Psychedelic Pharmacology

Clarence Darrow famously said: "I have never killed a man, but I have read many obituaries with great pleasure." It's likely that Dr. John Halpern experienced a similar kind of schadenfreude on hearing of Timothy Leary's death in 1996.

For those of you too young to remember him as anything other than Uma Thurman's godfather, Leary was a renowned academic who launched the now infamous Harvard Psilocybin Project. The research project, which Leary developed in partnership with Richard Alpert (later known as Ram Dass), used psychedelics to facilitate "life-altering spiritual insights" in alcoholics and convicted criminals.

Today the idea of using hallucinogens for medicinal purposes sounds highly unorthodox. But in the early '60s, when Leary's project got underway, many psychologists were optimistic about their curative powers. Few of them, however, dipped into the product as often as Leary.

Leary's rampant drug use eventually got him dismissed from Harvard. Unfazed, he renounced the academic life and became the leading proselytizer for psychedelic self-actualization. In this role, he inspired countless hippies to "expand their consciousness" by engaging in such spiritually revelatory activities as dropping acid and watching Fantasia. You and I might find this cute. The medical establishment did not.

Thanks to Leary, the use of psychedelics in medical research became taboo. And John Halpern thinks that's a crying shame. "That man screwed it up for so many people," Halpern said of the late visionary.

Halpern's interest in psychedelics was spawned by a conversation he had with one of his medical school mentors in the early '90s. He was growing increasingly frustrated with his inability to help his alcoholic and drug-dependent patients:

He sounded off to an older psychiatrist, who mentioned that LSD and related drugs had once been considered promising treatments for addiction. "I was so fascinated that I did all this research," Halpern recalls. "I was reading all these papers from the 60s and going, whoa, wait a minute! How come nobody's talking about this?"

(Psychedelic Medicine)

The more he researched, the more incensed he became. There was a stockpile of evidence suggesting that hallucinogens were a singularly effective means of treating people in the grips of addiction, according to Halpern. But Leary's legacy had left psychiatrists so gun shy; no one wanted to touch it. Halpern is one of a growing number of iconoclastic psychiatrists who are bent on changing that. And if they have their way, pharmacists will soon be dispensing as much Ecstasy as they are Prozac.

If you think he's part of a fringe movement, think again. Halpern is the associate director of Harvard University's McLean Hospital substance abuse program. (Yup, he's picking up where Leary left off. He, however, seems less inclined to raid the hospital pharmacy when things get dull.) To Halpern, hallucinogens are a serious business. He truly believes in their medicinal potential and he's collected enough evidence to convince the FDA he's right.

In February 2005, the FDA agreed to let Halpern prescribe MDMA (Ecstasy) to terminal cancer patients. And he's working on getting permission to use LSD to treat sufferers of cluster headaches. But these are just baby steps--strategic maneuvers designed to get the medical establishment comfortable with the idea of using psychedelics in a psychiatric setting. In the long run, he hopes to get the go ahead for a study, which would evaluate the use of drugs like LSD, psilocybin, and DMT, in treating addiction. Some evidence suggests that the "profound insights and cathartic emotions" spurred by these drugs can reduce drug cravings. Many contend that this is the result of "after glow," but Halpern suspects that there is also a biochemical component.

Halpern is just one of a vanguard of psychiatric researchers around the world who are investigating the therapeutic potential of hallucinogens. Psychiatrist Francisco Moreno, of the University of Arizona, is testing psilocybin as potential treatment for sufferers of obsessive-compulsive disorder. Michael Mithoefer, a South Carolina doctor, is conducting a clinical trial to evaluate the use of MDMA in ameliorating post-traumatic stress disorder. A Russian psychiatrist by the name of Evgeny Krupitsky has administered ketamine(Special K) to upwards of 300 heroine addicts and alcoholics with good results.(66 percent of the alcoholics Krupitsky treated with Special K in one of his studies remained clean for a year or more after their session, while only 24 percent of the non-ketamine imbibers stayed sober.)

Charles Grob, a UCLA Medical Center psychiatrist, headed up a 1996 study of the psychological and physical effects of ayahuasca, a DMT-rich drug historically used by shamans in the Amazon. Uniao do Vegetal (UDV), a Brazilian church, administers ayahuasca as a sacrament. Grob studied UDV churchgoers to determine the long-term effects of ayahuasca. What he found was startling:

UDV members who regularly took ayahuasca were on average physiologically and psychologically healthier than a control group of non-worshippers. The UDV followers also had more receptors for the neurotransmitter serotonin, which has been linked to lower rates of depression and other disorders.

(Psychedelic Medicine)

Studies like these have convinced many psychiatrists that it's time to take a second look at psychedelics. Risk-adverse pharmaceutical companies, however, are in no rush to sink money into hallucinogen-based drug development. And it's hard to imagine that changing any time soon.

While I'm intrigued by the idea of using psychedelics as an alternative form of therapy, I'm also skeptical. Given the option, I'm not sure I'd choose a 12-hour foray into an LSD-induced parallel universe over a cluster headache. That might change, however, if I got my hands on the new synthetic compound designed to "induce transcendent experiences as reliably as LSD . . . but with a greatly reduced risk of a bad trip." (The Third Culture)