Welcome to the Psychedelic Future of Mental Illness Treatment
How 'Reefer Madness' has given way to marijuana mindfulness.
The trailer for the 1936 propaganda film Reefer Madness promises a cautionary tale of the utmost importance. “Smoking the soul-destroying reefer [grants] a moment’s pleasure, but at a terrible price: Divorce! Violence! Murder! Suicide! And the ultimate end of the marijuana addict—hopeless insanity!”
Straight-laced actors, formerly good kids, jitter to devilish jazz music to emphasize the effects. Marijuana, the narrator admonishes, is a “deadly menace… with roots in hell.”
Today, 80 years later, the majority of the American public disagrees with the Reefer Madness admonitions. Medical cannabis is legal in half of the United States, and growing anecdotal evidence and citizen science is touting the mental-health benefits of the herb.
“It helps people on every spectrum, from someone who has a little bit of anxiety or doesn’t sleep well at night all the way down to the cancer patient on their dying bed, providing some level of relief,” says Michael Ray, founder of Bloom Farms, a Bay Area–based “socially responsible cannabis company” that produces a line of vapor products.
One year after Reefer Madness’s release, the Marijuana Tax Act outlawed the possession or sale of marijuana. In 1970, Nixon’s war on drugs ushered in the Controlled Substances Act, under which the Drug Enforcement Administration classifies drugs according to medical usefulness and potential for abuse. Alongside heroin, LSD, psilocybin (magic mushrooms), and MDMA (molly), cannabis is a Schedule 1 substance—the most restrictive drug category—as if cannabis has no medical use and a high potential for abuse, a contention that increasingly fails to stand up to an informed public's scrutiny.
The Adult Use of Marijuana Act—an initiative to legalize recreational cannabis that is likely to pass on the California ballot this November—is the latest major sign that the tides are changing.
“When California legalizes cannabis, it will have a massive impact [worldwide],” says Natalie Ginsberg, the Policy and Advocacy manager at the Multidisciplinary Association for Psychedelic Studies (MAPS). Despite widespread medical cannabis usage in the U.S., MAPS is one of only a handful of organizations pursuing Food and Drug Administration approval to research cannabis as a prescription medicine.
The cannabis study pool is limited by a number of imposed restrictions that don’t exist for any other drug. Most significantly, research-approved cannabis is only available from one supplier—a farm in Mississippi run by the National Institute of Drug Abuse, a government agency. NIDA produces a meager supply of cannabis that Ginsberg says varies in quality and consistency. “They aren’t able to produce the strains that we ask or the THC or CBD ratios that we ask.”
After years of bureaucratic embroilment, MAPS is months away from initiating a small trial using cannabis to treat veterans with Post Traumatic Stress Disorder, funded by a grant of $2.15 million from the state of Colorado.
MDMA-Assisted Psychotherapy (via)
Concurrently, the group has been pioneering research on MDMA-assisted psychotherapy for PTSD and is on track to reach its projected goal of legalizing the drug for therapeutic contexts by 2021. Next year, MAPS will begin Phase 3, the biggest experimental psychedelic study ever conducted, with 400 study subjects.
Prior to its prohibition, MDMA was used experimentally in couples-therapy sessions in the early ‘80s. “As an empathogen, MDMA was really amazing for people to communicate, go deep, and have therapeutic dialog,” says MAPS therapist Shannon Petitt. In spite of significant positive anecdotal testimony by dozens of therapists, the DEA outlawed MDMA in 1984 before any clinical trials had been done. A year later, Dr. Rick Doblin founded MAPS. For the past 30 years, the nonprofit has used individual donations to raise awareness and understanding of psychedelics through research, advocacy, and education.
Subjects are given either a placebo or a dose of MDMA; neither they nor the therapists know which.
Petitt describes MAPS’s therapeutic approach as tapping into “inner healing intelligence.”
“People really just need the right environment, and they’ll do the healing themselves,” she says.
Though MAPS treatment protocols are strict and have been vetted by an ethics committee, experimental sessions don’t adhere to a rigid therapeutic structure. Subjects sit in a comfortable, decorated room with two therapists—one male, one female. They are given either a placebo or a dose of MDMA; neither they nor the therapists know which. Over the next six to eight hours, “the patient and the medicine take the driver’s seat,” Petitt says. Therapists create a supportive space for subjects to experience their inner feelings. “Sometimes the process is talking through memories or feelings that are coming up. Sometimes the process is just sitting in silence,” Petitt explains.
Petitt says psychedelic medicine provides a change in perspective that profoundly catalyzes realizations that in traditional talk therapy could take years for patients to come to.
Current PTSD drugs on the market are targeted at symptom suppression rather than a real cure. Ginsberg says psychedelics differ. “They address the root cause of things. They’re a more holistic approach to healing,” one that doesn’t require continuing medication.
“If your goal is making a profit, you aren’t going to develop something that heals someone in one or two sessions,” she says. Furthermore, Big Pharma isn’t much interested in psychedelics. Since the drugs have been in the public domain a long time, they can’t be patented, and the profit incentive is hobbled.
Nonetheless, psychedelics show promise in alleviating conditions that have proven hardest to treat, including addiction, obsessive-compulsive disorder, end-of-life anxiety, and depression. Several U.S. universities—including Johns Hopkins, the Harbor-UCLA Medical Center and the University of New Mexico—are conducting studies with LSD, psilocybin, MDMA, ibogaine, and others. At NYU, a psilocybin-assisted psychotherapy study yielded positive results in abating end-of-life anxiety in terminally ill cancer patients. Along with MAPS’s MDMA study, the psilocybin study is poised for FDA approval in five years. If these two studies make it through FDA approval, precedents will be on the books—a small, hopeful step toward a more psychedelic society.
From a research perspective, a psychedelic renaissance is underway, but the dropout mythology still needs to be combated. MAPS founder Rick Doblin’s mission is to change the conception of psychedelic use from ‘60s counterculture to one that’s integrated into today's society. As positive research findings continue to come forward, Doblin envisions a “post-prohibition world” where citizens can learn to use psychedelics responsibly through a tiered process similar to driver’s education.
In a recent appearance on The Joe Rogan Experience, he pointed out, “Most [societies] have had the use of drugs and altered states in some kind of sanctioned manner—encased in religious rituals or certain cultural contexts. They’re not prohibited; they’re respected.
“Psychedelics came at a time when culture wasn’t really ready,” Doblin said. “Now, our culture is ready.”