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Evening Standard
Evening Standard
Comment
Alexandra Jones

OPINION - Gwyneth Paltrow is a fan — but we must be rigorous before prescribing psychedelics

I went to the world’s largest psychedelic conference a few weeks ago — Psychedelic Science —the one where Jaden Smith told a crowd of some 11,000 psychonauts and scientists that his mum (Jada Pinkett Smith) recently introduced the family to psychedelics. Why was Jaden Smith being interviewed at a scientific conference? I honestly have no idea but the delightful wackiness of this industry is one of the main reasons I love reporting on it.

Of course, the phrases ‘delightfully wacky’ and ‘scientifically robust’ rarely feature in the same sentence and the more time I’ve spent researching (I first wrote about the renaissance in psychedelic research in 2016, for this publication) the more I’ve come to wonder whether we’re not letting the thrill of a new intervention stop us from asking some important questions.

The case for psychedelic mental healthcare is a robust one — psychiatry, as an industry, is in dire need of innovation. Despite 200 years of modern psychology, we’re no closer to finding a cure for mental illness than Freud was in 1899. Clinical trials using psychedelic compounds have shown promise in the alleviation of symptoms for conditions like depression, anxiety, PTSD — even eating disorders.

The treatments seem so effective that a new study published by Cambridge University Press has found that therapy assisted by the psychedelic psilocybin is a more cost effective way of treating depression than any currently available intervention. This comes hot on the heels of news that Australia has become the first westernised country to legalise the prescription of MDMA and psilocybin for PTSD and treatment-resistant depression respectively. As well as Jaden Smith a slew of celebrities have evangelised about these compounds — from Gwyneth Paltrow (I heard at least two people at the recent Psychedelic Science conference bemoan her praise for psilocybin on the grounds she was making it ‘passé’) to Elon Musk.

At the same conference I watched the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS) Rick Doblin deliver the keynote speech dressed head-to-toe in a white, l ike an evangelical preacher. He got a standing ovation before he’d even said anything. He got another when he said “welcome to the psychedelic twenties.”

We need to put evangelism and hype aside and be as rigorous as investigating their impact as we would be with any other medicine

I’m not so sure. The number of people who have been given MDMA and psilocybin in clinical trials is actually incredibly low (some scientists estimate that it is in the hundreds, others that it’s just over 1,000) — and the vast majority of trials are still in their very early exploratory phases. Other than that conducted by British author and researcher Jules Evans there is almost no research into the long-term impact of adverse reactions, despite the fact that a bad trip can really f*** you up.

Per Evans’ research: ‘in our survey of 608 people who report extended difficulties after a psychedelic experience, one third reported difficulties lasting longer than a year and one sixth longer than three years. The most common reported difficulties were anxiety, social disconnection, derealization, existential struggle and continued visual distortions.’ These ‘difficulties’ were much less likely to occurr if a person was part of a clinical trial, or in a safe and controlled environment, where they had proper aftercare, although 8% of survey respondents had taken psychedelics in a therapeutic or clinical setting, ‘so harms happen even under ‘safe’ settings,’’ the study authors concluded.

In the past few days, a number of London-based researchers — including Dr James Rucker, the lead doctor at King’s College psychedelic research centre — have lined up to condemn the Australian legalisation of these compounds.

He tweeted: “I have no understanding why the TGA would consider it safe to allow psychedelics on prescription when trials are not complete and no regulatory authority around the world has licensed them. Dangerous.” I am pro-psychedelics, but we need to put evangelism and hype aside and be as rigorous in investigating their impact as we would be with any other medicine.

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