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Do psychedelics have the power to heal us?

Psychedelics have become more popular in the UK in recent years, with some people using them recreationally to address mental illnesses. These drugs are illegal, but with recent medical developments in the US towards incorporating psychedelics into clinical mental health treatments, what sort of future are we looking at? Do psychedelics have healing potential? DJ Mag’s Lauren Martin talks to DJ and producer Lauren Flax about her own experiences with psychedelics, and Prof. Adam Winstock, CEO of Global Drug Survey, to find out more

A young life is punctuated by firsts: your first kiss, your first taste of alcohol, moments when you feel recklessly alive. Producer and DJ Lauren Flax smiles when she remembers the first time she took ecstasy. She was a high school junior in ’95, and techno music was bubbling in her home city of Detroit. Back then, it all felt so right. “I loved ecstasy,” she says fondly, “and I found an odd comfort in ecstasy too, because I felt that I couldn’t keep on it, 24/7, like you could with harder drugs like cocaine and heroin.”

She recalls the damage that addiction had inflicted on family members. “It might seem strange to some people, but my way of not becoming an addict was, for a time, to love ecstasy.” Raving and experimenting with MDMA led Flax to devote her life to dance music: DJing in Detroit, and her current home, Brooklyn; creating thundering house and techno music, for labels like The Bunker New York and Unknown To The Unknown. But she’s also gone on a complex personal journey, using psychedelic drugs to heal from traumatic experiences, and evolving her relationship with rave music and culture.

Though her story is inherently personal, it taps into a wider, contemporary discussion about the recreational use of psychedelic drugs to explore issues around mental health and wellbeing – and how, after decades of strict laws and complex stigmas, psychedelics could be on the cusp of being legally re-introduced into clinical therapies, in the United States and the United Kingdom. Before the Controlled Substances Act of 1970 designated LSD a Schedule I drug in the US — categorised as having “no currently accepted medical use and a high potential for abuse”, alongside heroin — it had been used in mid-20th century counter-cultural circles, as well as psychiatry and psychotherapy. In the near-50 years since, and despite the dedicated work of organisations such as Multidisciplinary Association for Psychedelic Studies (MAPS), long-term clinical research into the benefits and dangers of psychedelic drugs remains limited.

Positive anecdotal evidence, though, appears in popular culture. One-time or casual recreational users often describe a temporary release from the ego, and daily life, that can feel liberating. Long-term or regular users might take psychedelics to create environments that allow them to explore their subconscious, and cope with traumatic life events. Within that group, some may even use psychedelics to specifi cally address mental illnesses such as anxiety and depression, instead of using legally prescribed drugs and clinical therapies.

When Lauren Flax was 27 years old, four of her close friends died. “It sent me on this whirlwind,” she says, “I would ask myself, ‘Why have they gone, and where they are now?’” It wasn’t until she was in her early 30s that she decided to use psychedelics to explore their deaths, and the abuse that she’d suffered as a child. She’d taken mushrooms before — casually, at raves — but had “always been scared of psychedelics” otherwise. Now, and to her own surprise, she felt the urge to take ayahuasca, “the most potent psychedelic on the planet”.

“It took the major step of taking psychedelics for me to understand that anxiety is what happens when you’re not grounded in your body.” - Lauren Flax

Ayahuasca

Originating from the Amazon, ayahuasca is a plant-based brew that’s been used for spiritual and religious purposes for thousands of years. While it’s held in high cultural regard in countries like Peru — the Peruvian government gave ayahuasca a protected status in 2008, as “one of the basic pillars of the identity of the Amazon peoples” — its trade and use is still largely unregulated by formal authorities across South America. In the UK and the US, ayahuasca is illegal because one of its active components, Dimenthyltryptamine (DMT), is designated as a Class A drug in the UK and Schedule I drug respectively.

