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What will 'psychedelic therapy' look like when it's legalized?
Psychedelic therapy will become legal in Oregon in 2023. That's thanks largely to a renaissance of psychedelic research that's changing attitudes on the substances' medical potential.
- In November, Oregon voted to legalize psilocybin therapy.
- Psilocybin is already being used in clinical research settings, but it remains a controlled substance on the federal level.
- At the 2020 Web Summit, two experts in the field of psychedelic research and therapy shed light on what the future of psilocybin therapy might look like.
For millennia, humans have been using psychedelic drugs for medicinal and spiritual purposes. But today, most nations have criminalized psychedelics, including the U.S., where psilocybin and LSD are classified as Schedule 1 drugs, defined as having "no currently accepted medical use and a high potential for abuse."
But attitudes on psychedelics are shifting. That's thanks largely to a renaissance of psychedelic research that's been gaining steam since the 2000s, producing startling studies showing how psilocybin (and other psychedelics) can help alleviate mental health problems like major depression, anxiety, and addiction disorders.
In November, Oregon made history by passing Measure 109, which legalized the use of psilocybin in therapeutic settings. That's a step beyond measures in other progressive American cities, like Denver and Oakland, which have decriminalized the substance but stopped short of allowing people to consume it.
What it means for Oregonians is that, starting as early as 2023, adults 21 and older will be able to go to a clinic and consume psilocybin under the supervision of a licensed therapist, who has to obtain the psilocybin from a licensed manufacturer.
So, what exactly will psychedelic therapy look like, and why would people seek it out?
Those questions were explored in a recent presentation at the 2020 Web Summit by Ekaterina Malievskaia, co-founder of the mental health company Compass Pathways, and Kelsey Ramsden, the COO of Mind Cure, which identifies, develops, and commercializes new mental health products.
What psychedelic therapy could look like
Ramsden said a psychedelic therapy session might look like this: You enter "a lovely place that looks much like your living room with some lovely people [licensed therapists] who are going to sit with you for the duration of your treatment," and then you're administered psilocybin. You might sit or lie down with a mask over your eyes, potentially listening to some music, while being supported by the professionals in the room until the experience winds down.
This session would be followed by an "integration period," which would take place in the days and weeks following the psilocybin experience. The Entheogenic Research Integration & Education (ERIE) defines integration as "the process by which the material accessed and insights gained in a [psychedelic] experience are incorporated over time into one's life in a way that benefits the individual and their community."
What kinds of insights might you gain? It's hard to say, as everyone's experience varies, and scientists are still working to understand exactly how psychedelics interact with the brain.
"Because these experiences are so unusual, it's very difficult to explain what to expect, what people are going to be experiencing," Malievskaia said. "I think only with advancement in neuroimaging, and advancement in different scientific techniques, that we started understanding how they actually work, and we can show how they work, and that sort of paradoxically demystifies these mystical experiences."
How psilocybin acts on the brain
Malievskaia noted that psilocybin works primarily on the brain's serotonin system, attaching to specific serotonin receptors that trigger a cascade of different neurological events. These serotonin receptors are densely expressed in a system of connections called the "default mode network" (DMN).
"The DMN is not an anatomical structure in the brain," Malievskaia explains. "It's a system of functional connections that forms throughout people's lives based on their life experience, life events, their learning, their environment. So essentially, it's a collection of patterns — cognitive, behavioral, emotional patterns — in response to environmental stimuli. And we associate these patterns, perhaps sometimes, with a sense of self, or sense of ego."
"So, when psilocybin binds to these [serotonin] receptors, it downregulates the DMN, and temporarily, people are lifted out of their ego. In these profound psychedelic experiences, they're able to look at their life situation — their conflicts, their personal narratives — from a different vantage point."
"And with skillful support, and in carefully controlled, supported environments, they're able to process traumatic events, memories, and generate more insights. With subsequent skillful integration, they're able to embody those insights, and that could lead, potentially, to changes in unhelpful behavioral patterns."
Neuroimaging studies suggest that the DMN is active during much of our experience, particularly when we're doing repetitive tasks, worrying, daydreaming, or going over memories. It's something like an "auto-pilot" mode that helps the brain save energy. But for people suffering from, say, depression or anxiety, this function can make it difficult to overcome a mental-health rut.
