Should neuroscience researchers embrace religion and spirituality? Washington psychedelics ballot initiative advances; and learning from pre-1970s psychedelics researchers
Plus: Tensions over potential MDMA-assisted therapy approval continues, and ketamine paper results under fire
Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.
Should neuroscience researchers embrace religion and spirituality?
The culture of Western science emphasizes hard facts. Belief systems like religion and spirituality may defy quantification; scientists typically steer clear of them in their research. In a commentary published in Nature this week, four researchers argue that neuroscientists shouldn’t shy away from religion. “Around 85% of the global population identifies as religious,” they write. “Decades of work in the social sciences have found that religious or spiritual beliefs and practices can improve people’s health and well-being; increase social cohesion, empathy and altruistic behavior; and protect people against cognitive decline or substance abuse.”
They use psychedelics research findings as an argument for why it’s important to consider religion in science studies. “A systematic review of papers on the reported effects of psychedelics published during 2015–2020 indicates that many people have what they describe as religious or spiritual experiences after taking these drugs, which can have long-lasting effects on their behavior,” they write.
Washington ballot initiative for state-legal psychedelic use and services
This week, the Washington State Attorney General’s office issued a ballot title for Measure 2076, the Natural Psychedelics and Supportive Services Act. The ballot measure, drafted by an advocacy group called Reach WA, proposes that people over 21 can cultivate, possess, gift, and use psilocybin, psilocin, 5-MeO-DMT, and mescaline. It does not allow the selling of substances but does allow people over 21 to be paid for “supportive services.” The measure lays out some rules for those providers, such as prohibiting them from falsely presenting themselves as a Native tribal member or Indigenous person. The measure also forbids those offering psychedelic services from describing their services as “therapy.”
Now that the measure has received a ballot title, the group can begin collecting signatures to get the measure on the next ballot. To succeed, Washington State law requires organizers to collect at least 8 percent of total votes cast in the previous gubernatorial election and “strongly suggests” collecting 20% more signatures than the minimum threshold to account for any invalid signatures. In Washington, that would amount to approximately 388,156 signatures.
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Learning from pre-1970s psychedelics researchers
In the 1970s, the Controlled Substances Act made psychedelics illegal, and in the process, significantly reduced scientists’ ability to study them. Psychedelics research has seen a massive resurgence in the last two decades, and scientists have used new methodology and technology to examine the roles that psychedelics can play in treating mental health conditions. In a paper published in the journal npj Mental Health Research on Tuesday, psychiatrists affiliated with New York and London institutions argue that the current field might benefit from examining what research looked like before this resurgence.
Researchers in the 1950s and 60s used three main approaches to psychedelic treatment: the “psycholytic” approach, in which practitioners used low to moderate doses meant to enhance psychotherapy sessions; the “psychedelic” approach, which relied on “the profound and cathartic impact of experiencing dramatic, unitive, and visionary states” from a single large dose; and “psychedelic peak therapy,” which included large doses but also included preparation, support during the session, and integration.
“Clinician and patient-reported qualitative narratives of psychological processes of change were predominant in pre-prohibition research, playing a crucial role in the evolution of psychedelic research and treatment. However, in the modern era, the emphasis has shifted,” the authors write. Unlike these narratives, they say, current research is reliant on surveys and standardized measures of mental health symptoms. Going back to reports from early researchers can help illuminate best practices and the important role therapy and support play, the authors argue.
Tensions over potential MDMA-assisted therapy approval continues
On Monday, Republican Texas Congressman Dan Crenshaw, who is a former Navy SEAL, made a post on X about the “roadblock” to psychedelic treatments, in which he asserts that a U.S. Food and Drug Administration’s advisory board was “influenced by ICER.” After a nine-hour meeting on June 4, the advisory board voted 9-2 that they did not believe the available data showed MDMA was effective in treating PTSD, and 10-1 that they did not believe the benefits of MDMA-assisted therapy outweighs the risks. Five days before that, an appraisal committee of the nonprofit research group Institute for Clinical and Economic Review (ICER) had similarly voted 14-1 that there was not adequate evidence to demonstrate that the net health benefit of MDMA-assisted psychotherapy was superior to not treating patients with MDMA-assisted psychotherapy. “These technocrats think they know better than scientists,” Congressman Crenshaw says in his video. “Their job is to say NO and support the status quo that makes Big Healthcare plenty of money.” He also attacks the psychedelic non-profit group Psymposia, alleging that the group “insulted our veterans,” and claiming that the group believes psychedelic treatment “perpetuates white supremacism.” The next day, X’s owner Elon Musk reposted and supported Crenshaw’s message.