Reasons for participating in ayahuasca ceremonies vary from person to person, but many express a desire to explore issues like trauma and addiction. Ceremonies are ideally led by a shaman or elder, for the group’s safety, and participants report a wide variety of physical and mental effects after drinking ayahuasca: intense visual and auditory hallucinations that can last for hours, vomiting, and feelings of euphoria, panic, and fear; potentially triggering undiagnosed mental conditions, or even psychosis. To take part in a ceremony, then, is to accept that you may be putting yourself in harm’s way.

Aware of the risks, and on the advice of friends, Flax travelled to upstate New York in 2013, to participate in her first ayahuasca ceremony. Sheltering from a storm, her group was placed in one room, and given sleeping bags and buckets for vomit by an elder. “I’m thinking, ‘What am I doing? This is crazy,’” she remembers. After drinking the ayahuasca, she meditated. “During the trip, I saw my heart — out of my body, in front of me,” she says. “I grabbed it — not with my physical hands, but with my spirit, somehow — and threw it back in my chest.

“I thought about my abuser and said, ‘Fuck you forever. This was never yours. It’s mine’. I went in to forgive this person, but that’s not what happened.” Flax lifts her arms in the air, and points out a web of tattoos — there are close to a dozen designs of hearts, some of which were finished before her first ayahuasca trip. “I’d been looking for my heart, and I finally got it back. If I never went to another ceremony again, I was still a very changed person.”

Because DMT is illegal in the US and UK, largescale clinical research into the long-term effects of ayahuasca is scarce. However, in March of this year, US peer-reviewed journal Therapeutic Advances in Psychopharmacology published a 2016 systemic review of 25 years of clinical trials, on the therapeutic uses of psychedelics such as LSD, psilocybin (the main psychoactive component in mushrooms), and ayahuasca. One of its conclusions was that while “the mechanisms of action responsible for the benefi cial effects produced by ayahuasca... are not completely understood, preclinical evidence shows that ayahuasca [has] antidepressive, anxiolytic, and anti-addictive properties,” and “suggest that [ayahuasca] has therapeutic potential.”

Flax attended bi-annual ayahuasca ceremonies until early 2016. “After ceremonies, you have to change your life,” Flax says seriously, “and it would take the better part of a year to get those changes in motion.” When she decided to transition from the ceremonies to meditation, the process led to a series of revelations. Around this time, she also stopped drinking alcohol. “It took the major step of taking psychedelics for me to understand that anxiety is what happens when you’re not grounded in your body,” she says. “After a month, I felt like I’d been hit by a truck — I was 38 years old and had been drinking, every week, since I was 12 years old.” 

By the fourth month, she began to “navigate the earth differently. I needed to learn what I love and what I don’t love, and all of the things I wanted to understand but couldn’t [while drinking alcohol]. After meditating every day for a few months, I was like, ‘This is weird — was I always supposed to feel this way?’ I couldn’t believe it. Psychedelics told me to meditate, and meditation made me feel grounded and able to stop drinking. I had been living outside of my body for my entire life, feeling anxious every day until I was 36 or 37 years old. Now, I have no more random panic attacks — at all.”

Alcohol-Free

Now that she doesn’t drink alcohol, her relationship to raving has changed. “In rave culture, alcohol and drugs  are used to connect more easily to others, but alcohol, for me, was about being able to feel comfortable in my own skin,” she says. “There are things in me that were too insecure, and alcohol made me feel stable. I’m appreciative of alcohol for that, because I got to have a lot of fun, but it really did come to a head where I had to be that strong person without it. When I go raving now, I’m on nothing.”

What’s her rave ritual nowadays, since she’s alcohol-free and only occasionally takes psychedelics? “If I’m going somewhere that’s intense, I meditate before I go out.” Then, she roars with laughter. “If I’m at Berghain for a long time, I might slip away and meditate. Near the coat check, there’s this leather swing, but a lot of people don’t know about it. If no one’s around, I’ll meditate there!”

