Things were not going well for Marjorie Smith.
The combination of a leukemia diagnosis and a divorce led to depression.
Smith had read somewhere that the use of psilocybin, the active ingredient in hallucinogenic mushrooms, worked against anxiety for patients like her, so she told her oncologist: “If there ever is one of those trials, count me in.”
That day arrived.
She put on a mask, headphones playing instrumental music, took a high dose of the powerful psychedelic substance and lay down on a couch.
After half an hour she had a panic attack;
He felt like he was in a “black box” that he wanted to get out of at all costs.
The psychologist who accompanied her and who had participated in her preparatory sessions managed to calm her down with breathing exercises.
The patient lay down again “and that's where the adventure began.”
“The trip, very clear, was divided into three chapters,” the 60-year-old woman recently recalled in a downtown Washington cafe, “one about my family, another about separation, and the third, about being patient and tolerant. ”.
Obviously, the hallucinogens did not cure her – “that illness will be with me for as long as I have left” – but the treatment helped her return to being “her usual self”: “A positive woman.”
“It was wonderful” and she “would do it again,” she says now.
Although she prefers, due to the stigma that still surrounds these substances, that her parents or her co-workers do not find out about her.
For this reason, Marjorie Smith is an invented name behind which she hides an unexpected protagonist of the psychedelic drug
in the United States.
After half a century of prohibition, these substances are experiencing a second youth in a country plagued by an epidemic of mental health problems, fentanyl abuse and suicides.
Safe in which the psychedelic substances administered to patients at the Sunstone Therapies clinic in Rockville (Maryland, USA) are kept. Greg Kahn
The place where Smith tried the drug “for the first time” is a clinic in the suburb of Rockville (Maryland), north of Washington.
It is called Sunstone Therapies and it awaits on the third floor of the Aquilino Cancer Center cancer hospital, with which she is associated.
In 2020, it became the first non-university site to receive permission from the US Food and Drug Administration (FDA) to conduct clinical trials with psilocybin, pending general approval for its expected medical use. for this year or maybe for next.
The conclusions of that first study with 30 patients - and without a placebo group - were published in the Journal of the American Medical Association (JAMA) and were encouraging: the participants claimed that they felt less fear and something similar to acceptance of their fate.
One morning in August, oncologists Manish Agrawal and Paul Thambi opened the doors of the center to tell their story.
Both are children of Indian emigration.
Recently graduated, they met working at the National Institute of Health, before moving into private practice.
Dealing with patients with “end-of-life stress” and reading a 2018 study that argued that psilocybin could offer cancer patients six months of relief from existential angst convinced them of the need to mount a “mental healing” clinic, where they also work with other psychedelic drugs, such as lysergic acid (LSD), MDMA, popularly known as ecstasy, or 5-Meo-DMT, the molecule behind ayahuasca.
“We became very good at fighting tumors, but the quality of life of these people is something else, and we were not taking care of it,” Agrawal said.
The Sunstone Therapies facilities, which they named The Bill Richards Center for Healing in honor of psychologist Bill Richards, are clean and modern.
More similar to a spa than a hospital.
It cost 1.2 million dollars to build them, which they financed thanks to philanthropy.
They have four therapy rooms and a safe in which they keep “the medicines.”
Patients do not pay for the treatments (which cost thousands of dollars);
That is also covered by donations.
“When we did the first study, we were so moved by the response that we decided to do this,” Agrawal recalls.
Richards, 84, not only gives the center its name;
He also works there.
A man with a broad smile, he was the last doctor who, in 1976, legally administered psychedelic drugs to a cancer patient at the Maryland Psychiatric Research Center, before their use was prohibited by the authorities, as collateral damage of the “war on “drugs” declared at the beginning of that decade by President Richard Nixon.
In an interview from his home in Baltimore, Richards recalled the “feeling of helplessness” at being deprived of a tool he considered beneficial for certain patients.
Many patients: Before being banned, some 40,000 Americans took hallucinogenic substances in clinical settings in the 1950s and 1960s.
Today, it is estimated that more than a hundred FDA-authorized clinical trials are underway to treat two dozen diseases.
Part of the Sunstone Therapies team in Rockville: from left, oncologist Manish Agrawal;
Kim Roddy, director of operations;
psychologist Bill Richards, and oncologist Paul Thambi.
