Wednesday, 1 November 2017

Psychedelics and Drug Addiction

Overindulgence in anything can be intoxicating, even if it is something as essential as water. Though we all try to rationalize these things, sometimes we simply fail. Gone are the days when the word “addiction” was associated with some poorer and less educated parts of society. It is a fact that today substance abuse is equally prevalent among successful and intelligent people.

The American Psychiatric Association defines addiction as something that a person keeps indulging in despite the harmful consequences of overindulgence. The person has a compulsion or focus on taking that particular substance or practicing that particular habit. Addiction results in distorted thinking, it changes behavior and body functions. This addiction leads to changes in wiring of the brain. Addiction is also characterized by building up tolerance, meaning that a person needs higher doses with time.

There are two broad reasons for addiction, psychological and physiological. The psychological component is present in every addiction, as a person seeks and gets pleasure from his or her addiction. Some seek enjoyment, others look for stress relief. Some people even believe that addiction improves their performance, mental or physical. Physiological addiction develops when the body becomes dependent on the substance for normal functioning. For example, long time smokers have a problem with bowel movement after quitting the habit.

Fortunately, addiction can be treated, but only if a person is willing to get rid of it. After all, it has lots to do with the habit forming, pleasure-seeking nature of humans, a part of the physiological dependence.

Still, the effectiveness of addiction therapy is very low because few people sincerely wish to give up their addiction. Consciously or not, many addicts look for an excuse to continue.  Statistics show that as few as 10% of people who attempts to quit their addiction actually succeed.

The use of psychedelic drugs is banned almost universally, even scientific studies on their effects are prohibited in most countries. Nonetheless, it appears that some specific properties of psychedelics can be used to successfully treat a variety of addictions.

The logic here is to use one mind-altering agent to overcome dependence on another. The dose makes the poison: a poisonous compound can be an efficient medicine when used at the right dosage. Psychedelic drugs may help to cure addiction when they are used under controlled conditions and at the right dose. This is precisely what many researchers are trying to do.

Psychedelic drugs differ from other addictive drugs in their mind alternating properties: they alter thinking processes and perception through their action on serotonin receptors. They are known to change the level of consciousness experienced. People taking these drugs feel as if they are in a kind of trance. Some of the conventional psychedelic drugs include “magic mushroom” hallucinogens (psilocybin), LSD, and mescaline. There has been several trials and observational studies showing that these drugs are capable of altering the brain by resetting thinking patterns.

Ibogaine is one such psychedelic drug that is being studied. It is a potent hallucinogen that brings various memories and experiences to the person taking it that has been traditionally used in shamanic rituals in western Africa. Many underground clinics for treatment of severe drug addiction have reported the wonderful effects of even a single dose of this plant-derived drug. But this drug is highly toxic, and many pharmaceutical companies are trying to come up with an analogue that is safe for humans, free from hallucinogenic effect, and still has potency to treat addiction. Very little is known about the mode of action of this drug. Moreover, some people in the scientific community think that only natural ibogaine will have the desired properties. Medical professionals caution against the use of this drug in underground clinics, as ibogaine is known to cause seizures and heart failure.

Another natural compound that shows promising results in the treatment of drug addiction and some psychiatric illnesses is psilocybin, a compound found in magic mushrooms. A recent small scale proof-of-concept trial done by Johns Hopkins University in Baltimore, Maryland, demonstrated that the drug can help lifelong smokers to quit the habit. The therapy with psilocybin worked much better than any other currently known forms of anti-smoking treatment.

In another study, psilocybin was used to treat alcohol addiction. This study was rather specific, as only people with the most extreme cases of alcohol addiction were accepted for the trial. Though this was a small scale study, it had terrific results in overcoming the years of alcohol addiction and completely changing the outlook for the participants.

LSD is perhaps one of the best-known psychedelics. It is used as a recreational and addictive drug, although it was banned in the 1960s and 1970s in most countries around the globe. But very few people know that LSD is the most intensively tested in clinical trials for the treatment of addictions.

In one of the large-scale studies performed in six hospitals across Saskatchewan, Canada, more than 1000 alcoholics were treated for their addiction with LSD. The study enrolled people known to be resistant to other forms of treatment for addiction, people with broken lives, former prisoners, and people with severely damaged health. The majority of those treated with LSD were able to stay away from alcohol for quite a long time. In fact, the researchers reported a success rate of 70%. Considering the statistics and the scale of the study, this is not something to be neglected. However, due to the criminalization of LSD, it could neither be used for treatment of alcohol addiction, nor could further clinical trials could be carried out.

Bearing in mind that psychedelic drugs have consistently provided excellent results in the treatment of various addictions, we should probably reconsider the total ban on their use for research and medical purposes. One future direction could be the development of synthetic analogues of psychedelics with lesser side effects but similar mind-altering properties. Taking into account the growing epidemics of opioid addiction in the US, psychedelics should be seriously considered for their potential to contribute positively to the solution for this problem.

References:

Jacobson, R. (2017, January 1). Treating Addiction with Psychedelics. doi:10.1038/scientificamericanmind0117-10

Johnson M, Garcia-Romeu A & Cosimano MP. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology. 2014;28(11):983–992. doi: 10.1177/0269881114548296

Krebs TS & Johansen P-Ø. Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. Journal of Psychopharmacology. 2012;26(7):994–1002. doi:10.1177/0269881112439253

Schenberg EE et al. Treating drug dependence with the aid of ibogaine: A retrospective study. Journal of Psychpharmacology 2014;28:993–1000. doi:10.1177/0269881114552713

Studerus E, Kometer M & Hasler F. Acute, subacute and long-term subjective effects of psilocybin in healthy humans: a pooled analysis of experimental studies. Journal of Psychopharmacology 2011;25:1434–1452. doi:10.1177/0269881110382466

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