Sep 30, 2021 - Science

The science of psychedelic therapy breaks on through

Illustration of a mushroom with the top made from a human brain
Illustration: Annelise Capossela/Axios

Scientific studies of psychedelic therapies may be entering a new, broader phase thanks to more interest and funding from federal governments.

Why it matters: MDMA, psilocybin and LSD — combined with psychotherapy — have shown promise for treating a range of addictions and mental health disorders, including treatment-resistant depression and PTSD.

  • Mental health and substance use disorders take lives and cost money — directly for treating the disorders and indirectly in productivity. Efforts to find new treatments have come up short, leading to a decline in investment in developing new drugs.
  • The big dollars that come with funding from science agencies like the National Institutes of Health (NIH) could allow researchers to study nitty-gritty details — about dosing and other variables — needed for a drug to become an accepted part of medical practice.
  • Public funding could also allow trials of psychedelic therapies to be larger and more diverse, as well as independently evaluated.

The big picture: The therapeutic benefits of psilocybin and LSD were studied in the 1950s and 1960s.

  • But that research largely stopped in 1970 for a combination of reasons, including concerns about recreational use of the drugs that led to them being classified as Schedule I compounds — which are considered to have no currently accepted medical use and carry a high risk for abuse. That hampered studies about their therapeutic use.
  • About 20 years ago, there was a resurgence in studying psychedelics in humans, but the research has largely been backed by private philanthropists.
  • That's partly because studies struggled to meet best scientific practices, like randomizing trials and having a placebo control, says Steven Grant, a former program officer at the National Institute on Drug Abuse (NIDA) who is now director of research at Heffter Research Institute, which promotes the scientific study of classic psychedelics, like psilocybin.
  • There also weren't companies lining up to take the drugs and further develop them.

Where it stands: Philanthropists have funded pilot studies about psychedelic therapies, and a recent boom in biotech companies pursuing them indicates the treatments could have a path to market.

  • But in between foundational research and a treatment that can be prescribed, there’s a need for more incremental science, which is often the purview of the NIH.
  • The agency has funded research in psychedelics, but largely focused on the their potential for addiction, how they work and how they affect the brain.
  • That informs whether and how they can be used in therapies but little federal funding in the past two decades has gone toward clinical studies in humans of treatments involving classic psychedelics like LSD and psilocybin. (NIH has supported research on the therapeutic effects of ketamine, which isn't considered a class psychedelic.)

Between the lines: “The funding side of the government has been the last to the party for a long time,” says Matthew Johnson, who studies psychedelics at Johns Hopkins University.

  • NIDA recently awarded Johnson a grant to investigate the use of psilocybin-enhanced therapy to help people quit smoking, building on earlier studies. The grant hasn’t been added to the NIH’s public database, but Johnson says it amounts to about $4 million.
  • It’s a significant moment for the field, several psychedelic researchers told Axios.
  • Funding from the NIH, which tends to award larger grants than philanthropists, allows researchers to delve more into the details, Johnson says. Studies can look at the effects of dosing, changing the type of therapy given and altering other variables that could optimize treatment.

"It is that type of non-sexy research that is the backbone for everything in the long term," he says.

  • The Australian government is also funding research into using psychedelics to treat mental disorders.

What they're saying: "Newly funded research on the therapeutic effects of hallucinogens reflects a resurgence in interest in hallucinogens in the scientific community and is predicated on the submission of well-designed research studies for funding consideration," NIDA director Nora Volkow told Axios in an email.

Background: Earlier studies demonstrated psychedelics can be safely administered in combination with therapy and that treatment may alleviate depression, obsessive-compulsive disorder and substance use disorders.

  • The work also brought more scientific rigor to the field and showed how the effectiveness of psychedelic drugs can be measured, Grant says.

Yes, but: There are still challenges in evaluating the treatment, including the possibility of bias in participants who have expectations of the drugs. And the treatment is administered in highly controlled environments alongside repeated therapy sessions, a practical hurdle for widespread use.

What to watch: Beyond the funding's impact on the science itself, knowing the NIH is open to investing in research about psychedelic therapies could spur more young researchers to enter the field, Johnson says.

Editor's note: This story has been updated to clarify that little federal funding has gone toward clinical studies in humans of treatments involving classic psychedelics like LSD and psilocybin over the past two decades specifically.

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