The Current Status of Psychedelics in Psychiatry VIEWPOINT
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The Ethics of Psychedelic Medicine: a Case for the Reclassification of Psilocybin for Therapeutic Purposes
THE ETHICS OF PSYCHEDELIC MEDICINE: A CASE FOR THE RECLASSIFICATION OF PSILOCYBIN FOR THERAPEUTIC PURPOSES By Akansh Hans A thesis submitted to Johns Hopkins University in conformity with the requirements for the degree of Master of Bioethics Baltimore, Maryland May 2021 © 2021 Akansh Hans All Rights Reserved I. Abstract Our current therapeutic mental health paradigms have been unable to adequately handle the mental illness crisis we are facing. We ought to ‘use every tool in our toolbox’ to help individuals heal, and the tool we should be utilizing right now is Psilocybin. Although it is classified as a Schedule I drug, meaning that it is believed to have a high potential for abuse, no accepted medical uses, and a lack of safety when used under medical supervision, Psilocybin is not addictive and does not have a high potential for abuse when used safely under medical supervision. For these reasons alone, Psilocybin deserves a reclassification for therapeutic purposes. However, many individuals oppose Psilocybin-assisted psychotherapy on ethical grounds or due to societal concerns. These concerns include: a potential change in personal identity, a potential loss of human autonomy, issues of informed consent, safety, implications of potential increased recreational use, and distributive justice and fairness issues. Decriminalization, which is distinct from reclassification, means that individuals should not be incarcerated for the use of such plant medicines. This must happen first to stop racial and societal injustices from continuing as there are no inherently ‘good’ or ‘bad’ drugs. Rather, these substances are simply chemicals that humans have developed relationships with. As is shown in this thesis, the ethical implications and risks of psychedelic medicine can be adequately addressed and balanced, and the benefits of Psilocybin as a healing tool far outweigh the risks. -
Neurobiology of Addiction and Implications for Treatment
BRITISH JOURNAL OF PSYCHIATRY (2003), 182, 97^100 EDITORIAL partial agonist, this drug stimulates the D Neurobiology of addiction and implications 33 receptor enough to keep withdrawal at for treatment bay, but not enough to cause a ‘high’ or to be rewarding. It is currently in phase 1 trials. One drug that affects the dopaminergic ANNE LINGFORD-HUGHES and DAVID NUTT system and has proven efficacy in the treat- ment of nicotine addiction is bupropion (Jorenby(Jorenby et aletal, 1999). The exact mechanism underlying this effect still has to be fully characterised; however, it has been shown that bupropion increases dopamine and noradrenaline levels by acting as an uptake Drug and alcohol misuse result in immense withdrawal as well. In an elegant series of inhibitor (Ascher et aletal, 1995).,1995). harm at both individual and societal level. experiments, Schultz (2001) found that in Our understanding of the neuropharma- primates trained to associate a cue with a cology of these disorders is increasing pleasurable experience (food), increased Related systems involved in reward through the use of approaches such as dopaminergic activity was seen in response Our understanding of other neurotrans- neuroimaging and gene targeting and the to the cue and not to the food. If the food mitter systems that are involved in reward availability of specific receptor agonists was not then presented, dopaminergic and that may modulate dopaminergic and antagonists. Our aim here is to describe function dropped. Reduced dopaminergic activity provides further targets for some interesting new findings that are function is thought to be associated with pharmacotherapy. likely to inform advances in treatment. -
Professor David J Nutt
2016 BAP LIFETIME ACHIEVEMENT AWARD Professor David J Nutt David Nutt received the BAP Lifetime Achievement Award at the 2016 summer meeting in Brighton. It gives me much pleasure to write about his long and very productive career in both preclinical and clinical psychopharmacology. I am primarily emphasizing his scientific achievements, both internationally and domestic, and his role in making the public aware of the need for evidence-based clinical science. It is scarcely necessary to detail his commitment to the BAP both as a former President and also editor of the Journal of Psychopharmacology for over 25 years. I have known David for nearly 35 years ever since he joined the MRC Clinical Pharmacology Unit in Oxford and undertook preclinical research for his MD. His enormous enthusiasm for both basic and clinical pharmacology and his impressive abilities were apparent from the outset, and in just 3 years we published together 11 papers and a book chapter, all in major journals (he also published work with other colleagues). A particular interest of David was the translation of basic research to clinical studies in psychiatry, something both David Grahame-Smith, the Unit Director, and I were already enthusiastic about. He then undertook clinical research in psychiatry in Oxford before appointments at the National Institutes of Health, Bethesda, Maryland, the University of Bristol and now Imperial College, London. David’s commitment to communicating clinical pharmacology research to the public is, of course, known to many people, and he has been tireless in demonstrating the need for evidence-based decision making when discussing the risks and benefits of drugs, particularly recreational drugs. -
