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Can psychedelics help treat pain?
Forthcoming Phase II trials with ibogaine aim to find out.
- Pharmacology professor Richard J. Miller is hopeful for the resurgence in clinical studies of psychedelics.
- Ibogaine, used in France for decades, is making a comeback in potentially helping curb addiction and treat pain.
- Psychedelics were deemed illegal for political and not medical reasons, an error we are reinvestigating.
With all the hype regarding the potential for psychedelics to help treat anxiety and depression, with the potential to replace or coexist with SSRIs, there are yet more realms hallucinogenic substances could aid in. Whereas psilocybin and MDMA are showing positive results in sufferers of mental pain, a formerly sanctioned drug, ibogaine, is making a comeback in pain management and addiction circles.
As with other psychedelics, ibogaine was swept up in Richard Nixon's crusade against minority and freethinking populations in the late sixties and deemed a Schedule 1 drug in 1971. Yet from 1939 to 1970, ibogaine was used in French psychotherapy under the trade name Lambarene, writes Northwestern University's Feinberg School of Medicine pharmacology professor Richard J. Miller.
As with the entire class of substances, the scheduling of ibogaine was a political, not medical, decision. As Miller recently told me from his office in Chicago,
"The drugs, at the federal level, are Schedule 1 drugs, which means that they have absolutely no medical utility whatsoever and are incredibly dangerous. People think that the reason that they're in that schedule is based on some kind of reasonable science or other understanding of what they do rather than just some complete bullshit, which is what it is."
I reached out to Miller after reading his excellent history on pharmacology, Drugged: The Science and Culture Behind Psychotropic Drugs (the full transcript is here). While he's spent decades clinically studying drugs, the narrative shines when Miller discusses the cultural stories about how and why we seek to alter our consciousness, be it through caffeine or magic mushrooms.
There is no greater substance for the treatment of pain—Miller's clinical speciality—than opiates. Drugs like morphine reduce the amount of the neurotransmitter acetylcholine, causing smaller muscle contractions. The inhibition of these neurotransmitters, combined with opiate receptors in our midbrain implicated in our reward center, help to make us feel better—and get us addicted.
Which is the rub: the greatest pain reliever yet discovered is highly addictive. The novelist Amitav Ghosh wrote an entire trilogy about the political and cultural effects of the opium trade; Thomas de Quincy famously defined a genre when penning a book about his addiction to laudanum. Today, in America, we have our own opium war in the form of fentanyl. The side effects are, as we are collectively experiencing, disastrous.
Just as the mental health industry needs a better solution than SSRIs, which are remarkably effective in the short-term but also deadly over the span of years and decades, physical pain management needs a revolution. The hallucinogenic shrub, Tabernanthe iboga, might provide relief.
Though the cradle of civilization, Africa is relatively void of hallucinogens. One of the strongest utilized comes via the main alkaloid in T. iboga, ibogaine. Iboga communities exist in Gabon, Cameroon, and Zaire, where adherents either eat or drink the yellow root to experience visions in order to, as the Bwiti phrase it, "break open the head."
Iboga made its way to France in 1864, first appearing in the scientific literature two decades later. Ibogaine was extracted in 1901. Howard Lotsof, a heroin addict in New York City, discovered ibogaine in the sixties and self-experimented to curb his addiction. It worked. He persuaded a pharmacologist in Albany to test the substance in morphine-dependent rats, which also "appeared to work," according to Miller. The researchers also noticed positive results getting the rats off of cocaine, alcohol, and nicotine.
The Albany team then worked with a team at the University of Vermont in an attempt to synthesize an ibogaine analog. Even the ceremonial users in Africa knew that the root is toxic; swallow too much and death ensues. The team, searching for a less toxic substance, synthesized 18-methoxycoronaridine (18-MC). Ibogaine has been used in addiction treatment for decades even as it has been predominantly illegal.
After Phase 1 trials, the funding was exhausted. A new organization, MindMed, is currently planning Phase II trials this year. So far, 18-MC does not appear to have the hallucinogenic effects of ibogaine, which might prove important if it is ever developed for widespread addiction treatment or pain management. Ibogaine notably causes cardiovascular problems in some users; 18-MC might also skirt that issue.
This also solves the patent problem. Given the money required in R&D of a new drug—over $1 billion, in some cases—it's challenging for pharmaceutical companies to profit from new drugs. At the same time, as Miller assures me, "they are definitely making money." That much is obvious given the billions of dollars that the Sacklers profited from helping create the opioid epidemic, the very reason we so desperately need a better solution now.
