Psychedelic trips may soon become a part of therapy; here’s how those sessions will look.

Investors are more open to the potential of psychedelic therapy, both in terms of mind and wallet.

Three biopharmaceutical companies have been publicly active in recent months in order to develop psychedelic medicines to treat mental health disorders:
Atai Life Sciences, backed up by Peter Thiel, was released in June and now has its market cap of $2.6 billion; MindMed was released in April and has a market cap of more than $1 billion; and Compass Pathways was released in November and has a market cap of nearly $1.5 billion.

A total of nine psychedelic treatment medicines are in the pipelines of the three companies.

Not to mention the work of many more private biotech & telemedical firms such as Gilgamesh Pharmaceuticals and Mindbloom, which are already treating ketamine-assisted patients.

(Ketamine is not a psychedelic; instead, it is a dissociating anaesthetic that can cause sight, colour, sound, ego and environment distortions.)

All this means that over the next two to five years, mind altering drugs like MDMA could become common for conditions ranging from, chronic pain and obsessive compulsive disorders and post traumatic stress disorder.

Here’s an example of what this might look like and what the research suggests.

How Psychedelic Therapy Works

Psychedelic medicinal products are psychoactive substances which change the perception, mood and various cognitive processes.
All of these are contemporary psychedelics known as MDMA, also known as “ecstase” or “molly,” LSD, psilocybine or “mushroom,” ayahuasca and ibogaine.

When used in conjunction with therapeutics, research has shown that psychedelics can contribute to treating previously difficult conditions, essentially by “reforming” the way in which “parts of the brain communicate,” according to Jennifer Mitchell, neuroscientist and professor in the neurology, psychiatry and behavioural departments of the University of California, San Francisco.

“Psychedelics facilitate treatment so that subjects can let go of previously afflicted issues,” she explains.

According to Mitchell, when young people are, their brains undergo critical learning and development periods that are shut down when they age.
According to her, researchers believe that psychedelics “open for a short time those closed critical periods.”

“You want to maximise the opportunity for positive change when this critical period reopenes,” she says.
For example, psilocybin increases brain connectivity and “neuroplastic states,” which refer to the brain being able to reorganise and adapt, according to Dr. Stephen Ross, a partner psychiatry professor at the Grossman School of Medicine, New York University, who has been conducting psilocybin-aided therapy clinical trials for sixteen years.

For example, a recent study at Yale University found that a single dose of psilocybin resulted in a one-month increase in neuronal connections.
When people take psychedelics, “sections of the brain that do not communicate normally begin to communicate,” he says.
“This seems to somehow reset brain patterns.”

‘This isn’t a burning man’

The FDA could approve medical therapy with MDMA by 2023, whereas other psychedelics, especially psilocybin, are waiting in the wings for medical evaluation.

If and when the FDA approves psychedelic therapy, it is much more complex and medical than just using mushrooms in the woods recreationally. “You don’t just get thrown into it,” Mitchell explains. “It’s not the same as Burning Man.

Patients must first be carefully screened in order to be eligible. “They are not for all,” says Corine de Boer, Chief Medical Officer of the Multidisciplinary Psychedelics Association, an educational and non-profit organisation. For example, people who have a history of psychosis or cardiovascular problems are not treatment candidates.

(Psychedelics are currently not tested on people with milder mental health or who are not clinically diagnosed.) According to de Boer, “psychedelic-assisted treatment sessions will be a synergy between participants, therapists and drugs.”

Before medicines are administered, medical professionals talk to patients about possible problems — for example, traumatic incidents or painful childhood memories — or how the disease affects their lives in terminally ill patients. Mitchell notes that psychedelic drugs may be quite laborious and lengthy during the sessions involving the patient (approximately eight hours).

A single MDMA dose lasts six hours, and a half dose takes about 90 minutes during the session. In order to offer patients an environment for a comfortable trip, providers create an area similar to a living room or bedroom, and before taking the drug, provide patients with eye shades and a soothing music playlist. Patients should “go in” and reflect on the topics discussed during preparatory sessions.

“The medicine, based on their history and [brain] circuits, determines what comes up to them,” explains Mitchell. Patients can discuss any topic and therapists can help them to accept and listen to whatever ideas surface, rather than to raise questions for them.
“There are numerous emotions, as you might imagine,” Mitchell explains.

Patients are conscious and can comfortably eat, drink and use the toilet, says Mitchell, though two staff are escorted when they are standing up or walking. The next day, there will be a ‘integration session’ during which therapists talk to the patient to help them understand their experience. The patient can first return to the reasons for seeking treatment and discuss their feelings or observations during the experience.

Mitchell asserts that there is a significant transformation when people take psychedelics in this clinical environment. “It’s unbelievable how much easier and lighter people seem to be after the first session,” she says. In fact, depression was alleviated or decreased significantly after three doses administered about a month apart in a recent MDMA study.

In future, health insurance is expected to cover these treatments. Insurance cover shall also depend on the rescheduling of compounds from their current Classification of Schedule I under the Controlled Substances Act. (Experts believe that in the next two years, MDMA will be reclassified.) There are obviously risks associated with treatment.

Hypertension and psychotic disorders are contraindications to psychedelic therapy.
Many psychedelics, such as psilocybin and MDMA, are classified under the Controlled Substances Law as Drugs in Schedule I other than clinical trials. But Ross maintains that psychiatry “will be profoundly modified in the next three to five years” with psychedelic-assisted therapy.