Abstract
Given the plethora of new studies and published papers in the scientific press and the increasingly emerging presence of articles about positive psychedelic experiences appearing in the popular media, there is little doubt that we are in the midst of a Psychedelic Renaissance. The classical psychedelic drugs LSD and psilocybin and the entactogen MDMA are showing promise as tools to assist psychotherapy for a wide range of mental disorders, with multiple pilot studies demonstrating their safety and efficacy. In this article, the author describes how MDMA in particular has inherent characteristics that make it well suited for assisting trauma-focused psychotherapy in a population of patients who have experienced child abuse. But despite these advances, there remain many obstacles ahead of the widespread mainstream acceptance of psychedelic medicines. The author argues that the Misuse of Drugs Act 1971 is one such obstacle. Other impediments include a prevailing attitude of pseudoscience and rigidity from within the non-scientific psychedelic community itself. Resolution of these conflicts must be sought if medicine and society are to see psychedelics gaining a place in mainstream culture and science.
References
Advisory Council on the Misuse of Drugs (1998) Drug misuse and the environment: a report by the advisory council on the misuse of drugs. Stationary Office, London
Balsa C, Vital C, Urbano C (2013) III Inquérito nacional ao consumo de substâncias psicoativas na população portuguesa 2012: Relatório Preliminar, vol 59. CESNOVA – Centro de Estudos de Sociologia da Universidade Nova de Lisboa, Lisboa
Bogenschutz MP, Forcehimes AA, Pommy JA, Wilcox CE, Barbosa PC, Strassman RJ (2015) Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. J Psychopharmacol 29(3):289–299
Brady KT, Back SE, Coffey SF (2004) Substance abuse and posttraumatic stress disorder. Curr Dir Psychol Sci 13:206–209
Brunner D, Hen R (1997) Insights into the neuro-biology of impulsive behavior from serotonin receptor knockout mice. Ann N Y Acad Sci 836:81–105
Carhart-Harris RL, Erritzoe D, Williams T, Stone JM, Reed LJ, Colasanti A, Tyacke RJ, Leech R, Malizia AL, Murphy K, Hobden P, Evans J, Feilding A, Wise RG, Nutt DJ (2012) Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. Proc Natl Acad Sci U S A 109(6):2138–2143
Carhart-Harris RL, Murphy K, Leech R, Erritzoe D, Wall MB, Ferguson B, Williams LTJ, Roseman L, Brugger S, Meer D, Tanner M, Tyacke R, Wolff K, Sethi A, Bloomfield MAP, Williams TM, Bolstridge M, Stewart L, Morgan C, Newbould RD, Feilding A, Curran HV, Nutt DJ (2014) The effects of acutely administered MDMA on spontaneous brain function in healthy volunteers measured with arterial spin labelling and BOLD resting-state functional connectivity. Biol Psychiatry 78(8):554–562
Carhart-Harris RL et al (2015) The effects of acutely administered 3,4-methylenedioxymethamphetamine on spontaneous brain function in healthy volunteers measured with arterial spin labeling and blood oxygen level-dependent resting state functional connectivity. Biol Psychiatry 78(8):554–562
Carhart-Harris RL, Bolstridge M, Rucker J, Day CM, Erritzoe D, Kaelen M, Bloomfield M, Rickard JA, Forbes B, Feilding A, Taylor D, Pilling S, Curran VH, Nutt DJ (2016a) Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. Lancet Psychiatry 3(7):619–627. doi:10.1016/S2215-0366(16)30065-7 Epub 2016 May 17
Carhart-Harris RL, Muthukumaraswamy S, Roseman L, Kaelen M, Droog W, Murphy K, Tagliazucchi E, Schenberg EE, Nest T, Orban C, Leech R, Williams LT, Williams TM, Bolstridge M, Sessa B, McGonigle J, Sereno MI, Nichols D, Hellyer PJ, Hobden P, Evans J, Singh KD, Wise RG, Curran HV, Feilding A, Nutt DJ (2016b) Neural correlates of the LSD experience revealed by multimodal neuroimaging. Proc Natl Acad Sci U S A 113(17):4853–4858
Chabrol H, Oehen P (2013) MDMA assisted psychotherapy found to have a large effect for chronic post-traumatic stress disorder. J Psychopharmacol s27(9):865–866
Conway KP, Compton W, Stinson FS, Grant BF (2006) Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 67(2):247–257
