How Does Psychedelic Therapy Work?

What Is Psychedelic Therapy?

Psychedelic therapy is a technique that involves the use of psychedelic substances to aid the therapeutic process. Hallucinogenic substances have been used in holistic medicine and for spiritual practices by various cultures for thousands of years.

Research on the use of psychedelics flourished during the 1950s and 1960s until such substances were made illegal in the United States. While psychedelic drugs such as LSD and psilocybin are still illegal in the U.S., they are believed to have the potential to treat a range of conditions including anxiety, depression, and addiction.

Over the last two decades, researchers have gotten approval from authorities to conduct trials on the use of these substances to treat various conditions. For example, researchers have found that psilocybin is not only safe but that it can produce significant positive effects on well-being.

When utilized under supervision in a carefully controlled setting, research shows that some psychedelic substances can produce lasting and significant psychological and behavioral changes.

Types of Psychedelic Therapy

There are a number of different types of substances that can have psychedelic effects. Some common psychedelic substance and their uses include:

• Ayahuasca: This brew originating in South America is purported to help with addiction, anxiety, and depression. Possible side effects of Ayahuasca include serotonin syndrome and medication interactions.
• LSD: Lysergic acid diethylamide (LSD) can lead to altered mood, perception, and consciousness. Potential uses include the treatment of addiction and anxiety.
• Psilocybin: Like LSD, psilocybin alters consciousness, mood, and perceptions. It is being studied for its use in the treatment of addiction, anxiety, and depression.
• MDMA (ecstasy): While not a classic psychedelic substance, MDMA (also known as ecstasy) is a drug that produces “psychedelic effects” including feelings of euphoria, altered perceptions, increased arousal, and increased sociability. Research suggests it has therapeutic potential in the treatment of post-traumatic stress disorder (PTSD).

Techniques

Because there is no standardized method of administration and practice, individual practitioners have their own methods for administering psychedelic therapy. However, there are often a few common elements:

• Administration of a low to moderate dose of a psychedelic drug
• Supervision by a professional during the psychedelic experience
• Repeating the psychedelic dose with one to two weeks between sessions

During a psychedelic session, factors known as set and setting are critical. Set refers to things such as mood and expectations. Setting refers to the environment where the session takes place and the relationship with the therapist. The goal is to be comfortable with the therapist and the room where the session will take place. It is also important for patients to go into the experience feeling calm and attentive.

After the psychedelic experience, the focus at the next step is a process known as integration. These psychotherapy sessions are designed to help the individual process, make sense of, and find meaning in the psychedelic experience.

Microdosing

One variation of psychedelic therapy is known as microdosing, which involves taking very small, sub-hallucinogenic doses of psychedelic substances. Proponents of microdosing suggest that even these very low doses can have beneficial health effects such as enhancing performance, increasing energy, and decreasing depression.

While there is some evidence that microdosing may have some beneficial effects, more research is needed.

What Psychedelic Therapy Can Help With

Researchers have uncovered a number of potential applications for psychedelic therapy. Studies have found that anxiety, depression, substance use, alcohol use, and PTSD may all respond positively to psychedelic-assisted treatments.

• Anxiety and mood disorders: Psychedelics appear to have potential mood benefits that may be helpful in the treatment of depression. A 2016 randomized double-blind controlled trial found that psilocybin treatment led to significant reductions in anxiety and depression in patients undergoing cancer treatment.
• Alcohol and substance use disorders: Early research showed strong evidence that LSD could help in the recovery from substance use conditions. Some more recent evidence also supports the idea that psychedelic therapy holds promise as an addiction treatment.
• Post-traumatic stress disorder (PTSD): Research also suggests that MDMA-assisted psychotherapy may be useful in the treatment of post-traumatic stress disorder (PTSD). MDMA is best known as the main ingredient in the club drug ecstasy (or molly), but it also has psychedelic effects that have been shown to be useful for severe forms of PTSD that have not responded to other forms of treatment.

Benefits of Psychedelic Therapy

Psychedelics are powerful substances that can produce profound mind-altering effects. These drugs are believed to work by affecting the neural circuits that use the neurotransmitter serotonin. Some of the potential benefits of these substances include:

• Feelings of relaxation
• Improved sense of well-being
• Increased social connectedness
• Introspection
• Spiritual experiences

It is important to remember that while psychedelics can produce positive benefits, it is also common for people to experience effects such as:

• Altered sense of time
• Distortions of reality
• Distorted perceptual experiences
• Intense perceptions or emotions
• Paranoia
• Seeing, hearing, or sensing things that one would otherwise not experience

According to the National Institute on Drug Abuse (NIDA), these effects are a type of drug-induced psychosis that affects a person’s ability to communicate with others, think rationally, and interpret reality. When used in a therapeutic setting where a trained professional can help a person understand and integrate these experiences, psychedelic therapy has the potential to help relieve the symptoms of certain psychiatric conditions.