Nearly identical language was included in a statement published last week by the veterans non-profit group Heroic Hearts, which has advocated for psychedelic-assisted therapy for veterans experiencing PTSD. (Psymposia has published allegations that psychedelic leaders’ actions have perpetuated a societal status quo that, it alleges, includes capitalism, white supremacy, and authoritarianism.) Heroic Hearts’s statement also claimed that “no mention was made of the veteran suicide epidemic” during the FDA’s advisory committee meeting. This reporter watched all nine hours of the meeting and counted at least nine veterans who spoke about this very serious issue during the public comment session. Some in the field have pushed back on the approach taken in the Heroic Hearts statement including former Veterans Affairs research psychologist Peter Addy, who wrote an open letter detailing what he saw as “mischaracterizations and inaccuracies” in the statement, including their synopsis of Psymposia’s work.
Ketamine paper results under fire
Last week, Nature Medicine published the results of a phase 2 trial using oral ketamine tablets for treatment-resistant depression. Over the course of the 13 week study, participants took the tablets twice a week, which contained either 0, 30, 60, 120, or 180 mg of ketamine, and completed a standard depression symptom inventory called MADRS before the study, and at roughly 6, 9, and 13 weeks into treatment. The drug being studied was an extended-release racemic ketamine formulation developed by a New Zealand company called Douglas Pharmaceuticals.
The authors hypothesized that this racemic ketamine treatment “could be an effective and well-tolerated treatment option” for treatment-resistant depression; they concluded that their results supported the study’s hypothesis and that the medication’s “tolerability was excellent.”
But researchers are taking issue with the authors’ interpretation of their results. University of Leiden psychologist Eiko Fried, known for his deep dives into methodological issues, wrote a blog post breaking down his concerns about the study. Chief among them: the only condition in which participants’ MADRS scores decreased by a statistically significant amount was the group given the largest ketamine dose, 180 mg. “This does not justify the overall conclusion in the abstract that ketamine ‘tablets were effective, safe and well tolerated,’” Fried writes. “This is the case particularly because of ~130 patients who received some dose of ketamine, the 180mg group of people who showed significant improvements over placebo was just 18 people in the end.” The Microdose reached out to the paper’s lead author, University of Otago scientist Paul Glue, about these concerns. Glue asserted that “if [Fried’s] only analysis of the study is to look at the primary endpoint in the abstract, he may have missed a lot of other detailed information in the body of the article.”
Researcher Ioana Cristea, who reviewed the paper for Nature Medicine, also posted on X that she has serious concerns about the study, but she has not publicly detailed those concerns.
In an essay for The Conversation University of Leiden cognitive psychologist Michiel van Elk writes, “My initial optimism about psychedelics and their potential has changed into skepticism about the science behind much of the media hype.”
For Vice, journalist Mattha Busby visits the Canadian factory of Optimi Health, which “might be the largest legal pharma-grade shroom farm in the world.”
Scientific American interviews Stanford anesthesiologist and psychedelic researcher Boris Heifets about how psychedelics work, and whether some of their power is attributable to placebo effects. Heifets points out that life-changing events can cause people to change their behavior, and often do function as a type of placebo effect. “You can’t exactly go out and give people heart attacks or even send them on life-changing experiences, such as skydiving or on trips to the Riviera. But you can give them a psychedelic,” he says.
Other states are watching how Oregon is taxing its psychedelic mushrooms as they launch their own psilocybin programs, Bloomberg Tax reports.
You’re all caught up! Have a great weekend. We’ll be back in your inbox on Monday with a new issue of 5 Questions.
Correction: In our June 21 issue, we covered a paper published in The Journal of Affective Disorders studying the safety and efficacy of at-home ketamine. We erroneously reported that patients who elected to undergo a second round of treatment had higher scores on drug and alcohol abuse scales and were more likely to live in rural areas; they were in fact *less* likely to have higher scores or to live in rural areas. We regret the error.
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