Monday, 22 December 2014

LSD: A dying wish to cure fear

This is my entry for the Wellcome Trust Science Writing Prize 2014 (in association with the Guardian and the Observer). It made the 20-strong shortlist from over 600 entries. The entire shortlist and the winning entries can be found here.

“Try LSD 100 intramuscular,” read the note passed to Laura Huxley by her dying husband. And so the wife of author Aldous Huxley injected him with the powerful psychedelic lysergic acid diethylamide. He died five hours later on 22 November 1963, his face an expression of “complete bliss and love”.

Before it was banned in 1968, a thousand clinical studies were conducted on LSD, demonstrating its use in treatment for conditions including alcoholism, depression and neurosis. For the next four decades, no further LSD psychotherapy research was published. Until now.

The California-based Multidisciplinary Association for Psychedelic Studies (MAPS) published a study in March 2014 investigating the effects of LSD on anxiety related to advanced-stage illness. In a small trial, 12 patients were given LSD before two psychotherapy sessions. The results of this pilot study show a reduction in anxiety levels, and, according to MAPS founder Rick Doblin, justify further investigation. Speaking to the Independent, Swiss-based lead researcher Peter Gasser confirmed that the beneficial effects of the treatment were stable over time and that no patients experienced “noteworthy adverse effects”.

 UK-based psychiatrist Dr Ben Sessa hopes the research will lead to LSD treatment not just for patients with terminal illness but “across the board for people of all ages with anxiety disorders. Existing treatments mask symptoms and can be lifelong. Psychedelic therapy would be a single treatment – it could treat anxiety disorder so it doesn’t return.”
Peter, a 50-year-old Austrian social worker, described his treatment in the MAPS press release: “My LSD experience brought back… a timeless moment when the universe didn’t seem like a trap, but like a revelation of utter beauty.” Sessa explains: “The psychedelic experience is particularly wellattuned to the existential issues of death and dying – there is something about psychedelics that connects people with the other-worldliness of death.”

 Doblin said research by MAPS has not focused on the mechanism, since they only need to demonstrate it works safely, not how it works, to get LSD approved as a medicine. This study builds on a foundation of research that began in the 1960s at Spring Grove State Hospital, Baltimore, where psychiatrist Stanislav Grof pioneered the use of LSD to treat fear of dying. This was cut short when LSD was criminalised in 1968, a move that Doblin suggests was due to the drug’s use by anti-establishment hippies and anti-Vietnam War groups. 

Naturally, there are concerns over the danger of using a class A illegal drug as a medicine. “There's an enormous amount of research that demonstrates LSD is physiologically safe,” says Doblin. MAPS Director of Development Virginia Wright says that due to LSD’s bad reputation, US researchers were unwilling to carry out the current study despite its approval by the US Food and Drug Administration. The trial took place in Switzerland, where there is more openness and interest in LSD research, not least because it was discovered there in 1938 by chemist Albert Hofmann. Nevertheless, when the trial was approved in 2008, the Swiss People’s Party (the largest in the country) told Bloomberg that if international experts come to the conclusion that LSD could be seen as a medication, “we would have another look at the situation. But for the moment our position is still a conservative one.”

To gain approval, there needs to be a much bigger study with a range of different patients to demonstrate wider efficacy. But this requires money – potentially tens of thousands of pounds. Drug development is often funded by pharmaceutical companies, and according to Sessa, these companies are unwilling to sponsor the process of bringing LSD to market. Since LSD might only be used once or twice in therapy, profit from drug sales would be limited. LSD’s reputation means public funding is scarce – MAPS relies on donations from individuals and charities. But, says Doblin, “So far no major foundation that supports medical research has funded psychedelic research.”

At the time of writing, MAPS does not have funding for further LSD research. But other psychiatric research is making this type of work more commonplace – a study on ketamine and a Medical Research Council-funded investigation into magic mushrooms are both exploring effects on depression. As the stigma around illegal drug research lessens and red tape is removed, more studies may yet convince regulators to put LSD on the NHS.

Written by Louise Crane
Edited by Mun-Keat Looi

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