Post Tag: Research

In part 2 of the article, “Surprising Results: Psilocybin Trial for Depression Alleviates Chronic Pain,” the disappearance of Court’s chronic pain leads to a new understanding of cortical remapping, mirror box therapy, and how science can treat phantom limb pain.

Immediate Changes Post-Dosing

I had years of experience in cold water training from my Aikido career, but as my depression had increasingly grown worse, I developed a severe cold intolerance. It had become painful to stand under the shower, with my scalp almost spasming in contraction, when I used to be able to stand in late winter melt-water waterfalls and rivers with ease. But post-dosing, my cold tolerance came roaring back; allowing me to stand under a cold shower for minutes at a time with no numbness and no pain – it was almost like it was happening to someone else or there was a micro-force field on the surface of my skin. I found myself having to leave the shower because I just had other things to do. Cold water tolerance is a gold-standard for measuring pain response in clinical trials, and in fact, later that year, the Department of Psychopharmacology at Maastricht University, sponsored by the Beckley Foundation, conducted the first LSD and pain study in nearly 50 years, showing that low-dose LSD significantly increased cold water tolerance without interfering with day-to-day activities.

I had been known for my mobility and flexibility throughout my career and my ability to train others to achieve the same results, but mine had been compromised for a good while at this point. But the day after my session, I was able to resume positions that I hadn’t been able to comfortably acquire in months, if not years. Movement now felt smooth and effortless once again, and I swear there was even improvement in the tissue quality in areas that had become “crunchy.”

There was also a significant change in my inflammatory baseline. Depression is seen as a disorder that also includes fairly significant neurological inflammation and is often bi-directional with chronic pain, but many of the same receptors that psilocybin operates on are also contained within the gastrointestinal tract, and mine had altered sensation for a month afterward. I believe my systemic inflammation significantly improved during that period because within three months of my dosing, I reacquired personal training records that had become elusive, and by summer, I passed those PRs and set new ones. I also felt incredibly less “puffy.” Accidentally banging into something didn’t hurt anymore and persistent joint aches and lack of motor activation disappeared. There were additional improvements in neurological issues that will be described in a future case study, but that was just as immediate and impactful.

Lockdown Leads to the Lowdown on the First Psychedelic Pain Studies

Within the training and recovery world, patients and trainees can loosely be categorized as super, normal, non, and negative responders. I had stopped being responsive to both training and rehabilitation efforts at the peak of my depression, and was entering negative-responder territory, which was severely distressing. Fascinatingly, I now seem to be trending somewhere between a normal and high responder. I began proclaiming to the researchers at NYU that psychedelics were going to completely change chronic pain treatment within five years. And I also had a secret; the day after my dosing session, I had what’s referred to as a huge download: I realized that if you could consider things like depression, PTSD, and severe anxiety to be nociplastic outputs of the Central Nervous System (CNS) that causes iterative rumination (a.k.a. looping maladaptive outputs), that was no different from the looping maladaptive outputs that characterize chronic pain – the neurology of which I had been studying for years at that point. Due to the extreme visual qualities of the psychedelic experience and the rapidity of my own remission, I saw, in a flash, that since psilocybin was an impact booster for neuroplasticity, it would enhance the impact of mirror box therapy for phantom limb pain or likely any other neuromodulation.

“Remapping” is the term describing the tactic of using visual or other sensory receptor inputs to modify and change nociplastic or noxious/painful outputs of the brain. As this is part of the Z-Health process, I had been introduced to the concept of mirror box therapy years earlier as part of my certifications, but I thought I had come up with a whole new approach and kept it to myself, barely hinting at what I believed I had uncovered. But, since NYC was locked down and I was unable to work, I had nothing to do but go online and research what had happened to me.

