‘Enough is Enough’ Series: LSD Reconsidered

Robert Berezin, MD
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Biochemical psychiatry is now moving in an unfortunate, potentially dangerous, yet predictable direction. It is turning to psychedelic drugs.

Michael P. Bogenschutz, MD writes about this in a recent article in the Psychiatric Times, published April 20th, 2017 and titled “Innovative Strategies for Addressing Substance Use Disorders: The Classic Hallucinogens.” This is how it begins. Dr. Bogenschutz presents himself as simply open to changing the status of hallucinogens for research, which was “prematurely dropped over 40 years ago.” He concludes that “they meet medical standards for safety and efficacy.” Most of the ‘research’ has been for off-label uses, which is of course illegal. He suggests making it legal. It sounds so reasonable, calling for patients to be carefully screened and prepared with appropriate safeguards. He writes, “Taken as a whole, the evidence suggest that classic hallucinogens may hold considerable promise in the treatment of substance use disorders.”

It all sounds so very scientific, thoughtful and reasonable. How could one object? In the language of psychiatric brain diseases, alcoholism and substance abuse are called disorders — “cocaine use disorder” (I love that one). The intent is to portray them as brain diseases which calls for a biochemical cure. But they are not ‘disorders.’ Alcoholism and substance abuse are addictions, which requires a human approach. So the plan is to treat an addictive drug problem with more drugs. The article is filled with technical chemical analyses of LSD, psilocybin, DPT, mescaline, and DMT, which gives a false gravitas to the drugs issue — such intimidating knowledge and expertise.

‘Evidence based’ research is accepted as the gold standard for pharmaceutical psychiatry. I have shown the fallacy of this kind of spurious evidence for antidepressants (see “Bad Science Creates False and Dangerous Beliefs”). These studies proved nothing. But it is guaranteed that the ‘evidence’ from future research will show effectiveness for the hallucinogens. They will be added to the list of antidepressants, amphetamines, benzodiazepines, and antipsychotics. Furthermore, it will soon be shown that hallucinogens are now ‘safe,’ with minimal side effects, no habituation, no addiction, and no problems with withdrawal. None of this is true for the above mentioned pharmacy.

The effectiveness of poly-pharmacy has increasingly shown itself to be specious, yet the belief system of the pharmaceutical psychiatry has gained ascendancy and taken hold. Now they are running out of new drugs to try. And so they want us to be open minded and extend the false belief system to these dangerous drugs, with the idea that this is a good thing. Let’s not be closed minded so we can go from the frying pan into the fire. Real psychiatry is no longer being taught. With no alternative model, where will we turn?

The real eventuality is to capitalize on the opioid crisis and alcoholism. This is a good way to open the door to hallucinogens. In truth, Dr. Bogenschutz is really advocating hallucinogens to treat all psychiatric conditions: “Early-stage clinical trials of psilocybin or LSD for obsessive-compulsive disorder, anxiety, and depression associated with a life-threatening cancer diagnosis, major depression, tobacco use disorder, and alcohol use disorder have recently been published.” He suggests, regarding ketamine: “The discovery of its short-term antidepressant effects has generated much excitement, and it is now seeing significant off label use for treatment-resistant depression.” The article sounds so reasonable — it mentions that there are dangers, but says they are exaggerated.

The experiences of the 1960’s and 1970’s correctly showed the destructiveness of these drugs. In the 70’s, the psychiatric wards were full of psychedelically induced schizophrenia. I was there. In general, the use of hallucinogens had a devastating effect on American culture, one which we haven’t fully recovered from to this day. A lot of lives were ruined. Research on hallucinogens was not dropped prematurely, as if from inappropriate fear-mongering, as this article implies. It was dropped appropriately.

