It’s common knowledge that a substance abuse problem digs its claws very deep into a user, but perhaps what’s less known is the arsenal of treatment options available. From psychotherapy and acupuncture to exercise therapy and hypnosis, anything and everything has been used to try and heal an addiction. Some choose to fight fire with fire – by using illicit drugs for recovery. This method of treatment has drawn equal amounts criticism and curiosity for its risks and potential.
Using Medication in Treatment
The idea of using drugs as part of treatment is not new. Medications are used either in the form of aversion therapy (where they provide an unpleasant reaction to the drug, such as disulfiram making a patient nauseous when they ingest alcohol); craving reduction therapy (where they control the compulsion to drink or use drugs again); or replacement therapy (where legal drugs are used to provide a less addictive alternative to the original substance, such as heroin addicts being prescribed methadone to help wean them off the heroin).
Such treatment methods are considered mainstream enough that the National Institute on Drug Abuse explains that they help patients stop their consumption of drugs, stay in treatment and protect against relapsing after treatment.
Bill W. and LSD
While these substances (and methods) have been vetted by the mainstream health care community, other schools of thought are turning to unconventional means of helping patients overcome their addictions. Curiously, one of the first people to advocate this kind of drastic out-of-the-box thinking was the founder of Alcoholics Anonymous, Bill W., who believed that LSD could help remedy alcoholics of their depression and alcoholism itself.
LSD (Lysergic acid diethylamide) is a hallucinogen in the same category of drugs as PCP and peyote. It is colloquially known as acid. As a psychedelic drug, it has historically been used in religious and shamanistic rituals because of how it
alters a user’s senses, making them feel as though they are undergoing some kind of quasi-spiritual experience. In reality, LSD (and other hallucinogens) work by temporarily interfering with the brain’s neurotransmitters in the prefrontal cortex – the area of the brain that regulates mood, thought and perception, and that also plays a role in how addictive behavior is developed. This is made possible because psychedelic drugs have chemical structures similar to those found in neurotransmitters and can “replace” neurotransmitters that have been corrupted by drug and alcohol abuse. However, it is not recommended that individuals attempt to self-medicate using LSD.
LSD is not physically addictive, but it has a number of undesirable side effects, including anxiety, paranoia and delusions that can last for up to 12 hours.
‘A Shining Goal on the Positive Side’
Carl Jung, who developed what we today call analytical psychology, wrote to Bill W. to tell him that spiritualism held the key for treating alcoholism. Bill W.’s own struggles with alcoholism had seen him convert to Christianity, and he was fully on board with Jung’s point of view.
To that end, Bill W. started taking LSD with his colleagues and his wife. Similar to how the 12 Steps (devised by Bill W. himself) would espouse the concept of a higher power to guide recovering alcoholics to sobriety, he found that LSD’s psychedelic potency mimicked what he called “a shining goal on the positive side,” which would serve as an incentive for alcoholics to aspire to sobriety.
In 1957, Bill W. wrote to a science writer and philosopher and said, “I am certain that the LSD experiment has helped me very much,” citing a heightened appreciation for beauty and colors that his alcohol-fueled depression had dulled.
Nonetheless, Bill W. felt that the LSD itself wasn’t some kind of miracle cure that would solve the problem of alcoholism; instead, he said that the temporary insanity provided by an LSD trip would break through the mental walls that alcoholics build around themselves, to inspire them to leave their chemicals behind and experience the real thing.
In 1976, the British psychiatrist who invented the term “psychedelic” explained that alcoholics needed a spiritual component to their recovery, but since not all patients could have one, LSD would help.
Despite Bill W.’s enthusiasm for the idea, the AA fellowship disagreed with his suggestion of using LSD as part of their treatment program. Notwithstanding that LSD is not addictive, the dangers incurred by exposing recovering individuals to substances that cause anxiety and paranoia were considered heretical to the tenets of the program.
Even as Bill W.’s LSD experiment came to an end, the idea of using potentially dangerous drugs in recovery persisted. The Fix explains that discoveries in the understanding of how the brain works, as well as developments in the field of mental health as it pertains to drug addiction, have opened doors that we didn’t know existed. As we understand that our concept of “self” and identity comes from neurons, transmitters, receptors and pathways, and how they are corrupted by drugs, the unique effect that psychedelic drugs have on the neurochemistry of the brain have made some scientists reconsider their previously taboo nature.
The founder and president of the Multidisciplinary Association for Psychedelic Studies, which funds and researches studies of unorthodox drugs in legitimate medical uses, explained to The Fix that since addiction is a construct of mental health issues that involve denial and escaping problems, psychedelics can help because they bring issues to light in such a way that patients have no choice but to deal with them. The intensely strong sensations that some people feel to be religious in nature present the experience in a positive light – one that strengthens and comforts the addict.
Such treatments can improve mood, empathy, and openness; and for a patient with substance abuse problems, these changes might help them overcome their cravings, increase their motivations to stay clean, and ultimately help them stay clean. Participants in one limited trial reported having a greater sense of consideration for how their addictive behavior (smoking) was damaging themselves and the people around them. They felt they were able to make better decisions and felt less trapped by their past habits.
How is all this possible? Psychedelic drugs work on the receptors in the brain that are active when the patient is actively craving drugs. Brain imaging shows that drug use reduces blood flow to the brain regions that deal with higher executive functions, thinking, and emotional processing. Stimulating them, even with drugs like LSD and psilocybin, might help restore those regions to functioning status and even replace the craving for the drugs that caused the original damage.
