Among animals, humans stand out in their consummate propensity to self-induce altered states of mind. Archaeology, history and ethnography show these activities have taken place since the beginnings of civilization, yet their role in the emergence and evolution of the human mind itself remains debatable. The means through which modern humans actively alter their experience of self and reality frequently depend on psychoactive substances, but it is uncertain whether psychedelics or other drugs were part of the ecology or culture of pre-human ancestors. Moreover, (nonhuman) great apes in captivity are currently being retired from medical research, rendering comparative approaches thus far impracticable. Here, we circumvent this limitation by harnessing the breadth of publicly available YouTube data to show that apes engage in rope spinning during solitary play. When spinning, the apes achieved speeds sufficient to alter self-perception and situational awareness that were comparable to those tapped for transcendent experiences in humans (e.g. Sufi whirling), and the number of revolutions spun predicted behavioural evidence for dizziness. Thus, spinning serves as a self-sufficient means of changing body-mind responsiveness in hominids. A proclivity for such experiences is shared between humans and great apes, and provides an entry point for the comparative study of the mechanisms, functions, and adaptive value of altered states of mind in human evolution.
Psychedelic Medicine’s Future Depends on Proactive Development of a Robust Medical Billing and Coding Strategy
Background: Although still investigational, psychedelic therapies appear poised to begin securing regulatory approval as medical treatments in the United States within the next 2 years. If approved, one of the most daunting barriers to equitable patient access to these novel treatments is their incorporation into the medical billing and coding system. Since specific billing codes for psychedelic therapy delivery do not exist, modification of existing codes or development of de novo codes will be necessary. This reality has created uncertainty about reimbursement and the financial future of psychedelic medicine.
Opinion: We argue that development of de novo billing codes in conjunction with the American Medical Association’s Current Procedural Terminology (CPT) Editorial Panel is the best approach for addressing psychedelic therapy reimbursement concerns. However, with no similar existing medical services to guide development, the potential need for multiple providers during dosing sessions, limited mental health care representation on the CPT Editorial Panel, and a number of misconceptions surrounding psychedelic therapy among critics, psychedelic therapy is particularly vulnerable to development of billing codes that undervalue the complexity of its delivery. With an industry-sponsored application for new CPT codes for “psychedelic drug monitoring services” soon to be reviewed by the CPT Editorial Panel, a critical step toward maximizing psychedelic therapy’s societal impact has been taken. However, many questions remain about whether these proposed codes will provide adequate flexibility for a treatment modality involving various drugs, therapeutic approaches, and patient monitoring strategies, as well as which types of providers will qualify to use them. Whether these proposed codes ultimately become the bedrock of billing for psychedelic therapy or future codes are developed to augment or replace them is not known, but it is a promising sign that efforts to create a robust medical billing and coding strategy for psychedelic medicine are now underway.
Principles of Harm Reduction
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
Psychedelic medicine: safety and ethical concerns
With the current surge of interest in the field of psychedelic research, a psychedelic renaissance in psychiatry depends primarily on the ability to establish safe and ethical settings for the use of these experimental medicines. However, few opportunities exist for learning the safe and effective administration of psychedelic therapies. When psychedelics were embraced by modern medicine in the 1950s and 1960s, enthusiasm and fervent portentousness overtook pragmatism before psychedelic science could develop safe and consistent structures. A similar collective enthusiasm is palpable in psychedelic psychiatry—a field that does not yet have in place the means to manage the consequences of its much-anticipated success. We wish to draw attention to several issues that need to be thoroughly addressed to allow the field of psychedelic research to grow in a safe and sustainable manner.
Drug Policy Alliance – Harm Reduction
Harm reduction is a set of ideas and interventions that seek to reduce the harms associated with both drug use and ineffective, racialized drug policies.
Harm reduction stands in stark contrast to a punitive approach to problematic drug use—it is based on acknowledging the dignity and humanity of people who use drugs and bringing them into a community of care in order to minimize negative consequences and promote optimal health and social inclusion.
Drug Policy Alliance – Real Drug Education
At the Drug Policy Alliance, we believe accurate, honest, compassionate drug education is a right for all young people.
Just Say No’ — Or ‘Just Know’?
My son Johnny, a high school junior this fall, is learning all kinds of new things — academic, social and physical. At 16, he seems fearless. And, as a typical American teenager, he faces two risk-sensitive issues: drug use and sexuality. So I read with keen interest a recent report by the Centers for Disease Control and Prevention that addresses both of these hot-button topics.
Its gist: Teen drug use is up, but fewer young people are having sex, and more of those who do practice ”safe sex.” A decade ago, a third of students surveyed said they had experimented with marijuana. By 1999, almost half had tried pot. But during the same time span, the number of students having sex declined from just over half to slightly under half. Most important: Of those who were sexually active, 58% reported using a condom in 1999, compared with 46% in 1991.
I wanted to know why risky teen sexual activity decreased while drug use rose. A look at our sex and drug education offers an answer: In a nutshell, while we’d all prefer that they abstain from both, we try to reason with teens about sex, but we scare them about drugs.
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.