UIT CAMBRIDGE Rights Catalogue the Physics of Everyday Life Extraordinary Insights Into Everyday Physics Professor Jo Hermans
UIT CAMBRIDGE rights catalogue The Physics of Everyday Life Extraordinary insights into everyday physics Professor Jo Hermans Description: This book brings the magic of physics to everyday life. With a glass of water, a few drops of milk and a torch, readers will be able to demonstrate why the sky looks blue during the day, but seems to turn red at sunset – and astound their friends by telling them how fast one can cycle on the moon. It will appeal to teenagers and their parents alike. 198 mm x 129 mm, 1 September 2018, Paperback The Author Prof. Jo Hermans is Emeritus Professor of Physics at Leiden University in the Key Selling Points: Netherlands. In addition to his academic research and teaching career he is active in • A best-seller in the Netherlands promoting and explaining science for the general public. He writes a books on everyday where it was originally published science which have been translated worldwide. He was appointed Knight in the Order of • A popular science book focusing Oranje-Nassau by Queen Beatrix in 2010. on the physics ruling everyday phenomena Contents: • Full of theoretical explanations OUTDOOR LIFE 8. Why is the sky blue (and the setting sun red)? and practical experiments 1. GPS navigation, how does it work? (With a tip SOUND AND HEARING of the hat to Einstein) 9. What do our ears hear? BICYCLE AND CAR 10. Why is there not more noise pollution? 2. The human engine when idling IN AND AROUND THE HOUSE 3. Me? A vacuum cleaner? 11. The lid on the pan 4. -
Nutt Dismissal in Britain Highlights Diverging Drug Views
NEWS Testy debate: Looking ahead: 2009 in review: Biomarkers for Warwick Anderson We take a look prostate cancer discusses funding back at the past stir controversy in Australia year’s headlines 1339 1346 1348 Nutt dismissal in Britain highlights diverging drug views At a time when the US government has Jacqui Smith over a paper Nutt published in signaled a softer stance on medical marijuana, January on perceptions of risk that compared the dismissal of an independent drug advisor 3,4-methylenedioxymethamphetamine in Britain has highlighted the UK’s hard-line (MDMA, or ‘ecstasy’) use to horse riding (J. stance on illegal substances. Psychopharmacol. 23, 3–5; 2009). David Nutt, until recently chair of the Advisory Council on the Misuse of Drugs Public dispute (ACMD), was fired by UK Home Secretary In a statement, Johnson claimed that Nutt’s Alan Johnson on 30 October. The sacking comments “damage efforts to give the public followed the issuing of a press release relating clear messages about the dangers of drugs.” to a lecture on drug risk and classification that Nutt, however, has hit back in a series of Nutt gave in July at King’s College London. interviews attacking the Labour government’s In his lecture, Nutt criticized the lack of approach to the issue of drugs. evidence for the current classification of drugs As Nature Medicine went to press, no less in the UK and claimed that this undermined than five members of the ACMD had resigned the credibility of the official message on drugs. in protest of Nutt’s dismissal. -
Serotonergic Psychedelic Drugs LSD and Psilocybin Reduce the Hierarchical Differentiation of Unimodal and Transmodal Cortex
bioRxiv preprint doi: https://doi.org/10.1101/2020.05.01.072314; this version posted April 14, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. Serotonergic psychedelic drugs LSD and psilocybin reduce the hierarchical differentiation of unimodal and transmodal cortex Manesh Girna, Leor Rosemanb, Boris Bernhardta, Jonathan Smallwoodc, Robin Carhart-Harrisb, R. Nathan Sprenga,d,e,f a Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada. b Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK c Department of Psychology, University of York, York, UK d Departments of Psychiatry and Psychology, McGill University, Montreal, QC, Canada e Douglas Mental Health University Institute, Verdun, QC, Canada f McConnell Brain Imaging Centre, McGill University, Montreal, QC, Canada 1To whom correspondence should be addressed. Correspondence: [email protected] Laboratory of Brain and Cognition Montreal Neurological Institute and Hospital 3801 Rue Université, Montréal, QC H3A 2B4 Conflicts of interest: none 1 bioRxiv preprint doi: https://doi.org/10.1101/2020.05.01.072314; this version posted April 14, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. Abstract LSD and psilocybin are serotonergic psychedelic compounds with potential in the treatment of mental health disorders. -
10 Facts About MDMA
