Depression, Psychedelics, Legality, and Stigma
Depression is one of the most serious plagues to the countries in the West. It is the leading cause of disability worldwide. It impacts productivity, pleasure in everyday activities, and can lead to suicide. Globally, depression rates among adults are estimated at around 5%. One of the most common treatments for moderate to severe depression are antidepressants classified as selective serotonin reuptake inhibitors, or SSRIs. They are often sold under the brand name of Prozac.
However, the research surrounding the efficacy of SSRIs is extremely controversial. The most influential hypothesis on the cause of depression historically has been that it is caused by a serotonin deficiency, leading to the mechanism by which SSRIs operate. A recent high-quality meta-analysis and review of past studies and research was conducted (July 2022), in which the researchers found “no consistent evidence of… …an association between serotonin and depression”, in addition to no support for the idea that the cause of depression was a deficiency in the neurotransmitter. This raises the question: do SSRIs really work to “cure” depression, or do they simply conceal the symptoms? More convincing evidence for the long-term benefits of these drugs should be brought to light as soon as possible, considering that 1 in 10 Americans are currently taking an antidepressant.
Turning to alternative treatments and remedies, psychedelics are showing promising evidence for serious mental health benefits. However, research on them is extremely limited, largely due to their criminalization in most of the US. The history of this goes back to the 1940s and 50s. During this time, the CIA in the US was looking for methods of mind control and “truth serums” in a project now declassified, called MKUltra. The CIA experimented with psychedelics in this project, bringing LSD and other psychedelics to the US. Many subjects of the MKUltra experiments ironically ended up launching the anti-establishment counterculture movement in the 1960s. During this period, there was a spike in research on psychedelic substances in high-prestige US universities. This swiftly ended with the Controlled Substances Act in 1970, signed into law by Richard Nixon, kicking off the War on Drugs. This act classified both LSD and psilocybin as Schedule I drugs, meaning they allegedly have “high potential for abuse” and “no currently accepted medical use”.
The claim that these psychedelics have high potential for abuse is absurd. Shown below is a graph showing the risk of dependency and the physiological risk (safety ratio) of an assortment of psychoactive substances, according to CGU (California). You can see LSD and psilocybin in the bottom left corner. Regarding legal status in the US, much more dangerous substances such as nicotine and alcohol are legalized for recreational use. The safety of psychedelic substances is widely understood in scientific literature, but is not reflected in the legal structure in the US.
The potential for one of psilocybin for treating depression is now being brought to light. There is a plethora of scientific literature backing the promises that this substance can have. A recent study by the British Association for Psychopharmacology (February 2022) found that “two doses of psilocybin provided in the context of supportive therapy for MDD produced large and stable antidepressant effects throughout a 12-month follow-up period”. An earlier study by the same organization, found an even longer-term 4.5-year follow up reduction in depressive symptoms (January 2020). Finally, a recent study by Yale university (July 2021) showed the possible mechanism by which psilocybin can have such safe and strong antidepressant properties, by documenting a 10% increase in neuronal connections up to a month after administering psilocybin to mice. In addition, the Yale study found stronger links between existing neurons after administering the drug. Psilocybin shows immense potential to change the lives of the mentally ill, not only for depression, but Post-Traumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), and more.
I will end this article on a note of speculation. There are many forces impacting the legal status of a substance in the United States. One must look at these forces through the lens of money and power. Regarding money, there are pharmaceutical giants that have been lobbying the US government for decades. Preventative treatment has never been in their best interest, since a sick patient is a paying one. This implies the motive behind the development of SSRIs, a drug that does not cure depression, but hides the symptoms for a time being. This could be seen as a monetary cause of the prohibition of psychedelics up to this point. Through the lens of power, the background of the anti-establishment counterculture movement, in addition to the communal ties that psychedelics created in the hippie community, created a motive for establishment politicians to dissipate these voter groups by criminalizing the substances that tied them together.
Take this speculation of causes behind the legal status of psychedelics with a grain of salt, merely as a presentation of possible ideas surrounding the subject. Large corporations (in this case, pharmaceuticals) and the government (in this case, the Nixon administration) arguably have a long history of neglecting the well-being of the individual, either for the interest of their own profits or to keep manipulating a collective ideology. It therefore comes as no surprise that psychedelics have been prohibited from the public, and extremely limited in research, for so long. Today and tomorrow, however, things are changing for the better. A new renaissance in neuroscience and treatment is taking place, with consequences that will reach the household, the voting booth, and more.