Background: Novel psychedelics approximate classic psychedelics, but unlike classic psychedelics, novel psychedelics have been used by humans for a shorter period of time, with fewer data available on these substances.
Aims: The purpose of this study was to determine the prevalence of novel psychedelic use and the associations of novel psychedelic use with mental health outcomes.
Methods: We estimated the prevalence of self-reported, write-in lifetime novel psychedelic use and evaluated the associations of novel psychedelic use with psychosocial characteristics, past month psychological distress, and past year suicidality among adult respondents pooled from years 2008–2016 of the National Survey on Drug Use and Health (weighted n=234,914,788).
Results: A fraction (weighted n=273,720; 0.12%) reported lifetime novel psychedelic use. This cohort tended to be younger, male, and White, have greater educational attainment but less income, be more likely to have never been married, engage in self-reported risky behavior, and report lifetime illicit use of other drugs, particularly classic psychedelics (96.9%). (2-(4-Bromo-2,5-dimethoxyphenyl)ethanamine) (2C-B) (30.01%), (2,5-dimethoxy-4-iodophenethylamine) (2C-I) (23.9%), and (1-(2,5-dimethoxy-4-ethylphenyl)-2-aminoethane) (2C-E) (14.8%) accounted for the majority of lifetime novel psychedelic use. Although lifetime novel psychedelic use was not associated with psychological distress or suicidality compared to no lifetime novel psychedelic use or classic psychedelic use, relative to lifetime use of classic psychedelics but not novel psychedelics, lifetime novel psychedelic use was associated with a greater likelihood of past year suicidal thinking (adjusted Odds Ratio (aOR)=1.4 (1.1–1.9)) and past year suicidal planning (aOR=1.6 (1.1–2.4)).
Conclusion: Novel psychedelics may differ from classic psychedelics in meaningful ways, though additional, directed research is needed.
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Strychnine and other enduring myths: Expert and user folklore surrounding LSD
A particularly noteworthy aspect of LSD mythology is its existence among both users of the drug and experts in the substance abuse field. Among professionals, some of these myths are pervasive enough to have received mention as “facts” in prominent professional publications.
Set, Setting, and Matrix
The future use of psychedelics as an aid to therapeutic change is bound to come. The best source of information on how to use these extraordinary drugs is clearly a detailed description of the successes (and failures) of those researchers who have used these compounds to bring curative, creative and growth-potentiating experiences to their patients. A study of their work is recommended in order to identify those elements that lead to successful sessions. Two known essential elements are “set,” which involves the personality and expectations of the patient, and “setting,” which has to do with the environment of the session. A third element of importance is that of “matrix,” which includes consideration of the environment (1) from which an individual comes, (2) in which the individual lives during the time of the sessions, and (3) to which the individual returns after successful therapy—the everyday living space; these three elements are discussed.
Humanistic Psychology, Psychedelics, and the Transpersonal Vision
In the 1950s and early 1960s the field of humanistic psychology was established, with the founding of the Journal of Humanistic Psychology (JHP) by Abraham Maslow and Anthony Sutich and the Association of Humanistic Psychology founded by Carl Rogers, Virginia Satir, and Maslow in 1961. Also known as the Third Force, following behaviorism (the First Force) and psychoanalysis (the Second Force), humanistic psychology broke with the restrictive and overly deterministic models of conventional psychology of that time and presented a more optimistic vision of human potential, stressing the importance of personal growth and self-actualization. Maslow, one of the leading founders and proponents of humanistic psychology charted a hierarchy of needs in order of decreasing priority yet increasing sophistication, starting with basic physiological needs and safety and extending to belongingness and love, fulfillment, self-worth, and autonomy.
Human Nature and the Nature of Reality: Conceptual Challenges From Consciousness Research
Holotropic states (a large special subgroup of nonordinary states of consciousness) have been the focus of many fields of modem research, such as experiential psychotherapy, clinical and laboratory work with psychedelic substances, field anthropology, thanatology, and therapy with individuals undergoing psychospiritual crises (“spiritual emergencies”). This research has generated a plethora of extraordinary observations that have undermined some of the most fundamental assumptions of modem psychiatry, psychology, and psychotherapy. Some of these new findings seriously challenge the most basic philosophical tenets of Western science concerning the relationship between matter, life, and consciousness. This article summarizes the most important major revisions that would have to be made in our understanding of consciousness and of the human psyche in health and disease to accomodate these conceptual challenges. These areas of changes include; a new understanding and cartography of the human psyche; the nature and architecture of emotional and psychosomatic disorders; therapeutic mechanisms and the process of healing; the strategy of psychotherapy and self-exploration; the role of spirituality in human life; and the nature of reality.