Within two weeks or so, I found an old photocopied English abstract from a 1962 study in Japan, by Kuromaru, et al., using low-dose LSD to treat phantom-limb pain with 50% of its participants going into instant remission by the end of their session, and the authors pointedly declaring that stacking the LSD with movement had a far stronger impact on resolving both phantom limb pain and phantom limb syndrome. Stacking inputs is a common practice within the neuromodulation world for pain treatment, often coupling a weaker input with a stronger one, and I realized that this was what had clearly happened to me while I was in my post-dosing neuroplastic window. It finally felt like I was getting traction again; that drills and exercises were once again effective, and crucially, maintaining their own momentum. I didn’t have to be hypervigilant anymore in my daily routine for these drills to become “sticky.” I also realized that the Kuromaru study had, in fact, been released earlier than the Kast study from 1964 investigating the analgesic properties of LSD for terminal cancer and other painful conditions, which is frequently and incorrectly cited as the first psychedelic pain study. I became aware of other previous psychedelic pain studies, as well as recent ones like Dr. Charles Nichols’ work on the anti-inflammatory properties of psychedelics, and studies involving Dr. Robin Carhart-Harris’ REBUS model and cortical reorganization, which is what happens when a stimulus results in the creation of a new cortical map (essentially a vertical column in the brain cortex consisting of neurons performing specific processes). 

Both of these discoveries are crucial because cortical reorganization (or remapping) and inflammation are key drivers of chronic pain. Conditions like depression and anxiety are characterized by rigid, fixed beliefs or frameworks where the same negative thought loop keeps reoccurring repeatedly, with no amount of incoming contrary information able to alter that belief. It becomes what’s known as a “strong prior” in neurology, becoming a top-down driven process in the CNS, actively suppressing any bottom-up sensory input error correction. The same mechanisms of action occur with chronic pain, where, despite the healing or resolution of an injury; a rigid, fixed pain signal is continually being sent out by the brain as a maladaptive response of the CNS’ protective suite. These are referred to as nociplastic or noxious neurological conditions. The same is true for multiple chronic pain conditions where inflammation causes maladaptive signaling and perceptions, leading to negative structural or nociplastic changes in the peripheral and central nervous system. In psychedelic-assisted psychotherapy, a non-rigid, chaotic state is induced, which allows the cortical landscape to reorganize into a more efficient and positive state.

Landmark Study in Pain and Psychedelics Confirms Insights

As everything was becoming more and more clear – in what had to have been one of my most transpersonal moments after my dosing session – a landmark review paper was published. “Chronic pain and psychedelics: a review and proposed mechanism of action” by Dr. Joel Castellanos, et al. was released from the Psychedelics Health and Research Initiative (PHRI) at UC San Diego in May of 2020, barely two months after my dosing session and pain revelation. It was an amazing overview of all the possible mechanisms of action that could be at play in psychedelics being an effective analgesic and resolver of chronic pain, but the most revelatory moment was when I found, buried within the heart of the paper, a link to the case study that had set PHRI in motion. It was written by the world-renown neuroscientist VS Ramachandran, the clinical faculty at PHRI, and by its case subject, Albert Lin, who had used high-dose psilocybin coupled with mirror box therapy to put his intractable phantom limb pain into full remission.

I sat speechless for at least five minutes, shaking my head in a feeling of wonder and disbelief, as if the universe itself had just delivered this paper to me. Other than my remission and the pandemic, I had thought of nothing else but the application of how these two approaches could be combined. Of course someone else had invented it well before me; of course they had. I knew that resourceful, capable people had been working on this for a while, and chronic pain is a singular motivator, but it was still astonishing to see my vision so vividly applied and executed.