But now pharmaceutical psychiatry once again wants to open the door to dropping acid. Old advocates like Stanislav Grof, who was freely quoted in this paper, have been around since the sixties, lying in the weeds waiting for the next opportunity to push hallucinogens onto the general public. Since psychiatry and the general public believe that the cause of human struggle is biochemical, it would seem to follow that treatments should be drugs. But human suffering is not a biochemical disorder. It is not created by chemical imbalances. Drugs cannot and do not treat the human condition. You cannot have it both ways: either suffering is a brain problem to be treated biochemically with a drug, or it is not. Psychiatric struggle is a human problem created by the trauma of our lives. It needs to be addressed on the human scale, not with drugs. I am an advocate for good psychotherapy, and have shown how it deals with all of psychiatry.

There is a peculiar amnesia that happens in relation to drugs. For example, take the history of cocaine. After a devastating epidemic of cocaine in the early 1880’s, which continued into the turn of the century, it was finally understood to be dangerous. It was taken out of Coca Cola in 1903. Cocaine continued along all the way to the 1940’s, where its usage pretty much died out. Then amnesia set in. When cocaine made its comeback in the 1980’s, it was advertised as non-addictive, no downside, just a fantastic high. Nothing could have been further from the truth. Oddly, the first blues song I learned as a young teenager was “Cocaine Blues” by the Reverend Gary Davis:

“Cocaine all around my brain
Hey baby won’t you please come quick
This old cocaine’s makin’ me sick
Cocaine all around my brain”

At the time I didn’t know what cocaine was. Years later, John Belushi taught us more about it.

The same amnesia is happening now in regard to hallucinogens. We are being sold a bill of goods that they should not be seen as a street drug like cocaine. Instead they will soon be pushed by men in white coats as a new miracle, which will cure cocaine disorder. The amphetamines did make it to the other side of the street after amnesia set in for them. Let’s not do the same with LSD. We don’t need to repeat past mistakes.

42 COMMENTS

  1. I don’t necessarily agree with you on addiction and harm reduction, however, I have to be more with you on using psychedelics again. I have seen people who took them one time and they really had a change to them for the positive. I also know several that ended up in the ward with schizophrenia. Just to stay on the psychedelics, there is no absolute way to know what kind of change can happen beforehand. I also know that there can be a positive change in outlook and feeling about life from a psychedelic. But not so fast, a change like that can be temporary and not repeatable in the patient. The next “trip” never brings them to that place that seemed so helpful the first time. Why? They are not the same (exact) person. Physically, psychologically and emotionally. The (exact) same result is not possible the next time. Just like cocaine! It’s just that any changes in feeling and thinking lasted longer with a psychedelic than a cocaine high!

    • There are ways to estimate if serious bad things or no serious therapeutic response will happen, and that’s through history-taking (looking for “schiz” first-order relatives, as well as taking a HOD test (I bought mine to screen individuals for taking hallucinogenic mushrooms), which can predict the likelihood of an individual having prolonged reactions. There’s also a urine test for pyrolles, which also suggest their likelihood, as well. None of this is rocket science, having been explored 50 years ago.

    • LSD has a lot of dangerous side effects. The night after people take LSD they are all tired out. As a matter of fact, I’ve seen some people who looked like they were about to die. There are safer medicines and there is no way of predicting how a person is going to react to the drug. When a drug is prescribed, the patient response should be reliable and predictable. The patient is not a lab rat.

  2. I think it’s terrible enough that we have doctors prescribing opioids now, and with these prescriptions, launching their own overdose epidemic. Mixing opioids and benzos I hear can be a real killer.

    We went through this thing way back when if anybody remembers. I think one might have called it non-prescription drug culture. Hallucinogens can be fun, and they can be Hell, but the question is why would anybody want to escape this planet in the first place, and for good. Ultimately such escapes fail, and the space aliens are not such friendly creatures as we’d imagined them to be. Stellar consciousness you say. Well, among all your lost marbles where is the earth? Keep searching. It must be in there somewhere. What am I saying? We’ve got an opioid problem now. If psychedelia is worthwhile for a few weeks, then you’re back to ordinary (unexpanded) consciousness, and if you can’t make do with that, what then? Opening that can of worms is certain to lead to excess, something we’ve got more than enough of to contend with at the present moment.