That's why psychedelics might function as something like a "reset button": By quieting activity in the DMN, psychedelics may help the brain break free of its usual patterns, allowing other regions of the brain to begin "talking" to each other, creating new connections. What's interesting is that studies suggest these beneficial effects persist long after the drug wears off — for months, in some cases.
Given popular misconceptions about psychedelics, Ramsden said it's important for researchers and psychedelic therapy advocates to be thoughtful in how they discuss emerging therapies, and she reiterated that the new wave of psychedelic research and therapy is grounded in real science.
"What we're not talking about is this idea of self-medicating, or going on these wild trips," she said. "This really is a practice with deep scientific rigor, with high-efficacy outcomes."
- From mushrooms to ecstasy, a renaissance in psychedelics research ›
- It's time to integrate psychedelics into therapy - Big Think ›
- Psychedelics may be a powerful treatment for alcoholism - Big Think ›
Evolution doesn't clean up after itself very well.
- An evolutionary biologist got people swapping ideas about our lingering vestigia.
- Basically, this is the stuff that served some evolutionary purpose at some point, but now is kind of, well, extra.
- Here are the six traits that inaugurated the fun.
The plica semilunaris<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwMS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY3NDg5NTg1NX0.kdBYMvaEzvCiJjcLEPgnjII_KVtT9RMEwJFuXB68D8Q/img.png?width=980" id="59914" width="429" height="350" data-rm-shortcode-id="b11e4be64c5e1f58bf4417d8548bedc7" data-rm-shortcode-name="rebelmouse-image" />
The human eye in alarming detail. Image source: Henry Gray / Wikimedia commons<p>At the inner corner of our eyes, closest to the nasal ridge, is that little pink thing, which is probably what most of us call it, called the caruncula. Next to it is the plica semilunairs, and it's what's left of a third eyelid that used to — ready for this? — blink horizontally. It's supposed to have offered protection for our eyes, and some birds, reptiles, and fish have such a thing.</p>
Palmaris longus<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMzQ1NjUwMn0.dVor41tO_NeLkGY9Tx46SwqhSVaA8HZQmQAp532xLxA/img.jpg?width=980" id="879be" width="1920" height="2560" data-rm-shortcode-id="4089a32ea9fbb1a0281db14332583ccd" data-rm-shortcode-name="rebelmouse-image" />
Palmaris longus muscle. Image source: Wikimedia commons<p> We don't have much need these days, at least most of us, to navigate from tree branch to tree branch. Still, about 86 percent of us still have the wrist muscle that used to help us do it. To see if you have it, place the back of you hand on a flat surface and touch your thumb to your pinkie. If you have a muscle that becomes visible in your wrist, that's the palmaris longus. If you don't, consider yourself more evolved (just joking).</p>
Darwin's tubercle<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgxMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0ODUyNjA1MX0.8RuU-OSRf92wQpaPPJtvFreOVvicEwn39_jnbegiUOk/img.jpg?width=980" id="687a0" width="819" height="1072" data-rm-shortcode-id="ff5edf0a698e0681d11efde1d7872958" data-rm-shortcode-name="rebelmouse-image" />
Darwin's tubercle. Image source: Wikimedia commons<p> Yes, maybe the shell of you ear does feel like a dried apricot. Maybe not. But there's a ridge in that swirly structure that's a muscle which allowed us, at one point, to move our ears in the direction of interesting sounds. These days, we just turn our heads, but there it is.</p>
Goosebumps<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNzEyNTc2Nn0.aVMa5fsKgiabW5vkr7BOvm2pmNKbLJF_50bwvd4aRo4/img.jpg?width=980" id="d8420" width="1440" height="960" data-rm-shortcode-id="8827e55511c8c3aed8c36d21b6541dbd" data-rm-shortcode-name="rebelmouse-image" />
Goosebumps. Photo credit: Tyler Olson via Shutterstock<p>It's not entirely clear what purpose made goosebumps worth retaining evolutionarily, but there are two circumstances in which they appear: fear and cold. For fear, they may have been a way of making body hair stand up so we'd appear larger to predators, much the way a cat's tail puffs up — numerous creatures exaggerate their size when threatened. In the cold, they may have trapped additional heat for warmth.</p>
Tailbone<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY3MzQwMjc3N30.nBGAfc_O9sgyK_lOUo_MHzP1vK-9kJpohLlj9ax1P8s/img.jpg?width=980" id="9a2f6" width="1440" height="1440" data-rm-shortcode-id="4fe28368d2ed6a91a4c928d4254cc02a" data-rm-shortcode-name="rebelmouse-image" />
Image source: Decade3d-anatomy online via Shutterstock<p>Way back, we had tails that probably helped us balance upright, and was useful moving through trees. We still have the stump of one when we're embryos, from 4–6 weeks, and then the body mostly dissolves it during Weeks 6–8. What's left is the coccyx.</p>