Human Hallucinogen Research: Guidelines for Safety
There has recently been a renewal of human research with classical hallucinogens (psychedelics). This paper first briefly discusses the unique history of human hallucinogen research, and then reviews the risks of hallucinogen administration and safeguards for minimizing these risks. Although hallucinogens are relatively safe physiologically and are not considered drugs of dependence, their administration involves unique psychological risks. The most likely risk is overwhelming distress during drug action (‘bad trip’), which could lead to potentially dangerous behaviour such as leaving the study site. Less common are prolonged psychoses triggered by hallucinogens. Safeguards against these risks include the exclusion of volunteers with personal or family history of psychotic disorders or other severe psychiatric disorders, establishing trust and rapport between session monitors and volunteer before the session, careful volunteer preparation, a safe physical session environment and interpersonal support from at least two study monitors during the session. Investigators should probe for the relatively rare hallucinogen persisting perception disorder in follow-up contact. Persisting adverse reactions are rare when research is conducted along these guidelines. Incautious research may jeopardize participant safety and future research. However, carefully conducted research may inform the treatment of psychiatric disorders, and may lead to advances in basic science.
Positive Psychology in the Investigation of Psychedelics and Entactogens: A Critical Review
Rationale
We reviewed the concepts and empirical findings in studies with psychedelics and entactogens related to positive psychology – the study of healthy human functioning, well-being and eudaemonia. It is an unresolved question how beneficial effects of psychedelics and entactogens are related to the potential risks of these substances – particularly in non-clinical settings.
Methods
We searched in PubMed, PsychINFO and the Cochrane Library for controlled clinical and epidemiological studies which applied concepts from positive psychology. We included N = 77 eligible studies with 9876 participants published before November 1st, 2017: (1) quantitative studies (N = 54), (2) preliminary or exploratory studies and reviews not including meta-analyses (N = 17), and (3) studies evidencing primarily negative results (N = 6).
Results
Positive psychology concepts have been applied for measuring effects of clinical trials, recreational and ceremonial use of psychedelics and entactogens. Psychedelics and entactogens were shown to produce acute and long-term effects on mood, well-being, prosocial behaviours, empathy, cognitive flexibility, creativity, personality factors like openness, value orientations, nature-relatedness, spirituality, self-transcendence and mindfulness-related capabilities.
Conclusions
There is preliminary evidence for beneficial effects of psychedelics and entactogens on measures of positive psychology in clinical and healthy populations, however their sustainability remains largely unresolved. The reported results must be considered preliminary due to methodological restrictions. Since longitudinal data on both positive and adverse effects of psychedelics are lacking, more rigorous and standardized measures from positive psychology should be applied in less biased populations with prospective longitudinal designs to carefully assess the benefit-risk-ratio.
This article is part of the Special Issue entitled ‘Psychedelics: New Doors, Altered Perceptions’.
Novel Psychopharmacological Therapies for Psychiatric Disorders: Psilocybin and MDMA
4-phosphorloxy-N,N-dimethyltryptamine (psilocybin) and methylenedioxymethamfetamine (MDMA), best known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research during the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and in patients with advanced cancer with anxiety. MDMA is showing encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, rather than as stand-alone drug treatments. This model of drug-assisted psychotherapy is a possible alternative to existing pharmacological and psychological treatments in psychiatry. Further research is needed to fully assess the potential of these compounds in the management of these common disorders that are difficult to treat with existing methods.
Altered States of Consciousness: Drug-Induced States
Drug effects on consciousness are powerful probes of how physical processes in the body are connected to conscious experience. Drugs that alter consciousness – producing arousal, sedation, sleep, anesthesia, analgesia, euphoria, amnesia, hallucinations, or psychedelic-like intensification of perceptions, thoughts, and feelings – have been identified as interacting in various ways with cellular and molecular processes within the nervous system. While the focus has thus far been on synaptic connections between neurons, there is likely to be much more going on in the interaction of drugs with living systems that has not yet been identified. Psychedelic drugs, plants, and fungi are associated with perhaps the most interesting and profound of the drug-induced alterations of consciousness. Contemporary investigations of psychedelics include renewed interest in the transformational therapeutic potential of these substances, and may also lead to new insights into the nature of consciousness.
Hallucinogenic Drugs in Psychiatric Research and Treatment: Perspectives and Prospects
Clinical research with hallucinogens has resumed after a generation’s hiatus. To place these new studies in context, this article reviews the history of hallucinogens’ use and abuse, discusses their pharmacological properties, and highlights previous human studies. Research with lysergic acid diethylamide and related hallucinogens with thousands of patients and control subjects was associated with acceptable safety when subjects were carefully screened, supervised, and followed up. Data were generated regarding hallucinogens’ psychopharmacology, overlap with endogenous psychoses, and psychotherapeutic efficacy. Current American and European studies emphasize systematic psychopharmacology, in addition to psychotherapy protocols. Human hallucinogen research will help define unique mind-brain interfaces, and provide mechanistic hypotheses and treatment options for psychiatric disorders. It is critical that human hallucinogen research in the 1990s make use of state of the art methodologies, or consensually define when modifications are required. Training and supervisory issues also must be explicitly addressed.