Cozzi NV, Sievert MK, Shulgin AT et al (1999) Inhibition of plasma membrane monoamine transporters by beta-ketoamphetamines. Eur J Pharmacol 381:63–69
Curran HV, Travill RA (1997) Mood and cognitive effects of ±3,4--methylenedioxymethamphetamine (MDMA, ‘ecstasy’): week-end ‘high’ followed by mid-week low. Addiction 92(7):821–831
Danforth AL et al (2017) MDMA-assisted therapy: a new treatment model for social anxiety in autistic adults. Prog NeuroPsychopharmacol Biol Psychiatry 4(64):237–249
Doblin, R. (2017) Personal Communication
Doblin R, Greer G, Holland J, Jerome L, Mithoefer MC, Sessa B (2014) A reconsideration and response to Parrott AC (2013) “Human psychobiology of MDMA or ‘Ecstasy’: an overview of 25 years of empirical research”. Hum Psychopharmacol 29(2):105–108. doi:10.1002/hup.2389
EMCDDA (2002) Early warning system http://www.emcdda.eu.int/policy_law/joint_action_nsd/early_warning_system.shtml
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2014) Data and statistics. http://www.emcdda.europa.eu/
Ferry F, Bolton D, Bunting B, Devine B, McCann S, Murphy S (2008) Trauma, health and conflict in Northern Ireland: a study of the epidemiology of trauma related disorder and qualitative investigation of the impact of trauma on the individual. The Northern Ireland Centre for Trauma and Transformation and the Psychology Research Institute, University of Ulster
Foa EB, Keane TM, Friedman MJ, Cohen JA (2009) Effective treatments for PTSD, practice guidelines from the International Society for Traumatic Stress Studies, 2nd edn. Guilford Press, New York
Froese T, Woodward A, Ikegami T (2013) Turing instabilities in biology, culture, and consciousness? On the enactive origins of symbolic material culture. Adapt Behav 21(3):199–214
Gamma A, Buck A, Berthold T, Liechti ME, Vollenweider FX (2000) 3,4- Methylenedioxymethamphetamine (MDMA) modulates cortical and limbic brain activity as measured by [H(2)(15)O]-PET in healthy humans. Neuropsychopharmacology 23:388–395
Gasser P (1995) Psycholytic therapy with MDMA and LSD in Switzerland. Newsletter of the Multidisciplinary Association for Psychedelic Studies MAPS 5(3):3–7
Gasser P, Holstein D, Michel Y, Doblin R, Yazar-Klosinski B, Passie T, Brenneisen R (2014) Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. J Nerv Ment Dis 202(7):513–520
Greer G (1985) Using MDMA in psychotherapy. Advances: Journal of the Institute for the Advancement of Health 2(2):57–59
Greer, G. (2017) Personal Communication
Greer G, Tolbert R (1986) Subjective reports of the effects of MDMA in a clinical setting. J Psychoactive Drugs 18(4):319–327
Greer G, Tolbert R (1990) The therapeutic use of MDMA. In: Peroutka SJ (ed) Ecstasy: the clinical, pharmacological and neurotoxicological effects of the drug MDMA. Kluver Academic Publishers, Boston, pp 21–36
Griffiths RL, Johnson MW, Carducci MA, Umbricht A, Richards WA, Richards BD, Cosimano MP, Klinedinst MA (2016) Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: a randomized double-blind trial. J Psychopharmacol 30(12):1181–1197
Grob C, Chopra AL, Danforth MC, Hagerty CR, McKay ALH, Greer GR (2010) Pilot study of psilocybin treatment for anxiety in advanced-stage cancer patients [with G.S.] Arch Gen Psychiatry 68(1):71–78
Harris DS, Baggott M, Mendelson JH, Mendelson JE, Jones RT (2002) Subjective and hormonal effects of 3,4- methylenedioxy-methamphetamine (MDMA) in humans. Psychopharmacology 162(4):396–405
Health and Social Care Information Centre (HSCIC) (2016) Statistics on smoking. Health and social care, England
Home Office (2007) Drug misuse declared: findings from the 2006/07 British Crime Survey. UK government, UK
Hoskins MD, Pearce J, Bethell A, Dankova L, Barbui C, Tol WA, van Ommeren M, de Jong J, Seedat S, Chen H, Bisson JI (2014) Pharmacotherapy for post-traumatic stress disorder: a systematic review and meta-analysis. The British Journal of Psychiatry Feb 206(2):93–100
Hughes, C. E. and Stevens, A. (2012) op. cit., p. 107; data for year 2012 taken from Instituto da Droga e da Toxicodependência (2013), op. cit., p. 64
Huxster JK, Pirona A, Morgan MJ (2006) The sub-acute effects of recreational ecstasy (MDMA) use: a controlled study in humans. J Psychopharmacol 20(2):281–290
