Pubdate: Thu, 01 Feb 2018
Source: Georgia Straight, The (CN BC)
Copyright: 2018 The Georgia Straight
Author: Travis Lupick
Page: 10


Decades after Canada abandoned the field, the B.C. Centre on Substance
Use is investigating the benefits of drugs like MDMA and psilocybin

In 2011, Gerald Thomas was invited to an Indigenous community in a
remote area of British Columbia. Working for the Centre for Addictions
Research of B.C., he was one of a small team of scientists who
observed 12 people take ayahuasca, an Amazonian mixture that induces
vivid visual and auditory hallucinations as well as deep emotional and
intellectual reflection.

Harm-reduction expert Kenneth Tupper is on a team that's probing
positive effects of psychedelics. Amanda Siebert photo.

"The ceremonies themselves are really intense," Thomas told the
Georgia Straight in a telephone interview. "People are pushed to their
emotional edge."

The group remained in a longhouse and its surrounding forest for four
days. They slept on its dirt floor and bathed in the nearby river. It
wasn't your typical experiment, Thomas conceded. At the same time, he
explained how the team observed rigorous protocols for research
involving human subjects.

"There were months of work getting ethics approval, designing the
study, finding the instruments that we would use to collect
psychometric data. Then, for four days, we were all holed up in a 

Most of the 12 patients were victims of severe childhood trauma who
struggled with addictions to a variety of drugs: alcohol, cocaine, and
opioids such as heroin.

"One man described how, when they were kids, their parents would throw
parties and the folks would get drunk and then wander upstairs and
molest them," Thomas remembered. "Can you imagine being in your own
home, in your own bed, waiting? The terror, the confusion. Can you
imagine what that would do to your psyche?"

Participants struggled with terrible memories and many years of drug
abuse. In the longhouse, they delved into those issues. A shaman- an
ayahuasquero-who had travelled to B.C. from Peru worked alongside a
"retreat team" that ran group-therapy sessions and meditation.

Participants' reactions were encouraging.

"When I went to this retreat, it more or less helped me release the
hurt and pain that I was carrying around and trying to bury…with drugs
and alcohol," a 41-year-old female patient said, quoted in a report on
the experiment. "Ever since this retreat, I've been clean and sober."

"I got my spirit back," a 49-yearold woman told researchers. "It's so
beautiful outside, and where was all that all this time? You know, I
was just living with a black cloud over me. And the black cloud's been

Positive feedback continued in follow-up interviews conducted during
the next six months. "But we didn't know what we actually had until we
analyzed the data," Thomas said. "Then we saw it."

A 2013 paper Thomas coauthored for the academic journal Current Drug
Abuse Reviews describes the results: "Self-reported alcohol, tobacco
and cocaine use declined, although cannabis and opiate use did not;
reported reductions in problematic cocaine use were statistically

"Given the potential to decrease the personal suffering and social
costs associated with addiction, further research on
ayahuasca-assisted addictions treatment is warranted."

Five years later, very little further research has

Rigorous studies of psychedelic plants and chemicals are rare. It
wasn't always that way. Decades ago, scientists across North America
eagerly investigated the clinical benefits of psychedelic and
otherwise psychoactive substances. They were fascinated with
mescaline, found in the peyote cactus; psilocybin from so-called magic
mushrooms; and lysergic acid diethylamide, better known by its
acronym, LSD. And they were making progress. Then, in 1970, the U.S.
government classified all three as Schedule I narcotics, grouping them
in with hard drugs like cocaine and heroin. Officially, they had "no
currently accepted medical use in treatment". Investigations into how
psychedelic drugs might help people with disorders such as depression
and alcoholism halted.

Almost half a century later, a psychedelic renaissance of sorts is
under way. Reputable scientists working for prestigious institutions
are increasingly paying attention to these drugs.

