Countries must radically change health systems to better prepare for future shocks

Countries must radically change health systems to better prepare for future shocks

By VITTORIA D’ALESSIO

Mind-blowing drugs and psychedelics are generally stigmatized and illegal in EU member states, due to concerns about their possible harmful effects. However, in other parts of the world, some psychedelic compounds are extolled for their healing properties and have been consumed in spiritual and cultural ceremonies for millennia.

Now scientists in Europe and the US are beginning to realize what shamans have been saying for years. There is mounting evidence to suggest that some psychoactive substances have immense therapeutic potential, especially when it comes to addressing serious and difficult-to-manage mental health issues such as post-traumatic stress disorder (PTSD), depression, alcoholism Y eating disorders.

Mental disorders contribute enormously to the global burden of disease, with enormous costs to both society and the economy. psychedelics (that are generally considered non-addictive) may offer a tempting form of therapy for difficult-to-treat conditions.

In response to growing interest from the scientific community, dozens of privately funded studies in the US, and a handful in Europe as well, are trying to unravel the neuroscience of psychedelic “trips.”

The ultimate goal for many scientists in this area is to decriminalize psychedelics (both synthetic and natural) and establish safe protocols that allow doctors and psychotherapists to harness the “magic” of these compounds for medical purposes. The goal is to achieve a lasting recovery in patients.

“Researchers involved in this field envision a world where psychedelics are safely and legally available for beneficial use, and where research has the opportunity to fully assess their risks and benefits,” said Dr Claudia Schwarz-Plaschg. , who recently completed the three-year program, Horizon-funded ReMedPsy projectwhere he examined (among other things) the evolution of society’s views on psychedelics.

general acceptance

“Before we can make real progress in the medical use of psychedelics, we need to cultivate widespread acceptance of these substances,” said Dr. Schwarz-Plaschg, adding, “In this regard, the United States is definitely ahead of Europe”.

While psychedelics enjoy favorable attention from scientists, this is not the first time that research institutions have expressed interest in these substances. The 1950s and 1960s were an era before the scientific and cultural exploration of psychedelics. However, when the political mood turned against all categories of “recreational” drugs, the investigation was closed.

Today’s revival of interest seeks to deepen our understanding of the biological mechanisms that give rise to psychedelic mind-altering effects, so that they can be safely integrated into society.

“These substances must be used with great care and respect,” said Dr. Schwarz-Plaschg. “They can be abused and they can be used to control people, so it’s vital to have both the setting and the setting right before you take them.”

The “set” refers to the mindset of the person entering the experience. People need to be relaxed and free from fear, as this will influence the experience they have.

And the “environment” refers to the physical place where you are. ‘You must be comfortable and in good hands, and you must feel safe,’ she said.

altered state

So what is it about these substances that makes them so attractive both in nightlife and in a therapeutic setting?

Psychedelics trigger an altered state of consciousness. They affect all the senses and change a person’s thought processes, sense of time, and emotions. Dr. Schwarz-Plaschg says that the feeling they cause is one of ‘openness’.

She said: ‘He takes a substance like MDMA (the active ingredient in the dance drug Ecstasy). It produces a lot of empathy and strong feelings of bonding with others. Taken in the right setting, a person will also go inside of it and feel a lot of love and empathy for themselves, and if they have been the victim of a traumatic crime, probably the perpetrator as well.”

In this state of emotional expansion, patients can sometimes relive traumatic experiences and confront catastrophic memories in a way that would be impossible under normal circumstances.

“They may feel the same powerful feelings that they first experienced at the time of the trauma, but with less fear,” explained Dr. Schwarz-Plaschg. And with the help of the psychedelic and his therapist, they can reframe the memory in a new light.

positive outlook

“This process can help a person release feelings that have been stored in their body and give their traumatic experience a fresher, more positive perspective,” said Dr. Schwarz-Plaschg. “This perspective seems to stay with them even after the effects of the substance have worn off.”

Dr. Schwarz-Plaschg is quick to point out that the work of psychedelics is explained through science, not magic. Its active molecules bind to the body’s receptors for serotonin, the ‘feel good’ neurotransmitter. Established antidepressants work in a similar way. However, psychedelics, when combined with therapy, seem to stave off mental health disorders longer, for some, perhaps even forever.

A radical approach being proposed by scientists in this field is psychedelic-assisted psychotherapy (PAP). This is the professionally supervised use of psychedelic substances as part of a detailed program of psychotherapy.

psychedelic therapy

“We envision a world where psychotherapists are trained in the use of psychedelics, so that these substances can be offered as part of a package,” said Dr. Schwarz-Plaschg. The program would involve the pairing of a specific substance with a specific type of therapy. Perhaps the patient would have two sessions where the therapist gives them psilocybin (found in “magic mushrooms”) and then two sessions of pure therapy.

In a 2021 trial, led by the Multidisciplinary Association for Psychedelic Studies (MAPS) – an American non-profit organization to increase awareness and understanding of psychedelics – administered MDMA-assisted therapy to people suffering from chronic post-traumatic stress disorder (PTSD). This condition is profoundly difficult to treat. After just three sessions, 67% no longer met diagnostic criteria for PTSD, while 88% experienced improvement in symptoms.

‘Once we have more data on the best type of treatment mode to make people better, we are hopeful that the European Medicines Agency will give his approval,’ said Dr. Schwarz-Plaschg.

The three substances at the center of current scientific research are MDMA, psilocybin, and ketamine (used as a sedative in higher concentrations and also known for its hallucinogenic effects).

Since 2019, esketamine, a ketamine-based nasal spray, is allowed in the US and EU to treat major depressive disorders, but only when other antidepressants have failed and only when administered in a certified clinic.

For many (but not all) people with depression, esketamine is proving to be a revolutionary therapy. It works fast and appears to significantly lower the chance of a relapse into severe depression, compared with oral antidepressants combined with a placebo nasal spray.

Optimal dose

However, as with other psychedelics, more data is needed on the mechanism by which this mind-altering treatment works. More work is also needed to establish how many doses and in what concentration patients should take the treatment to achieve optimal results.

The use of MDMA and psilocybin is prohibited in most of Europe (some exceptions are available, with restrictions, in the Netherlands and Austria). However, champions of psychedelics are making good progress in the US.

Since 2021, magic mushrooms have been legal for mental health treatment in supervised settings in some parts of the US, and a pending bill in California would help legalize the use of a mix of psychedelics that includes magic mushrooms, MDMA and LSD.

Dr. Schwarz-Plaschg is hopeful that MDMA-assisted psychotherapy will be available in Europe within the next two to three years.

The research in this article was funded through the EU’s Marie Skłodowska-Curie Actions (MSCA). The article was originally published in Horizonthe EU research and innovation magazine.

Leave a Comment