Flax’s work as a producer and DJ has changed, too. She’s keen to release new music, in collaboration with a friend who works as a healer. It’s still techno, made on drum machines and synthesisers, but her approach is more spiritual than before. “My idea of what a healer does has grown exponentially,” she says. “It’s made me delve deeper into the frequencies in music, and the frequencies of healing — that chakras can have a key. Just like when a shaman hits his drum, I’m creating a type of heartbeat with my drum machine and meditating to that. It’s just what feels good.”

Despite her spiritual experiences, Flax is still grounded in reality: a warm Midwesterner with an in-your-face sense of humour. “I want my music to be accessible to people that just love dancing hard to house and techno in the club, and don’t usually get down with all this hippy-dippy bullshit,” she says bluntly. “I don’t ever teach anybody what worked for me, because it might not work for you, but because of my journey, I might have something to offer you — something to listen to, that might bring you some comfort.”

“I worry that the way that psychedelics are being portrayed at the moment is: ‘here we are, take these drugs, have a trip, and your problems will be solved.’ That offers a false promise.” - Prof. Adam Winstock

Lauren Flax’s method of “self-medicating” was personally transformative. It is also illegal — but for others, who are interested in using psychedelics as part of their mental health treatment, that could be about to change. This March, the Food and Drug Administration (FDA) approved esketamine, a form of ketamine typically used by doctors as an anaesthetic, as a treatment for depression in the United States. It is the first psychedelic to be given such approval. The FDA has also approved MDMA and psilocybin for “breakthrough therapy” status, which will fast-track research into their use for treatment of PTSD and depression respectively. Half a century after LSD was made illegal, could psychedelic-assisted psychotherapy become a new field of medicine in the US and, if successful, in other countries, like the UK?

Prof. Adam Winstock is the CEO of Global Drug Survey (GDS). It’s the largest single drugs survey in the world, and studies the prevalence of drug use in the general population. As part of GDS2019, more than 85,000 people were surveyed. Over the last six years, GDS has observed a general upward trend in the recreational use of psychedelics in the UK. Between 2014 and 2019, the use of LSD was up from 12.2% to 25.9%, the largest single increase of any psychedelic, while the use of mushrooms was up from 13.7% and 19.3%, and 2CB was up from 7.7% to 18%.

While the use of psychedelics appears to be steadily growing, this doesn’t necessarily mean that people have an appetite for them in a clinical or therapeutic setting. When it comes to how accepting people were to different approaches of treating mental illness, 70% would take part in “talking therapies”, like Cognitive Behavioural Therapy (CBT), but only 40% would accept drugs — pharmaceutical or psychedelic — as part of any clinical therapy program. Among that 40%, of those who would accept any psychedelics, the substances of choice were, in order of preference: low doses of LSD or psilocybin, followed by high doses of LSD or psilocybin, then MDMA. Ketamine and ayahuasca were rated as the “least acceptable”.

Psychedelics

Prof. Winstock thinks that there are many complex issues in play here. In the medical community, he’s seeing a generational change. He thinks that young doctors and psychiatrists, who haven’t been as exposed to stigmas around “bad trips” and other cultural associations of psychedelics as their older peers have, seem more accepting to new research that appear to challenge those stigmas. Recent imaging studies of what different psychedelic drugs do to the brain have proved key in this. “Unless you can explain on a neurological level how these drugs are working, how it makes any anecdotal benefits seem biologically plausible, it makes it very difficult to integrate them into your view of mental health [as a medical professional],” he says.

With these studies, “the data is not just consistent with patients’ experiences, it’s consistent with people’s recreational experiences of taking psychedelics. People have breakdowns in rigid patterns of thought [which] allow parts of their brain that don’t normally communicate to communicate.” When it comes to mental illness, Prof. Winstock sees psychedelics as potentially providing a new kind of clinical treatment for those who have found little longterm success elsewhere. “For the last 30 years there’s been no innovation in the medications we use,” he says, “whether they’re antidepressants, antipsychotics or sedatives, they’re all basically the same and nothing really very much has changed. So, there is a gap in the market.”