The palmar grasp reflex<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMyMC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjY0MDY5NX0.OSwReKLmNZkbAS12-AvRaxgCM7zyukjQUaG4vmhxTtM/img.jpg?width=980" id="8804c" width="1440" height="960" data-rm-shortcode-id="67542ee1c5a85807b0a7e63399e44575" data-rm-shortcode-name="rebelmouse-image" />
Palmar reflex activated! Photo credit: Raul Luna on Flickr<p> You've probably seen how non-human primate babies grab onto their parents' hands to be carried around. We used to do this, too. So still, if you touch your finger to a baby's palm, or if you touch the sole of their foot, the palmar grasp reflex will cause the hand or foot to try and close around your finger.</p>
Other people's suggestions<p>Amir's followers dove right in, offering both cool and questionable additions to her list. </p>
Fangs?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Lower mouth plate behind your teeth. Some have protruding bone under the skin which is a throw back to large fangs. Almost like an upsidedown Sabre Tooth.</p>— neil crud (@neilcrud66) <a href="https://twitter.com/neilcrud66/status/1085606005000601600?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hiccups<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sure: <a href="https://t.co/DjMZB1XidG">https://t.co/DjMZB1XidG</a></p>— Stephen Roughley (@SteBobRoughley) <a href="https://twitter.com/SteBobRoughley/status/1085529239556968448?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hypnic jerk as you fall asleep<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">What about when you “jump” just as you’re drifting off to sleep, I heard that was a reflex to prevent falling from heights.</p>— Bann face (@thebanns) <a href="https://twitter.com/thebanns/status/1085554171879788545?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script> <p> This thing, often called the "alpha jerk" as you drop into alpha sleep, is properly called the hypnic jerk,. It may actually be a carryover from our arboreal days. The <a href="https://www.livescience.com/39225-why-people-twitch-falling-asleep.html" target="_blank" data-vivaldi-spatnav-clickable="1">hypothesis</a> is that you suddenly jerk awake to avoid falling out of your tree.</p>
Nails screeching on a blackboard response?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Everyone hate the sound of fingernails on a blackboard. It's _speculated_ that this is a vestigial wiring in our head, because the sound is similar to the shrill warning call of a chimp. <a href="https://t.co/ReyZBy6XNN">https://t.co/ReyZBy6XNN</a></p>— Pet Rock (@eclogiter) <a href="https://twitter.com/eclogiter/status/1085587006258888706?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Ear hair<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Ok what is Hair in the ears for? I think cuz as we get older it filters out the BS.</p>— Sarah21 (@mimix3) <a href="https://twitter.com/mimix3/status/1085684393593561088?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Nervous laughter<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">You may be onto something. Tooth-bearing with the jaw clenched is generally recognized as a signal of submission or non-threatening in primates. Involuntary smiling or laughing in tense situations might have signaled that you weren’t a threat.</p>— Jager Tusk (@JagerTusk) <a href="https://twitter.com/JagerTusk/status/1085316201104912384?ref_src=twsrc%5Etfw">January 15, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Um, yipes.<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sometimes it feels like my big toe should be on the side of my foot, was that ever a thing?</p>— B033? K@($ (@whimbrel17) <a href="https://twitter.com/whimbrel17/status/1085559016011563009?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Are we enslaved by the finer things in life?
- The Roman writer, Tacitus, argued that the Roman Empire was built by enslaving conquered people who became accustomed to fine living and luxury.
- Technology today has become so essential to our daily lives that it seems impossible to break free of it. It's as much a cage as a luxury.
- Being dependent on a thing gives it power over you. To need something or someone is, for better or worse, to limit yourself.
- There was a massive die-off of marine life 359 million years ago, and nobody knows why.
- A new study proposes that the Late Devonian extinction may have been caused by one or more nearby supernovae.
- The supernova hypothesis could be confirmed if scientists can find "the green bananas of the isotope world" in the geologic record.
Fifty years of research on children's toy preferences shows that kids generally prefer toys oriented toward their own gender.