From The Times

August 23, 2008

Can illegal drugs help depression?

Ketamine for depression and LSD for improving brain power; meet the lady who funds the science that no-one else will do, Amanda Feilding is on a mission to unlock the secrets of the mind

Arran Frood

Many people will enjoy some yoga or meditation this weekend. Both practices have proven health benefits, but for some people knowing that it works is never enough. They have to know why it works - what is really happening in the brain - and they will stop at nothing to find out, even if it means initiating and funding the research themselves.

Amanda Feilding is one of those people. Last week she started an investigation that will examine the changes in blood flow during meditation, and how this prompts states of relaxation.

But this is just one of Feilding's curiosities. Also known as Lady Neidpath, Feilding is not a scientist, but spends a six-figure sum of her own money each year to explore the inner workings of our mind: how we think; where creativity comes from; and how we can harness this knowledge. Through her charitable trust, the Beckley Foundation, she instigated the first scientific trial in 35 years to use LSD on human subjects. Based in Beckley Park, the Oxfordshire estate where Feilding has spent all her life, the foundation's remit is to push for drug policy reform and fund research that will delve into the altered states of consciousness induced by meditation, deep breathing and powerful psychoactive drugs such as LSD. Even trepanning, the ancient practice of drilling a hole in the skull, is a line of modern inquiry as a treatment for Alzheimer's. It is research that - in the UK at least - no one else appears willing to back.

"We are on the verge of making real breakthroughs," she says.

Why would an English Lady want to spend her money on high-risk projects with poor-to-zero financial returns? Feilding's fascination with consciousness started at an early age. Interested in spirituality through her Roman Catholic upbringing, she was sent aged 16 to India to visit her godfather, a Buddhist monk. She went on to study mysticism and comparative religion at Oxford University and dabbled with drugs throughout the Sixties. But her interest in the medical applications of such substances sprung from a friendship with Albert Hofmann, the Swiss scientist who invented LSD, and who pushed for the medical benefits of the drug to be investigated. Hofmann died this year aged 102, shortly before the foundation published his last book, Hofmann's Elixir: LSD and the New Eleusis, a collection of his essays and lectures.

Feilding realised that there was no research at UK universities into hallucinogens, so she started her own. "The best way to go was to set up a foundation, get an impressive board of top scientists to see if we can get some research going," she says. "We are very tunnel-visioned in our view of consciousness. We tend to direct our vision to technical advances, like things that have got us to the Moon," she says. It would be easy to label her as merely a well-heeled old hippy, but for some years she has been networking with scientists, ministers, drug czars, and other academic intelligentsia. Her board of advisers includes top international names, such as Colin Blakemore, former head of the UK Medical Research Council, and Mike Trace, her co-director of the Beckley Policy Programme, who worked at the United Nations Office on Drugs and Crime until 2003.

She rates one of her most rewarding achievements as kickstarting a paper that reassessed the relative harms of legal drugs alongside prohibited substances. The paper, published in The Lancet, grew out of Beckley Foundation seminars in 2003 and 2004. It caused a stir: of the 20 drugs, alcohol was the fifth most dangerous, ketamin sixth, and MDMA (Ecstasy) the third least dangerous. Heroin and cocaine were ranked first and second most dangerous.

Research is beginning to bear fruit

Although active for more than five years, the Beckley Foundation is only now showing signs of success. Last year it scored a serious hit: the first permission to use LSD with human subjects in a scientific context in 35 years. The study - at a secret institution in the US - is investigating the effects of LSD on the brain chemistry underpinning consciousness and how it might modulate the creative process. "The study of consciousness is so central to our happiness, survival and creativity, it's a mistake not to explore scientifically the potential benefits this compound might yield," says Feilding.

Another Beckley-funded study to monitor blood flow in the brain using functional magnetic resonance imaging (fMRI) in people under the influence of LSD is also poised to begin in Europe. Micro-doses of LSD might increase blood flow in some parts of the brain, as has been noted in its chemical cousin psilocybin (the active ingredient in magic mushrooms).

Tracking the changes as participants undergo cognitive tests could reveal how the brain completes complex tasks, hopefully providing insights into how we can boost brain power.

"To deny science a valuable tool like psychedelics is just myopic. It's ignoring a good possibility to learn more about the brain, our master tool, and how these substances can be used as an aid in psychotherapy."

Cannabis will also come under the microscope. Dave Nutt, a neuropharmacologist at the University of Bristol, will use brain-imaging techniques to measure the biological basis of the marijuana "high". No one understands why some users find cannabis appealing, and in some it provokes the opposite reaction: anxiety. Because cannabis has potential as a medicine for conditions such as multiple sclerosis, but is not well tolerated by many people, clinicians want to find out why such reactions occur. The brain scanner experiments may reveal whether different parts of the brain are activated.

