The Economist - USA (2022-01-29)

The Economist January 29th 2022 United States 35

Drugpolicy

Turn on, tune in

C

had kuske was a Navy seal for 18
years.Whenheretired,hefoundhim­
self “struggling with depression, sub­
stance abuse and anger”. Various treat­
mentshad failed,until anotherex­seal
suggestedpsilocybin,theconsciousness­
altering compound in “magic mush­
rooms”.“Itbasicallychangedmylifeforev­
er,”MrKuskesays.“IrealisedthatI’dbeen
livinginmyownpersonalhellandI was
keepingmyselftherebymyownchoices
andI hadthepowertochangethat.”
MrKuske’sexperienceisnotunusual.
Scientistsbeganstudyingthepotentialfor
psychedelicstotreatmentalillnessmore
than 60 yearsago,beforeanxietyoverthe
drugs’countercultural popularity in the
1960sshutdownresearch.Thankfully,it
has restarted—and studies are showing
thatpsychedelic drugshavepotentialin
treatingseveralthornymental­healthpro­
blems.Oregon’svotersapprovedpsilocy­
binforsupervisedusein2020,andother
jurisdictionsmaysoonfollowsuit.Thisis
goodnews notjustfor peoplesuffering
fromdepressionandpost­traumaticstress
disorder(ptsd), butalsoforAmericandrug
policy:itshowsthatevidence­baseddeci­
sionsarereplacingmoralpanic.
That does not mean Oregonians can
pickupafewmushroomsontheirway
homefromworkandspendtheevening
tripping.Measure109,whichalmost56%
ofvotersapproved,doesnotlegalisepsilo­
cybinormakeitavailableatdispensaries,
ascannabisnowis(a separate measure
passedinthesameelectiondiddecrimi­

nalisethepossession of small amounts of

alldrugs,punishable with only a $100 fine

thatcanbevoided by completing a health

screeningatanaddiction­treatment  cen­

tre).Instead,itmakes  psilocybin  therapy

availableattreatment  centres  under  the

supervisionofa trained facilitator. 

Oregon’s health  department  will  li­

censethecentres,  facilitators,  psilocybin

producers and testing  labs.  People  who

wanttherapywill not need to provide a di­

agnosisofdepression or ptsd. Tom Eckert,

a psychotherapist  who  with  his  late  wife,

Sheri,begantheefforts leading to Measure

109,saidheintended  such  therapy  to  “sit

outsidea conventional  medical  model...It

willbeopentoanyone who can safely ben­

efitfromit.”The screening process should

helpexcludethose unsuited to it. Precisely

whatthatmeans is under discussion. Ore­

gonisstillhoning its rules, with the goal,

accordingtothestate’s health department,

ofhaving thetreatment  centres  up  and

runninginthespring of 2023.

Psychedelicdrugs  put  users  in  an  al­

teredstateofconsciousness. They include

lab­synthesisedcompounds  such  as  lsd

andmdma(commonly  called  ecstasy)  as

well as naturally  occurring,  plant­based

substancessuch as psilocybin, mescaline,

ayahuasca and ibogaine.  George  Gold­

smith,whosefirm, Compass Pathways, has

developeda synthetic  version  of  psilocy­

bin,explainsthat the drugs act on “a brain

network that integrates  perception  with

prediction” and  so  help  break  “the  dys­

functionalpattern of thinking characteris­

tic of so many mood disorders”.

They also appear to spur the growth of

neural connections that stress and depres­

sion  tend  to  erode,  suggesting  that  they

may  have  a  reparative  function.  Studies

have shown that psychedelics have poten­

tial to treat addiction, ptsdand severe de­

pression, as well as to alleviate end­of­life

anxiety in terminally ill patients.

These  studies  have  mostly  had  small

sample sizes. Some worry they might over­

estimate  psychedelics’  benefits—notably

of  microdosing,  a  fashionable  practice  of

regularly taking small doses of psychedel­

ics.  A  study  by  Imperial  College  London

found that people given placebos and actu­

al  microdoses  reported  equal  levels  of

well­being and happiness. 

Still, America’s Food and Drug Adminis­

tration—hardly  a  cheerleader  for  illegal

drugs—called  psilocybin  a  “breakthrough

therapy”  for  depression.  That  designation

is  meant  to  speed  development  of  drugs

that may represent a big improvement over

current  treatment.  Mr  Goldsmith  says  his

conversations  with  European  regulators

have been like “pushing on an open door”. 

Far out

Nor is it just Europeans and coastal liberals

interested  in  psychedelics’  potential.  Tex­

as  legalised  research  into  them  last  year;

the state’s flagship medical school opened

the  Centre  for  Psychedelic  Research  and

Therapy  in  December.  Graham  Boyd,  who

runs  a  political­action  committee  that

supports  criminal­justice  reform,  credits

veterans  with  persuading  Rick  Perry,  the

state’s arch­conservative former governor,

to back the measure. Jesse Gould, a former

Army Ranger who runs a charity that sends

veterans  abroad  for  psychedelic  retreats

and  credits  ayahuasca  with  helping  him

overcome his ptsd, said he initially resist­

ed the therapy because “I didn’t identify as

someone who did drugs”. 

At least ten cities have made psychedel­

ics a low priority for law enforcement. Leg­

islators in Washington state recently intro­

duced  a  bill  that  would  replicate  Oregon’s

model, and California’s legislature is mull­

ing  a  bill  as  well.  Politicians  in  around  12

other states have introduced legislation to

decriminalise or study the benefits of psy­

chedelic drugs.

Such openness is welcome not just for

the  benefits  it  may  provide  traumatised

soldiers or people with severe depression,

but  for  what  it  indicates  about  America’s

shifting  attitude  to  drugs.  “Building  pri­

sons and filling them with people who use

these  substances  was  the  worst  policy,”

says Mr Boyd. It “obliterated our ability to

think  clearly  about  what  good  policy

would  look  like...Once  we  clear  away  the

overhang  of  criminalprohibition  I  think

we can come up withbetterpolicy toward

all of these substances.”n

P ORTLAND, OREGON

The emergence of sensible policy on psychedelic drugs

Letting them work their magic