The coming years might bring a revolution. No, I’m not talking about social upheaval aimed at righting centuries of racialized inequities, open inter-class warfare as the windfalls of eye-popping government stimulus packages accrue to those who needed it least, or agitation felt following a mass migration precipitated by rising seawaters. Instead, I’m talking about a mental health revolution spurned by the updating of North American laws with respect to psychedelic substances. With this piece I aim to share:
- Some thoughts on the mental health crisis we are facing, the depth and breadth of which, I believe, will grow as a result of the COVID-19 pandemic.
- Some resources to learn more about how certain substances might help treat depression, anxiety, PTSD and end of life care.
- Some recent developments, mostly regulatory in nature, impacting this space.
By using the terms “psychedelic substances” or “psychedelic medicine”, I’m referring to the wide array of mental state altering compounds including psilocybin (think magic mushrooms), LSD, DMT and, even though it’s not considered a classic psychedelic per say, MDMA. I’m not an expert and there is plenty of debate about the proper categorization of these substances, but so we’re on the same page, this is how I am using the terms.
Disclaimer: I’m not a doctor, nor an investment advisor.
The Impending Crisis
I’ve been slow to grasp the challenge presented by mental health. Indeed, I am fortunate to have enjoyed a trauma-free youth, to lead an active lifestyle which includes much social interfacing, and to be unburdened by genetic pre-dispositions to debilitating chemical imbalances. In short, although I know people who suffer, my appreciation for their suffering is generally without meaningful first-hand experience. Now, after being confined for long stretches to my (admittedly) comfortable home for the past 10 months, I feel more sympathetic to the experience of those who suffer than ever before. Many similarly situated friends and family have expressed a similar shift in perspective. None of us suggests that we are clinically depressed, suffering from PTSD or combatting crippling anxiety. However, the general current is that our veneer of invincibility has been pierced.
In this vein, I expect that the lockdown measures which have been adopted by many Western governments since March to combat COVID-19 will, once the dust settles, have dealt a blow to the mental well-being of their citizens. Humans aren’t designed to be separated from spontaneous interpersonal contact. While confined to our homes, humans don’t cease our quest to make sense of the world around us. We are constantly consuming information and folding that stimulus into the mental models that we have previously constructed. New information does one of three things: reinforces understanding (thereby cementing expectations for the future), challenges comprehension, or nothing. Over the past year, the mediums which provide such new information have become incredibly limited in scope and exist fundamentally differently from those we are, at least historically, most accustomed to. Further, and most crucially for the purposes of this writing, social media and Zoom calls are not a substitute for first-hand experience with the physical world.
Now, we could dive deep into social media’s role, writ large, in providing a window of connection to the broader world during a time in which many of us have ordered an Uber Eats delivery of a Starbucks Americano to our front door. But I don’t need to. We all watched The Social Dilemma this fall and so we’re on the same page.
The bottom line is that any person who had, whether claimed or genuine, exquisite mental health at the start of 2020, surely cannot suggest they haven’t, to some degree, been shaken.
In sum, before the onset of the pandemic, there was a mental health crisis. Now, as result of the pandemic, I think the demand and need for solutions to address mental health problems in North America over the coming years will soon grow to be one that we can no longer ignore. Society will soon be starved for solutions and governments, at least Western ones, will feel pressure to deliver them.
Upon this foundation, I think we will experience a revolution in psychedelic medicine as a tool to assist in the fight against mental illness.
Now before we wade too deeply into territory I know nothing about – mental health – let’s pivot to something I know equally little about – psychedelics substances. That’s right, I don’t profess to know much, but I’ve recently read books and listened to podcast interviews and it’s piqued my interest as topic worth exploring. I don’t have more to say other than recommending the following:
- Read or listen to the audiobook of How to Change Your Mind by Michael Pollan (kooky title I know). The book is an approachable, well-researched and compelling account of the promise of psychedelic medicine to treat addiction, depression , etc.
- Listening to one of these podcasts:
- Tim Ferriss and Michael Pollan on his above mentioned book
- Joining this Slack channel hosted by Microdose HQ
- Researching any of these public companies who are working to develop and/or commercialize products:
At present, psychedelic substances are effectively outlawed in Canada and the US. However, there are signs that the attitudes of North American governments with respect to psychedelic substances is beginning to shift.
Over the past year alone, the following policy shifts have occurred:
- Oregon legalized psilocybin derived from mushrooms for use in therapy
- For the second time in a year, the US Food and Drug Administration granted “breakthrough therapy” status to an organization to run a clinical trial into psilocyn’s potential to treat sever treatment residence depression
- The Canadian government granted legal exemptions to a series of healthcare specialists to use psilocybin in certain circumstances
- Researchers raised $30 million to fund research focuses on MDMA-assisted psychotherapy to treat victims of PTSD
While none of these developments is a proverbial breakthrough (even despite the FDA’s nomenclature), there are at least two reasons to believe that opposition to the use of psychedelic substances may continue to thaw. First, an initial loosening of restrictions should enable increased investment into clinical research. Such research, if it leads to enhanced understanding of the impact, efficacy and pitfalls of these substances, would better equip policymakers to make informed decisions which, if the research favours greater adoption of certain substances in the treatment of mental illness, could beget more thoughtful laws with respect to the substances. Second, the societal cost of failing to take steps to solve a looming mental crisis are high. There is an increasingly, unignorable need to act and the only thing that is certain, in my mind, is that maintaining the hyper restrictive approach which has characterized North American policy since the 1970s, doesn’t best serve our citizens. Failure to at least permit the exploration of psychedelic substances as a tool to heal and rejuvenate mental well-being is a missed opportunity.
I believe there is opportunity hidden within psychedelic substances. If used thoughtfully in controlled ways and circumstances and subject to medically rigorous oversight, more widespread adoption of their potential is a revolution that should be welcomed. If nothing else, it’s an interesting and exciting topic to follow. Listen to podcast. It could be a trip.