Hysek CM, Domes G, Liechti ME (2012) MDMA enhances “mind reading” of positive emotions and impairs “mind reading” of negative emotions. Psychopharmacology 222:293–302
Hysek CM et al (2013) MDMA enhances emotional empathy and prosocial behavior. Soc Cogn Affect Neurosci 9(11):1645–1652
Jahannes JA (1987) Substance abuse and the legacy of racism. J Natl Med Assoc 79(5):473–475
Jerome, I. (2017) Personal Communication
Johnson MW, Garcia-Romeu A, Cosimano MP, Griffiths RR (2014) Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. J Psychopharmacol 28(11):983–992
Kessler RC, Sonnega A, Bromet E et al (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52:1048–1060
Khoury L, Tang YL, Bradley B, Cubells JF, Ressler KJ (2010) Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population. Depression and Anxiety 27(12):1077–1086
King, L. (2011) Evidence based policy? Why banning mephedrone may not have reduced harms to users. https://profdavidnutt.wordpress.com/2011/09/19/evidence-based-policy-why-banning-mephedrone-may-not-have-reduced-harms-to-users/
Krebs TS, Johansen P-Ø (2013) Psychedelics and mental health: a population study. PLoS One 8(8):e63972 https://doi.org/10.1371/journal.pone.0063972
Krupitsky EM, Grinenko AY (1997) Ketamine psychedelic therapy (KPT): a review of the results of ten years of research. J Psychoactive Drugs 29(2):165–183
Lavelle A, Honner V, Docherty JR (1999) Investigation of the prejunctional alpha2-adrenoceptor mediated actions of MDMA in rat atrium and vas deferens. Br J Pharmacol 128:975–980
Lee A, Hankin BL (2009) Insecure attachment, dysfunctional attitudes, and low self-esteem predicting prospective symptoms of depression and anxiety during adolescence. Journal of Clinical Child and Adolescent Psychology : The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53(38(2)):219–231
MAPS (2016) MDMA Investigational Brochure. http://www.maps.org/research/mdma/mdma-research-timeline/104-other-mdma-resources/5400-mdma-investigator-s-brochure-and-fda-annual-report&Itemid=485
Maté G (2012) Addiction: childhood trauma, stress and the biology of addiction. Journal of Restorative Medicine 1(1):56–63(8)
Mikulincer M, Shaver PR (2012) An attachment perspective on psychopathology. World Psychiatry 11(1):11–15
Mithoefer, M (2017) Personal Communication
Mithoefer MC, Wagner TM, Mithoefer AT, Jerome L, Doblin R (2011) The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. J Psychopharmacol 25(4):439–452
Mithoefer MC, Wagner MT, Mithoefer AT, Jerome L, Martin SF, Yazar-Klosinski B, Michel Y, Brewerton TD, Doblin R (2013) Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependence after 3,4-methylenedioxymeth- amphetamine-assisted psychotherapy: a prospective long-term follow-up study. J Psychopharmacol 27(1):28–39
Moreno FA, Wiegand CB, Taitano EK, Delgado PL (2006) Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry 67(11):1735–1740
Nash JF, Roth BL, Brodkin JD et al (1994) Effect of the R(−) and S(+) isomers of MDA and MDMA on phosphatidyl inositol turnover in cultured cells expressing 5-HT2A or 5-HT2C receptors. Neurosci Lett 177:111–115
NCCMH (2005) Post-traumatic stress disorder: the management of PTSD in adults and children in primary and secondary care, vol 26. Gaskell and the British Psychological Society, London Clinical guidelines, CG26 - Issued
Netherlands Institute of Mental Health and Addiction (NIMHA) and the Ministry of Security and Justice Research and Documentation Centre (MSJRDC) (2012) The Netherlands drug situation 2011: report to the EMCDDA by the Reitox National Focal Point. Netherlands Institute of Mental Health and Addiction and the Ministry of Security and Justice Research and Documentation Centre, Netherlands, p 40 Table 2.1.1
Nichols DE (1986) Differences between the mechanism of action of MDMA, MBDB, and the classic hallucinogens. Identification of a new therapeutic class: Entactogens. J Psychoactive Drugs 18(4):305–313
Nutt D, King LA, Saulsbury W, Blakemore C (2007) Development of a rational scale to assess the harm of drugs of potential misuse. Lancet 369(9566):1047–1053
