Psychedelic Medicine

Contemporary Outview on Psychedelics
Complementary Outview

Renaissance of an ancestral medicine

For thousands of years, hallucinogens have been used as an important part of healing rituals all over the world. Their use goes back to human history. Unfortunately, the moralizing war on drugs, that emanated from the US in the 1960s, has made further exploration and dissemination within the western world very difficult. The studies that still have been carried out with special permission did not attract much attention in the mainstream until recently. Since 2020, the healing potentials of psychedelics are finally being seriously discussed in public again. Not only through the people who return with new life perspectives from a trip to a shamanic ceremony, but also in news articles, talk shows and Netflix documentaries. In addition, there is a massive increase in the number of scientific publications,1 no longer just by researchers from leading universities in Europe (Zurich, Basel, London, Amsterdam or Barcelona) and the the United States.

From a substitution based to a transformative approach

We owe it to the big crisis in psychopharmacology, that public debates and research have become possible again. The pharmaceutical industry is increasingly helpless these days, facing an increasing number of psychologically and neurologically ill people with drugs for mental disorders, that have barely developed further in the past 50 years. An independent meta-study found that traditional substitution based psychotropic drugs are as effective or as ineffective as their placebos across all users. Sometimes the doctors then prescribe several preparations next to each other (political toxicology). As in a blind-cow game, they then look for the pharmacological levers that reduce the suffering of their patients. This must not be misunderstood. The medication helps patients survive in major crises and sometimes buys important time. However, they are expensive, have many side effects and only help for a short time or until the dosage is changed. But the biggest problem is: you don’t solve the root cause of the problem.

With psychedelics, the paradigm is shifting away from substitution-based drugs, which specifically intervene in the biochemical process of the symptoms of a disease, towards a so-called transformation-based approach, in which the triggered self-experience plays a greater role. Whereas psychotropic drugs are added to compensate an obvious deficiency (e.g. of serotonin), hallucinogens do not necessarily respond to a specific disease diagnosis. The research takes mental illnesses into account and tries to treat them. However, it focuses on positive life concepts as change mechanisms for long-term healing. The paradigm can be found in positive science, which deals with positive human functioning and thriving on multiple levels that affect the biological, personal, relational, institutional, cultural and global dimensions of life. Psychedelics trigger an experience that indirectly improves the symptoms of a wide variety of diseases. And this clearly. As one of the studies from Nature describes, 1 to 3 ingestions already reduce the symptoms of difficult-to-treat patients with anxiety disorders over several months, without triggering undesirable side effects at the same time. In addition to curing anxiety disorders, the effectiveness has been proven above all for depression, traumatic stress disorders and addiction disorders.

Classification and definition

The group of psychedelics (or hallucinogens) includes the phenethylamines, the tryptamines, deliriants and dissociativa. In addition to the group of psychedelics, the graphic below also shows the groups of stimulants, anti-psychotics (tranqualizers) and depressants (sedatives) for a complete overview.

Psychedelics are known for evoking inner images and pseudo-hallucinations. Hence the term: hallucinogens. However, it is not the case that all the substances listed in the diagram under hallucinogens evoke internal images after ingestion. For example, this does not apply to the phenethylamines MDMA or 2CB. In European-speaking countries, psychedelic substances that do not evoke inner images are often referred to as entactogens or empathogens. This delimitation is not found in the American and Latin American language areas. The terms entactogen or empathogen are used here for all substances that touch the inside of a person (Greek en, “inside”, Latin tactus “touched”) and thus synonymous with the terms psychedelics and hallucinogen.

I would like to address another form of classification that is also related to the effect. Psychedelic substances can be of purely plant origin, ie “plant-based”, on the other hand they can be “non-plant-derived” and artificially synthesized. Psilocybin, mescaline, and DMT, for example, come naturally. Psilocybin is found in many types of mushrooms (such as magic mushrooms), mescaline in many cacti in Central and South America (e.g. in the San Pedro or in the peyote cactus) and DMT occurs naturally in plants as well as in humans and animals. A synthetic simulation of the connections is possible, however. MDMA or LSD, for example, are always produced in the laboratory (non-plant-derived). This is confusing because the artificial production of compounds can actually be based on plant raw materials (biosynthesis).