Yet it also begs the question: why are we in so much pain? The reasons are varied: sedentary lifestyles; dramatic income gaps; social media's role promoting the constant yearning for youth; intensely laborious jobs; being overworked and underpaid. If the revolution in pharmacology last century taught us one thing, it's that humans will seek pills to cure problems instead of addressing the root cause. As Miller and I discussed, the distance between physical and emotional pain isn't necessarily as far as believed.
"When you use the word pain, which you just used in a certain way, pain could mean things like somebody's emotional pain to a clinician. However, it's usually much more involved in actual physical pain. That's the kind of thing that people are usually talking about when they're talking about trying to replace opiates for treatment of those kinds of things. On the other hand, there is emotional pain. On the third hand, there is actually a connection between physical pain and emotional pain. We know about how different parts of the brain connect with each other. So there are a lot of levels that you can attack pain."
While it's hard to find a bright side to the opioid epidemic, Miller says one positive is that governmental agencies are taking pain management more seriously. That covers mental and physical pain—there's a reason the FDA has labelled both psilocybin and MDMA as breakthrough therapies. Regardless of the type of pain, and knowing there is a meeting point between the two, psychedelics are showing efficacy in many aspects of treatment. This is a field of research whose time has come.
- Why psychedelics should be over-the-counter medicine - Big Think ›
- A potential cure for chronic pain has been discovered - Big Think ›
Innovation in manufacturing has crawled since the 1950s. That's about to speed up.
Richard Feynman once asked a silly question. Two MIT students just answered it.
Here's a fun experiment to try. Go to your pantry and see if you have a box of spaghetti. If you do, take out a noodle. Grab both ends of it and bend it until it breaks in half. How many pieces did it break into? If you got two large pieces and at least one small piece you're not alone.
But science loves a good challenge<p>The mystery remained unsolved until 2005, when French scientists <a href="http://www.lmm.jussieu.fr/~audoly/" target="_blank">Basile Audoly</a> and <a href="http://www.lmm.jussieu.fr/~neukirch/" target="_blank">Sebastien Neukirch </a>won an <a href="https://www.improbable.com/ig/" target="_blank">Ig Nobel Prize</a>, an award given to scientists for real work which is of a less serious nature than the discoveries that win Nobel prizes, for finally determining why this happens. <a href="http://www.lmm.jussieu.fr/spaghetti/audoly_neukirch_fragmentation.pdf" target="_blank">Their paper describing the effect is wonderfully funny to read</a>, as it takes such a banal issue so seriously. </p><p>They demonstrated that when a rod is bent past a certain point, such as when spaghetti is snapped in half by bending it at the ends, a "snapback effect" is created. This causes energy to reverberate from the initial break to other parts of the rod, often leading to a second break elsewhere.</p><p>While this settled the issue of <em>why </em>spaghetti noodles break into three or more pieces, it didn't establish if they always had to break this way. The question of if the snapback could be regulated remained unsettled.</p>
Physicists, being themselves, immediately wanted to try and break pasta into two pieces using this info<p><a href="https://roheiss.wordpress.com/fun/" target="_blank">Ronald Heisser</a> and <a href="https://math.mit.edu/directory/profile.php?pid=1787" target="_blank">Vishal Patil</a>, two graduate students currently at Cornell and MIT respectively, read about Feynman's night of noodle snapping in class and were inspired to try and find what could be done to make sure the pasta always broke in two.</p><p><a href="http://news.mit.edu/2018/mit-mathematicians-solve-age-old-spaghetti-mystery-0813" target="_blank">By placing the noodles in a special machine</a> built for the task and recording the bending with a high-powered camera, the young scientists were able to observe in extreme detail exactly what each change in their snapping method did to the pasta. After breaking more than 500 noodles, they found the solution.</p>
The apparatus the MIT researchers built specifically for the task of snapping hundreds of spaghetti sticks.
