Psychedelic Medicine

Psychedelic Medicine

Other drugs may soon follow marijuana’s path from illegal to medical to decriminalized to legal.

Magic mushrooms, those mind-bending fungi that helped to inspire the hippie counterculture of the 1960s and 1970s, are going through an existential transformation. And so is MDMA, also known as ecstasy, the drug that fueled all-night rave parties back in the 1990s.

Earlier this year, the cities of Denver and Oakland made news when they voted to decriminalize magic mushrooms and other psychedelic plants—declaring that enforcement of state laws against them are to be the lowest police priorities in those jurisdictions. Legalization advocates in California, Oregon, and other states are circulating petitions in efforts to change state laws.

Meanwhile, pharmaceutical startup companies have their sights set on the therapeutic potential of MDMA and psilocybin, the active ingredient in magic mushrooms, even though it’s still a bit of a mystery as to how Big Pharma can make big profits out of psychedelic revelation.

Three startups have invested more than $80 million to conduct government-approved clinical trials in the United States and Europe. They’ve set out to prove that psychotherapy done with psilocybin and MDMA is safe and effective at alleviating depression, substance abuse, and PTSD.

They have been so successful that the FDA has designated both treatments as breakthrough therapies, opening the door to legal reclassifications that will soon allow doctors or trained therapists to use them with patients suffering from a variety of mood disorders.

What makes all of this interesting and a bit comical is the fact that psychedelic drugs are not like other drugs. They don’t work like painkillers or mainstream antidepressants. They are not pills you take every day. It is not the drug that heals people or alleviates their psychic pain. What helps people is the psychological insight or spiritual revelation they experience during a six-hour-long therapeutic session.

Is that so different than getting high? Yes and no.

What’s different is the preparation and intention of the patients, along with the guidance of the therapist to help patients take those insights and change their behavior—to stop drinking, to feel more empathy and compassion toward their loved ones, to not get fired because of arguments with the boss.

Big Business

One of the major players in the medicalization of magic mushrooms is a London-based, for-profit company called Compass Pathways Technologies. It was cofounded by George Goldsmith, who describes himself as a “serial entrepreneur with significant experience in pharmaceutical regulation,” and his wife, Dr. Ekaterina Malievskaia, the company’s chief medical officer.

Compass and other organizations sponsoring clinical trials do not use actual mushrooms. They use a laboratory-produced version of psilocybin that has the same mind-altering effect as the naturally occurring molecule. The artificial version allows for precise dosing. While psilocybin was first synthesized in the 1950s, Compass has devised its own manufacturing process for an “Investigational Medical Product” that has its own chemical fingerprint that can be patented.

While some may balk at the idea of a profit-making company patenting magic mushroom medicine, officials with the company said this provides “an incentive for investors … to raise the tens or hundreds of millions required” to bring these drugs to market.

“Others can generate their own data through their own clinical trials and manufacture psilocybin in their own way,” said Tracy Chung, the director of communications at Compass.

Her company has raised $35 million from a group of investors that includes Peter Thiel, the Silicon Valley venture capitalist. Thiel has made headlines over the years by cofounding Paypal, making a fortune as an early Facebook investor, supporting Donald Trump, and starting a data analytics company that recently landed an $800 million contract with the U.S. Department of Defense.

This all goes to show how the rebranding of psychedelic drugs has inspired some strange investment bedfellows.

Rick Doblin, the founder of the Multidisciplinary Association of Psychedelic Studies (MAPS), which has raised more than $30 million to get MDMA into the therapeutic marketplace, likes to point out that his investors include Rebekah Mercer, the billionaire backer of Steve Bannon and Donald Trump, and also George Soros, known for his support of progressive and liberal causes.

“We’ve been funded by all sorts of people,” Doblin said. “We got $8 million in cryptocurrency, which we sold, so now it’s real money.”

For more than a decade, Doblin has been in a mostly good-natured pharmaceutical arms race to be the first entrepreneur to get a medical psychedelic product to market. In addition to Compass, which started in Europe but is rapidly breaking into the American market, his main U.S. competitor on the psilocybin front is the Usona Institute, a medical research organization started in Madison, Wisconsin, in 2014 by Bill Linton, the CEO and founder of Promega Corporation, an international life science company.

Usona, building on research by the nonprofit Heffter Research Institute, has raised more than $17 million to get FDA approval to offer psilocybin therapy in a clinical setting with licensed practitioners.

In San Francisco earlier this year, Doblin said he was close enough to actually offering legal psychedelic therapy with MDMA that he had set the price range—estimating that the treatment would cost between $7,000 and $15,000 per patient. Insurance companies will not cover this cost under expanded-access rules and may also balk once MAPS completes its final round of clinical trials and the drug is officially rescheduled for routine therapeutic use. That could take another three to five years.