    • I find this entertaining, because these new advocates come from the same bunch that anathematized hallucinogens back in the 1960’s, when protocols for their safe usage were devised in Saskatchewan by Hoffer and Osmond, making it a primary drug in that province for treating alcoholism, until our DEA suppressed it by pressuring the province several years later.

      Now it’s become forgotten lore, existing only in the pages of their books: The Hallucinogens and New Hope for Alcoholics, which neither you nor these neo-advocates for hallucinogens have apparently read (they’re out of print). I’m surprised the neo-advocates have read Stanislas Grof, the only person on earth who had licenses to dispense LSD from both the capitalist and communist blocs in that bygone era.

  3. This all reminds me of the movie, “What About Bob?”, where the psychiatrist (Leo) behaves in a more and more crazy fashion while his client, Bob, gets more and more rational. In the end, he attempts to murder Bob, but calls it “Death Therapy” – “It’s a sure cure!”

    What is wrong with these people??????? It would be funny if it weren’t really happening!

  4. “So the plan is to treat an addictive drug problem with more drugs.”

    This isn’t exactly new, nor is it a bad development. Methadone has been used to treat opiate addiction for a long time and is currently considered the gold standard for the treatment of opiate dependence:

    “Given the burden of disease, the development of effective treatments for opioid dependence is of great significance. Methadone maintenance is currently the gold standard of treatments as it is associated with reductions in intravenous drug use, crime, HIV risk behaviors and mortality, and is well-established in community treatment programs around the world.”

    [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874458/]

    The idea that many of these substance are addictive (especially in the case of psychedelics) is simply untrue:

    “The curious property of psychedelics is that they’re anti-addictive,” Dr. James Fadiman, author of The Psychedelic Explorer’s Guide from Santa Cruz, Calif. told Medical Daily. Fadiman has been researching psychedelics since the 1960s, and over the decades, he’s observed that the drugs are difficult to abuse because they are incapable of producing psychoactive effects when used in succession.

    “You can take 100 micrograms of LSD, [a typical dose], on Monday and have an experience. Then if you take 100 micrograms on Tuesday, you’ll maybe get one tenth of that experience. Take 100 micrograms on Wednesday, [and you’ll get] no experience. Take even 1,000 micrograms on Thursday, zero experience. It’s as if your system says, ‘this is not appropriate!’”

    [http://www.medicaldaily.com/psychedelic-drugs-mental-health-disorders-bad-rap-war-drugs-385946]

    We should certainly resist psychiatry’s attempts to promote new “miracle cures” for the bill of ailments promoted within the DSM, but we should not adopt and continue to spread drug war propaganda in the process. For example, the idea that research into psychedelics was abandoned “for good reason” is simply not true, and any cursory reading about the history of psychedelic research and the drug war’s effects on it reveals its falsehood:

    [http://www.newyorker.com/magazine/2015/02/09/trip-treatment]

    [http://psypressuk.com/2015/07/30/professor-david-nutt-why-banning-lsd-and-magic-mushrooms-is-the-worst-censorship-of-medicine-in-world-history/?utm_content=buffer1b1e4&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer]

    [https://www.nytimes.com/2014/11/30/opinion/sunday/can-mushrooms-treat-depression.html?action=click&pgtype=Homepage&region=CColumn&module=MostEmailed&version=Full&src=me&WT.nav=MostEmailed&_r=2]

    Furthermore, the most vocal proponents of psychedelic research, such as Dennis McKenna and his MultiDisciplinary Association for Psychedelic Studies (http://www.maps.org/research) are on record as being extremely critical of big pharma:

    “… Big Pharma wants drugs that people consume… You can’t use [psychedelics]… in a therapeutic session without intense psychotherapy, whether that’s actual psychotherapy or shamanism or some combination of those things. These are drugs that have to be used in context. The ‘take two and call me in the morning’ model doesn’t work for these. These have to be used in a very highly controlled set and setting. So I think where the business model comes in is you have places where people can go and get this kind of therapy… Our whole bio-medical-industrial complex is set up to encourage Band-Aid solutions. You have a problem. You go see your psychiatrist. He has seven minutes, if he’s lucky, to talk to you. Here’s a prescription. Get out of here. That’s the way it works. With psychedelics, you actually have to have a therapist who will sit down and talk with you. This is a whole novel concept. So I think where the business potential comes in is to have centers of therapy where you can go and get psychedelic therapy. And the emphasis is more on the setting and the services provided than on the actual chemicals.”