(Courtesy of the researchers)
What possible application could this have?<p>The snapback effect is not limited to uncooked pasta noodles and can be applied to rods of all sorts. The discovery of how to cleanly break them in two could be applied to future engineering projects.</p><p>Likewise, knowing how things fragment and fail is always handy to know when you're trying to build things. Carbon Nanotubes, <a href="https://bigthink.com/ideafeed/carbon-nanotube-space-elevator" target="_self">super strong cylinders often hailed as the building material of the future</a>, are also rods which can be better understood thanks to this odd experiment.</p><p>Sometimes big discoveries can be inspired by silly questions. If it hadn't been for Richard Feynman bending noodles seventy years ago, we wouldn't know what we know now about how energy is dispersed through rods and how to control their fracturing. While not all silly questions will lead to such a significant discovery, they can all help us learn.</p>
Join Pulitzer Prize-winning reporter and best-selling author Charles Duhigg as he interviews Victoria Montgomery Brown, co-founder and CEO of Big Think.
Women today are founding more businesses than ever. In 2018, they made up 40% of new entrepreneurs, yet in that same year, they received just 2.2% of all venture capital investment. The playing field is off-balance. So what can women do?
In a recent study, researchers examined how Christian nationalism is affecting the U.S. response to the COVID-19 pandemic.
- A new study used survey data to examine the interplay between Christian nationalism and incautious behaviors during the COVID-19 pandemic.
- The researchers defined Christian nationalism as "an ideology that idealizes and advocates a fusion of American civic life with a particular type of Christian identity and culture."
- The results showed that Christian nationalism was the leading predictor that Americans engaged in incautious behavior.
A pastor at the chapel of the St. Josef Hospital on April 1, 2020 in Bochum, German
Sascha Schuermann/Getty Images<p>Christian nationalists, in general, believe the U.S. and God's will are tied together, and they want the government to embody conservative Christian values and symbols. As such, they also believe the nation's fate depends on how closely it adheres to Christianity.</p><p style="margin-left: 20px;">"Unsurprisingly then, in the midst of the COVID‐19 pandemic, conservative pastors prophesied God's protection over the nation, citing America's righteous support for President Trump and the prolife agenda," the researchers write.</p><p style="margin-left: 20px;">"Correspondingly, the link between Christian nationalism and God's influence on how COVID‐19 impacts America can be seen in proclamations about God's divine judgment for its immorality―with the logic being that God is using the pandemic to draw wayward America <em>back </em>to himself, which assumes the two belong together."</p><p>The logical conclusion to this kind of thinking: America can save itself not through cautionary measures, like mask-wearing, but through devotion to God. What's more, it stands to reason that Christian nationalists are less likely to trust the media and scientists, given that these sources are generally not concerned with promoting a conservative, religious view of the world.</p><p>(The researchers note that they're unaware of any research directly linking Christian nationalism to distrust of media sources, but that they're almost certain the two are connected.)</p>
Predicted values of Americans' frequency of incautious behaviors during the COVID‐19 pandemic across values of Christian nationalism
Perry et al.<p>In the new study, the researchers examined three waves of results from the Public and Discourse Ethics Survey. One wave of the survey was issued in May, and it asked respondents to rate how often they engaged in both incautious and precautionary behaviors.</p><p>Incautious behaviors included things like "ate inside a restaurant" and "went shopping for nonessential items," while precautionary behaviors included "washed my hands more often than typical" and "wore a mask in public."</p><p>To measure Christian nationalism, the researchers asked respondents to rate how strongly they agree with statements like "the federal government should advocate Christian values" and "the success of the United States is part of God's plan."</p><p>The results suggest that, compared to other groups, Christian nationalists are far less likely to wear masks, socially distance and take other precautionary measures amid the COVID-19 pandemic.</p><p style="margin-left: 20px;">"Christian nationalism was the leading predictor that Americans engaged in incautious behavior during the pandemic, and the second leading predictor that Americans avoided taking precautionary measures."</p><p>But that's not to say that religious beliefs are causing Americans to reject mask-wearing or social distancing. In fact, when the study accounted for Christian nationalist beliefs, the results showed that Americans with high levels of religiosity were likely to take precautionary measures for COVID-19.</p>
Limitations<p>Still, the researchers note that they're theorizing about the connections between Christian nationalism and COVID-19 behaviors, not documenting them directly. What's more, they suggest that certain experiences — such as having a family member that contracts COVID-19 — might change a Christian nationalist's behaviors during the pandemic.</p><p style="margin-left: 20px;">"Limitations notwithstanding, the implications of this study are important for understanding Americans' curious inability to quickly implement informed and reasonable strategies to overcome the threat of COVID‐19, an inability that has likely cost thousands of lives," they write.</p>
Parental anxieties stem from the complex relationship between technology, child development, and the internet's trove of unseemly content.