Kenneth Tupper is a director at the B.C. Centre on Substance Use
(BCCSU). He previously worked in drug policy and harm reduction for
the B.C. Ministry of Health, but his passion is psychedelics. Their
"educational and cognitive value" was the subject of his master's
thesis, and his PHD dissertation for UBC is a 348-page paper on
ayahuasca and public policy. Tupper also worked on the ayahuasca
review of which Thomas was the lead author. Now he's part of a team
the BCCSU has assembled to put Vancouver at the forefront of this

"Psychedelic plants and drugs have been used for thousands of years in
traditional healing and spiritual ceremonies, and contemporary western
science has not paid them much attention," Tupper told the Straight.
"Now there's new interest in these traditional practices, as well as
interest in bringing a clinical, scientific approach to the substances
contained in these plants."

One reason this is exciting, Tupper continued, is that many of the
areas where psychedelics look most promising are ones where
pharmaceutical medicines long ago hit a wall, areas like posttraumatic
stress disorder (PTSD), depression and anxiety, eating disorders, and
dependence on drugs and alcohol.

The question of addiction is an especially urgent one. In 2017, more
than 1,400 people in B.C. died of an illicit-drug overdose. In the
United States, that number exceeded 64,000 in 2016. An overdose is now
the leading cause of death for Americans under the age of 50. The
majority of cases lead back to a dependence on opioids: Oxycontin,
heroin, or fentanyl.

"Opioid addiction is a challenging one to treat, and whether this
intervention is going to be helpful, we have yet to see," Tupper said.
"But we want to try."

THE STORY OF HOW research concerning psychedelic drugs fell out of
favour in North America and then only recently regained some
legitimacy is a long and strange tale.

Parts of it are well-known. In 1943, a Swiss chemist named Albert
Hofmann inadvertently ingested LSD and discovered that it stimulated
hallucinations. In the 1960s, an American psychologist named Timothy
Leary spread word of its therapeutic and recreational potentials with
the zeal of a preacher. Rock 'n' roll legends like John Lennon and
Jimi Hendrix led youths to embrace the drug. Another musician, Charles
Manson, caused the general public to fear it.

According to Erika Dyck, Canada Research Chair in the history of
medicine at the University of Saskatchewan, Canada played an
underappreciated role in this story.

In a telephone interview, she began her story in 1951, when an English
psychiatrist named Humphry Osmond responded to a want ad for a job at
Weyburn Mental Hospital in Saskatchewan. Upon moving to Canada, Osmond
connected with Aldous Huxley, a British author then living in America
who two decades earlier had gained considerable fame with the
publication of a dystopian novel called Brave New World. Huxley
introduced Osmond to mescaline and other psychedelic drugs, and the
two forged a close friendship.

In 1956, they searched for a name for this category of substances that
had so captured their imaginations. In letters, Osmond and Huxley
traded words and debated their meanings and Latin roots.

"To make this trivial world sublime, take half a gramme of
phanerothyme," Huxley wrote in April that year.

To which Osmond replied: "To fathom Hell or go angelic, just take a
pinch of psychedelic."

Meanwhile, Dyck continued, closer to Vancouver, a facility in New
Westminster called Hollywood Hospital began using LSD and mescaline in
the treatment of alcoholism.

"This was an elite, private facility where people could pay to get a
safe space to experience a psychedelic," Dyck recounted. "There's a
lot of glitz and glamour and it's shrouded in these really fantastic

Dyck, who holds Hollywood Hospital's patient files in her possession,
described how at 525 West 6th Street, Dr. J. Ross Maclean treated
patients with psychological exams, counselling, and between 50 and 250
micrograms of LSD.

"And they would talk about these really sacred moments," Dyck said.
"Sometimes with profound insight into a piece of trauma that they had

Hollywood Hospital's results were promising. "Publications from there
and other collaborating units suggested between 50- and 90-percent
recovery rates," Dyck said. But by the late 1960s, psychedelic drugs
and researchers paying them attention were becoming badly

Across the country, at the Allan Memorial Institute at Mcgill
University in Montreal, another group of researchers was working with
LSD using very different methods. Under the leadership of Ewen
Cameron, and with financial support from the CIA, patients were
administered LSD without their knowledge and often under conditions of
sensory deprivation or repetitive stimulation. The program, which the
CIA code-named MKULTRA Subproject 68, became public in a high-profile
lawsuit and badly tarnished psychedelics research across North America.