    So, I’m sorry, but this piece reads like one written by someone who has not kept up with developments on psychedelic research nor of someone with in depth familiarity of the history of the drug war and its subsequent influences on the abandonment of research of these substances.

    • Pitolay2002

      I like some of what you say here but the following part of your comment is WAY OFF:

      You said: ” Methadone has been used to treat opiate addiction for a long time and is currently considered the gold standard for the treatment of opiate dependence…”

      The “gold standard” comment only makes sense if you are talking about the profits of Big Pharma and the ability of the ruling classes to control certain sections of the population. The current uses of methadone are very dangerous and overall very harmful to those caught up in the clutches of the “orange handcuffs.” I suggest you read my past blog at MIA:

      https://www.madinamerica.com/2014/04/manufacture-maintenance-oppression-profitable-business/

      And as to its dangers: less than 5% of opiate prescriptions involve methadone (a synthetic opiate), yet it is implicated in one third of all the deaths associated with opiate drugs.

      This profit based System we live under has NO solution to drug overdose crisis and as long as there is the existence of poverty and various forms of class oppression, it will NEVER be solved.

      And I will add, that I agree with many of the criticisms of this blog’s dogmatism when it comes to the possible benefits of psychedelic drugs, especially as it pertains to the reprocessing of past trauma experiences.

      Richard

      • Thank you for adding this about social context, Richard. I would add that psychedelics have a potential role in this, in that unlike prescription psych drugs, they can help people to think more freely and break out of the sort of constraints and conceptual (and material) oppression you’re referring to. They certainly tend to shift people from power to love. But that freer thinking is not always the case, or doesn’t always lead in anti-oppressive directions. They can also simply reassure the privileged by introducing superficial “free thinking” without any real critique of social oppression. I also have pondered how the power of psychedelic experience may play into our addiction to spectacle and so keep people on that treadmill–it’s always got to be bigger, more spectacular, more mind-blowing, whether it’s a car chase in a movie or another psychedelic experience. So, as you and others have said here, it’s complicated and variable and I think these things require not only medical and psychological carefulness, but elucidation of social context and oppression and how we deal with that. All the more reason for these discussions. Thanks again for your thoughtful post.

    • Thank you for your statement. LSD is probably not for everyone but can be extremely useful in helping some people deal with PTSD and trauma issues. It seems to allow some people to look at the trauma objectively and without fear, something that usually doesn’t happen for trauma survivors. It also seems to keep the ego from getting involved, which may lead to the increased objectivity.

  5. Psychiatrists are not the ones to be prescribing anything. However psychedelics are not drugs in the standard sense, they might be considered adjuncts to meditation. The insight gained when all goes well is not dependent on repeat doses. They should not be put in the same category as uppers and downers, which is basically what psychiatry has to offer. Nor should they be considered as “medicines” for “mental illnesses.”

    • I used to be a tester in Amsterdam for an LSD lab to get the visuals or euphoria levels right and to do that my qualification was that I tripped for over a year with a friend of mine, so that my mind/body had adapted to the drug. We got to the point where we could take very large amounts, we used to chew on a card of 100 trips. So were ingesting around 10-15 at a time every day. We developed the ability to telepathically communicate via chakra openings. I learnt this was the case because in later years I spent 10 years learning chakra yoga and the affects are the same, the opening of the chackras to release kundalini.

      Acid is a shortcut to releasing kundalini, but it needs about a year of ingestion to adapt to functioning in the world without the visuals or euphoria inhibiting your ability to cope/adapt, so that other people don’t realize what you are doing. We then moved onto IVing pure acid- from operation julie, blue mikes from Wales, acid which was wonderful. This chemist really knew his stuff. It felt like having a warm shower, a max out trip in less than 60 seconds, no throat problems, with bliss being quickly achieved.

