Inside the Seattle conference room where experts ponder the future of psychedelic research

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About 65 scientists, doctors, activists and even a farmer or two arrived at a glass-fronted medical building in South Lake Union one recent morning. They crowded into a conference room, coffees in hand, to discuss the next frontier in the treatment of substance use disorders and addiction: psychedelics.

The meeting of minds was timely for several reasons. In less than nine months, Oregon’s fledgling psilocybin industry can begin applying for licenses to manufacture, transport and sell the psychedelic derived from certain mushrooms for use in supervised therapy. And in October, Seattle became the largest city in the country to decriminalize psilocybin.

And there was an official reason for the meeting: Washington’s flagship public university is creating a new research center devoted to the use of psychedelics to treat addiction. The South Lake Union meeting marked the launch of the center. Psychedelics are gaining ground as a therapy for treatment-resistant depression; in November, the largest trial ever of psilocybin and depression found the drug to be highly effective. But its potential use against substance use disorders is less well understood.

Dr. Jürgen Unützer, who heads the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, began the morning by reflecting on the importance of serious study of alternative remedies for substance use disorders – especially those that are impervious to standard treatment.

Why not try something else? Why not try something that might change of opinion? The psychedelics got “a lot of heat,” he said, but “not a lot of light.”

Dr. Nathan Sackett, an addiction psychiatrist and the main reason everyone had come together, took to the podium next. He made a joke about being dressed up because he was wearing a suit — he’s the one running UW’s new addiction research center, after all — then dove into his speech.

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Addiction-related mortality exceeds all cancer deaths five times, he said – and think of the money spent on cancer research, treatments and prevention. What a contrast to the dearth of resources that target behaviors linked to cancers and death in general, he added, such as the consumption of alcohol and tobacco.

“Imagine if we had a healthcare system focused on prevention, early detection, aggressive treatment and long-term follow-up of addiction in the same way that we expect from cancer? »

A growing number of promising studies suggest a way forward: a treatment that had historically been “pushed to the fringes” – psychedelics, used in tandem with psychotherapy – could be used as a tool against alcohol abuse, tobacco and even opiates, Sackett continued.

“I will never forget the description of a very memorable patient, who described the first time he injected heroin to me as having fallen into a pool full of puppies,” he said. declared. “For others, substance use is initially a seemingly rational choice; an urgently sought means of pleasure for temporary relief from suffering, or a response to trauma or curiosity. And for the most part, the syndrome is characterized by a mixture of the two extremes.

Regardless of how the path begins, he said, the end is often intense pain.

As a physician, Sackett increasingly felt that the therapies and medications available were not sufficient to bring change at a pace that was helpful to patients. His interest in psychedelics – a powerful way for people to experience new emotions and see their life and purpose through a new lens – grew.

But starting a new center dedicated to using psychedelics as addiction treatment?

“I was told it was politically dangerous. It could backfire on you. It was too controversial… And trust me, for every reason you can give me why this might fail, I can give you five more,” he joked as the crowd, many of whom were supportive at his argument, laughed.

“But I also believe we are at a critical crossroads,” he said. “Psychedelic-assisted psychotherapy is here to stay, and people are doing it whether we study it or not.”

Bagket is right. Ketamine clinics are popping up across the Pacific Northwest and elsewhere in what has been widely dubbed a “psychedelic revolution” in mental health care. Last year, a New York Times article described psilocybin and MDMA as the “hottest new therapies since Prozac.” “Universities want to participate, and so does Wall Street,” the article read. And then a warning: “Some worry that a push to ease access could have unintended consequences.”

People who self-administer shrooms or guide others to use psychedelics do so largely underground. And there is little data to support how psychedelics can or should be used to treat different substance use disorders.

At the new UW research facility, Sackett imagines, researchers will ask questions such as: Which psychedelic is best paired with which behavioral therapy, and what kinds of patients might benefit from treatment? The first studies will use animals. Eventually, Sackett hopes, the center will help initiate clinical trials at multiple treatment sites.

To start, he asked the crowd to help him brainstorm in small discussion groups – the new center needs help thinking up potential research projects.

In one room, about two dozen people sat in a semicircle to talk about how ketamine could be used to treat substance use disorders. Perhaps an observational study, someone suggests, that draws on the experiences of people who already run ketamine clinics? A man who says he runs such a clinic likes the idea, but says all the bureaucracy attached to research could be a burden on practitioners.

One of the group’s moderators, a clinical social worker named Ian Pocock, names one tension that sharpens throughout the morning.

“There is a huge knowledge gap between people with research training and those with clinical training. The language is different, the motivations are different.

In another session, however, a familiar face brings a sense of excitement to the conversation.

On a giant screen, Paul Stamets, mycologist and celebrity in the psychedelic community who co-sponsored the event, appears on Zoom to chat with people in person about the path to legalizing various psychedelics, psilocybin in particular. He cautions against the recent relaxation of psychedelic laws and suggests that “we’re not locking ourselves into something” that doesn’t allow for further modifications, especially as the science around psychedelics is rapidly changing. He criticized Oregon’s new law, in particular, citing concerns that it doesn’t leave room for people to microdose.

“We have an amazing opportunity with probably multiple delivery platforms, and we shouldn’t stifle innovation,” he added.

Angela C. Hale