10 Facts About MDMA August 2015 1. What is MDMA? and a desire to intensify these feelings by dancing, talking and touching. MDMA, often referred to as “ecstasy” or “molly”, is short for 3,4 methylenedioxymethamphetamine, a A typical dose of 80 - 125 mg lasts three to six hours. psychoactive drug derived from safrole oil. MDMA Some people experience nausea at the outset, but produces effects that resemble both stimulants and after about 45 minutes, report feelings of relaxation psychedelics, as well as its signature effect: a feeling and clarity. MDMA also causes dilation of the pupils of connectedness. It impacts brain function primarily and, often, sensitivity to light, as well as possible jaw- releasing the neurotransmitter serotonin, and also clenching, tooth-grinding, muscle tension, faintness, temporarily inhibits its reuptake. MDMA is usually and chills or sweating. taken orally, whether in pressed pill form, powder or crystal; or sometimes snorted. After the drug wears off, the theory from preclinical studies is that brain levels of serotonin (a chemical MDMA was originally synthesized in 1912 by the drug responsible for maintaining mood balance) are company Merck.1 However, its psychoactive effects depleted, which can lead in some cases to sadness, weren’t widely discovered until 1976 when Alexander anxiety, depression and sleep problems.4 If they occur, Shulgin developed a new synthesis method, tested the these symptoms arise in the several days that follow. drug on himself, and shared it with a few friendly Generally, they abate within a week, though frequency psychotherapists.2 Because of the drug’s effects of of use and higher doses can slow or stop this increasing empathy and reducing fear, it started to be process.5 used in psychotherapy practices in the 1970s and early 80s, as well as recreationally. -
MDMA ('Ecstasy'): a Review of Its Harms and Classification Under the Misuse of Drugs Act 1971
MDMA (‘ecstasy’): A REVIEW OF ITS HARMS AND CLASSIFICATION UNDER THE MISUSE OF DRUGS ACT 1971 Advisory Council on the Misuse of Drugs ACMD Advisory Council on the Misuse of Drugs 3rd Floor (SW), Seacole Building 2 Marsham Street London SW1P 4DF February 2008 Rt Hon Jacqui Smith MP Home Office 2 Marsham Street London SW1P 4DF Dear Home Secretary, The Advisory Council on the Misuse of Drugs (ACMD) recently considered that a review of MDMA (‘ecstasy’) would be timely as there is a much greater body of evidence regarding the harms and misuse of MDMA since the Council last provided its advice to Ministers in 1996. I have pleasure in enclosing the Council’s report. The use of MDMA is undoubtedly harmful. I would therefore like to emphasise that the Council continues to be concerned about the widespread use of MDMA; particularly among young people. Due to its prevalence of use, MDMA is a significant public health issue and we believe that criminal justice measures will only have limited effect. You will wish to note that the Council strongly advises the promulgation of public health messages. It is of vital importance that issues of classification do not detract from messages concerning public health. Forensic evidence shows that MDMA is by far the most commonly seized of the ‘ecstasy-like’ drugs. MDMA is presently generically classified in Class A under the Misuse of Drugs Act with other ‘ecstasy-like’ drugs. The ACMD has not extended this review to other compounds within the generic classification since their use is considerably less than that of MDMA. -
Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss
Supplemental Material can be found at: /content/suppl/2020/12/18/73.1.202.DC1.html 1521-0081/73/1/202–277$35.00 https://doi.org/10.1124/pharmrev.120.000056 PHARMACOLOGICAL REVIEWS Pharmacol Rev 73:202–277, January 2021 Copyright © 2020 by The Author(s) This is an open access article distributed under the CC BY-NC Attribution 4.0 International license. ASSOCIATE EDITOR: MICHAEL NADER Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss Antonio Inserra, Danilo De Gregorio, and Gabriella Gobbi Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada Abstract ...................................................................................205 Significance Statement. ..................................................................205 I. Introduction . ..............................................................................205 A. Review Outline ........................................................................205 B. Psychiatric Disorders and the Need for Novel Pharmacotherapies .......................206 C. Psychedelic Compounds as Novel Therapeutics in Psychiatry: Overview and Comparison with Current Available Treatments . .....................................206 D. Classical or Serotonergic Psychedelics versus Nonclassical Psychedelics: Definition ......208 Downloaded from E. Dissociative Anesthetics................................................................209 F. Empathogens-Entactogens . ............................................................209 -
Psychoactive Drugs of Misuse: Rationalising the Irrational