Psychotropic Drugs
Psychotropic Substances with Psychedelic Medicine (Hallucinogens)

Measurable effects

The specific effect of psychedelics is mainly achieved by stimulating the 5-HT2A receptor in the brain2 The resulting processes are complex, firstly because different substances can cause the opposite via the receptor, and secondly because it influences different functions in different types of cells. Basically, the effect runs via the serotonin system and the vagus nerve to the organs such as the heart, lung or digestive tract. It is assumed that it intervenes here to regulate the vegetative nervous system. In patients with chronic complaints and autoimmune diseases, relief of problematic symptoms is observed shortly after ingestion.

Furthermore, the substances induce a change in consciousness, which is responsible for the change in self-perception as well as for the perception of inner images, the so-called pseudo-halicunations3 The consumer’s experiences are measured with a series of questionnaires. Many of the questionnaire scales that achieve significant results in psychedelic research come from the domain of meditation research or are very similar to it. Important constructs, which are measured with further questionnaires beyond the experiences on the day of the meeting, are well-being, empathy, prosocial behavior or cognitive flexibility.

The biological processes that contribute to or cause changes in the disorder symptoms can also be observed and described over the course. That is what is done in the large-scale registration studies to learn about contraindications as well as risks and side effects. This is particularly important for later use in groups of people with paranoid and bipolar disorders, where the use of psychedelic medicine is still described as risky today.

Psychedelic markets

For a long time, psychedelic research was disreputable and inefficient. The high costs for clinical approval and efficacy studies that have become necessary, were potentially counterbalanced only with a small revenue. That is because many of the hallucinogens are plant-based or for other reasons no longer simply patentable for profitable pharmaceutical sale.4

The new ongoing revolution was sparked with the power of many individuals, who have had a profound healing experience with psychedelics themselves. They have one initiated the reversal trend through organizations like MAPS. MAPS was able to raise enough money to register and conduct its own initial studies. With great expectations for the coming era of effective mental therapies, a handful of new biotech companies now joined the race. These include Compath Pathways from England, Mindmed from Canada or ATAI from Germany. They bring hundreds of millions of dollars from the pockets of financially strong investors and from their own IPOs to develop and test new substances. Here is an overview from ATAI of some ongoing programs.

The evolution of psychedelic markets does not stand alone on the feet of western capitalism and its synthetic psychedelic derivatives. Fortunately, the revolution is also being driven by companies that are committed to upholding ceremonial traditions and cultures following ethical guidelines such as the Northstar. This include the financial participation of indigenous communities, who reveal the wisdom for proper substance application.5.

More important will be the contribution of the non-profit organizations and the many independent researchers, who continue to commit themselves to research and use of near-natural and natural (plant-based) psychedelics.

Hallucinogens can make us aware of the connection to our own and the nature around us. That goes for any type of hallucinogen. But for the indexing of this experience, plant-based hallucinogens have a quality of their own. What difference this natural spirit has in the transformative healing process, will have to be answered in the future. It is to hope however, that the treatment of substances in therapies and in the markets, in which they are produced and sold, will become part of a western culture, that remains connected to tradition and nature.

  1. See Forstman and Sagioglou []
  2. For some substances, the 5HT2C and the σ1 receptor also play an important role. []
  3. Today the images are described more precisely with the term pseudo-hallucinations, because the consumer is always aware of the unreal origin of these images remains. []
  4. Ketamine was researched and approved in the 10s. However, this is no exception. Ketamines can only be produced synthetically and were patentable. Johnson & Johnson sells the substance approved today under the brand name Spravato for $ 599 generic product in roughly the same pack size (50 mg) costs $ 11.99. []
  5. Journey, for example, has a 35% stewardship business model []