Illustration: Yehrin Tong/Retouching: Westmac
THERE’S an old joke in renewable energy circles: nuclear fusion is 30 years away, and always will be. This is slightly unfair, but it carries a whiff of truth. The breakthrough always seems tantalisingly close, yet never arrives.
If biomedicine has a nuclear fusion of its own, it has to be psychedelic medicine. Every few years, there is a surge in scientific interest followed by breathless proclamations of the long-awaited psychedelic renaissance. The story always follows the same arc: psychedelic therapy showed huge promise in the 1950s, was crushed by the establishment in the late 1960s and is now being revived by a group of fearless visionaries. In five years, 10 at the most, doctors will be routinely prescribing LSD, psilocybin, MDMA and other psychedelic drugs for a range of conditions.
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New Scientist has not been immune to the hype cycle. In 2005, we ran a feature-length article about the imminent revival of psychedelic therapy. At the time, there were promising early results for a range of conditions including PTSD, obsessive-compulsive disorder and end-of-life anxiety. “It may not be long before doctors are prescribing hallucinogens,” we said.
How long is long? Nearly 13 years on, none of these early trials has delivered on its promise.
The research goes on, however, and on the back of encouraging results from clinical trials and brain scans, scientists are again confidently asserting that psychedelics are on the verge of medical approval (see “Mind menders: how psychedelic drugs rebuild broken brains“).
“Scientists are again making confident assertions that psychedelics are on the verge of medical approval”
So is it really different this time? We cannot know the future, but there are a number of reasons to believe that psychedelic medicine really can break out of its ghetto and into the mainstream.
One is that the grey-suited establishment is more receptive than it was a decade ago. Back then, psychedelic research operated under a cloud, always scratching around for money and constantly butting up against onerous drug laws. But the times they are a-changin’, with money flowing from mainstream sources and noises emanating from the US Food and Drug Administration and others about loosening the regulatory straitjacket. Can it be a coincidence that the people now occupying positions of power lived through the acid, ecstasy and shroom-fuelled youth culture of the late 80s and early 90s?
More still needs to be done. The law remains excessively tight: psychedelics are still schedule 1 drugs, which means they have no acknowledged uses in medicine. The onus is on scientists to show conclusively that they do.
Some of the scientists also need to embrace the system rather than pushing against it. Talk to many a psychedelics researcher and it doesn’t take long to hear complaints of risk-averse funders and regulators. Enough. The outlaw-maverick pose was once an asset in this field; it is increasingly becoming a liability.
It may transpire that, as with so many drugs, the early promise melts away under the glare of full-scale clinical trials. Such is life in pharma research. What must not be allowed to happen is for these promising and much-needed drugs to fail for anything other than the purest of scientific reasons.
This article appeared in print under the headline “The long trip to the clinic”
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