I had learned in 2015 that cluster headaches had been effectively treated with psilocybin for 25 years, and of mirror box therapy a few years before that. I had even blogged about it because people in the rehab and training communities thought that my using visual inputs to treat pain was so weird they called it “voodoo.” But there is a neural hierarchy, and many pain and performance conditions in the body actually have higher-order components within the visual and vestibular systems. That’s often why, no matter how much manual/physio therapy one does, it is often a downstream compensation within the body in order to reconcile perceptual discrepancies between the visual and vestibular system. The visual system lets you assess the surrounding environment and predict any threats that exist within it, and the vestibular system helps you orient within that space, keeping your body in balance so that you might be able to execute any motor actions in response to any perceived threats. If your eyes are telling you the horizon is 5° tilted to the left, but your vestibular system, a.k.a. your inner ear, is telling you that it’s 5° to the right, your body will compensate so that those discrepancies are reconciled and you maintain a stable, level “sight picture” – your viewscreen of the world. Having an unstable sight picture makes for poor predictions; in other words, in an evolutionary survival context, having a “shaky cam” is not so great for avoiding saber-tooth tigers.

So, those downstream bodily compensations that keep your viewscreen steady are creating distortions and possible maladaptations in the structure of your body, and are now being cemented due to repeated compensatory use. The nervous system will protectively reduce motor output and increase pain perception as a response, to slow you down in order to avoid potential injury and survive another day. Ultimately, the body has evolved towards survival, not performance. And pain is an alarm/action signal designed to keep you alive.

Mirror Box Therapy and Pain as An Output of Perception From the Brain

When we look at phantom limb pain, what we’re seeing is the phenomenon known as deafferentation: the loss of afferent or ascending inputs from the peripheral nervous system up to the brain. No limb equals no signal, and the loss of signal is very dangerous within an evolutionary context because limb loss due to injury or infection will mean, at the least, loss of sensation and loss of coordination for motor outputs/muscle contraction/movement, meaning a lost ability to gather food or to avoid threats. Or worse, it could mean signaling that you’re going to bleed to death in a matter of minutes.

Multiple pain conditions could be considered sub-clinical deafferentation: peripheral neuropathy from conditions like diabetes or shingles, or different types of phantom limb pain where the limb is still present but the nerves are so injured that they no longer transmit afferent signals – such as we see in cancer, stroke, or crush injuries. That loss of signal gets hardwired into the cortical representations of that limb, and never gets a counterbalancing signal, so the CNS registers it as an ongoing sense of threat. That creates a huge alarm signal in the form of pain perception.

What mirror box therapy does is replace that loss of signal with the image of an intact limb, generating input that dampens down that pain signal. And when you touch the remaining limb (which is generating normal signals) while seeing it reflected in the mirror in place of the missing or injured limb, it can immediately cause the pain signals to cease; so powerful are visual representations within the somatosensory cortex of the brain. Essentially, through seeing a limb appear where it wasn’t before, one tricks their own brain into thinking it’s still there, and the pain signals from the CNS for that lost limb stop being sent.

Mirror box therapy is often not enduring though; only being effective for as long as you do it, and that was the case with Albert Lin. It often takes a lot of repetition for it to become “sticky.” Neuroplasticity requires novelty and intensity, usually in the volume of work. But that can be hard to achieve, thus the issue in pain treatment that I had experienced directly as a practitioner and as a patient; everything works, nothing lasts. When it was suggested to Lin that psilocybin had strong neuroplastic properties that could impact cortical reorganization for chronic pain, he tried it a few times, taking a high dose of psilocybin mushrooms, which gave him approximately 3-12 pain-free hours, depending on the dose. But then the pain came back with a vengeance. Within the cluster headache communities, this is known as a “slapback effect” and can actually be a sign that the nervous system is adjusting and more permanent relief could be imminent.

Then, Lin’s wife suggested combining (stacking) mirror box therapy with psilocybin. He went out to the desert with a closet door mirror, and while under high-dose psilocybin, he would stare at the reflected image of his remaining leg and then at the space where his amputated limb had been, while repeating the phrase “You are safe. You are totally safe,” for approximately 45 minutes. This met all the conditions for driving neuroplasticity: novelty, intensity, and volume of work with deep assurance of emotional and physical security. Amazingly, it worked, immediately putting him into remission for the next 20+ hours, with 50% reduced pain for nearly two weeks. He shared his success with the lab, and experiments with different types of visual neuromodulation while under high-dose psilocybin quickly began.

