A therapist in Canada wrote an article about how one of his patients asked for supervision during the administration of psychedelic medicine. The reasoning behind the patient wanting to take the psychedelic medicine psilocybin (the active compound in magic mushrooms) was due to the overwhelming depression brought on by the diagnosis of breast cancer and how current research is showing that its use is safe and effective to treat these symptoms. The patient found that research being done by John Hopkins Medical Centre using psilocybin is currently under Phase 3 of clinical trials and is shown to help with the treatment of anxiety and depression especially in the cases of cancer-related demoralization and hopelessness. The therapist talks about the ethical dilemma he was placed in. His patient stated that they would take the drug (magic mushrooms) whether it was under his supervision or not. The legal stance that the Canadian government takes is that new medicines can only be available after they have completed Phase 3 of clinical trials.
This got me thinking about what I would do as a provider if my patient came to me asking me a similar request. Personally, I would ask the patient to allow time for me to do research on the effects and side effects that psilocybin can have on the body if things were to go wrong. I would then see what the projected time frame is for the drug to complete clinical trials. This way I may be able to tell my patient to wait that length of time so that I supervise them. This situation though is a tough one to take a stance because you are stuck between breaking the law and losing the relationship you have with this patient.
The therapist decided to start the Therapeutic Psilocybin for Canadian project which filed an exemption to Health Canada requesting that the use of psilocybin-assisted psychotherapy to terminal patients be allowed. They are expecting that there will be a rejection of their proposal due to the recent legalization of cannabis and how another group is now asking a psychedelic medicine to be allowed. The therapist goes into more details though about how they have the ammunition to continue their fight and provide comfort to those patients suffering from terminal cancer.
http://theconversation.com/what-if-psychedelics-could-revolutionize-the-way-you-die-105124
This is a tough ethical dilemma, and it dives into the hot topic of other banned substances that are being researched for their psychotherapeutic abilities. Studies have proven that substances including psilocybin, amphetamines such as MDMA, ketamine, DMT, and ergolines in LSD can stimulate dendrite growth in atrophied neurons in the prefrontal cortex that contribute to symptoms of anxiety, depression, addiction, and severe symptoms of PTSD. In fact, the FDA has ruled the use of MDMA for PTSD a “breakthrough therapy” in recent years. Research has proven that all of the aforementioned substances promote structural and functional neural plasticity in cortical neurons. Of course, there are limitations to these studies as the compounds tested are illegal in most countries and are accompanied by negative stigmas and safety concerns; therefore, funding for research is difficult to attain. The future of clinical research using such substances will be very interesting and open up a new field of regulations and patient safety. What if we are missing out on valuable medical gains if we avoid clinically researching substances just because they have been deemed illegal for recreational use? How can we tap into the positive influences these drugs can have for those who critically need them? If they are proven to have powerful and positive effects but aren’t accessible in a safe and supervised fashion, people surely will go to such lengths as attaining them off the streets or through less official means and dealers, risking their health and safety severely. We’ve seen this with marijuana use. Will LSD, magic mushrooms, MDMA, and DMT be available at your local dispensary at some point? Or better yet, prescribed by your physician? Interesting stuff to think about.
ReplyDeleteThis was a really interesting research paper published earlier this year about the effects of trippy substances on psychedelic-induced neuronal plasticity:
https://www.cell.com/cell-reports/fulltext/S2211-1247(18)30755-1
I know there is a lot of research going on about the use of psychedelic drugs in western medicine, I was wondering if you found anything about using these chemicals found in LSD and shrrooms as a real possibility as a pharmaceutical drug in the US? Or have you only seen it in Canada? In general, from my research is that it only solves short term solutions, while having negative and lasting impacts on someone's brain if one decides to use it throughout their lives. Some negative impacts I have found are neuronal death, decrease in dopamine production, and decrease in grey matter. So overall, it might be useful for a short period of time, but the side effects could cause other diseases or health concerns.
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