Another study at the Institute of Psychiatry, King's College London, will compare the effects of two of the principal components of cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD). The ratio between the two chemicals in the cannabis plant is thought to affect whether users experience a pleasurable high or the cosmic heebie-jeebies. This is a first in the UK - previous research has been limited only to the direct medical applications.

"We need to overcome taboos"

Research using psychedelic drugs has a chequered history around the world. Many studies conducted in the Fifties and Sixties that reported benefits were not properly controlled and lacked adequate follow-ups. Feilding knows this, but points out that methodology and technology have improved, particularly in areas such as brain-imaging techniques.

"In a scientific age we need to give scientific explanations to overcome taboos," she says. She will also be working with University College London on a study into the antidepressant effect of ketamine, a medical anaesthetic growing in popularity at clubs and parties.

Scientific philanthropy is not common in the UK. But Robin Murray from the Institute of Psychiatry, King's College London, says that private funding is certainly welcome for studies that governments shun. And although Professor Murray doubts that hallucinogens will have direct therapeutic benefits, he says that understanding their neurochemical effects will help us better to understand mental illness. "Derivatives and drugs based on changing their molecules may well have benefits."

And in one of the most controversial studies, Feilding is collaborating with a Russian neurophysiologist, Yuri Moskalenko, in studies into cerebral circulation and age-related decline in cognition. Incredibly, measures to counteract progressive senility could include trepanation: drilling a small hole into the skull, an operation that has been performed for perhaps thousands of years. The theory goes that releasing the pressure in the cranium by trepanation can increase cerebral circulation and prevent age-related cognitive decline.

Harriet Millward, the deputy chief executive of the Alzheimer's Research Trust, says there is no conclusive medical evidence that trepanning improves brain function. However, the procedure has been understudied so far and until further research has been undertaken the possibility of beneficial effects remains open.

Feilding stresses that her work is not designed to promote drug use; she is aware of the destructive effect they can have on people's lives. She is interested simply in investigating the medical benefits of such substances, in a controlled and safe environment.

"What motivates me is that I feel it's an area where one can contribute a real benefit to humanity," she says.

HISTORY OF DRUGS

3,000BC Cannabis is cultivated in China and Asia. Evidence of cannabis smoking in Eastern Europe

1800s Laudanum, a cordial containing opium, becomes hugely popular. Coleridge and Keats are fans

1874 A British scientist isolates heroin from morphine

1880 Doctors start to use cocaine as an anaesthetic in surgery

1903 Cocaine is substituted with caffeine in Coca-Cola

1912 MDMA, later known as Ecstasy, is synthesised by pharmaceutical company Merck

1916 Harrods withdraws gift packs for soldiers at the front that contain cocaineand morphine

1955 UK bans heroin import, export and manufacture

1952 The world's first therapeutic LSD clinic opened in Worcestershire

21st century Scientists study drugs such as marijuana and LSD as potential treatments for a range of ailments

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Tuesday 12 August 2008

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by: James Randerson, The Guardian UK

"Psychedelic psychotherapy" is being tested to improve the quality of life for people suffering a broad range of ailments. (Photo: Drug Information Resource)

    First test of "psychedelic psychotherapy" since the 70's. Researchers hope effects will improve quality of life.

    Scientists are exploring the use of psychedelic drugs such as LSD to treat a range of ailments from depression to cluster headaches and obsessive compulsive disorder.

    The first clinical trial using LSD since the 1970s began in Switzerland in June. It aims to use "psychedelic psychotherapy" to help patients with terminal illnesses come to terms with their imminent mortality and so improve their quality of life.

    Another psychedelic substance, psilocybin - the active ingredient in magic mushrooms, has shown promising results in trials for treating symptoms of terminal cancer patients. And researchers are using MDMA (ecstasy) as an experimental treatment for post-traumatic stress disorder.

    In the Swiss trial eight subjects will receive a dose of 200 microgrammes of LSD. This is enough to induce a powerful psychedelic experience and is comparable to what would be found in an "acid tab" bought from a street drug dealer. A further four subjects will receive a dose of 20 microgrammes. Every participant will know they have received some LSD, but neither the subjects nor the researchers observing them will know for certain who received the full dose. During the course of therapy researchers will assess the patients' anxiety levels, quality of life and pain levels.

