The Scientist, the Activist & the Elephant in the Room
Plus early Public Health & Safety Data from Colorado
“You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”
It is a valuable exercise to consider and examine the potential risks to the ‘Psychedelic Renaissance.’
This exciting, promising, and hopeful domain challenges many orthodoxies and entrenched systems. And if history is any indication, it is not a given that this renaissance is here to stay.
When people think about the risks to this field/movement, it usually refers to two things:
Getting ahead of the science
Cult-like dynamics in unregulated settings
These are different sides of the same coin of the sky-rocketing increase in demand for psychedelics in unregulated settings, driven by the increased awareness of the healing potential of these compounds.
Consider the findings of a study published last week in JAMA Psychiatry: Trends in Illicit Ketamine Seizures in the US From 2017 to 2022
“In this cross-sectional study, we investigated seizures of illicit ketamine in the US from 2017 through 2022 as a measure of availability of ketamine for nonmedical use.”
What did they find?
The volume of illicit ketamine seizures rose 1,100% between 2017 and 2022.
Many consider this exponential rise in the illicit use of psychedelics like a Déjà vu back to the late ’60s and early ’70s when Timothy Leary was the “Most Dangerous Man in America,” and the Nixon administration introduced the Controlled Substances Act (CSA), thereby shutting down research and making the substances illegal to possess, consume and cultivate.
However, making this an incredibly complex situation is the meteoric rise in mental illness, an epidemic of loneliness and isolation, and what some, I think accurately, identify as an overarching crisis of meaning.
For an increasing number of people, psychedelics and their psycho/spiritual/emotional fruits are a significant part of the solution to this meta-crisis that cannot afford to wait for FDA approval or some other regulatory leniency.
This tension is best depicted in the debate between the Scientist and the Activist archetypes.
The Blind Men & the Elephant
The most helpful metaphor for understanding the ‘Psychedelic Renaissance’ and the diversity of perspectives is the parable of the blind men and the elephant.
You know the one I am talking about.
It is an ancient parable shared by the early Eastern traditions (Buddhism, Jainism, Hinduism) to illustrate the concept of subjective truth and the limitations of individual perception.
In the story, a group of blind men come across an elephant for the first time.
Each man touches a different part of the elephant’s body, such as its trunk, leg, ear, or tail. The blind man who feels the trunk thinks it’s a snake, while the one who touches the leg thinks it is a tree trunk. The one who touches its ear thinks it’s a fan, and so on.
As each blind man describes his experience, they begin to argue, each insisting that his perception is correct. However, none can see the entire elephant or understand its complete form and nature.
The parable illustrates that our perspectives are inherently based on limited experiences, and we cannot fully comprehend the complexity, nuance, and subtleties of the whole.
The Psychedelic Elephant
The beauty, and the challenge, is that the ‘Psychedelic Elephant,’ as it were, has innumerable parts.
As humans with limited perspective and bandwidth, those drawn to this domain will gravitate to different parts depending on our professional skills, personal beliefs, interests, and world views.
For some, the field is an investment opportunity; to others, it is an exciting challenge of psychopharmacology; to others, it is a nascent scientific domain yet to be mapped; for some, a journey into the nature of consciousness; for others, an opportunity to right the wrongs of past drug policy, for others still a new paradigm for healing, a chance to invoke and honor traditions of the past, to bring forth a new treatment for mental illness, and for others a chance to usurp the dominant power structure.
The list goes on and on—shared perspectives can seem hard to come by.
But two defining features of the psychedelic elephant—the tusks and the trunk, you might say—are the (1) scientific quest to understand these unique compounds, their effects, utility, and risks on the one hand and on the other (2) an effort to create access NOW to transformational, and even life-saving, medicines amidst a pandemic of suffering.
These two perspectives are often in tension, not unlike blind men arguing whether the object in question is a spear or a hose.
The Scientist’s perspective laments and fears the hasty cultural adoption and premature legalization.
The proliferation of non-clinical, non-scientific psychedelic use jeopardizes the scientific pursuit.
“People will get hurt, and it will invite yet another backlash” is the Scientist’s refrain.
After all, that’s precisely what happened in 1971 when Nixon invoked Timothy Leary as “the most dangerous man in America” and the ring leader of the drug-fuelled counterculture. As a result, a very promising field of research was shut down, and 50 years of scientific progress was lost.
