statements by reputable scientists reacting to various claims made about DMT. Usually, these words are used to attack “pseudoscience,” the kiss of death for scientific theories that lack merit, are patently false, and objectively falsifiable. Several theories about DMT have aroused these strong reactions. In this week’s post, I suggest that some of these reactions are appropriate whereas others are not. The psychedelic theory of schizophrenia’s decent burial, 1976 After DMT’s discovery in mammalian lung in the 1960s, psychiatric researchers sought a relationship between endogenous DMT and naturally-occurring psychoses, especially schizophrenia. To the extent that the psychological effects of DMT administration in normals resembled naturally-occurring psychotic symptoms, one could hypothesize that endogenous DMT was involved in those non-drug syndromes. Additional studies sought differences between normal and patients viz. DMT blood levels, and in metabolism of, or...

Mainstreaming “Psychedelic Medicine”

October 31, 2017

Creating a field of psychedelic medicine opens the window to potential benefits and risks by increasing their accessibility. Rescheduling psychedelics out of the highly restrictive Schedule I is necessary for this to occur. Additional issues of public health policy must be determined, and who takes the lead in shaping these policies requires careful attention. Momentum is building to carry outside of the ivory tower biomedical research’s positive and measured, yet preliminary, findings of psychedelics’ benefit for a number of conditions. This goal is generally referred to as creating “psychedelic medicine” or establishing “psychedelics as medicine.” Medicine, more-or-less different than, but still falling within the realm inhabited by, any other medicine. This momentum has been moving forward through the successes wrought through strict adherence to the biomedical model, and levelheaded relationships with the media. We see double-blind, placebo-controlled trials, statistically demonstrable biological and psychological data, minimal if any media grandstanding, manageable...

Misguided Mainstreaming of Psychedelic Drugs: Challenging Experiences

October 25, 2017

Backlash against the wider biomedical availability of psychedelic drugs is likely at some point. However, we may take steps that minimize causes of a potential backlash. One of these steps is to avoid overreaching. Any failure to maintain intellectual rigor and honesty in such a highly controversial field will not serve the research community well when media coverage turns negative for any reason. The worst thing we can hear is: “You were not honest in portraying benefit and risk.” I see at least three phenomena related to the biomedicalization of psychedelic drugs where overreach could come back to haunt us. 1) Renaming psychedelic drug adverse effects as “challenging experiences”; 2) Non-clinicians advocating for policy changes with clinical implications—specifically attempts to re-schedule psychedelics; 3) Homogenizing widely disparate religious traditions by proposing that they all share a “common mystical core.” In my last post, I presented arguments against the one-size-fits-all approach to...

Mainstreaming Psychedelics: Secularizing spirituality with the aid of Eastern religion

October 19, 2017

Clinical spirituality research is an area where psychedelics’ placebo-enhancing effects play a very prominent role. This research’s guidelines for set, setting, and suggestion have been rigorously standardized, resulting in the marshaling of psychedelics’ placebo-enhancing effects toward a particular end. These guidelines are an outgrowth of those developed by the original University of Maryland research group in Spring Grove during the 1960s. At that time, the Spring Grove group demonstrated a relationship between a particular experience—the “peak-psychedelic” effect—and psychotherapeutic benefits in alcoholics and the terminally ill. The results using this model were impressive then, just as they are now using updated Spring Grove guidelines. However, I do not believe that this model is the only relevant one. This paradigm reflects a particular religious worldview belonging to two of that team’s most influential members: William Richards and the late Walter Pahnke. Richards, now with the Johns Hopkins group, has developed and spread...

