Pubdate: Tue, 10 Sep 2019
Source: New York Times (NY)
Copyright: 2019 The New York Times Company
Author: Benedict Carey


The announcement on Wednesday that Johns Hopkins Medicine was starting
a new center to study psychedelic drugs for mental disorders was the
latest chapter in a decades-long push by health nonprofits and wealthy
donors to shake up psychiatry from the outside, bypassing the usual

"Psychiatry is one of the most conservative specialties in medicine,"
said David Nichols, a medicinal chemist who founded the Heffter
Research Institute in 1993 to fund psychedelic research. "We haven't
really had new drugs for years, and the drug industry has quit the
field because they don't have new targets" in the brain. "The field
was basically stagnant, and we needed to try something different."

The fund-raising for the new Johns Hopkins center was largely driven
by the author and investor Tim Ferriss, who said in a telephone
interview that he had put aside most of his other projects to advance
psychedelic medicine.

"It's important to me for macro reasons but also deeply personal
ones," Mr. Ferriss, 42, said. "I grew up on Long Island, and I lost my
best friend to a fentanyl overdose. I have treatment-resistant
depression and bipolar disorder in my family. And addiction. It became
clear to me that you can do a lot in this field with very little money."

Mr. Ferriss provided funds for a similar center at Imperial College
London, which was introduced in April, and for individual research
projects at the University of San Francisco, California, testing
psilocybin as an aide to therapy for distress in long-term AIDS patients.

The spiritual father of psychedelic medicine was the chemist Albert
Hofmann, who discovered the effects of LSD in 1943 after accidentally
ingesting it while working at the Swiss firm Sandoz. Dr. Hofmann had
at least one bad trip - "Everything in the room spun around, and the
familiar objects and pieces of furniture assumed grotesque,
threatening forms," he wrote afterward. But he also recognized his
"problem child," as he called the drug, as a potential therapeutic

So did a host of prominent doctors, in time. Beginning in 1960, the
renowned Scottish psychiatrist Dr. R.D. Laing gave LSD to patients,
some with psychotic disorders, and used it himself. Through the 1960s,
other prominent psychiatrists experimented liberally, including Dr.
Stanislav Grof, Dr. Humphry Osmond and Dr. Abram Hoffer.

These "treatments" showed promise for some problems, like alcoholism,
but the results were mixed, and dosing someone with psychosis would
never clear an ethical review committee today.

By 1970, acid and related compounds had become part of a dangerous
menu of street drugs, and governments cracked down, bringing research
to a near halt. Other mind-altering recreational drugs, like
psilocybin (the ingredient in magic mushrooms) and MDMA, or ecstasy,
also landed on the lists of banned substances.

The revival of interest began in the early 1990s, when the Food and
Drug Administration agreed to approve careful, well-designed,
ethically vetted studies of psychedelics for the first time in
decades. The Heffter Institute and the Multidisciplinary Association
for Psychedelic Studies, or MAPS, a nonprofit funded by an assortment
of wealthy donors, financed projects in the United States and abroad.
MAPS collaborated with Dr. Hofmann and Alexander Shulgin, a former Dow
chemist who discovered the effects of ecstasy, and with his wife, Ann,
experimented with scores of hallucinogens.

Experiments using ecstasy and LSD, for end-of-life care, were underway
by the mid-2000s. Soon, therapists began conducting trials of ecstasy
for post-traumatic stress, with promising results. One of the most
influential scientific reports appeared in 2006: a test of the effects
of a strong dose of psilocybin on healthy adults. In that study, a
team led by Roland Griffiths at Johns Hopkins found that the
volunteers "rated the psilocybin experience as having substantial
personal meaning and spiritual significance and attributed to the
experience sustained positive changes in attitudes and behavior."

At least as important as the findings, which were exploratory, was the
source, Johns Hopkins, with all its reputational weight, and no
history of institutional bias toward alternative treatments. "I got
interested through meditation in altered states of consciousness, and
I came into this field with no ax to grind," said Dr. Griffiths, the
director of the new center.

By late 2018, the Johns Hopkins group had reported promising results
using psilocybin for depression, nicotine addiction and cancer-related
distress. Others around the world, including Dr. David Nutt at
Imperial College London, were producing similar results.

Mr. Ferriss, who organized half the $17 million in commitments and
contributed more than $2 million of his own for the new Johns Hopkins
center, said he approached wealthy friends who he knew had an interest
in mental health. The new venture, he said he told them, "truly has
the chance to bend the arc of history, and I've spent nearly five
years looking at and testing options in this space to find the right
bet. Would you have any interest in discussing?"

Mr. Ferriss said he met Dr. Griffiths in 2015, became intrigued with
the research, and began thinking about the Johns Hopkins group as he
might an investment bet. He launched a crowdfunding campaign for a
small depression study, to see how efficiently the Johns Hopkins team
used the money. "Essentially it was a seed investment," Mr. Ferriss
said. "I ran a beta test, and they really delivered."

Craig Nerenberg, one of those friends and the founder of the hedge
fund Brenner West Capital Partners, quickly agreed to contribute. "I
have lost a family member to addiction and have felt the pain of loved
ones who struggled through depression," Mr. Nerenberg said by email.
"It's hard for me to imagine a contribution that I can make which - if
the research data continues to bear out - will have a greater impact
over the next decade."

The remaining half of the commitments for the center came from the
Steven & Alexandra Cohen Foundation and supports studies on the
benefits for people with persistent Lyme disease symptoms, PTSD and
other conditions. Mr. Cohen is a billionaire investor; the foundation
focuses on education, veterans issues, Lyme disease and children's
health, among other concerns. In an email, Ms. Cohen wrote, "I
strongly believe that we must dare to change the minds of those who
think this drug is for recreational purposes only and acknowledge that
it is a miracle for many who are desperate for relief from their
symptoms or for the ability to cope with their illnesses. It may even
save lives."

Investigators at the Johns Hopkins center, its counterpart at Imperial
College London and elsewhere still have an enormous amount of work to
do to learn which mind-altering substances are beneficial for whom, at
what doses, and when such treatment is dangerous. The same concerns
that shut down similar research in the 1970s are audible in the
caution expressed by many psychiatrists today: These are powerfully
mind-altering substances, and administering them to people who are
already unstable is uncertain work, to put it mildly. One scary
adverse event could cripple the whole enterprise.

But for now, the supporters of a revived psychedelic medicine are
taking a victory lap. "It's taken half a century since the backlash
against the psychedelic '60s, but cultural evolution takes time," said
Rick Doblin, executive director of MAPS. "We're seeing a global
renaissance in public and scientific interest, regulatory approvals
and funding for psychedelic research."
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MAP posted-by: Matt