Richards came into contact with psilocybin in 1963, when he was a Theology student in Germany, where he began working with it.
“When the United States Government offered me a scholarship to treat alcoholism with LSD, I returned.
Then those drugs hit the streets and Nixon declared Timothy Leary 'the most dangerous man in America.'
These were the years of the
and Leary, a doctor in Psychology, had founded the Harvard Psilocybin Project with Richard Alpert in the early sixties to document the effects of this powerful natural entheogen on the brains of a handful of volunteers.
Amid accusations of malpractice, the university closed the project, and both, banished from the academy, transferred their proselytism to popular culture.
From Leary, who ended up as a fugitive from justice, is the famous phrase
“Turn on, tune in and drop out”
, which he uttered in 1967, the year of the Summer of Love, before some 25,000 hippies in a festival in San Francisco.
Hero of the counterculture or villain of psychedelic science, Leary's rush to make the revolution embodied the psychosis of the parents of a society in full change, whose authorities encouraged misinformation about the ravages that these drugs, contraindicated for consumption to the slightest, they could cause in their children.
And this is how psilocybin, which had been used for centuries in Mexico for ceremonial purposes, and LSD, a molecule synthesized in 1938 in Switzerland by Albert Hofmann, ended up in 1970 in the group of the most dangerous substances along with heroin.
Unlike this, the probability of dying from an overdose after consuming LSD or psilocybin is extremely low and there is little chance of them causing addiction, according to the US Narcotics Agency (DEA), although they are drugs that, taken in unfavorable conditions or by people with certain psychiatric histories, they can lead to traumatic experiences or manic or psychotic episodes.
Almost a quarter of a century after its therapeutic use was banned, Richards was also there to witness its rebirth.
Together with psychopharmacologist Roland Griffiths, from Johns Hopkins University in Baltimore, they obtained authorization in 2000 to carry out a clinical trial with psilocybin again.
Their results were published in 2006 in a scientific article about its potential to provoke mystical experiences.
It is considered the first stone of the renaissance of psychedelic science in the United States, which has generated a considerable cultural shock wave and is about to get the Administration to approve the use of psilocybin in patients with mental health problems, as Australia already did. on July 1, 2023.
In the midst of this
the Center for Psychedelic and Consciousness Research at Johns Hopkins University continues to be the great reference.
It is hidden in a building on a campus east of Baltimore, where they carry out experiments on addictions, severe depression or anorexia and treat patients with Lyme or Alzheimer's disease.
An answering machine with countless options cuts off those who believe that the solution to their minor problems awaits there after reading an article like this or watching one of the documentaries that Netflix has dedicated to the subject (a platform on which they are almost a subgenre). .
One of the rooms where psychedelic drugs are administered at the Johns Hopkins University Psychedelic and Consciousness Research Center. Greg Kahn
Media attention is great: there are agencies like
with someone dedicated full time to the subject, and everyone wants to tell how the United States is embracing psychedelia for the second time.
“If we said yes to so many requests from reporters around the world, we would simply have to leave the rest behind,” psychologist Albert García-Romeu, who has worked in downtown Baltimore for a decade, said during a visit last November. .
“I think there is a lot of fashion in all this, like someone who signs up for the latest diet,” he added.
“This is how the world we live in works, in which the attention span is very short.
“When [psilocybin] is approved for medical use, it will seem less
and, I hope, the waters will calm down.”
This fashion that García-Romeu describes, together with the hopes that psychedelic therapy represents the first psychopharmacological innovation of mass reach since the emergence of Prozac in the nineties, caused that in 2022, according to official figures, 1.4 million Americans will consume for the first time these substances without medical supervision (27% more than in 2018).
The figure is similar to that of those who started smoking during that period.
That same year, the publication of the largest psilocybin study to date—carried out by the British company Compass Pathways, which, along with the American Usona Industries, is the firm best positioned to obtain FDA approval—guided the focus on adverse effects, including suicidal thoughts, among some of the patients taking the higher doses.
That served to give reasons to those who criticize the defenders of psychedelic therapy for minimizing the risks to prevent something from going wrong on the path to its legalization.