Considering recent developments in the US, how far off are we from having access to psychedelic drugs as part of clinical treatments for mental health issues in the UK? On this point, Prof. Winstock is sceptical. While there is currently one legal ketamine clinic in the UK, in Oxford — a paid-for service, available through referral on the NHS from a patient’s GP and/or psychiatrist — he believes that there’s “likely to be a fairly long time before psychedelics could be available on the NHS, through your local psychiatric service, for a whole bunch of reasons.”

Staff will need to be retrained. National medical services will need to be reframed. Medications will also likely be very expensive, too. Companies producing medical grade psilocybin, for example, “will be out to make profit. [If and when] these drugs become available, I imagine they will be available through the private sector, for people who can afford to pay lots of money.” These delays are partly why GDS has focused on how people currently use psychedelics “off license” to treat issues of mental health and emotional distress, including those who seek supervision from what Dr. Winstock calls “underground therapists”.

This is another reason why Prof. Winstock would be interested in seeing psychedelics become available for legal treatment — it’s about therapist accountability, and patient safety. “There will be people out there who are legitimate and have excellent clinical backgrounds, running underground, supervised MDMA or LSD sessions. But there will also be people who will exploit vulnerable, frustrated individuals — those who have remained depressed or traumatised for decades, and can’t access psychedelics on the NHS.”

He stresses the need for any psychedelic-supported therapy sessions to be closely monitored and discussed at every stage, with the ultimate aim of helping the patient being able to live a healthy life without taking any psychedelics. “I worry that the way psychedelics are being portrayed at the moment is: ‘Here we are, take these drugs, have a trip, and your problems will be solved’. That offers a false promise. We don’t want psychiatry to make the same mistakes [with psychedelics] as with others [clinical drug treatments],” he says, pointing towards corrupt practises and inflated prices within pharmaceutical industries.

Grey Areas

Then, there are the grey areas. While Prof. Winstock currently sees no medical reason why a recreational user of psychedelics could not go on to use psychedelics as part of supervised therapy, he wonders about how they could best take steps towards further treatment. “One of the things we’re asking [in GDS] is whether or not you disclose your use of psychedelics to your doctor,” he explains. “When we asked cannabis users if they’ve disclosed their use of cannabis to their doctor for medical purposes, two-thirds of them said no. Most consumers would assume that their doctors would be sceptical, ignorant, or frightened.”

From the doctor’s perspective, that fear could be about “not knowing much about [the drug], and the medical and legal consequences of giving [a patient] advice about a drug that they’re not prescribing.” A hypothetical scenario: a patient feels that their prescribed medication for a mental health issue is not working, and decides to replace it with recreational psychedelic use without telling their doctor. A patient like that is now potentially at risk because “they step out of being monitored or supervised. We have to accept that there will be a large body of people who will either continue or start to use psychedelics, whether regulated or not, to treat their mental health. They need to have a way of understanding whether their response is reasonable, positive, and effective, and how it compares to everyone else.”

As someone who has used psychedelics “off license”, Lauren Flax is an enthusiastic supporter of the potential legal use of psychedelics for the clinical treatment of mental illness. “I’m all for it,” she says. “We’ve been self-medicating for decades, so it would be nice to have someone to sit down and have monitored sessions with, in a controlled environment. I also think, though, that as humans, we’re always going to abuse the things that bring us happiness. People are going to do the fucking drugs. People will still self-medicate, be at risk, or even die, but if we legalise and regulate them, that risk could be a fraction of what it is now.”

If awareness of the healing potential of psychedelics became mainstream, and not solely the purview of clued-up ravers, the benefits could be profound. “Parents, siblings, grandparents — could you imagine what that would be like?” Flax wonders. “Your war veteran uncle, taking MDMA to work through his PTSD? Maybe this could open them up to a new kind of healing, a healing that we’ve been doing in the rave community.”

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Lauren Martin is DJ Mag's features editor. You can follow her on Twitter here