Psychedelic Drug Doses: From Mega to Micro

October 12, 2017

Understanding psychedelics as amplifiers of the placebo response helps explain their ever-widening scope of applications—from accelerating one’s spiritual growth to reducing tobacco use. Manageable doses of these drugs may thus be conceptualized as optimizing placebo’s contribution to their observed benefits. The biological correlates of successful outcomes may therefore relate as much to indirect psychedelic-effected changes in the placebo response as to direct effects of the drugs. A “mystical/peak experience” is now believed to be the common denominator underlying the benefits reported in current research across a wide variety of conditions. However, I believe that an enhanced placebo response is a more fundamental explanation, and may allow for even greater application of the psychedelic drug state. More on this later when I post on explanatory models and future directions. To the extent that psychedelics enhance placebo effects within a highly structured set and setting, there necessarily exists an optimal dose range....

The Political Correction of Psychedelics. Part 4. Manageable Doses

October 5, 2017

In last week’s post, I promised to discuss high-dose psychedelic work. However, as I began writing this week’s post, I saw that it would be beneficial to first discuss not-high-doses. These are what I refer to as manageable doses. Modern clinical research with psychedelics is generating uniformly and markedly beneficial results, both practical and heuristic. Researchers are deliberately administering modest doses of drugs, in combination with rigorously structured set and setting. In this context, modest doses maximize sessions’ effects toward desired outcomes and away from negative ones. These results enable psychedelic research to progress within the mainstream, albeit at its further edges.  However, modest doses are not the only doses available for study. In last week’s post, I introduced the idea that psychedelics enhance the placebo response, and that this is the basis of their astonishing efficacy for so many different conditions. If so, activation of the serotonin (5HT)-2A site...

The Political Correction of Psychedelics. Part 3. Psychedelics as Super-Placebos

September 28, 2017

The three pillars of the psychedelic drug experience—set, setting, and dose—are the topics for this and the next blog post. They are inextricably intertwined. Channeling the set and setting toward well-defined goals acceptable by the mainstream requires staying within “manageable” doses of drug. By carefully regulating dose, set, and setting, we are now witnessing the publication of a remarkable series of beneficial and heuristically useful outcomes to psychedelic drug projects. In addition, such studies report a very low incidence of serious adverse effects. Posttraumatic stress disorder, obsessive-compulsive disorder, eating disorders, anxiety, depression, creativity, spirituality, end-of-life palliation—the list seems to grow by the month. British psychiatrist Ben Sessa has even wondered if the psychedelics are the equivalent of “psychiatric penicillin.” However, the placebo effect is a more operationalized construct, and one more amenable to study. It may help us understand how one drug can benefit so many indications by means of...

The Political Correction of Psychedelics. Part 2: Mainstreaming through the Media and Objectivity

September 21, 2017

How do the current presentation and reception of psychedelic drugs reflect lessons learned from the backlash against these drugs in the 1960s? And what does this say about their future? In this week’s blog I describe some ways in which psychedelics and their effects are being mainstreamed and attaining political correctness through their biomedicalization. However, by this process, I see a potential risk in limiting our understanding and application of the full range their effects. The media In the current revival of interest in psychedelics, the media have up until now taken a balanced and positive approach to anything psychedelic. Stories about psychedelic art, music, and ayahuasca tourism assume a curious and questioning perspective, rather than regaling readers with psychedelic horror stories. When psychedelic tragedies occur, media coverage is negligible. The media have been especially enthusiastic about biomedical research. However, there is no guarantee of future good relations with the...

The Political Correction of Psychedelics. Part 1. Are We Closing the Psychedelic Mind?

September 12, 2017

September 12, 2017 “At the very least, we must enlarge the discussion about psychedelics.” Dr. Willis Harman, one of the pioneers of research into the effects of psychedelics on creativity, made this declaration to me while I was in the early stages of performing my DMT studies. We were walking along the central California coast during a break in an invitational conference on psychedelics at Esalen Institute. I was nervously prattling on about God knows what, and he cut right through the fog with his characteristic precision. It was great advice, and has been one of the touchstones of my work ever since. Now that the resurgence in human studies with psychedelic drugs has taken firm root in the academic research world, I see some developments that point to a diminution of that discussion, a premature closing of inquiry into the mechanisms, meanings, messages, and utility of the psychedelic drug...