A path along which other obstacles loom, for example, the greed of the pharmaceutical industry and its subterfuges to patent substances and practices of ancestral use, the threat of trivialization that the phenomenal business of well-being represents, the possibility that the rosy conclusions of The preliminary studies are due in part to the demanding selection of patients or the risk that, due to their high price, these compounds end up helping only those in this country who can afford good insurance.
Mary Cosimano, therapist at the Center for Psychedelic and Consciousness Research at Johns Hopkins University in Baltimore. Greg Kahn
If the twenty scientists consulted in this report agreed on something, it is in warning that these drugs “are not for everyone” and that it is essential to take them with the necessary advice.
Also, so much expectation is not good, and many of those who go to them convinced that they will have a transformative experience may end up, at the very least, disappointed.
For now, the drug agency published a draft protocol for medical trials in June.
It aims to unify criteria before these substances can be administered in private clinics, such as those that have emerged in recent years throughout the country to provide ketamine-assisted therapy, a legal substance in the United States whose reputation suffered a setback when it was recently associated with the death of
actor Matthew Perry.
It is about ordering increasingly intense traffic and preventing therapists full of good intentions from doing more harm than good to patients.
It is also on the table to set limits on physical contact during sessions, to avoid cases of sexual abuse.
The relief of a pioneer
Three weeks before our visit to Baltimore, Roland Griffiths, founder and director of the Center for Psychedelic and Consciousness Research, had died at age 77 from colon cancer.
After helping hundreds of people deal with this anxiety, he was able to apply the story to himself when he was diagnosed with the disease.
The neuroscientist Frederick Barrett has succeeded him at the helm.
He, who received his doctorate with a thesis on the effect of music on the brain, explained his future plans in his office with a music-loving simile: “We will leave behind the Elvis model, with a charismatic leader, to move on to another more orchestral one.” symphonic, with the sum of brilliant individuals from a group of world-class experts of different interests.”
Barrett estimates that in the almost 25 years that the center has been open, they have administered nearly a thousand doses of psilocybin without incident to more than 500 people, who received between six and eight hours of prior therapy, in addition to the session itself, which It lasts as long as the effect of the drug lasts, around six hours, and the subsequent assistance to assimilate what has been experienced.
That part is what is known in jargon as “integration.”
“A deep connection is generated, in many cases very intimate, with the patients,” explained psychedelic therapist Mary Cosimano that day in Baltimore, a legend in her field and a strikingly empathetic woman, who turned the first five minutes of the interview into in an interrogation to better understand the reporter's state of mind.
She participated, along with Griffiths, Richards and Bob Jesse, another key name in the resurgence of psychedelia, in the trial at the beginning of the century that revived the medical use of hallucinogens.
“We had to keep it secret, we couldn't talk about the experiment when we got home with our families to prevent it from spreading, something like that would have been fatal,” recalls the therapist.
Gifts from volunteers given to guide Mary Cosimano, in her office at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, in Baltimore. Greg Kahn
The ritual in which he has participated so many times—the silent room, the mask, the headphones and the guide—is more or less the same as in the sixties, when Richards helped put together a musical playlist dominated by classical composers such as Brahms or Vivaldi which, updated, is still used.
“So, we believed in the need to have two therapists, a man and a woman, because of the representation of the maternal and paternal figures, and also because someone had to turn the record around,” Richards clarifies.
The idea of the couple was overcome, also due to a question of costs (labor is what makes these therapies most expensive), but the rest is still designed to avoid bad experiences by taking care of two basic concepts in the language of the psychonaut : the
(the consumer's mental state) and the
(the environmental conditions).
A conference in Denver
Last June, the Psychedelic Science 2023 (PS'23) conference, held in Denver, Colorado, a State that has taken the step with Oregon to decriminalize the possession of hallucinogenic mushrooms, was proof that the set and
to that psychedelic therapy takes the last step in its conquest of the
in the United States.
It was an event organized by MAPS, a non-profit organization that stands for the Multidisciplinary Association for Psychedelic Studies.
It was founded in 1986 by Rick Doblin, a lively and charismatic guy with a mission in life: to achieve the legalization of MDMA for the treatment of patients with post-traumatic stress disorder, for example, victims of sexual violence or war veterans.
