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Sunday, September 25, 2022

Where research and legalization efforts stand – Santa Cruz Sentinel

When Ian McCall retired in 2018, at age 34, from a 16-year career in mixed martial arts, he dedicated himself to a new kind of fight.

He wanted relief from the depression and anxiety that had plagued him since he was growing up in Dana Point, where he was known as a bully, a gang member and a self-proclaimed “savage.” His initial mental health issues had been compounded over the years by personal traumas and brain injuries that McCall sustained from a snowboarding accident and years in the octagon.

He’d sought refuge in oxycontin, fentanyl and cocktails of other substances. At times McCall contemplated suicide, once going so far as putting a loaded gun in his mouth.

But today, two years into his retirement, the Mission Viejo resident says he’s found solace. He’s off painkillers. He says his mental health issues are “in check,” and he no longer struggles to accomplish simple tasks. Most importantly, he said, “I don’t want to kill myself anymore.”

The improvement, he says, has come from his controlled embrace of psychedelics.

In this, McCall is not alone.

Psychedelics — everything from ayahuasca, a psychoactive brew with Amazonian origins, to psilocybin, the mind-altering compound produced by more than 200 species of mushrooms — are at the center of the kind of burgeoning image and legal makeover most recently seen in America’s relationship with cannabis.

Though psychedelic drugs remain illegal under federal law, and in most states, a handful of cities across the country have decriminalized psilocybin. Oregon on Nov. 3 became the first state to decriminalize all drugs, while voters also approved a measure that will legalize and regulate psilocybin for therapeutic use in special clinics.

There’s a push to do the same in California. Both a revived ballot measure and promised legislation from State Sen. Scott Wiener, D-San Francisco, could open access to hallucinogenic mushrooms and perhaps other psychedelics in the Golden State within the next two years.

“I think we should fast track it,” said Del Potter, a medical anthropologist who’s studied use of psychoactive plants in Latin and South American cultures.

“These really seem to be game-changing in terms of being able to make real difference in people’s lives.”

Many medical experts who study psychedelics also believe they hold promise in treating a wide variety of conditions, with minimal risks of side affects or addiction.

That includes Alan Davis, a clinical psychologist and professor at Johns Hopkins University School of Medicine who specializes in psychoactive drug research. Still, while he supports decriminalization, Davis warns against creating a commercial market and he urges caution on rushing into even a supervised therapeutic model like the one Oregon is creating.

“I think that there is a potential for people who are not trained well to deliver a treatment that has the potential to harm someone,” Davis said.

Long and rocky history

The idea that psychedelics might free the mind and heal the soul is far from a new concept. Many cultures around the world have used psychoactive plants in rituals and ceremonies for millennia.

The practice gained favor in the West in the early 1950s, as psychiatrists experimented with using hallucinogenic mushrooms, newly discovered LSD, and other psychedelics to treat patients for a range of mental health issues. Hundreds of scientific papers from the era suggested psychedelics could be useful in helping people overcome everything from alcoholism to trauma.

But in the 1960s the federal government began clamping down on LSD and other psychedelics. And most scientific work was officially squelched in 1970, when President Richard Nixon signed the Controlled Substances Act. That law classified psilocybin alongside heroine as a schedule I drug, the most restrictive category of drugs said to have a high risk of addiction while containing no medicinal value.

“That act did not fit even the current evidence at the time,” Davis said. “But the legislature just decided not to listen to that.”

Scientists in Europe and the United States started to study psychedelics again in the 1990s, kicking off a second wave of research that’s now grinding into high gear. While American scientists have to jump through major hoops to do trials with schedule I drugs, studies have continued to show psilocybin can help treat conditions such as obsessive compulsive disorder and tobacco addiction.

Some of the most promising research suggests psilocybin might be of use to address various forms of depression.

Davis and his team recently published results of a randomized clinical trial using psilocybin to treat 24 patients suffering from major depressive disorder. After hours of psychotherapy, they gave patients synthetic psilocybin. Patients sat on a couch in a room with pleasant music playing while two experts monitored them throughout the eight-hour “trip.” Davis’ team then followed up with those patients to assess the results.

More than two-thirds of those patients reported reductions in their symptoms and 54% remained in remission a month later. Those outcomes, Davis said, are about four times better than most legal antidepressants.

“It represents an opportunity for real healing unlike things we’ve seen before,” Davis said.

Compass Pathways, a London-based biopharma company, is close to starting phase three of clinical trials into using synthetic psilocybin to ease treatment-resistant depression. The study could be wrapped up by the end of 2021, with the company hoping to secure Federal Drug Administration approval for the first psilocybin-based drug.