Lin was dealing with a persistent pain in his phantom foot that felt as if a railroad spike was being driven through, suspected to be a sensory remnant from when the bones in his foot were surgically pinned together as they attempted to save it before ultimately deciding to amputate. An artificial foot and a pen with a telescoping pointer was introduced, and they covered the space between his stump and the plastic foot with a blanket, then “pulled” the telescoping pen out of his foot at the site of pain, mimicking the action of removing pins (or really, removing the pain). He felt instant relief.

Another experiment involved a novelty Halloween-store “flame” (bright light with orange and yellow fabric and a fan underneath that makes it flutter). Lin chuckled when he saw it, but when they brought it near his representational foot, he actually felt heat from the “flame,” which was intensely relieving.

Through these experiments and continued work, Lin went into full remission after five weeks, and has been free of chronic pain ever since. It’s worth noting that he had a top research team working with him that was extremely creative in creating novel inputs, and he is known for being an almost Michelangelo-type character, with a high degree of inventiveness and novelty-seeking, allowing him to discover unique, lateral approaches to solve problems. And, it bears repeating: chronic pain is a singular motivational force.

Additionally, post-dosing, cortical reorganization was happening during a psychedelically-induced “critical period reopening”; when the brain has a metaplastic quality that allows it to reset to an almost-new condition. As described in the work by Dr. Gül Dölen, critical period reopening happens during crucial phases of nervous system development in childhood, such as when toddlers can learn multiple languages without an accent or when adolescents are uniquely sensitive to social cues from peer pressure (and/or support), allowing them to quickly adopt different social customs and frameworks. This reopening is also seen post-stroke, when there is a limited window for rehabilitating from brain injury, so this likely applies very well here with chronic pain. We know that veteran groups like the Heroic Hearts Project, VETS (Veterans Exploring Treatment Solutions), and The Mission Within, who are employing psychedelics for treatment, are having striking results both in recovery from combat-induced PTSD as well as traumatic brain injury – typically seen as treatment-resistant conditions.

Conclusion

If there’s anything I would like you to understand after reading this article, it’s that:

We don’t have to prove that psychedelics are effective for treating chronic pain; we have to establish that this has already been proven.

Psychedelics are not an instant cure for chronic pain, but they are strong impact boosters for neuroplasticity and can make physiotherapy/neuromodulation become “sticky,” creating enduring relief.

We know that many mechanisms that create psychiatric conditions that are responsive to psychedelic-assisted psychotherapy are extremely similar in nature to the same mechanisms that generate chronic pain; it’s just that psychiatric conditions have gotten far more focus in psychedelics, perhaps because the non-ordinary states of consciousness they are known for producing seem more applicable to conditions more traditionally thought to be related to the mind.

But both arise out of the central nervous system and are rigid, fixed states of cognition and perception. With depression, you have negative outlooks and self-perceptions: “Nothing I do makes a difference,” “People are just saying that to make me feel better,” etc. At one point, these thoughts may have helped you to cope with a traumatic incident, environment, or upbringing, but now they’re maladaptive, weigh you down, are out of step with reality, and have actually caused (or are the result of) structural deficits in the neurology of your brain. It’s the same with chronic pain: when there is an acute injury or even the possibility of one, pain is part of the protective suite of responses from our nervous systems to prevent further injury and allow healing to occur – an alarm bell/action signal to change a behavior. But it can be so overprotective that it gets embedded and cemented with movement, emotions, and surrounding environments long after all tissue healing is done – getting triggered by seemingly innocuous events, maladaptively hardwired into your neurology in a negative loop of conditioned responses.