      We also went to Wales a place called Ruthin were psyilocibin semilanceata were grown on the mountains and we worked up to a trip which involved ingesting these mushrooms for over 30 minutes. It was difficult to estimate the volume but I reckon we swallowed around 2-3 thousand fresh with water.

      The only struggle was that my friend said he had seen enough in this incarnation, to move on and fell forward over a 400 foot drop. He held out his arms and was going to drop but I was able to hold his waist and pull him back. I then burst into tears and said no, no my dear friend not now. He was 22 years old.

      After we came back he was admitted to a psych ward and called a schizophrenic for 9 months. When I visited him he was sitting in the lotus position and just said: there are no reference points. I held his hand and said: you go well now.

      He was released after a year and we never too these drugs again. He is now a priest and I’m sane.

      I think these drugs can do good but they are very wild…go well

  6. Robert,

    I’ve appreciated so much of your writing on this site, and agree that the current resurgence of interest in psychedelics warrants scrutiny. But I find some things here troubling.

    Your suggestion that psychedelics have been put forth as a cure for supposed chemical imbalance is completely at odds with both their pharmacology and how proponents (and even opponents) describe their mode of action and effects. This suggestion is not even in the ballpark and, at least for me, raises questions about other aspects of your account and the sort of bias you may be bringing to the discussion.

    As for their usefulness and safety, I think it’s safe to say that there is great variability. Personally, I’ve had considerable experience and found them very helpful at certain junctures and also encountered some serious problems when they’ve not been used carefully. Let me offer a few examples.

    I spent four years working with a careful, and chemically very conservative, therapist trying in vein to get off of SSRIs, which I never had any great need for but was told they would just make everything better (cf Peter Kramer; I was supposed to be “better than well.”). But after ten years on them, I could not get off. Or more precisely, every time I DID get off them, within a month I would enter a dark depression far, far worse than anything I had experienced before the drugs and it would go on for months until finally I had to start up the drugs again. But they were slowly killing me, emotionally and physically. The last thing I had to try was guided work with MDMA. I did just one session and it worked, not by shifting any “chemical imbalance” but by re-opening a window on authentic emotion that I had lost years before and so giving me hope and soul susteneance. Staying off SSRIs was still very hard for months, but that work got me over the hump. I doubt I would have been able to do this without pschedelics; my therapist, who I am still working with, agrees. I shudder to think what I would be like without it. Well, I know: I would be fat, asexual, and emotionally numb.

    I did, however, make the mistake after that of getting involved with a “therapeutic” and “shamanic” community that was not at all good or careful in it’s use of psychedelics. The work was very free-form. Unlike the careful and controlled work being done in some quarters, you had many people in various states of experience with various substances roaming around or huddled up together. I think some people were helped. Others had some really interesting times. It was not good for me, and I’m sure for some others. Finally, after a year, as I was sliding downhill, someone pointed out to me that in such settings psychedelics can be re-traumatizing. As she said to me, “you never know who’s going to come by and drop their shit on you when you’re in a deep and vulnerable place.” I learned that the hard way and it took me a year to work through it all after getting out of that community. One of the reasons I got involved and couldn’t see the problems for almost a year is that this group included many highly reputable and esteemed professionals. Doctors, lawyers, philanthropists, therapists. And a couple of very talented, even brilliant, neo-shamans who were, in my view (retrospectively) quite reckless. But my normal avoidance of flakeyness and carelessness was overridden by all that prestige and by the very powerful experiences involved. I mention this and offer those details in support of your suggestion that this sort of work begs critical scrutiny. There is, indeed, dangerous and damaging stuff happening in the psychedelic resurgence. I did not however, encounter anything even close to the sort of psychedelically-induced scizophrenia you suggest is so common. In fact, now after five years of substantial familiarity with this sort of work, including attending conferences and consulting with many researchers and practitioners, I have yet to even hear of a case like that. I’m sure it has happened but I think it’s pretty darned rare, and about unheard of when the work is done carefully.