"All of those things emerging in the media spotlight in the 1970s
really threw a dark shadow on some of the earlier research," Dyck
said. "There was increasing pressure on researchers around the world
to stop using LSD."

Psychedelic drugs had also become associated with counterculture
movements that were upsetting the status quo. Then, in August 1969,
LSD and psilocybin were on display at the Woodstock festival, where
they appeared to lead to dancing. The same month, Manson gave LSD to
members of his cult following and they carried out a string of murders
in and around Los Angeles. The nation was captivated and horrified.
Less than one year later, the U.S. government made most psychedelics
Schedule I narcotics. In Canada, they were placed under the Narcotic
Control Act. Sanctioned medical experimentation effectively came to an

FOR ALMOST HALF a century, the field lay dormant. Then, slowly,
through the 1990s and early 2000s, academics' interest perked and
papers began to trickle forth. A full-blown "re-emergence of a
paradigm", as one paper describes it, is now under way.

A 2014 article published in the Journal of Nervous and Mental Disease
described how a team in Switzerland found that LSD may help terminally
ill patients cope with anxiety associated with death. A 2015 paper in
the Journal of Psychopharmacology shared impressive results from a
proof-of-concept study where psilocybin was used to treat alcohol
dependence. A 2016 paper in the Lancet Psychiatry reported that
patients who struggled with moderate to severe depression were
administered psilocybin and, as a result, "depressive symptoms were
markedly reduced."

Other projects have sought to explain the clinical effects that those
sorts of studies associate with psychedelic drugs. A 2016 paper in the
Proceedings of the National Academy of Sciences, for example,
described how neuroimaging tools revealed how the brain and nervous
system responded to LSD and how those changes appeared to correlate
with states of well-being that patients reported after taking the drug.

Dozens more papers have appeared in equally reputable journals during
the past decade. The studies are generally characteristic of a field
of research still in its infancy: their sample sizes are small; they
sometimes lack control groups; and experiments are often not
"double-blind" or "blind" (an experimental-standard procedure that
hides information in order to prevent bias but is difficult to apply
to psychedelic drugs because their effects are so obvious). But now a
second period of research is under way wherein academics are expanding
sample sizes and building on that earlier work. And scientists in
Vancouver have positioned themselves at the front of the field.

The B.C. Centre on Substance Use was established in April 2017 under
the leadership of Dr. Evan Wood. At a cafe across the street from St.
Paul's Hospital, Wood described the team he's brought together.

"Kenneth Tupper probably brings the most knowledge from an academic
perspective," Wood began. "Mark Haden has come on to help.… cody
Callon is coming at this as a highly experienced researcher.… katrina
Blommaert was the lead study coordinator for a prior MDMA study.… and
Dr. Keith Ahamad is experienced in conducting clinical research with
the U.S. National Institute on Drug Abuse's clinical-trials network."

Wood acknowledged there is a lingering stigma around psychedelic
drugs. He noted that funding remains a challenge. ("I'm at the ready
to help philanthropists and possible donors understand the nature of
the work and why we believe this is a critically important research
area," he added.) But Wood said they're taking a "science-driven and
evidence-based" approach, the same as the BCCSU would for any field of

"The potential here is enormous," he said. "So we're going to do
studies in a way that will stand up to the highest level of not only
ethical scrutiny but scientific scrutiny. That's the only way to move
forward things that are in controversial areas."

In a separate interview, Tupper revealed the team's first project: a
clinical trial that will begin later this year to examine the
effectiveness and safety of MDMA-assisted treatment for PTSD. That is,
they're going to study ecstasy, or molly (though street drugs sold
under those names are usually cut with other substances unknown to the
buyer, whereas the BCCSU's MDMA will be pure).