Most of this expense is the therapist’s time, not the cost of the drug. According to Doblin, MAPS pays $167 to produce a single dose of government-approved MDMA. Before swallowing that pill, clients must undergo preparatory therapy. The actual psychedelic therapy session lasts four to six hours and is supervised by two trained facilitators. Then there is follow-up talk therapy to integrate the insights into the patient’s life.

MDMA and synthesized psilocybin have been around for decades and can’t be patented under U.S. law, but FDA data-exclusivity rules have enabled Doblin to secure a virtual monopoly over MDMA therapy for approximately five years. The same may be true for psilocybin therapy, once Compass or Usona reach that stage of the approval process.

Those with other ideas about how to help people with psychedelics are not waiting for the laws to change. Underground MDMA therapists have been around ever since the U.S. government banned the drug in 1985. They basically do what MAPS will soon do but for a fraction of the cost. The only problem is that the therapist or client could be sent to prison.

Traveling for Trips

A psychedelic tourism industry has sprung up for psychonauts not willing to wait for American drug laws to change.

Mexico, Peru, and Brazil have long been popular destinations for consciousness explorers looking to legally trip out on an array of mind-altering plants and exotic elixirs. More recently, those favoring more luxurious accommodations are booking “truffles therapy” or “psychedelic experience” retreats in the countryside outside Amsterdam, where a loophole in Dutch law makes truffles, the below-the-surface parts of the psilocybin plant, legal.

Over the last few years, rising interest in the spiritual and therapeutic benefits of psychedelic therapy has inspired growing numbers of entrepreneurs to offer weekend retreats in Amsterdam and the Dutch countryside.

Ciara Sherlock, the founding director of The Psychedelic Society of Ireland, is the lead facilitator of what the organization calls “Psychedelic Experience Retreats.” Over the last three years, it has held more than forty retreats for about five hundred people.

Her team of facilitators includes Buddhist meditation teachers, shamanic counselors, and psychotherapists, along with dance and yoga teachers.

“We focus on personal development, connecting to ourselves and others and to the earth,” said Sherlock, a massage therapist who has completed a MAPS training program in the U.S. “Psilocybin is the pinnacle of the experience. It allows access in a ceremonial way with sitters and a group of like-minded people.”

For the four-day retreat, participants pay between $600 and $1,300, based on their income. Between 12 and 16 people gather at a rural estate about a two-hour drive outside Amsterdam.

One recent participant was Tina Page, a California psychotherapist who had been living in rural France. Her interest was sparked by a therapy client, an American soldier who was stationed in Europe. He had been struggling with autism and obsessive-compulsive tendencies, but he seemed to get relief and new insight into his condition through the use of magic mushrooms.

“I did some research and decided I needed to do this for myself, but also as research for my clients,” said Page, who is married to a Frenchman and has two young children. “It was a stressful year in France. I was feeling lonely and isolated. I don’t speak the language. I just wanted to go to the retreat and cry, but I also had some hope of having a profound spiritual experience.” Plus, she was just about to turn 40, so why not?

The mind-altering effects of psilocybin came on fast and were intense. “There were sparkly kaleidoscopes when I opened my eyes, but when I closed my eyes there was just a whole other world of things going on. Strange, mechanical people. I felt like I was disintegrating and melting, and thought, ‘No. I’m not going to do that.’

“My mind and body were trying to control it. I was just going to come and cry. One of the lessons for me was how much ego I have. I was tense and shaking, my hands clenched in fists. It was not a pleasant feeling. My stomach hurt. Once I did start to cry, I couldn’t stop. I cried through the whole thing. But I was vocal about what I needed, and the facilitators were there for me.”

“Afterward, I felt very regressed—like I was back in adolescence,” she recalled. “But by the end of the weekend I felt very lifted up and so calm after that initial regression.”

Her experience shows the double-edged sword of psychedelics, which can inspire profound feelings of spiritual unity, interpersonal connection, and deep gratitude, but also paranoia and existential terror. For that reason, some observers of the burgeoning Dutch retreat scene worry that commercialization may attract people with serious mental health issues, like bipolar disorder and severe trauma. Untrained and inexperienced retreat operators may not be equipped to handle such clients.

“I think it’s a positive development that people are offering some form of structure and safety,” said Joost Breeksema, executive director of The OPEN Foundation, a Dutch group formed to stimulate serious scientific research into the psychedelic experience. “But if you claim to offer therapy and are not actually a licensed therapist, or you do not offer long-term psychological support, there are some risks.”

One of the new players in the Dutch retreat business is French woman Leti Passemier and her American partner, Mitsuaki Chi. They burst onto the scene last year with a big marketing push and a slick website.

“A lot of people have not liked that we came in and did not ask for permission before doing the things we are doing,” said Chi, who grew up on Long Island and spent some time in San Francisco working for a Silicon Valley startup.