Other studies are looking at how psilocybin might be used in issues ranging from anorexia to Alzheimer’s to opiate abuse.

How psilocybin works

Psilocybin has both biological and psychological effects on the brain.

As with many pharmaceutical antidepressants, it elevates levels of serotonin, a chemical messenger that regulates mood, sleep, appetite, sex drive and more. But psilocybin also strengthens and makes new connections between different parts of the brain. Potter said those connections make the brain more elastic, so we can see beyond our regular routines and immediate struggles.

That’s tied to the harder-to-explain psychological, and often spiritual, impacts of psilocybin.

Potter relayed a story of a friend who’d been highly allergic to cats. While that friend was under the influence of psilocybin, a cat jumped into his lap. Potter said the friend told himself he wasn’t allergic to cats anymore, and said the friend never had symptoms again.

While the science can’t yet explain such changes, Davis said there are anti-inflammatory benefits to psilocybin, with inflammation tied to allergies. The placebo affect also can be very real, where the brain can convince the body something is true.

Psilocybin and other psychedelics generally aren’t recommended for people who are schizophrenic or suffer other borderline personality disorders, Davis said, since they can trigger those conditions. But he said psilocybin shows virtually no signs of creating physical addiction. The biggest risk seems to be having a “bad trip,” or what insiders prefer to call a “challenging experience” — which can become dangerous if people haven’t been properly prepared and aren’t monitored by a trained professional while they’re under influence.

“But challenging doesn’t always mean bad,” Davis said, with intense experiences often tied to breakthroughs during any form of therapy.

One of the patients in Davis’ study, for example, experienced a vision of getting buried alive over and over again. Eventually, the patient came to realize the hands burying him were his own. That helped him finally accept that he has control over his life. Davis said the patient went from being suicidal for a decade to being in remission from depression.

While the patients in Davis’ study took large doses, there’s a growing trend toward microdosing psilocybin. In that model, people take the drug regularly but in doses small enough that they can go about their normal day.

Jackie McGowan, a longtime cannabis activist from the Bay Area, said soon after she started microdosing psilocybin earlier this year, police raided the Oakland “church” where she was getting her mushrooms. She was devastated, since she was experiencing relief from severe depression and a longtime tobacco addiction. The church soon reopened, but McGowan said the incident drove home for her the importance of making sure psilocybin is readily accessible.

Legalization efforts gain steam

With high interest in finding new ways to address mental health conditions, plus a sweeping push for an end to the war on drugs, many cities and states are eyeing decriminalization and regulation of psychedelics.

Denver was the first city to tell its cops to deprioritize psilocybin crimes with a ballot measure in May 2019. Oakland, Santa Cruz and Ann Arbor, Mich. followed suit through city council votes, with Washington, D.C. voting to join the ranks Nov. 3.

Oregon on that day also set in motion a plan in which by 2023 people could use psilocybin in open clinics. In this model, certified specialists will provide psilocybin doses that would be taken under observation.

So far, Griffen Thorne, a Los Angeles-based attorney who works with businesses interested in getting into this space, said the federal government hasn’t interfered into any of these city or state programs. He expects this area of law will be treated much like cannabis, which remains illegal at the federal level though states are now largely allowed to set their own rules regulating use and sales.

State Sen. Wiener said he plans to introduce a bill when the legislature reconvenes in January that would make it no longer a crime to possess psychedelics.

Decriminalization California, a campaign that aims to also create a commercial market for psilocybin, failed to get the signatures needed to qualify for the Nov. 3 ballot. The team is ready to try again for 2022, said campaign spokesman Paul Antico. But Antico said they’re meeting with Wiener’s team this week in hopes of encouraging him to introduce three bills: one to decriminalize all drugs, one to support psychedelic research and one to create a commercial market for psilocybin.

McCall believes there’s big money to be made in psychedelics. He’s started a new career as a psychedelic integration coach, where he’s trying to help top MMA fighters and special forces soldiers find relief. He said a Canadian company is interested in his formulations of certain mushroom strains. And he plans to open a psychedelic sports institute on a 40-acre farm he owns near Desert Hot Springs.

Though he’s interested in the industry, McCall speaks about psychedelics like a preacher, with a reverence that’s as close to religion as the self-proclaimed “proud pagan” gets.

“This whole thing is going to save humankind and the human condition and make us all better people and love each other like we’re supposed to be doing.”

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