This is exactly what happened to me when I went through NYU’s psilocybin trial; an adverse financial and work environment, repeated (and under-recovered) musculoskeletal stress/injuries, and (likely) sub-clinical post-concussion syndrome and PTSD, all topped off by the sudden death of a close friend releasing long-suppressed grief and leading to a significant nociplastic output in the form of increasingly treatment-resistant depression and moderate chronic pain. Many recovery efforts were attempted using every modality I knew, but there was too much of a deficit to overcome – until psilocybin was introduced to the mix. That life-changing experience allowed for metaplasticity, cortical reorganization, descending inhibition, and anti-inflammatory properties to take root, giving all post-dosing interventions the opportunity to gain traction and for me to flourish once again.

Future articles in this “Pain and Psychedelics” series will focus on old assumptions vs. new science, additional case studies, the suspected mechanisms of action behind the interaction between psychedelics and pain, and best practices and safety concerns for working with psychedelics to alleviate chronic pain.

Could a nation defined by inflammation find relief in psychedelics?

It’s a verifiable truth that the United States of America may be considered a global leader, especially when it comes to the prevalence of mental and physical health disorders. In fact, of the nearly 330 million people in the population, millions to hundreds of millions of Americans suffer from chronic conditions like: 

• Obesity (42%)
• Arthritis (24%)
• Anxiety (19%)
• Irritable Bowel Syndrome (IBS) (15%)
• Allergies (15%)
• Attention Deficit Hyperactivity Disorder (ADHD) (14%)
• Diabetes (11%)
• Depression (8%)
• Asthma (8%)
• Cancer (6%)
• Autism (2%)
• Fibromyalgia (2%)

These sobering statistics beg the questions: How could a single nation of relatively modest size be home to such a vast selection of chronic diseases? And how could psychedelics be used to combat these conditions affecting so much of the population? 

Why is Inflammation so Prevalent?

The answer begins with key lifestyle factors such as diet, exercise, tobacco use, or genetic predispositions, each of which contribute to the pathology of a given disease. For example, a 2010 study by the American Cancer Association found that 90% of Americans don’t meet their daily recommended requirement of vegetables, with 75% failing to eat even a single piece of fruit during an average day.

The American diet overall is egregiously devoid of whole grains, beans, fruits, vegetables, and nuts, with the US Department of Agriculture estimating they represent a mere 11% of the populous’ typical daily food intake. Despite this lack of prevalence, these unprocessed natural foods are otherwise rich in medicinal phytochemicals found to support the immune system and strengthen the body’s resistance to infections, as well as fight cancer and diabetes; diseases that are twice as prevalent in the US relative to the global average. Shockingly, the US also leads the world in obesity rates by nearly 400%, and is first in global consumption of sugar, outranking Germany by about 26% yearly.

Although diet quality is proven to significantly impact the likelihood of disease development, what Americans eat is only one contributing factor among many. Poor diet alone doesn’t explain the exceptional amount of chronic health conditions seen in the population. In fact, it’s estimated that over 60% of Americans suffer from at least one chronic health condition, 42% of the population are diagnosed with at least two, and up to 12% of Americans live with five or more chronic diseases. 

To put those percentages in perspective, the 2020 election saw the highest voter turnout in 120 years, with the most votes for a single presidential candidate ever recorded in American history. Joe Biden reportedly received over 81 million popular votes, representing less than half of the 198 million Americans suffering from at least one chronic health condition, and only marginally more than half of the 139 million with at least two.

Despite the fact that they’re by no means a minority in the population, chronic diseases are found to disproportionately affect socioeconomic minorities in the United States of America and beyond. A recent study published in the journal, “Archives of Public Health,” used 20 years (1995-2015) of empirical data from the Organization for Economic Cooperation and Development (OECD) to investigate the impact of education on health across the populations of 26 countries, including the United States, Canada, United Kingdom, France, Germany, and other founding nations that became members when OECD was created in 1960. This data, taken from millions of people in numerous countries across the globe over one fifth of a century, clearly demonstrated that higher educational attainment in adults positively correlates with longer lifespans, better health outcomes, increased Gross Domestic Product (GDP) per capita, and reduced infant mortality rates.