    Before hallucinogenic drugs became popular with the counter culture, they were at the forefront of brain science. They were used to help scientists understand the nature of consciousness and how the brain works and as treatments for a range of conditions including alcohol dependence.

    Charles Grob, a professor of psychiatry at the Harbor-UCLA Medical Centre, is in the vanguard of the resurgence of scientific interest in psychedelics, having recently completed a trial that used psilocybin to help patients with terminal cancer come to terms with their illness. "I think there's a perception these compounds hold untapped potential to help us understand the human mind," he said.

    The way hallucinogens such as LSD (lysergic acid diethylamide), psilocybin and mescaline (the active ingredient in the peyote cactus) act on the brain is reasonably well understood by scientists. The drugs stick to chemical receptors on nerve cells that normally bind the neurotransmitter serotonin, which affects a broad range of brain activities. But how this leads to the profoundly altered states of consciousness, perception and mood that typically accompany a "trip" is not known.

    Prof Roland Griffiths at the Johns Hopkins School of Medicine in Baltimore Maryland recently published a study of 36 healthy volunteers who were given psilocybin and then observed in the lab. The participants' ages ranged from 24 to 64 and none had taken hallucinogens before. When the group were interviewed again 14 months later 58% said they rated the experience as being among the five most personally meaningful of their lives, 67% said it was in their top five spiritual experiences, and 64% said it had increased their well-being or life satisfaction.

    "The working hypothesis is that if psilocybin or LSD can occasion these experiences of great personal meaning and spiritual significance ... then it would allow [patients with terminal illnesses] hopefully to face their own demise completely differently - to restructure some of the psychological angst that so often occurs concurrently with severe disease," said Griffiths. So by expanding their consciousness during a session on the drug, the patient is able to comprehend their thoughts and feelings from a new perspective. This can lead to a release of negative emotions that leaves them in a much more positive state of mind.

    Twelve patients with terminal cancer have already helped Grob to test this idea and, although the research is not yet published, anecdotal reports from some subjects are encouraging. Pamela Sakuda (see below) was diagnosed with stage 4 colorectal cancer in December 2002. Her husband, Norbert Litzinger, said the psilocybin treatment transformed her outlook.

    "Pamela had lost hope. She wasn't able to make plans for the future. She wasn't able to engage the day as if she had a future left," he said. Her "epiphany" during the treatment was the realisation that her fear about the disease was destroying the remaining time she had left, he said.

    Despite fears that psychedelic drugs can induce psychosis, they are comparatively safe when administered with the proper precautions and with trained medical professionals present, according to a manual for studying their effects, which was recently published in the Journal of Psychopharmacology.

    They do have a powerful effect on a person's perception and consciousness and cannot be considered "safe", but they are almost entirely nontoxic, they virtually never lead to addiction and they only rarely lead to long-lasting psychosis (usually in people with a family history of mental illness). The main danger is that the person taking the drug injures him or herself while in a mind-altered state, for example because they think they can fly. The manual states, for example, that, "investigators need to be confident that the volunteer could not exit the window if in a delusional state". Griffiths does not advocate recreational use.

    Since the 1970s, scientific research into the effects hallucinogenic drugs have on the brain and their potential benefits has become a pariah field for any scientist who wanted to keep their reputation - and funding - intact. The psychologist Timothy Leary was the most famous advocate of the scientific and recreational use of psychedelic drugs. He conducted experiments at Harvard that were widely criticised and he was accused of faking data.

    "The way I view it is we experienced some kind of broad cultural trauma back in the 60s and these drugs became demonised in that context," said Griffiths. "As a culture we just decided clinical research shouldn't be done with this class of compounds," he said. "This was partly the federal regulatory authorities, it was partly the funding agencies and it was partly the academics themselves ... Leary had so discredited a scientific approach to studying these compounds that anyone who expressed an interest in doing so was automatically discredited."

    Dr Rick Doblin is president of the Multidisciplinary Association for Psychedelic Studies (MAPS) in California, a nonprofit organisation which funds clinical studies into psychedelic drugs, including the Swiss LSD trial. "These drugs, these experiences are not for the mystic who wants to sit on the mountain top and meditate. They are not for the counter-culture rebel. They are for everybody," he said.

    Case Study: Edited extract from an interview Pamela Sakuda did for researchers on the psilocybin experience.