After taking psychedelic substances, some people report having mystical or spiritual experiences. They may describe having feelings of peace, joy, unity, and empathy.

One study published in the Proceedings of the National Academy of Sciences suggests that the mood improvements induced by psychedelic drugs also appear to have lasting benefits. People who took psilocybin continued to experience improved well-being and increased social connectedness even after the substances wore off.

Effectiveness

Psychedelic therapy shows a great deal of promise in the treatment of a wide variety of mental health conditions including addiction and depression. While further research is needed, current trials are underway to better determine the applications and effectiveness of using different psychedelic drugs to treat specific conditions.

Anxiety and Mood Disorders

Psilocybin-assisted therapy was also associated with increased quality of life, improved optimism, and reduced anxiety over mortality. About 80% of participants continued to show improvements six months later.

Another study looked at the effects of real-world psychedelic use by surveying music festival attendees. The participants reported that taking LSD and psilocybin helped improve mood and feel more socially connected. They also reported that these effects continued even after the drugs had worn off.

Alcohol and Substance Use Disorders

A 2015 study found that psilocybin-assisted therapy was associated with decreased drinking, reduced alcohol cravings, and increased abstinence. Psychedelic therapy’s efficacy for alcohol and substance use has not yet been clearly established, however. One 2012 study found that a single dose of LSD had a beneficial effect on alcohol misuse up to six months after treatment, but the effects were not significant at the 12-month mark.

One 2019 study involved surveying people who had already quit using alcohol with the use of psychedelics. While only 10% of the respondents used psychedelics intentionally as a way to reduce alcohol use, more than 25% reported that the hallucinogenic experience played a role in changing their alcohol use.

It is important to note, however, that studies such as this are based on self-reports by people who have taken psychedelics in the past. In order to determine if psychedelic therapy is truly effective in the treatment of alcohol and substance use disorders, more research using randomized clinical trials is needed.

Post-Traumatic Stress Disorder

Clinical trials have demonstrated the treatment’s long-term efficacy in the treatment of PTSD. One study found that 54% of participants no longer met the criteria for diagnosis following treatment. Only 23% of participants in the control group no longer met the diagnostic criteria upon follow-up.

The benefits also appear to be long-lasting: 68% of those in the MDMA-assisted therapy treatment did not meet the diagnostic criteria for PTSD a year after treatment.

Things to Consider

While psychedelic therapy is generally considered safe and is well-tolerated, there are some potential risks and adverse effects to consider. The classic psychedelics such as LSD and psilocybin pose few risks in terms of physical or psychological dependence along with other risks such as the following.

Negative Psychological Reactions

The potential for negative psychological reactions such as the symptoms of anxiety, panic, and paranoia is something to consider. The use of psychedelics can also result in what is known as a “bad trip.” These experiences are marked by intense and terrifying feelings of anxiety and the fear of losing control.

Possible Personality Changes

Some have suggested that these drugs have the potential to produce long-term mind-altering, personality-changing effects. For example, one study found that psilocybin therapy was associated with increases in extroversion and openness. These findings suggest that people may become more outgoing and willing to try new things after being treated with psilocybin-assisted therapy.

Dangers of Self-Treatment

Another potential concern is the possibility of people using psychedelic substances to self-treat. Self-treatment can pose a number of risks including the psychological dangers of experiencing a bad trip, the possibility of drug interactions, and the fact that many street drugs are mixed with unknown and potentially harmful substances.

The effects that a person experiences with psychedelic substances can be unpredictable and can vary depending on the amount of the substance that is used as well as the individual’s personality, mood, and surroundings.⁵

How to Get Started

In 2019, the Food and Drug Administration (FDA) named psilocybin-assisted therapy as a “breakthrough therapy.” This designation is designed to speed up the development and review of drugs that preliminary clinical trials have indicated treat serious conditions.

Currently, clinical trials into the use of LSD and psilocybin as treatments for alcohol dependence, anxiety, and depression are underway

If you are interested in trying psychedelic therapy, signing up for a research trial is an option. You can search for clinical trials that are recruiting participants through the National Institute of Health (NIH). The Multidisciplinary Association for Psychedelic Studies (MAPS) and the John Hopkins Center for Psychedelic and Consciousness Research may also sponsor research and trials that are accepting participants.

Never try to self-treat with psychedelics. In clinical settings, people are given a specified, pure dose, are supervised during the psychedelic experience, and receive professional help from a therapist to integrate the experience.

It is also important to note that while psychedelic therapy has demonstrated that it can be helpful in the treatment of a number of conditions, researchers are still exploring the exact mechanisms of action. Further research will allow scientists to figure out which drugs are most helpful for specific conditions, what doses should be used, and when such treatments should be avoided.