Chi, 30, and Passemier, 43, met in Thailand in January 2018, took magic mushrooms together, fell in love, and later that year moved to Amsterdam to organize their psychedelic retreat startup company. In a Skype interview, she questioned whether people really need training to work as paid guides for psychedelic journeys. “Shamans in the jungle don’t receive training,” she said. “When I trip-sit I go into this meditative state. The goal is to look after the other person—to send love and good energy.”

Nevertheless, more seasoned psychonauts worry about the messianic messages coming from the new kids on the block. Marta Kaczmarczyk, a co-founder and coordinator of the Psychedelic Society of the Netherlands, said Chi “is a very nice person” who has “a naive approach and is promoting this idea that mushrooms will save the world.” She added: “He has a bit of a guru syndrome.”

Kaczmarczyk, a Polish-born cognitive scientist who has lived in Holland for the past five years, wants to “demystify the psychedelic experience” and establish “a scientific framework that would be more accessible to the Western mind and more relevant than the shamanic or new age framework.”

“That’s a big problem in our community,” she said. “A lot of people think they’ve gotten enlightened. They’ve found ‘the truth’ and they don’t want to land back on earth.”

Mexican Mycology

For the past two decades, Françoise Bourzat has been leading pilgrimages of spiritual seekers eager to work with medicine women in a remote region of Oaxaca, Mexico, where psilocybin mushrooms can be legally offered by native healers. 

Bourzat, who just published a book, Consciousness Medicine, about her experience as a psychedelic guide, said some of her clients “have done a lot of therapy and come to a wall.” 

“They may have read articles about the new wave of psychedelic therapy and want to go further in their psychological healing. They know this opens a space of spirit, an expansion of consciousness, and they are curious about that.”

Bourzat grew up in a strict Catholic family, but when she was 20 years old, in the fall of 1976, she dropped out of her Parisian university and hit the road, heading to New York City and then Bolivia. She kicked around the world for a few years and settled in San Francisco in 1981. The psychedelic drug culture was still going strong. “I was a young, ignorant French woman who didn’t know what I was stepping into,” she recalled in an interview in her home, hidden away in the coastal hills south of San Francisco. 

One of Bourzat’s teachers was known for his powerful therapy sessions fueled by MDMA. He had studied with Salvador Roquet, a controversial Mexican psychiatrist who practiced a radical form of group therapy using a variety of powerful psychedelic drugs. Roquet had worked with an Oaxaca medicine woman, Maria Sabina, who was made famous in a 1955 Life magazine article written by R. Gordon Wasson, a New York banker and amateur mycologist. Through those connections and that lineage, Bourzat started working with other healers in the mushroom cult in Maria Sabina’s Mazatec village, Huautla de Jimenez, where she now leads her tours. 

Bourzat requires her clients to do a variety of therapy sessions and preparatory work before embarking on the two-week pilgrimage to Oaxaca, which costs between $2,000 and $3,000 and includes three magic mushroom journeys. 

The medicine women in Huautla de Jimenez practice a blend of Catholic devotional practices and psychedelic shamanism. “At first, it was very challenging to me because of my strict Catholic background,” Bourzat recalled. “When they’d pray to Mary and Joseph and Jesus on the cross, I was resistant. But then the symbols became archetypal. Jesus was the mushroom, the messenger of the divine. Catholics believe that in communion, you eat the flesh and blood of Jesus. The Mazatec eat the flesh of the earth and of God in the body of the mushroom. It’s a sacred communion."

Hands Jennifer Davis

The Road to Legalization

In June, the city council of Oakland, urged by a growing nationwide campaign to “decriminalize nature,” passed a resolution instructing the police department to stop investigating and prosecuting people who use psychedelics that come from fungi or plants, including magic mushrooms, peyote cacti, and the plants used to brew ayahuasca, an increasingly popular psychedelic tea. Synthetic psychedelic chemicals like LSD and ecstasy were not included in the resolution. 

The Oakland vote followed public hearings in which residents testified that insights gained on psychedelics have helped them overcome years of depression or substance abuse. 

Councilman Noel Gallo, who introduced the resolution, cited the traditions of his own grandmother. “She didn’t go to Walgreens to heal us spiritually and physically,” he said. “She did it out of plants we use as Native Americans.”

One of the extraordinary things about the city council’s action is that the resolution it passed reads, in part, as a user’s guide to the smart use of organic psychedelics. It recommends that those suffering from depression or post-traumatic stress disorder first go to a doctor. It advises first-time users to start with small doses and recommends that they have an experienced guide. 

The resolution does not approve commercial cultivation and sale of psychedelic plants, outlaws possession or distribution in schools, and forbids driving under their influence. 

Earlier this year, voters in Denver narrowly approved a ballot measure to decriminalize psychedelic mushrooms. Other statewide voter initiatives are being circulated in California and Oregon, leading to the possibility that entire states could legalize psychotropic plants as early as next year.

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