Hallucinogens as antidepressants: ethical or not?

I'll start by linking the original article, but it was the subsequent letter to the editor, and its response, that really got my attention.

GOOD AND BAD TRIPS In “Hallucinogens as Medicine,” Roland R. Griffiths and Charles S. Grob describe the therapeutic benefits of hallucinogens such as psilocybin and LSD, as well as some of their risks. I was surprised, however, to see no discussion of perhaps the largest risk: causing patients to form false beliefs. Patients in the studies they cite emerge from their hallucinogenic experience believing that “all is One,” that “God asks nothing of us except to receive love,” and having a “peculiar disregard for ... their impending death.”

Indeed, having used both psilocybin and LSD myself, I have experienced these states. Not only did I have a disregard for my own death, I spent half an hour during one trip considering whether I ought to chew off and eat my own fingers. Happily, I chose not to, and overall I recall the trips of my youth fondly. But the visions they gave me were not real or true; they were the result of overstimulation of specific brain centers by a chemical. Allowing credulous patients to alter their entire life outlook and philosophy based on such experiences is, I think, fundamentally unethical, whatever the positive side effects might be.

Imagine if a study proposed to hypnotize patients, to tell them to believe all sorts of nonsense, and then to wake them up and leave them with those beliefs for the rest of their lives because it was expected that the nonsense beliefs would produce positive clinical outcomes. Would such a proposal pass an ethical review panel? I would certainly hope not. That situation is precisely parallel to the hallucinogen studies, except that instead of the doctor whispering falsehoods into the patient’s ear, it is the drug given by the doctor.

Ben Haller Department of Biology Mc Gill University

GRIFFITHS AND GROB REPLY: We were glad to read that Haller did not eat his fingers. This is not surprising, however, as hallucinogen-involved trauma is very rare under the haphazard conditions of illicit use—which we nonetheless caution against—and it is virtually unheard of within supervised research settings. Haller dismisses the philosophical statements by psilocybin study volunteers as “false.” We regard them as unfalsifiable, and so, as scientists, we take no position for or against them. We do note, without judgment, that they tend to align with the mystical teachings of the world’s religions. The analogy with hypnosis is spurious, because in our psilocybin sessions we do not introduce explicit content to the patient.

During informed consent, candidate volunteers learn up front of psilocybin’s potential effects, including lasting changes in philosophy and outlook. Our ethics committees have approved our studies, which we stand behind. The risk-to-benefit assessment for this research is favorable. Preliminary studies in patients and healthy volunteers suggest substantial and sustained positive effects.

What do you think?

edited 24th Apr '11 2:01:30 PM by feotakahari

Very ethical, I think. This is why we need to legalize drugs. You can inform them beforehand of the possible effects and let them decide.

Isn't that what curing an addiction is.

Ugh, geez, that sounds like a horrible idea.

The correct way to cure depression in someone is to help them become able to deal with the real world exactly as it is, just with more productive lines of reasoning. Not to pretend things and ideas that don't exist. Hiding from the reality of the world is not healthy no matter how it's accomplished, and that's what this feels like to me.

(And I say this as someone who's suffered from clinical depression for most of her life.)

OP: I'll admit to just skimming your post. But all drugs have risks (any doctor worth their salt knows this) you just have to weight up the benefits with the downsides.

edited 24th Apr '11 6:09:27 PM by joeyjojo

"Patients in the studies they cite emerge from their hallucinogenic experience believing that “all is One, ” that “God asks nothing of us except to receive love, ” and having a “peculiar disregard for ... their impending death.”"

These sound like true beliefs to me.

Which can be achieved by therapy or by seeking out an appropriate church and discovering religion, if need be. Drugging yourself is not required.

IMHO drugs should only be used if there is an actual genuine chemical imbalance going on, not for things that can be helped by therapy, making changes in someone's life circumstances, or similar measures.

If they worked effectively without significant risks I think everyone should take it.

Linky: [1]

Yeah, no thanks. I'd rather deal with reality from a logical and practical standpoint, not artificially drug myself into being different.

I mean, I've taken prescription drugs for my depression/anxiety in the past, but I hated it each time, as in my case my condition isn't caused by a chemical imbalance, so the drugs weren't actually doing anything to help me fix the problems in my life that were the real cause of my issues.

Felt too much like just trying to drug myself into pretending my problems didn't exist. This seems like it'd be the exact same thing.

I think the new antidepressant should be an apple injected with heroin.