The BCCSU will serve as one of 16 locations across Canada, the United
States, and Israel where teams will work on the same experiment under
the guidance of the Multidisciplinary Association for Psychedelic
Studies' (MAPS) MDMA-Assisted Psychotherapy project. It's a so-called
Phase 3 clinical trial, which is normally the last phase of review a
drug receives before it is approved for public use. Only 25 to 30
percent of drugs that enter Phase 3 pass successfully. But MAPS's
Phase 2 review was promising. Concluded in 2016, it found that one
year after participants diagnosed with PTSD were given MDMA, 68
percent no longer experienced symptoms. Phase 2 results were based on
107 participants. The goal for Phase 3 is for more than 200 patients
to complete the study, approximately 18 of whom will do so at the BCCSU.

"It's a larger-scale randomized-control trial," Tupper said. "And at
the end of it, we believe, this is a hypothesis, but we believe it
could generate sufficient data to move MDMA to become an approved
medication for the treatment of PTSD."

However, Tupper added, "It wouldn't be like 'Take two and call us in
the morning.' "

Similar to the ayahuasca ceremony that Tupper reviewed in 2011 and the
earlier experiments with LSD at Hollywood Hospital, he explained, the
MAPS Phase 3 review of MDMA will see it administered in highly
controlled settings where two therapists are present and engage each
participant to establish a strong therapeutic relationship.

"The therapists sit with the patient in the clinic space for the
duration of the effects of the medication, which is about eight
hours," Tupper said. "Then, once the session is finished, they
actually stay overnight for monitoring. And then they have subsequent
sessions with the therapist team over the next couple weeks."

Actual work with patients likely won't begin until mid-2018, but
Tupper said the BCCSU is already preparing for its second foray into
psychedelics: psilocybin for the treatment of substance-use disorders.

"We're going to be looking for people with alcohol-use disorder,
stimulant-use disorder, and opioid-use disorder," Tupper said. "We're
not sure whether psilocybin will be as effective with one versus
another. It's an open scientific question right now."

ANOTHER OPEN QUESTION is exactly how psychedelic drugs like MDMA and
psilocybin work to help correct the problems that researchers suspect
they do. That's in part because we don't fully comprehend the problems

Modern science can usually explain how a medicine works to heal a
physical ailment. For example, antibiotics resolve a bacterial
infection by killing those microorganisms or inhibiting their growth.
But ailments like PTSD and addiction are problems of the
brain-disorders that we generally know much less about.

Before joining the BCCSU, Mark Haden established a MAPS presence in
Canada and served as its board chair for the Vancouver portion of the
MAPS Phase 2 review of MDMA. That study marked the first time a
psychedelic drug received a proper clinical review in Canada in more
than 40 years. In a telephone interview, he explained what we know and
don't know about how MDMA could assist people with PTSD.

"It's a very complex question," Haden began. "For MDMA, let's go back
a notch: what is PTSD? PTSD is an unconscious tape loop that repeats
itself and is associated with emotional distress.

"It is expressly distressing because it is a process that is
unconscious, therefore you don't have control over it," he said. "It
is associated with fear."

Taken in a therapeutic setting, Haden continued, MDMA can help address
those symptoms.

"MDMA creates a physical-relaxation response, and so fear is reduced.
It also reduces permeability between the conscious and the unconscious
mind. It gives people access to parts of themselves they don't
normally have access to," he said. "MDMA specifically is also an
empathogen. It's an alliance builder. And the greatest predictor of
success of any therapy is the alliance between the therapist and the
person who is seeking the therapy."

Haden suggested that, more broadly, it's about addressing the root of
a problem. With psilocybin and addiction, he hopes the same principle
will be found to apply.

"We would like to start to work with people in a way that is about
dealing with underlying issues," he said. "The larger view of drugs
that only sees them as something that needs to be criminalized has
failed us all miserably. And so now we're approaching this with a more
nuanced view."
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MAP posted-by: Matt