    Lastly, I will say that since then, I have participated in a few ayahuasca ceremonies with a very careful and skilled practitioner who has trained extensively with native Peruvians. To give one positive example of what is possible, after several years (since I got off the SSRIs and started to become aware of and to work on underlying trauma) of waking almost every night in a sort of tense, wrestling panic, during one experience I was able to go back and see my earliest trauma, which was very intense and had a feel very similar to those wakings in the night, and to bring my own adult kindness and love to my very young self. That was almost a year ago and I have not woken up in that way since. At that point, I had been for seven years in the sort of careful and caring therapy that you and I both believe strongly in and that has helped me immensely. Would another seven years, or ten years, of therapy have eventually healed those very early wounds? Maybe. I don’t know. But I do know that psychedelics helped.

    My point is simply that, despite limitations and problems, these substances have legitimate uses and help many people. I hope the best minds and souls in psychiatry and psychology, like your own (and I really mean that), can at least stay open to these possibilities, even while bringing much needed scrutiny to this realm.

      • Yes, bc, I think that’s exactly right. They are catalysts for experience. In that sense, vis. addiction, they often function in much the same way as finding a “higher power.” Religion, AA, psychedelics are all ways of seeing something bigger than ourselves and taking the enormous pressure off of wounded egos and connecting to something bigger in the world, and to love.

  7. Thanks to those who have already criticized Berezin’s post: the post itself seems unfortunately far from a thoughtful analysis of this complex subject.

    It might be worth bringing up a large study done a few years ago looking at the mental health consequences of doing psychedelics, outside of any “mental health” setting. Here’s what they found:

    “21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems.” That’s from Psychedelics and Mental Health: A Population Study – http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063972

    Anyway, that’s kind of hard to reconcile with the notion that psychedelic use will create hospital wards “full of psychedelically induced schizophrenia” as Berezin suggests.

    The truth may be much more complex. In random use of psychedelics, some people may have healing experiences that save them from otherwise going mad: others may go mad and end up in the system. With proper guidance, outcomes might be much more positive. Of course, if “guidance” is left up to those currently running the mental health system, there could be huge problems! But it would be nice to see a more thoughtful analysis of all the issues involved here.

  8. I have mixed feelings about this piece. I don’t believe in the concept of “substance use disorders,” nor am I thrilled with the idea of psychiatrists “prescribing” hallucinogens to people. But I personally benefited greatly in my own development from the conscious use of hallucinogens 40-some years ago, and I think they should legal and available to people who want to use them. And I don’t believe that back in the 60s and 70s “the psychiatric wards were full of psychedelically induced schizophrenia” (not a term I think is valid in any event) – I’d like to see some citations that show this.

  9. I’m open-minded as to the possible benefits of LSD for psychiatric patients, including (horrors) when given to people with psychiatric diagnoses like schizophrenia and bipolar. People with these diagnoses were routinely discouraged by their doctors from something as helpful as meditation, as this was thought to “destabilize” them. (I was really annoyed when the TM center wanted permission from my son’s psychiatrist to participate.) The only help available is generally what psychiatrists determine to be helpful, which, unsurprisingly, doesn’t stray from the services they provide. My son (unbeknownst to the psychiatrist) went through several out-of-body experiences induced by sound, and he benefited a lot in terms of growing insight. If LSD had been offered, I would have encouraged him to go for it. Unfortunately, it seems that LSD in controlled therapeutic settings is only being encouraged for cases of depression associated with end of life issues. Pity.

  10. To know is not to know

    As I said, as an LSD tester in the lab, the drug does does lead to full kundalini chakra release- full realization of universal consciousness, but this requires about 6 months of ingestion for the body/mind to adapt- to get beyond the surface visuals/euphoria/illusions. The alternative – the natural way- took me around 5 years through chakra yoga with the help of a highly skilled swami.

    Go well