The Stigma of Psychedelics

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In 2019, prior to the COVID-19 pandemic, 1 in 8 Americans were taking selective serotonin reuptake inhibitors (SSRIs). Six million of those people were reported to have been taking them for a decade or more. An effective treatment for clinical depression—regardless of severity—is not necessarily one that patients depend upon for decades or more, but one that helps them make a permanent change.

Psilocybin, the active compound in mushrooms, seemingly works by reducing the effect of memory on perception. Most of what we perceive or see in the world is memory. If we look at a tree, the tree is not a new concept; it’s a tree. We can’t not see that it’s a tree. The concept of tree is a memory that automatically attaches to the tree that we see. Psychedelics, in part, remove this memory from perception—the memory being an inhibition to pure perception—so that an individual is left in a complex world with no preexisting concepts, or memories, to cloud the pure perception of that world. They are a natural fit for individuals suffering from PTSD or similar mental disorders that could benefit from this kind of perspective change.

Countless studies have shown that psilocybin can alleviate existential distress in terminal cancer patients and those suffering from PTSD, and a single psilocybin treatment has a high success rate of producing long-term positive change in the emotional state of those struggling with clinical depression. Psilocybin also tends to be well-tolerated and has no significant side effects, which is not the case with some conventional SSRI treatments.

While psilocybin is not the only potential treatment for PTSD and clinical depression, existing treatments for PTSD such as MDMA work differently on the brain. With MDMA, the inhibition (the memory) is left intact, and a learned reaction to that memory is effectively suppressed. Some patients may be more willing to allow their mind to be “opened” by lifting the inhibition (or memory) that clouds pure perception—as happens with psilocybin—rather than suppressing the learned reaction to that memory with MDMA. Psilocybin may be the best course of treatment for individuals who are averse or to have been non-responsive to other treatments.

However, the stigmatization and illegality of psychedelics in the 1960s has left some individuals who could benefit from psilocybin without access to an effective treatment. After the explosion of psychedelic drug use in the 1960s, then-President Richard Nixon approved the Controlled Substances Act, which made the use of such drugs illegal. At this time, and for decades after, until the early 2000s, research on psychedelics was effectively halted. By 2017, at around the same time as researchers developed new brain stimulation technology to treat individuals with certain mental disorders, psychedelic research reemerged on a grand scale. With the arrival of new biotechnology and a renewed focus on psychedelics, 2017 was a turning point in the development of trauma treatments. Since then, psychedelic research has made its way into the mainstream conversation by virtue of its ubiquity. Of 105 registered clinical trials surrounding psychedelics conducted from 2007 to 2020, 77.1% of studies commenced in 2017 or later.

Today, even though psychedelic research has recommenced and progress has been made, government regulators continue to operate largely on legal inertia. If PTSD and clinical depression could be treated with a single psilocybin experience, any regulatory delay in making it available to patients—whether due to residual stigma or outdated law—is unconscionable.

This article draws from ideas discussed in Episode 3: “The Brain Part 1: Psilocybin and Existential Distress” of my Grey Matter video podcast series.

Copyright © 2023 Kaitlin Puccio