Put simply, the OECD data suggests that highly educated adults with ample finances generally live up to 12% longer (8-10 years), enjoy healthier lives, make more money, and are less likely to die at birth or of cancer, when directly compared to individuals of lower socioeconomic status (SES). Unsurprisingly, adults with higher GDP per capita also spent more money on healthcare and education over their lifetime, with college and university education found to positively influence life expectancy, child vaccination, and enrollment of children in education, as well as negatively impact infant mortality. Taken as a whole, the OECD data demonstrates an essential principle: 

If appropriate education and adequate income significantly increase life expectancy, then access to quality schooling, sustainable employment, and equitable socioeconomic mobility are inherent to health care services. 

However, even if we factor in education and employment as essential contributors to health, the fact remains that as of 2021, over 85 million Americans older than 25 had attained a Bachelor’s Degree or higher, and US unemployment was a mere 3.7% in August 2022. Since neither education nor employment are able to fully reconcile the disproportionately large number of Americans currently suffering from chronic health conditions, there must be a deeper underlying cause contributing to the pathology of diseases reportedly observed in the country’s citizens and resident aliens. 

What is Chronic Inflammation?

Compellingly, inflammation has been identified as a central contributor to all aforementioned chronic health conditions and beyond, and is implicated in over 60% of all human deaths around the globe. Some may already be familiar with acute inflammation in the form of localized pain, redness and swelling, usually in response to an injury or infection. Acute inflammation is typically a normal immune response during which the immune system is activated through the release of specific proteins, essentially called inflammatory markers. These markers then act as beacons to recruit immune cells, which subsequently migrate to the particular body part(s) in need of defense or repair.

In contrast, chronic inflammation is less apparent and far less immediate, but has insidiously dire consequences when left unchecked. Instead of causing localized pain or swelling, chronic inflammation causes systemic issues with immune cell signaling through excess “noise” created by high levels of inflammatory markers. Rather than being recruited to areas of the body most in need of healing, immune cells are drowned in an overwhelming number of biochemical beacons and ultimately disoriented. By disrupting this essential communication between immune cells, chronic inflammation prevents the appropriate direction of immune cells to critical issues needing attention, and may instead direct disproportionate amounts of immune activity to arbitrary areas – thus crippling the body’s capacity to effectively heal itself or prevent systemic disease.

The dysregulation of the immune system may ultimately induce the development of one or a combination of diseases, including autoimmune disorders like Crohn’s Disease, IBS, Alzheimer’s, arthritis, and diabetes, as well as various cancers and neurological disorders. Furthermore, children of mothers with chronic inflammatory conditions are demonstratively more likely to be diagnosed with ADHD, anxiety, depression, obsessive compulsive disorder (OCD) and autism, especially when chronic prenatal exposure to maternal inflammatory markers is exacerbated by psychological or physiological stress.

Over the past  20 years, a growing body of research has further investigated the complex relationship between chronic inflammation, various mental and physical diseases, and socioeconomic status (SES). High levels of inflammation measured by markers in the blood of low SES patients were found to prospectively predict whether they would suffer from depression, heart disease, ischemic stroke, and/or mortality.

Furthermore, factors such as poverty, lack of social or educational resources, obesity, and diets rich in refined sugar were all closely associated with increased inflammatory markers, chronic diseases, and mortality rates. Stress derived from socio-political, financial, environmental (chemical, biological, electromagnetic), or psychosocial (relationship experiences, trauma, social conditioning) aspects of a patient’s life also reportedly influenced inflammation, with chronic psychological and emotional stress inducing a significant increase in observed blood inflammatory markers; thus promoting immune dysfunction and ultimately increasing the likelihood of chronic diseases in individuals of low SES. 

Psychedelics as Anti-inflammatory Medicine

Despite these undeniable correlations and profound implications, the medical model of inflammation as the root of disease is not a new concept. Whether willow bark or aspirin, both traditional Ayurvedic and modern Western medicine employ preparations of anti-inflammatory drugs to treat a number of maladies, from headaches to heart disease. In fact, many over-the-counter (OTC) medications, commonly prescribed pharmaceuticals, and even psychedelic drugs owe some portion of their medicinal benefits to anti-inflammatory effects exerted in particular tissues of the human body.