Ecstasy is a synthetic drug that was introduced into psychiatric practice in the late 1970s by scientist Alexander Shulgin, who is credited with being the author of some 320 psychoactive compounds.
, as it is popularly known in the United States, where it was legal until 1985 and for a brief period two years later, also jumped over the laboratory wall and took over European dance floors around that time as part of rave culture
until the authorities ended up making it illegal for medical use.
One of the two legs of MAPS is a pharmaceutical company that, recently renamed Lycos after raising $100 million in investment, has completed the third and final phase of clinical trials and is approaching FDA authorization, which could arrive as soon as possible. like this year.
Access to one of the treatment rooms at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, in Baltimore (USA).
The event in Denver, which brought together, for $900 a ticket, some 12,000 participants in a convention center that hosted 477 talks on 11 stages, was opened by Doblin with a presentation in which he launched a provocative slogan: “For a free world of trauma in 2070″.
In a later interview he explained that he is not afraid to “err on the side of optimism.”
“Humanity is in crisis and I am convinced that psychedelics can help it significantly,” he added.
The heart of the event was a scientific conference in which the conclusions of clinical trials carried out by dozens of universities throughout the country and also by foreign entities were presented, such as Imperial College, London, another world reference, or the Center International for Education, Research and Ethnobotanical Services (ICEERS), which, based in Barcelona, is dedicated to “indigenous medicines” and has published a study on the potential of ibogaine to treat opioid addiction.
There were scenarios focused on the reform of drug policy and the opportunities of a business that moved around $4 billion in the United States in 2022 and that during the pandemic has already recorded the bursting of its first bubble.
Also, in the effects of microdoses of hallucinogenic substances, whose method – taking imperceptible quantities on alternate days, between 5% and 10% of a full dose – was popularized by another octogenarian pioneer, the psychologist James Fadiman, after learning that Hoffmann, the inventor of LSD, had practiced it for decades.
In a Zoom talk from San Francisco, Fadiman explained that since 2011 he has been documenting stories of people for whom microdosing has helped with anxiety or depression, although there is currently no consensus in the scientific community on these conclusions, for two reasons: because it is difficult to separate the effects of those who receive them from those who take placebo and because when people expect to benefit from a medication, they usually achieve it.
“Placebo is a manifestation of the body's natural ability to heal itself, so if microdosing doesn't actually do anything and you heal yourself... what's the problem?” asks Fadiman.
Another great focus of the Denver convention was directed at the traumas of veterans, a fundamental piece in the puzzle of the psychedelic rebirth.
Few things agree more between the two Americas than the debt owed to them.
Stories like the one that Amber Capone, the wife of a retired military man, shared in an interview in the lobby of a hotel in front of the Congress headquarters have convinced Republican politicians, such as former Texas governor Rick Perry, who participated in it, to support in deeply conservative states the legalization of psychedelics to ease the return home of their soldiers.
Albert García-Romeu, researcher at Johns Hopkins University.Greg Kahn
Marcus Capone belonged to the elite Navy Seals for 13 years, and was deployed seven times to Afghanistan and Iraq.
Upon graduation, his depression, anxiety, alcoholism, and irascibility devastated his family life: “It became an existential struggle,” his wife Amber remembers of him.
When they concluded that psychiatric treatments and antidepressants were not solving the problem, they decided as a last resort to try ibogaine in Mexico, a plant of African origin that takes the consumer on a demanding mental walk of about 12 hours.
“He came out of there a new man.
He didn't want anything to do with alcohol.
He was miraculous,” he adds.
The couple then decided to found an association to help others in their situation.
Looking like a blonde morning TV host, Capone didn't look like your typical psychedelic drug meeting attendee, but Denver really had everything.
The battered psychonauts mixed with newcomers eager for knowledge, as well as a wide range of enlightened people, more typical of the Burning Man festival than a scientific conference.
There were camouflaged FBI agents and politicians;
academics, therapists and so-called clandestine practitioners, who have been offering these treatments outside the law for decades.
The sum of the attention that these substances are receiving and the rigor in the criteria for participating in a clinical trial have made the guild of psychedelic counselors grow exponentially on the margins for a clientele that, many times, does more than solve a health problem. mental, seeks to have a significant experience, perhaps transcendental.
