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Eroom's Shrooms: Are Psychedelics Better than The Beatles?
Breathing life into the stagnant drug development pipeline
Psychedelic Medicine: Better than The Beatles
In 1957 Gordon Moore and seven colleagues pitched well-known businessman, Sherman Fairchild, for capital to start a company that would build a new type of semiconductor, one made out of silicon, instead of the commonly used germanium.
Fairchild agreed and Fairchild Semiconductor would become the first venture-backed Start-up in what would later be a sea of startups in an area known as Silicon Valley—I am sure you’ve heard of it.
Moore went on to start Intel, the world’s largest producer of semiconductors, the inventors of microprocessors, the technology credited with the rapid rise of the personal computer and creators of a very clever jingle.
However, Moore is most known for Moore’s Law:
The observation that the number of transistors on a microchip doubles every two years while the cost of computers is halved. Moore's Law states that computer’s speed and capacity should increase every couple of years and that the cost will decrease.
Moore’s law is what allows for software and technology to be such lucrative areas of investment since new technology, in the form of smaller and faster processors allows for smaller and faster computers such as smartphones, smartwatches, and for computers to become mainstays in many everyday devices.
Moore’s Law in Gene Sequencing
The field of Genomics was expected to yield the end of disease and illness when Watson & Crick first discovered the DNA as the blueprint of life.
In 1990 the Human Genome Project was announced, a scientific project that set out to “map” the physical and functional properties of human genetic code with the belief this data would unleash an explosion of pharmaceutical discovery. It became the largest biological collaboration in history.
At the time the cost of gene sequencing was nearly $3 billion.
In 2016, 13 years after the Human Genome Project was successfully completed, the cost of sequencing an individual’s DNA was an astounding $1,000.
This rate of efficiency improvement surpasses Moore’s Law—by a lot.
Since biotechnology benefits from advances in technology, such as gene sequencing and proteomics which require computational power aided by the rapid improvement afforded by Moore’s Law— we would expect the trend to be at least in the same direction for pharmaceutical and biotechnology development.
However, this is not the case.
In fact, it is almost a complete reversal.
In 1950 $1 Billion in pharmaceutical investment produced about 30 new drugs.
Today, it costs $3 Billion to bring a single drug to market.
Whereas Moore’s Law observes that the cost of processing power halves every two years, Eroom’s Law—the clever reversal of Moore’s Law—observes that the number of new drugs approved per billion dollars spent on R&D has halved every nine years since 1950.
What’s the deal?
But isn’t humanity getting smarter? Technology and biosciences offer an ever-increasing understanding of human biology and disease, the genome has been mapped, we have CRISPR, computational drug discovery, etc.—what is going on?
The scientists who identified the trend identified four major reasons for it:
The 'better than the Beatles' problem — this proposes that all the low hanging fruit has been picked and that new drugs need to be not only better than placebo but better than what’s available. “This problem was phrased as "better than the Beatles" to highlight the fact that it would be difficult to come up with new successful pop songs if all new songs had to be better than the Beatles.”
The 'cautious regulator' problem: First Do No Harm. The FDA learned hard lessons from Vioxx and Thalidomide
The 'throw money at it' tendency: Creativity and improving processes solve problems, not money on its own.
The 'basic research–brute force' bias: “fuck it, I am going to make this work”
Can Psychedelics Make a Dent?
To my mind, this is because scientific medicine rewards specificity within a reductive framework and honors a gold standard of research that cannot reasonably capture the complexity of the human psyche.
Scott Alexander, the pseudonymous psychiatrist and beloved blogger notes:
“The two most exciting developments in psychopharmacology in the 21st century so far have been ketamine for depression and MDMA for PTSD.”
Let’s keep in mind these compounds were not discovered by deep learning algorithms from a stream of noise. They were not recently and painstakingly extracted from a rare, in danger of extinction Amazonian flower. They were not even synthesized in the last 50 years. MDMA was first produced by Merck in 1912 and Ketamine is over 50 years old.
MDMA and Ketamine are drugs that have been overlooked, not because of lack of technology, or computational power, or awareness. They were overlooked because of stigma.
Stigma and false perspective.
(Without getting too meta, if psychedelics change anything it is perspective.)
And these two are just the beginning.
The end of prohibition on the classic psychedelics, their derivatives and the long and fabled history of psychedelic tinkering from the likes of Sasha Shulgin and others has the potential to radically transform psychiatry and perhaps even make positive strides against the prevailing wind of Eroom’s Law.
With as much excitement and anticipation those of us closely watching and participating in this next phase of medicine are, many, many more are watching from the sidelines to see what happens with MDMA, two psilocybin projects and the other psychedelic derivatives that are in early stages of research.
The promise of psychedelic medicine is that it breathes life into a field that has grossly underperformed and whose underperformance has been felt across generations and across society.
Secondly, the advent of psychedelic medicine will breathe life into a stagnant drug discovery trend that reinforces the need for a biopsychosocial perspective in pharmaceutical development strategies.
We’re in the midst of a revolution in consciousness, medicine, and health.
The transition, already underway, from underground, illegal and sacred to commercialized, legal and profane is fascinating.
If you’re as fascinated by this transition as we are, The Trip Report has you covered.
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Written, curated and toiled over by Zachary Haigney