Psychedelic medicine: Mind bending, health giving

OHN HALPERN clearly remembers what made him change his mind about psychedelic drugs. It was the early 1990s and the young medical student at a hospital in Brooklyn, New York, was getting frustrated that he could not do more to help the alcoholics and addicts in his care. He sounded off to an older psychiatrist, who mentioned that LSD and related drugs had once been considered promising treatments for addiction. "I was so fascinated that I did all this research," Halpern recalls. "I was reading all these papers from the 60s and going, whoa, wait a minute! How come nobody's talking about this?"

More than a decade later, Halpern is now an associate director of substance abuse research at Harvard University's McLean Hospital and is at the forefront of a revival of research into psychedelic medicine. He recently received approval from the US Food and Drug Administration (FDA) to give late-stage cancer patients the psychedelic drug MDMA, also known as ecstasy. He is also laying the groundwork for testing LSD as a treatment for dreaded super-migraines known as cluster headaches.

And Halpern is not alone. Clinical trials of psychedelic drugs are planned or under way at numerous centres around the world for conditions ranging from anxiety to alcoholism. It may not be long before doctors are legally prescribing hallucinogens for the first time in decades. "There are medicines here that have been overlooked, that are fundamentally valuable," says Halpern.

These developments are a remarkable turnaround. Scientists first became interested in psychedelic drugs - also called hallucinogens because of their profound effect on perception - after Albert Hofmann, a chemist working for the Swiss pharmaceutical firm Sandoz, accidentally swallowed LSD in 1943. Hofmann's description of his experience, which he found both enchanting and terrifying, spurred scientific interest in LSD as well as naturally occurring compounds with similar effects: mescaline, the active ingredient of the peyote cactus; psilocybin, found in magic mushrooms; and DMT, from the Amazonian shamans' brew ayahuasca.

At first, many scientists called these drugs "psychotomimetics" because their effects appeared to mimic the symptoms of schizophrenia and other mental illnesses. However, many users rhapsodised about the life-changing insights they achieved during their experiences, so much so that in 1957, British psychiatrist Humphry Osmond proposed that the compounds be renamed "psychedelic", from the Greek for "mind-revealing". The term caught on, and psychiatrists started experimenting with the drugs as treatments for mental illness. By the mid-1960s, more than 1000 peer-reviewed papers had been published describing the treatment of more than 40,000 patients for schizophrenia, depression, alcoholism and other disorders.

A prominent member of this movement was Harvard psychologist Timothy Leary, who among other things tested whether psilocybin and LSD could be used to treat alcoholism and rehabilitate convicts. Although his studies were initially well received, Leary eventually lost his reputation - and his job - after he began touting psychedelics as a hotline to spiritual enlightenment. Leary's antics helped trigger a backlash, and by the late 1960s psychedelics had been outlawed in the US, Canada and Europe. Unsurprisingly, clinical research ground to a halt, partly because obtaining the necessary permits became much more difficult, but also because few researchers were willing to risk their reputations studying demonised substances.

But to some brave souls, psychedelic medicine never lost its allure. One of them is Rick Doblin, who in 1986 founded the Multidisciplinary Association for Psychedelic Studies (MAPS) in Sarasota, Florida, and who earned a doctorate from Harvard's Kennedy School of Government after writing a dissertation on the federal regulation of psychedelics. For nearly 20 years MAPS has lobbied the FDA and other government agencies to allow research on psychedelics to resume. It has also persuaded scientists to pursue the work and raised funds to support them. A similar body, the Heffter Research Institute in Santa Fe, New Mexico, was founded in 1993 by scientists with an interest in hallucinogens.

In the past couple of years their efforts have begun to pay off. Doblin is optimistic that psychedelic research is back for good, and this time it will do things right. "This gives us the chance to show that we have learned our lessons," he says. Halpern, too, is anxious to lay to rest the ghost of Leary. "That man screwed it up for so many people," he says.

With this in mind, Halpern says the first task for him and others is to evaluate the safety of psychedelics. And they are up against an entrenched orthodoxy: a 1971 editorial in The Journal of the American Medical Association warned that repeated ingestion of psychedelics causes personality deterioration. "Only a few of those who experience more than 50 'trips' are spared," it warned.