Oehen P, Traber R, Widmer V, Schnyder U (2013) Pilot study of MDMA-assisted psychotherapy for treatment-resistant PTSD. J Psychopharmacol 27(1):40–52
Office for National Statistics (ONS) (2015) Crime in England and Wales: year ending march 2015. ONS, UK Government
Office of National Statistics (ONS) (2014) – Alcohol related deaths in the United Kingdom: Registered in 2014)
Parliament of the United Kingdom (1971) An Act to make new provision with respect to dangerous or otherwise harmful drugs and related matters, and for purposes connected therewith. (AKA 'The Miususe of Drugs Act 1971). 1971, c38
Pirona A, Morgan MJ (2010) An investigation of the subacute effects of ecstasy on neuropsychological performance, sleep and mood in regular ecstasy users. J Psychopharmacol 24(2):175–185
Pudney S, Badillo C, Bryan M, Burton J, Conti G, Iacovou M (2006) Estimating the size of the UK illicit drug market. In: Singleton N, Murray R, Tinsley L (eds) Measuring different aspects of problem drug use: methodological developments, 46–85, Home Office online report 16/06. Home Office, London
Rolles S (2010) An alternative to the war on drugs. BMJ 341:c3360. doi:10.1136/bmj.c3360
Room R, Rehm J, Trotter RT, II, Paglia A, Üstün TB (2001) Cross-cultural views on stigma, valuation, parity and societal values towards disability. In: Üstün TB, Chatterji S, Bickenbach JE, Trotter RT, II, Room R, Rehm J, Saxena S (eds) Disability and culture: universalism and diversity. Hogrefe & Huber, Seattle etc, pp 247–291
Ross S, Bossis A, Guss J, Agin-Liebes G, Malone T, Cohen B, Mennenga SE, Belser A, Kalliontzi K, Babb J, Su Z, Corby P, Schmidt BL (2016) Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol 30(12):1165–1180
Royal Society for Public Health (RSPH) (2016) Taking a new line on drugs. RSPH, UK
Schifano F, Oyefeso A, Webb L, Pollard M, Corkery J, Ghodse AH (2003) Review of deaths related to taking ecstasy, England and Wales, 1997–2000. BMJ 326:80–81
Scott RM, Hides L, Allen JS, Lubman DI (2013) Subacute effects of ecstasy on mood: an exploration of associated risk factors. J Psychopharmacol 27(1):53–61
Sessa B (2011) Can MDMA enhance trauma-focused psychotherapy? Progress in Neurology and Psychiatry 15(6):4–7
Sessa B (2017a) MDMA and PTSD treatment: PTSD: From novel pathophysiology to innovative therapeutics. Neurosci Lett 649:176–180
Sessa B (2017b) The psychedelic renaissance, 2nd Edition. Chapter 10 edn. Muswell Hill Press, London
Sessa B, Nutt DJ (2007) MDMA, politics and medical research: have we thrown the baby out with the bathwater? J Psychopharmacol 21:787–791
Streeck-Fischer A, van der Kolk B (2000) Down will come baby, cradle and all: diagnostic and therapeutic implications of chronic trauma on child development. Aust N Z J Psychiatry 34(6):903–918
Substance Abuse and Mental Health Services Administration (SAMHSA). (2010). Results from the 2009 National Survey on Drug Use and Health: Volume II. Technical Appendices and Selected Prevalence Tables (Office of Applied Studies, NSDUH Series H-38B, HHS Publication No. SMA 10-4586Appendices). Rockville, MD, p. 99, Table G.2, and p. 101, Table G.4
Thompson MR, Callaghan PD, Hunt GE, Cornish JL, McGregor IS (2007) A role for oxytocin and 5-HT(1A) receptors in the prosocial effects of 3,4 methylenedioxymethamphetamine (“ecstasy”). Neuroscience 146(2):509–514
Towne CH (1923) The rise and fall of prohibition: the human side of what the eighteenth amendment has done to the United States. Macmillan, New York, pp 159–162
Transform Drug Policy Foundation (TDPF) (2009) A Comparison of the Cost-effectiveness of Prohibition and Regulation of Drugs
van Ours J (2001) Is cannabis a stepping-stone for cocaine? Centre for Economic Policy Research, London
Vollenweider FX, Gamma A, Liechti M, Huber T (1998) Psychological and cardiovascular effects and short-term sequelae of MDMA (“ecstasy”) in MDMA-naive healthy volunteers. Neuropsychopharmacology 19:241–251
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Sessa, B. The 21st century psychedelic renaissance: heroic steps forward on the back of an elephant. Psychopharmacology 235, 551–560 (2018). https://doi.org/10.1007/s00213-017-4713-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00213-017-4713-7