The Scientist’s fear, I think, is best captured by a tweet from a psychedelic researcher who quotes Sidney Cohen, a psychiatrist who warned of the dangers of LSD in the 1960s.
“The trouble is, LSD attracts unstable therapists as much as it does the neurotic patient. It gives them an intoxicating sense of power to bestow such a fabulous experience on others.” Sidney Cohen 1963. Rarely discussed, but possibly #psychedelic medicine’s greatest threat.
If the powers-that-be decide that the underground and activity in legal/decriminalized jurisdictions becomes too dangerous, it could jeopardize scientific pursuits.
This is a completely reasonable and understandable perspective.
On the other hand, the Activist perspective views the scientific enterprise as a partner and collaborator until the point when the Scientist objects to the liberalization of access.
“But people are suffering NOW!” is the Activist refrain.
The Activist also understands that the scientific rationale of prudence now for safe and accessible future access via the healthcare system is a flawed argument.
For the Activist, the modern healthcare system is unfit for stewarding psychedelics.
When it comes to the conditions of subjective suffering—depression, anxiety, substance abuse, loneliness, meaninglessness—that do not fit into neat biomedical frameworks, the biomedical paradigm is not to be trusted to steward psychedelic therapies responsibly.
The Activist’s equivalent of the quote from above might be:
“The trouble is, LSD attracts gatekeeping medical professionals as much as the patients the system has failed. Academic credentials and affiliation with pharma is an intoxicating sense of authority to control such experiences.” Rarely discussed, but possibly #psychedelic medicine’s greatest threat.”
The healthcare system, the Activist will note, is uninterested in matters of the spirit, wholism, and healing.
The Activist’s perspective adds a third existential risk to the psychedelic movement:
Top-down control of legal psychedelic therapy by an antithetical treatment paradigm, institutions, and industry incentives
A new system is needed.
An Early Look at Colorado
For the Activist and many others, the new model is characterized by bottom-up, decentralized, non-hierarchical systems & networks—the type of systems thought possible under local decriminalization.
This is the type of system that proponents hope to bring to life in Colorado, where last November, voters passed Proposition 122, also called the Natural Medicine Health Act.
The law stipulates the state develop a commercially regulated access framework in which adults can consume psychedelics with support from certified facilitators.
It also decriminalized possessing, cultivating, gifting, and consuming several psychedelic plants and fungi.
Since then, Colorado has been running a social experiment in drug reform as the decriminalization decree went into effect immediately.
So how’s it going in the Centennial State?
Last week, Ferenstein published his findings: Early data suggest no health or safety harms from Colorado psychedelics legalization.
His findings are captured below in a few brief excerpts from the piece.
“As of yet, there has not been a single police agency that reports psychedelics as a public safety issue. “Psilocybin has not been a significant law enforcement issue in Denver either prior to or following the passage of Proposition 122,” wrote a representative for the Denver Police Department in a statement to me...
We contacted two of the largest hospital systems in Colorado to see if similar trends followed the legalization of psychedelics.
“[T]he general consensus is that there has not been any noticeable changes” a media relations representative fromHealthOne, a network of hospitals and clinics serving Denver wrote to me.
“Since proposition 122 passed last year, Denver Health has not seen an increase or decrease in incidences related to hallucinogens,” wrote a spokesperson forDenver Health, another network of medical and health organizations.”
The Future is Collaborative
These are positive signs from the experiment Colorado is running; hopefully, they will persist.
Furthermore, funding and access restrictions to clinical research imposed by the Controlled Substances Act—combined with the proliferation in underground and decriminalized settings, will create the scientific opportunity of a lifetime.
Unorthodox research approaches in this setting will become increasingly impactful in this new paradigm.
Projects like the Qualia Research Institute, the collaborative effort between Heroics Hearts, Imperial College London and Beckley Retreats, and the Emergent Phenomenology Research Consortium will be where breakthroughs of the future come from, and these projects combine the technical skills of the Scientist and the heart of the Activist.
Despite the apparent antagonism of the present, to develop the move the field forward, the Scientist and the Activist will find common ground and collaborate in these unorthodox settings—and this is where I find the most optimism and opportunity in this burgeoning field.
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