The most veterans, those who worked with these substances when there was not even the option of clinical trials at universities, generally have the respect of scientists.
“They have been accumulating enormous knowledge through practice for decades, and that knowledge should be used when these drugs are legalized,” considers Mary Cosimano, the guide at Johns Hopkins University.
For those who are new, inexperienced and in the worst cases attracted by the business or by fashion, it is more problematic for them to put their hand in the fire.
It took a couple of months to find someone who wanted to tell his story with a first and last name.
Jahan Khamsehzadeh finally did it by videoconference from Oakland.
He said that he has “celebrated about 500 ceremonies” and that he walks “the line that separates the surface [where he publishes books and participates in
and the underground [after all, he is dedicated to something that is currently illegal]” .
"I've studied a lot.
I don't feel like I do anything wrong, and I think the feds won't come after you unless you make a lot of money, or if you sell drugs.
Since I started this, I feel more confident with each passing week, because science supports us,” he says.
Khamsehzadeh, who charges “between $2,000 and $3,000 a session,” works with cocktails of substances that the FDA is unlikely to approve, although he believes he is prepared to surface “when the time comes.”
The Center for Psychedelic and Consciousness Research at Johns Hopkins University. Greg Kahn
Fadiman says that in the past he collaborated with the DEA and that an official clarified to him that there was no interest in pursuing the clandestine business of psychedelics.
'Why?' I asked him.
'There is no money there,' he told me."
Rahul Gupta, White House drug czar, confirmed in an interview in Washington that the priority of the Joe Biden Administration, which has decreed the forgiveness of all minor federal convictions for marijuana possession, is another.
In the midst of the fentanyl crisis, the largest drug crisis in the country's history, Gupta's commitment is to treat addicts "as sick people" and to avoid filling prisons with offenders for possession crimes.
How to Change Your Mind,
the book that has done the most to spread this resurgence - so much so that its author, Michael Pollan, has earned the nickname
- the essayist turned to clandestine practitioners to tell the story of the failure of the first wave. about psychedelia and how he was about to break the second one.
In a conversation in Denver, Pollan noted, however, his concern about the proliferation of “
underground therapists who take advantage of people.”
Regarding his role in the movement, he said that when he published his essay in 2018 he could not have guessed how much he was contributing to that renaissance.
“Something was about to change in the compass of culture;
I was just lucky enough to guess it before the pandemic hit and we all started looking for help,” he explained.
“We must also take into account our proverbial enthusiasm;
"When we Americans see a train passing we take it to the last station."
The writer spoke on the main stage of the conference, reserved for politicians, rockers (Melissa Etheridge), Hollywood actors (Willow Smith), podcast stars (Andrew Huberman) and other big names.
As big as that of American football star Aaron Rodgers, who recalled his “coming out” as a psychedelic user, when he recounted that he had participated in an ayahuasca ceremony.
Rodgers, who in 2022 brought the hallucinogenic concoction to homes across the country when he celebrated an important goal by forming a circle with his teammates and pretending to drink the concoction from imaginary bowls, argued that this experience had helped him improve his performance.
“The year before, 26
, four interceptions.
A good season,” he said.
“[I took] Ayahuasca, 48
five interceptions, best player in the league.
What do you say to that?”
[After his signing by the New York Jets, the
's last year , injured in his debut, has been rather forgettable].
The event also had a fair with 300 exhibitors, where venture capital investors walked and there were
laboratories that presented patents for new substances, psychedelic law firms, luxury travel agencies to go take mushrooms in Jamaica. or Costa Rica or companies that sell kits to grow mushrooms at home.
Against this backdrop, ethnopharmacologist Dennis McKenna, whose myth dates back to the trips he made to the Amazon in the early seventies with his brother Terence, a legendary psychonaut, lamented: “Unfortunately, psychedelics do not cure the disease of capitalism.” .
McKenna also warned of another of the contradictions of this second
: “Much of all this is borrowed from indigenous communities, and there is a long and shameful history of looting their drugs.
The white man arrives, takes the plants, synthesizes them and becomes a millionaire.”
