Psychedelic medicine: a re-emerging therapeutic paradigm
This commentary (2015) analyses emerging research on psychedelic drugs for therapeutic purposes that involve humans and considering both the potential benefits and the possible harmful effects of using psychedelics in combination with psychotherapy or counselling for mental disorders illness.
Authors
- Matthew Johnson
- Kenneth Tupper
Published
Abstract
In clinical research settings around the world, renewed investigations are taking place on the use of psychedelic substances for treating illnesses such as addiction, depression, anxiety and posttraumatic stress disorder (PTSD). Since the termination of a period of research from the 1950s to the early 1970s, most psychedelic substances have been classified as “drugs of abuse” with no recognized medical value. However, controlled clinical studies have recently been conducted to assess the basic psychopharmacological properties and therapeutic efficacy of these drugs as adjuncts to existing psychotherapeutic approaches. Central to this revival is the re-emergence of a paradigm that acknowledges the importance of set (i.e., psychological expectations), setting (i.e., physical environment) and the therapeutic clinician-patient relationship as critical elements for facilitating healing experiences and realizing positive outcomes.The public is often well-versed in the potential harms of psychedelic drugs, but much of this knowledge is from cases involving patients who used illicit substances in unsupervised nonmedical contexts. We discuss the emerging research for therapeutic purposes involving human subjects, considering both the possible benefits and the potential harms of using psychedelic agents as adjuncts to psychotherapy or counselling for mental illness.
Research Summary of 'Psychedelic medicine: a re-emerging therapeutic paradigm'
Introduction
Renewed clinical research is examining psychedelic substances as potential treatments for conditions such as addiction, depression, anxiety and posttraumatic stress disorder (PTSD). After an active period of research in the 1950s–early 1970s ended amid ethical breaches, methodological criticisms and restrictive drug scheduling, many psychedelic compounds were classified as having no medical value. Tupper and colleagues note that contemporary studies have restarted under controlled conditions and emphasise a therapeutic paradigm that foregrounds set (patients' psychological expectations), setting (the physical environment) and the clinician–patient therapeutic relationship as central determinants of outcome. This review summarises emerging clinical work using psychedelic agents as adjuncts to psychotherapy, focusing on two main classes: the classic psychedelics (primarily 5-HT2A receptor agonists such as LSD, psilocybin and DMT) and entactogens (principally MDMA). The authors aim to describe recent clinical and observational findings, outline potential benefits and harms observed under clinical supervision, and identify outstanding scientific, clinical and policy questions that should guide future research and implementation efforts.
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Study Details
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Tupper, K. W., Wood, E., Yensen, R., & Johnson, M. W. (2015). Psychedelic medicine: a re-emerging therapeutic paradigm. Canadian Medical Association Journal, 187(14), 1054-1059. https://doi.org/10.1503/cmaj.141124
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