Furthermore, psychedelic drugs act on the brain network that deals with daydreaming, self-reflection, and meta-referential thought – in other words, how we see ourselves. Psychedelic drugs subdue this network, which would normally be considered undesirable; however, for a patient struggling with depression and harmful thoughts of self-harm and substance abuse, psychedelics may arrest the negative thinking patterns that lead them to their addiction.
But one of the problems of using psychedelic drugs is their (relatively) short effect time of up to 12 hours. For a recreational user, 12 hours is a dangerously long period of time to be in an altered state of consciousness. Administering powerful drugs to a patient in recovery every 12 hours to keep them happy defeats the purpose of recovery.
One of the more controversial drugs to be used in this kind of treatment is MDMA. The drug (known in its full form as 3,4-methylenedioxymethamphetamine, and better known as Ecstasy or “Molly” in a derivative form) is infamous for its recreational use in nightclubs, but two side effects (the inducement of feelings of emotional closeness and connection) and even relaxation have put MDMA on the radar of alternative recovery methods.
Despite some researchers calling for “a dispassionate and open-minded debate” to examine the legitimacy of MDMA in psychotherapy, the idea has received significant pushback. A psychologist and MDMA expert at Swansea University spoke out against the United States Food and Drug Administration for greenlighting MDMA trials to treat post-traumatic stress disorder, saying that MDMA is incredibly potent, “neurochemically messy,” and potentially damaging.
MDMA works by causing the brain to release extra amounts of serotonin, a neurotransmitter that is responsible for causing feelings of well-being and happiness. This flood of serotonin also triggers the release of hormones associated with love and sexual arousal. A serotonin deficiency can lead to depression and vice versa.
Another neurotransmitter stimulated by MDMA is norepinephrine, which makes users feel very mentally alert and focused. The amphetamines in MDMA force norepinephrine into overdrive, putting users into a state of heightened consciousness where every sensation can be intense and possibly overwhelming.
Both the serotonin and norepinephrine stimulation (to say nothing of the dopamine stimulation) explain why MDMA is popular in the clubbing scene, with its loud music, vivid light, laser displays and emphasis on social togetherness and openness (either platonic or sexual).
In March 2015, the United States Drug Enforcement Administration approved the use of MDMA in a clinical trial to treat patients with “serious” illnesses. It’s a marked reversal from when the DEA placed MDMA on its list of Schedule I drugs in 1985, citing a nationwide problem from a drug that presented no legitimate medical use. The Multidisciplinary Association for Psychiatric Studies claimed that the tide has turned in psychedelic research, saying that while derivatives of MDMA (like Ecstasy and Molly) are still illegal and dangerous, “pure MDMA” was proven “sufficiently safe” when taken in moderate doses and a restricted number of times.
The DEA’s move was probably influenced by a study in the Journal of Psychopharmacology, which found that there was no link between psychedelic drugs and psychosis, other mental health disorders (such as schizophrenia, anxiety, or depression), and suicide. While individual cases of adverse events do occur, and while the addictiveness of certain psychedelics can be devastating, a study of 190,000 respondents found that people who used LSD or psilocybin had lower lifetime instances of suicidal thoughts and attempts. One of the study’s authors, an associated professor at Johns Hopkins University in Baltimore, said that the instances of negative mental health outcomes as a result of the consumption of psychedelic drugs were “rare,” and that any data that suggests psychedelics are harmful overstates the case.
‘Peace and Understanding’
If this trial is successful, it raises the possibility (and red flags) of further use of MDMA (and other psychedelics, like LSD) in treatment for alcoholism. Six LSD research trials conducted in the 1960s of over 500 people found that even one dose of LSD caused a 59 percent reduction in drinking six months after the intervention (the control group managed only 38 percent). Echoing Bill W., the professor of psychiatry at the Imperial College of London argued that treating alcoholism requires seismic changes to how a user perceives himself, and this is what LSD provides. However, the positive effects of LSD tend to wear off after some months, which would require continued administration of the drug and may lead to the possibility of the patients becoming dependent on LSD.
Similarly, psilocybin (the naturally occurring psychedelic compound in over 200 species of mushrooms) has also been tapped for its potential in treating alcoholics. The professor and vice-chair for Addiction Psychiatry and Clinical Research at the University of New Mexico oversaw a pilot study that combined psilocybin with psychotherapy and found that the stronger the patient’s response to the drug, and the more they reported quasi-spiritual experiences, the greater was their clinical improvement in terms of drinking and mental health. One study participant said that taking psilocybin simultaneously caused her deep emotional pain, but also pure joy. The dichotomy “brought [her] to a place of peace and understanding.”
The director of the alcohol and drug abuse program at Bellevue Hospital Center in New York City cautions that psychedelic drugs like LSD, MDMA and psilocybin are not “cures” for addiction; rather, they may act as a catalyst to make traditional therapeutic methods more effective. For all the transcendental and mystical experiences a patient may undergo, a lack of therapy fundamentals will not amount to long-term psychological insights or behavioral change.
Furthermore, even though psychedelic drugs do not have the addictiveness of some of the standard anti-anxiety medications administered during recovery (like benzodiazepines and methadone), the potency of hallucinogenic drugs does raise the possibility of their misuse, even in treatment and clinical settings.
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 “How Do Hallucinogens (LSD, Psilocybin, Peyote, DMT and Ayahuasca) Affect the Brain and Body?” (February 2015). National Institute on Drug Abuse. Accessed July 8, 2015.
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