At the congress, concern about the representation of indigenous peoples among the speakers and criticism of the extractive dynamics that is affecting the consumption of ayahuasca in the Amazon jungle or peyote, a cactus that grows in the deserts on the border between the United States and Mexico, were a persistent rumor that crowned Doblin's escrache during his last intervention, when a group of Protestants rebuked him.
This one, whom it was not possible
to hunt down
during the congress—he went from here to there followed by a television crew, and he was not the only one: according to the organization, 15 documentaries were filmed those days in Denver!—, defended himself a couple months later in a video conference interview from his home in Boston.
“We assume that they are expressing themselves from a position of deep pain that has been inflicted on them for centuries, but that was a scientific conference.
We have learned from indigenous peoples, but also from modern scientists.
I think that if we waited for those leaders to organize a conference like that, it would never have happened.
And, in particular, MDMA does not come from any plant.”
Simulation of psychedelic drug treatment at Sunstone Therapies in Rockville. Greg Kahn
A career psychologist, Doblin, who experimented with LSD in the seventies, decided to dedicate his life to ecstasy because “it is the kindest of psychedelics.”
“I am not dedicated to science, but to political science,” he clarifies.
“It is a substance with great potential to help people and is the easiest to sell in society.
“Who can deny help to combat trauma?”
He also clarifies that when the Administration gives it the green light it can be prescribed for other purposes under what is known in the United States as off
This is what happens with medicines when they are used for a purpose other than the original one.
“The nuance is that the insurers will not take responsibility in those cases.”
And it is an important nuance: a dose of MDMA that can be found on the street for a handful of dollars can cost, including therapy, up to $11,000 prescribed within a health system as savagely capitalist as the American one.
“I don't like that, but we also have to take into account the millions that we have invested in achieving FDA approval, and that has forced us to look for investors, investors who want profits,” warns Doblin.
“All in all, the amount is not that high if you compare it with the expenditure of years of psychotherapy.”
The same thing happens with psilocybin (and its comparison to the cost of chemotherapy).
Again, what makes the final bill more expensive is the labor of the sessions before, during and after taking the substance.
To complete the picture in that case, we must add the criticism of the pharmaceutical company Compass Pathways, whose representatives preferred to skip the Denver meeting to avoid reproaches.
“They tried to patent a production process that forced others to pay them to consume psilocybin.
A lot of people didn't like that,” according to Doblin.
Another challenge has to do with scale.
If these treatments are legalized, it will be more difficult to control who administers them and how, but also who receives them.
A recurring warning invites us to take into account that the funnel with which volunteers are selected is very narrow, and that patients arrive very well chosen, something that will be more complex when the hand is opened.
There is also curiosity to know how the great religions plan to react to substances that have been used for centuries as a source of mystical experiences.
After the Supreme Court ruling in 2006 that ruled in favor of freedom of worship for a sect in its desire to import ayahuasca for use as a sacrament, “psychedelic churches” have proliferated in the United States, with permission to celebrate those ceremonies.
Given this, Pollan asks: “Will Islam or Christianity see these substances as a threat to their authority and will they banish them from temples or incorporate them into their spiritual practices?”
The answer could lie in the conclusions of a study soon to be published, carried out by Johns Hopkins and New York universities with religious leaders who received high doses of psilocybin.
After all these questions, there is an effort by the psychedelic community to prevent the train from derailing by running too much.
It won't be easy, according to drug policy reform activist Adam Smith, who is often associated with a famous 1980s slogan, “the war on drugs is a war on us,” coined (he insists that in a collective creation process), to point out that decades of prohibition disproportionately impact minorities.
“The legalization of marijuana [allowed in 38 of the 50 States for medical use and in 24 for recreational use] is a good example that there are many ways to do it wrong.
We must closely follow the first mushroom decriminalization experiments in Oregon and Colorado, and learn from mistakes,” he warns.
Psychologist Bill Richards, perhaps because he has already witnessed a death and resurrection of psychedelic science, is not so worried.
“These substances,” he recalls, “have been in use since more or less the 5th century BC.”
“They emerge in the culture, they are suppressed, and they re-emerge.
Now the pendulum is returning them to the surface, but the best we can hope for is to educate the masses in their responsible and open employment.
If it goes wrong later, at least we will have tried.”
Of course, the United States seems willing to try a second time.
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