A trip out of addiction

Bad habits: they’re not great. And drug addiction is surely one of the most destructive and costly bad habits you can get yourself into. In the UK, approximately 200,000 people are being treated for drug addiction, with many more suffering without help. Although current treatments help some control their addiction, a large proportion go on to chronically relapse. This outcome not only cripples the addicts’ lives but costs society greatly. Novel treatments that will boost the number of successfully recovered addicts must be embraced. One pharmacotherapy for drug addiction that appeared to have fantastic potential was the use of serotonergic hallucinogens. Between 1950 and 1970 hundreds of studies investigated the benefit LSD could have on the lives of alcoholics. Researchers in the United States gave doses, often up to 800 micrograms, of LSD to alcoholics amongst periods of psychotherapy. Patients were often allowed to relax in rooms decorated with stimulating pictures and calming music while they tripped, but others had a more restricted experience, in which they were physically restrained on a bed. Not quite the liberating, psychedelic experience one might associate with LSD. Despite the huge variation in dosage and methodology, the outcomes were generally positive, with many patients showing impressive reductions in drinking. However, the vast majority of studies lacked the scientific rigour we demand today, frequently missing control groups and objective measures of drinking behaviour. With the 1971 UN Convention on Psychotropic Substances came the damning and ignorant report that LSD, along with all other schedule I drugs, has no medical use. This inevitably stopped any mainstream research and the ability of LSD to treat alcoholism and other drug addictions was left probable, but scientifically ambiguous. Another lesser known psychedelic drug that has a very successful history of treating drug addiction is ibogaine. Although it has a slightly different pharmacological action to most other hallucinogens, as it both antagonizes NMDA receptors and stimulates serotonin receptors, ibogaine has been found to be remarkably successful in reducing opioid withdrawal symptoms and therefore preventing relapse. Additionally, ibogaine significantly reduces cocaine, heroin and nicotine seeking behaviour in rats. Despite this overwhelming evidence, and huge funding from the National Institute of Drug Abuse during the ‘90s, ibogaine remains unavailable for treatment due to seemingly needless concerns about its neurotoxicity. In spite of these unnecessary obstacles, interest in these compounds is reemerging. A meta-analysis of the LSD and alcoholism studies, which only included the studies that meet modern-day scientific standards, was conducted this year. It found that one session of LSD treatment does have a beneficial impact on drinking behaviour up to 12 months after the treatment, compared to a control group. It is unsurprising that more than one session of treatment may well be needed for very long term benefits. Furthermore, the Johns Hopkins University in Baltimore is currently investigating the role psilocybin treatment can play in helping nicotine addicts quit smoking. Although this research is only in its preliminary phases, the results have been wholly successful, with four heavy smokers becoming abstinent. So how might these hallucinogenic drugs lead to the attenuation of addictive tendencies? The explanations vary from low-level physiological mechanisms to high-level worldview shifts. It has been discovered that hallucinogenic drugs can increase the expression of BDNF, a protein that boosts the growth of new neurons in the brain. Most drugs of abuse cause neuronal cell death and by reversing this effect hallucinogens may help provide the behavioural flexibility necessary in breaking an addictive cycle. Another possibility is the modulation of the serotonin system, which is critical in mood regulation. By decreasing stress and negative mood, hallucinogens may decrease the likelihood of relapse. However, perhaps the most likely explanation is a more holistic one. Tripping can produce very intense and mystical experiences. Many ibogaine-treated addicts describe experiences involving an epiphany concerning the origins of their addiction which can remain salient for months afterwards. It may also simply provide a radically new take on the world which addicts need to break their destructive cycle. It is almost unbelievable that these drugs are not utilised in order to drastically improve many addicted lives. Clearly the inappropriate international laws on psychedelic drugs have stifled research. Now these laws are being loosened and researchers are being given new opportunities to study these drugs’ clinical benefits we will hopefully see a paradigmatic shift in the treatment of addicts.