For example, recent research has revealed that two of the most commonly prescribed classes of antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs) and Selective Norepinephrine Reuptake Inhibitors (SNRIs), may instead induce their expected medical effect via anti-inflammatory action within the brain itself, thus alleviating underlying neuroinflammation implicated as a central contributor to malaise, fatigue, brain fog, emotional reactivity, and other psychological symptoms. This revelation casts significant doubt on the broadly accepted model for the pathology of depression that classically purports serotonin deficiency as the primary cause. Today, a new breed of antidepressants specifically intended as anti-inflammatory drugs are undergoing feverish development by major drug corporations.

But before we herald these pharmaceutical innovations as the ultimate solution to tame the treachery of chronic neuroinflammatory disease, we must address the unjust marginalization and criminal victimization of disaffected Americans self-medicating via naturopathic means. Notwithstanding their evolutionary, anthropological, and social significance, the potent anti-inflammatory effects of cannabis, psilocybin mushrooms, and other psychedelic derivatives are now well-supported by an ever-growing body of recent scientific research. Although prohibitionist laws previously precluded a thorough investigation of their potential, the US has slowly and begrudgingly allowed the pursuit of psychedelic pharmacological power. As the barriers of outdated, impermissible, and fallacious legislative paradigms fall, clinicians are finally gaining critical insights that have enabled the development of novel pharmaceutical psychedelic derivatives with extreme precision; such that specific medical characteristics like an anti-inflammatory effect or psychedelic effect may be intentionally targeted and enhanced or diminished. 

However new this scientific perspective may seem, medicinal preparations of psychedelics have reportedly been used for centuries, and even pharmaceuticals investigated and approved for clinical use decades ago were arguably directly modeled after psychedelics like LSD and psilocybin. Most notable of these compounds, Methergine (methylergometrine), is an LSD derivative used to induce contractions during childbirth since 1582, and is currently included on the World Health Organization’s (WHO) List of Essential Medicines. A similarly indispensable class of pharmaceutical psychedelic derivatives, the triptans, were first developed and patented in 1991 to treat migraines and cluster headaches, conditions which are both implicated to be caused by neuroinflammation. Interestingly, early triptans display remarkable structural similarities to tryptamine psychedelics like DMT and psilocybin.

Further progress spearheaded by brave and dutiful psychonauts in professional practice, underground social circles, and beyond has steadily illuminated the psychological and pharmacological nuances of many psychedelic drugs, revealing that they’re in fact highly safe and effective treatments for Post-Traumatic Stress Disorder (PTSD), suicidality, depression, anxiety, addiction, Fibromyalgia, various chronic inflammatory diseases, and more. Tireless efforts across decades of clinical trials using psychedelics such as cannabinoids, MDMA, ketamine, and psilocybin have paved the way to their current or imminent approval by the US Food and Drug Administration (FDA).

It finally seems quite possible that psychedelic medicines previously incorrectly admonished as “psychomimetic drugs” that imitated psychosis, damaged DNA, and were toxic to the human body may soon be available as legitimate pharmaceutical compounds aiming to alleviate the suffering of millions. With the current medical and legal trajectories, it’s highly likely that sometime in the not-so-distant future, inflamed Americans in need of psychedelic therapies will be able to access them without the unnecessarily harmful (but now still-looming) threat of social, criminal, and civil persecution. As much as one author celebrates this opportunity for a modicum of much needed progress in the United States, a single question remains:

Do a handful of state-level decriminalization initiatives for some select drugs, as well as the monetization and regulation of a limited number of pharmaceutical psychedelics at the federal level truly represent a sufficiently compassionate and broad solution to remedy the innumerable and egregious offenses against American life, liberty, and the pursuit of happiness committed by the war on drugs?