Originally published in the Boston Globe
Psychedelics allow the brain to get reorganized and process information from a new perspective, making mind and brain temporarily more malleable and able to learn.
On Election Day, Massachusetts voters will have the opportunity to enable regulated, therapeutic access to naturally occurring psychedelic substances that show promise in treating a range of mental health conditions. If approved, Question 4 would establish a regulated framework for licensed and trained facilitators to provide psychedelic services to adults at approved locations. The measure would not permit the retail sale of psychedelics.
Surveys in recent years have consistently documented an upsurge in stress in society, which is associated with increased anxiety, depression, and social isolation. This, in turn, has led to increased attempts to self-medicate with drugs and alcohol, leading to larger rates of substance use disorder as exemplified by the horrendous fentanyl epidemic that is haunting our nation, which claims the lives of over 100,000 Americans each year.
For the past five decades my colleagues and I have studied post-traumatic stress disorder, a condition that in 2020 affected about 13 million Americans, which often causes people to react to minor stresses as catastrophes and to real challenges by shutting down. They can also have difficulties focusing and concentrating as well as dealing with conflict. Toxic stress, or trauma, results in enduring changes in genes, hormones, and brain circuitry. Sadly, about half of people who receive current gold standard PTSD treatments do not benefit and discontinue treatment. Traditional psychiatric medications, which earn Big Pharma billions of dollars each year, are largely ineffective for PTSD. It is essential that new treatments and interventions are made available.
Over the past eight years I have had the privilege of being a principal investigator of a large, multisite study on the effectiveness of a psychedelic agent MDMA, or Ecstasy, for treating PTSD. The results have been stunning. More than 86 percent of those who received the treatment achieved a significant decrease in their PTSD symptoms, and 71 percent no longer suffered from PTSD. Those who received psychedelic-assisted therapy, instead of just psychotherapy, showed significant improvements in self compassion, emotion regulation, and the ability to negotiate interpersonal conflict.
Studies out of Johns Hopkins and the Imperial College London have demonstrated the profound effects of psychedelics for treating depression. With these promising early studies, top universities around the country now are racing to set up research centers.
The side effects in our and our colleagues’ contemporary studies of psychedelic-assisted psychotherapy were largely transient and mild. Compared to opioids, alcohol, or tobacco, psychedelics have low addictive potential and benign toxicity profiles.
Much remains to be learned about the potential of psychedelics. As clinicians we compare the therapeutic process to how immunotherapy helps to fight cancer: by stimulating the mind’s own capacity for defense and healing. Researcher Gul Dolen of the University of California at Berkeley has shown that psychedelic agents open up windows of neuroplastic activity, in which the brain can get reorganized to process information from a new perspective, making mind and brain temporarily more malleable and able to learn.
Millions of citizens use psychedelic agents in underground settings. As long as these substances are illegal, or confined to extremely controlled research laboratories like ours, there is a lack of capacity to exercise quality control or to evaluate their efficacy on a larger scale, including potential adverse reactions.
Question 4 requires that this therapeutic program include pre-screenings, facilitator training, and other guardrails to promote responsible use and reduce risks. Implementation of the program would be guided by an advisory board composed of medical professionals and subject matter experts. The measure also directs the advisory board to develop guidelines for public education.
Voters should pass Question 4 and offer another tool to Bay Staters who are struggling with their mental health.
Dr. Bessel van der Kolk is professor emeritus at Boston University School of Medicine, president of Trauma Research Foundation, and author of “The Body Keeps The Score: Brain, Mind, and Body In The Healing From Trauma.”