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Terry Maguire says psychedelics may be making a return, but beware of hippy marketeers hell-bent on altering the narrative of their own past

When I met Albert Hoffman in Basle in the late 1970s I had no idea who he was. At a pharmacy student conference he was the main speaker and I was immediately enthralled and captivated as he outlined his work in the discovery of LSD and his interest in the origins of man’s association with psychopharmacology. I have remained enthralled ever since. I read all I could find on the topic in the years following his lecture.

Foolishly, I wrote an article for the Chemist and Druggist magazine in 1993, ‘Witches Drugs and Religion’, in which I suggested that accidental ingestion of psychedelics might explain religious experiences such as the visions at Lourdes. My logic was that Bernadette Soubirous (St Bernadette) had been exposed to ergot – her father was a miller and ergot grew on rye – and egotism is suggested in the symptoms that eventually led to her death. I was naive in the extreme and was attacked ruthlessly by colleagues of a Catholic bias. One was so concerned she wrote to my wife suggesting she leave me and take the children. Paradoxically, at that time, a Queen’s student bible study group recommended the article as essential reading and held a number of discussion groups on it.

The social history of psychedelics in the 1960s when the recreational use of LSD got into full swing is well known. Terence McKenna’s Food of the Gods articulated the zeitgeist but I found his hippy counter-culture mantra about “an experience of pure being” and how the use of these drugs “allowed a fusion into a larger whole” difficult to understand or grounded in any practical reality. As McKenna might have retorted, ‘you needed to have been there, man’. Albert Hoffman was more pragmatic in his book LSD My Problem Child where he accepted that society would ultimately decide on the application of these drugs either for recreational or medicinal use, or both, but we needed science to underpin it.

Psychedelic means ‘mind manifesting’. Others termed these drugs ‘entheogens’, the power to elicit experience of the Divine within

The moral panic Timothy Leary (the American psychologist and author known for his strong advocacy of psychedelic drugs) unleashed led to a ban and, due to these restrictions, little serious research has been done since the 1960s. There is now a rehabilitation plan, bringing mainstream psychedelics into clinical use. It would be good to be able to say that these drugs are now getting the serious scientific attention they deserve but it seems that claim might be premature as what appears to be, and is reported as, science turns out to be good old- fashioned marketing.

Psychedelic means ‘mind manifesting’. Others termed these drugs ‘entheogens’, the power to elicit experience of the Divine within. They create visual hallucinations and dream-like ecstatic states, powerful shifts in cognition and emotional perceptions dissolving of time and space. These chemicals loosen the grip of our everyday perception. They were an essential part of sacred religious rituals in ancient societies across the globe and still are.

They are proving a tricky group of drugs to work with scientifically. They don’t act like conventional medicines and their effect occurs over hours where the patient needs to be closely monitored and supported. The treatment is often a one-off where the efficacy is sustained long term. Psychedelic Assisted Psychotherapy is now in Phase 2 clinical trials in the US. One study has treated 107 PTSD patients with, as the authors claim, impressive results. The thing is, this team is using MDMA (Ecstasy) which is not really a true psychedelic and they will have great difficulty designing a randomised controlled trial to assure the efficacy and safety of the drug and the process in a Phase 3 trial. I don’t see big pharma knocking on their door anytime soon.

Treatment currently is focused on mental conditions, those that prove difficult to manage with conventional medicine; addiction, post-traumatic stress disorder, fear of approaching death and intractable depression. Imaging studies suggest that these chemicals – LSD, psilocin, mescaline etc act on serotonin receptors and down regulate a theoretical system known as the Default Mode Network (DMN). Existence of the DMN has been speculated for about 20 years and repeated brain imaging studies have more or less confirmed its existence and its role in brain function. When not focused on a task, for example, when daydreaming you are thinking about your past, planning your future or working out why your neighbour dislikes you and it is then that your DMN is functioning.

The DMN is pretty rigid in adults in the types of thinking that occurs but not so in children and it is speculated that for those with addictions, depression, a morbid fear of imminent death or PTSD, the DMN is fixed so rigidly it is causing the individual serious problems. They ruminate on negative thoughts or promote destructive behaviours. Appropriate use of psychedelic drugs might effectively disrupt the DMN breaking up this rigid thinking and allowing other insights and different options. Use of psychedelics, in theory, resets the DMN. The addict can break free of his addiction, imminent death is not so frightening to the cancer patient, the depressive patient can think more positively about life and the PTSD patient can stop ruminating on horrific experiences.

This radical theory is covered well in Michael Pollen’s book How to change your mind. The journalist and food critic has moved sideways to look at the possibilities beyond the nutritional value of foods and he does it well. He is an engaging and intelligent speaker. Pollen resists the acolyte stance of others such as Rick Doblin who sadly lacks any real objectivity which questions the real scientific value of the work he is currently undertaking.

So why do psychedelics exist? Merlin Sheldrake’s Book Entangled Life provides a fascinating if not chilling overview of the hidden complex world of fungi. Merlin discusses the trick many fungi learnt since they first came onto the planet billions of years ago and that is to produce chemicals that precisely control insect behaviour that ultimately improves fungal spore dispersal and therefore fungal survival. For example, Carpenter ants once infected by a specific fungus immediately lose their inherent fear of heights, climb the nearest tall plant, clamp their jaws in a death grip into a central vein on the leaf and die. Fungal mycelia grow from the ant’s feet and adheres the insect’s body to the plant. The fungus eats the ant from within and showers spores down on the ants below repeating the cycle. The fungus orientates ants according to the direction of the sun, the ant clamps onto the plant at noon; perfect, precision, chemical control. These are the chemicals of the psychedelic revival. It is very unlikely that they were ever intended for controlling human minds and we are merely and opportunistically getting an effect that nature designed for another purpose. If we could get some medical benefits that would be great but what is currently happening is a marketing exercise by a few old 1960s hippies who seem hell-bent on proving to their dead mums and dads that there was a reason they dropped out. Albert Hoffman, a great hero of mine, was not one of them. He was too much of a scientist.

Terry Maguire owns two pharmacies in Belfast. He is an honorary senior lecturer at the School of Pharmacy, Queen’s University Belfast. His research interests include the contribution of community pharmacy to improving public health.