Comment Psychoactive drugs of misuse: rationalising the irrational Ideally, policy responses to psychoactive drugs of misuse (1920–32) make it unlikely that any industrialised society would take into account the variations in harm that each will criminalise alcohol use. But that still leaves plenty of kind causes to users and the community. In today’s Lancet, room for more effective use of taxation and regulatory David Nutt and colleagues1 show that the UK classification controls to reduce alcohol-related harm. of psychoactive drugs into three categories of harm (A, Populism favours tough policies towards illicit drugs such B, and C) is only modestly correlated with expert ratings as cannabis. Psychoactive drugs (other than alcohol and of the harms caused. They also point out the obvious: the tobacco) remain the last holdout of the most restrictive classification excludes the psychoactive drugs whose use form of regulation—criminal prohibition—despite the causes the greatest harm—ie, alcohol and tobacco.2 enthusiastic embrace of market deregulation almost Science Photo Library Nutt and colleagues asked UK experts in psychiatry, everywhere else. This situation could change if the USA See Health Policy page 1047 pharmacology, and addiction to rate drugs on three major embraced a free market regime for all psychoactive drugs. dimensions of harm: physical health effects, potential But as attractive as this approach may be to libertarians, for dependence, and social harms. The experts showed it would not be good public-health policy. Allowing a free reasonable levels of agreement in their rankings. By market for all currently illicit drugs would add substantially contrast, their ratings were not well correlated with the UK to the harms now caused by alcohol and tobacco. -
Charlie Hughes (A Minor) by His Mother and Litigation Friend Alison Hughes
IN THE HIGH COURT OF JUSTICE CLAIM NO: CO/620/2020 ADMINISTRATIVE COURT BETWEEN: THE QUEEN (on the application of) Charlie Hughes (a minor) by his mother and litigation friend Alison Hughes Claimant - and - (1) CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST (2) THE NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Defendants - and - (1) SECRETARY OF STATE FOR HEALTH AND SOCIAL CARE (2) NHS ENGLAND Interested Parties WITNESS STATEMENT OF PROFESSOR DAVID NUTT I, Professor David Nutt of Drug Science UK will say as follows: 1. I am a psychiatrist and professor at Imperial College London. I have prior training in neurology at Guys and St Mary’s hospitals. My doctorate from Oxford University was on the neuropsychopharmacology of seizures. Since then I have worked for almost all my professional life on the effects, both beneficial and harmful, of drugs on the brain and have extensive clinical and research experience in this field. I am a Fellow of the Royal Colleges of Physicians, of Psychiatrists and of the Academy of Medical Sciences of the UK. I was a member of the Adviory Council on the Misuse of Drugs for 10 years and chair of the Council for one. My expertise has been recognised with a number of prestigious appointments including Presidencies of the European Brain Council, the European College of Neuropsychopharmacology, the British Association of Psychopharmacology and the British Neuroscience Association. I have also served on the MRC Neuroscience board. 2. I have conducted scientific research on the brain actions in humans of a wide range of legal and illegal drugs including alcohol, tobacco, heroin, amfetamines, cocaine, GHB, buprenorphine, antidepressants, benzodiazepines, antipsychotics, methadone, LSD, psilocybin, DMT, cannabis, cannabidiol, ketamine, paracetamol, ibuprofen and caffeine. -
A Placebo-Controlled Investigation of Synaesthesia-Like Experiences Under LSD
2016, Neuropsychologia A placebo-controlled investigation of synaesthesia-like experiences under LSD Devin B. Terhune Department of Experimental Psychology, University of Oxford, Oxford, UK Department of Psychology, Goldsmiths, University of London, London, UK David P. Luke Department of Psychology & Counselling, University of Greenwich, London, UK Mendel Kaelen Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK Mark Bolstridge Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK Amanda Feilding The Beckley Foundation, Beckley Park, Oxford, UK David Nutt Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK Robin Carhart-Harris Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK Jamie Ward Department of Psychology, University of Sussex, Sussex, UK Correspondence: Devin B. Terhune Department of Psychology, Goldsmiths, University of London, London, UK Email: [email protected] Robin Carhart-Harris Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK Email: [email protected] Jamie Ward Department of Psychology, University of Sussex, Sussex, UK Email: [email protected] Investigating LSD-induced synaesthesia 2 Abstract The induction of synaesthesia in non-synaesthetes has the potential to illuminate the mechanisms that contribute to the development of this condition and the shaping of its phenomenology. Previous research suggests that lysergic acid diethylamide (LSD) reliably induces synaesthesia-like experiences in non- synaesthetes. However, these studies suffer from a number of methodological limitations including lack of a placebo control and the absence of rigorous measures used to test established criteria for genuine synaesthesia.