    "As the session began, and as it built up, I felt this lump of emotions welling up and firming up almost like an entity. I started to cry a little. Then it started to dissipate and I started to look at it differently and I think that is the beauty of being able to expand your consciousness. I don't think the drug is the cause of these things. I think it is a catalyst that allows you to release your own thoughts and feelings from some place that you have bound them to very tightly. I began to realise that all of this negative fear and the guilt was such a hindrance to making the most of and enjoying the healthy time that I'm having - however long it may be. I was not utilising it to the best and enjoying my life because I was so afraid of what wasn't there yet. These substances occur in our natural world and people have been using them for thousands of years to treat physical illness, to treat social and behavioural problems."

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Hang-gliders of the mind

Illegal drugs can be dangerous but we should recognise their benefits too

Sue Blackmore

guardian.co.uk

Wednesday 29 October

 

Why is that whenever we hear about illegal drugs people are said to be "experimenting" with them or "abusing" them - never "enjoying" or even just "using" them? You'd think that all illegal drugs are devoid of any positive benefits or valid uses which is, I guess, what those who favour prohibition like to believe. But they are wrong.

Most illegal drugs are dangerous to some extent; some very and some hardly at all. We know that our classification system does not reflect the true danger but at least analyses of danger have been done. Almost no one talks about the positive uses of illegal drugs, and that's why I'll be discussing this on Radio 4's Iconoclasts this evening at 8pm. It's a live discussion show so you can email in your comments (as well as posting them here) to iconoclasts@bbc.co.uk. The trails seem to suggest that I'm going to get demolished.

People use drugs for all sorts of reasons, not just because they are wicked (and should be punished) or because they are sick (and should be treated) but because they actually like using them or derive some benefit from them, whether it's for simple pleasure or delight, to ease pain, to inspire insight or creativity, or for self healing.

I would like to live in a society that treats them with respect, encouraging their positive uses and discouraging abuse, but instead we have handed control over to criminals and ensured they are widely abused. We manage much better with other dangerous wonders. We have flying lessons, and sailing schools, pilots licences and apprenticeships. Philosopher Thomas Metzinger has suggested we could have "driving licences" for drugs. Yet we simply push these most dangerous and wondrous of substances into the corner and hope they will go away. They will not.

Among these are the solar-powered hang-gliders of the mind, the major hallucinogens, such as LSD, psilocybin, and mescaline - potentially dangerous if abused but wonderful if treated well. Also known as psychedelics or "entheogens" (meaning "releasing the God within") many of them derive from plants and have been used for millennia - but used by cultures with long experience, social controls, training for users, and very specific conditions for use. A good example is DMT, the active ingredient in ayahuasca, a complex brew of psychoactive plants used by Amazonian Indians in rituals for spiritual and mental healing.

I first took this short-acting hallucinogen 20 years ago or so and was told by my experienced guide (yes, such guides do exist) that it would be like an eight-hour LSD trip condensed into 15 minutes. That it might be horrific, and that one of his friends had called it the worst experience he'd ever had. Hmm. That sounds fun! So why did I take it? Because then, like now, I was obsessed with understanding the mind. I wanted to learn how to face demons and terrors, how to let go of self, how to explore the further reaches of human experience.

As the drug took hold the world disintegrated in a roaring chaos of green and orange contorting creatures. I can say little that does it justice now, except that I sat there grinning happily and saying "terrible, terrible". I learned much from this difficult drug, as from other easier ones. I have found peace and deep tranquillity, had visions and mystical insights, been enveloped in empathy with others, and laughed at the cosmic joke. Not everyone shares my enthusiasm for exploring weird states, and nor should they, just as not everyone wants to go hang-gliding. Yet there's something wrong with a society that blocks people's natural desire to explore their own minds.

There are many other uses too. Before the major hallucinogens were made illegal a few therapists were using them to great effect. Sometimes a single, well-controlled dose of LSD or psilocybin could transform patients' understanding of themselves and their problems, leading to improvements rarely seen in years of expensive therapy. Many more people have simply used the drugs in their own way, but how sad that they have to take risks and go without expert guidance. I know a young woman who has been anorexic for 10 years - a horrible condition of self-starvation and misery. In an LSD trip by the sea on a beautiful sunny day, she went through what she called "growing mental torture". Yet she sat still and looked into it, until she finally found deep pleasure in being totally present "without any fear or any desire" and realised that her anorexic life had precluded precisely this. I can't say, and nor would she, that a single trip cured her anorexia, but it certainly contributed to her beginning to eat. This, I suggest, is use not abuse.

Many profound drug experiences include inner meetings with death and these can, in their paradoxical way, destroy the fear of death. With so many of us facing old age, disease and dying, this possibility of inner transformation needs encouragement, not prohibition. I hope that before I die I may live in a society that has learned respect for the most powerful of mind-changing drugs. They deserve to be used, and not abused.

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