Erika Dyck describes how the recent surge in psychedelic research presents opportunities to rethink how we do science, and how we measure the impact of science.
Are psychedelics returning to modern medicine, or are we having a flashback? What have we learned after a 50-year hiatus in clinical experimentation with psychedelics that might open the proverbial doors to a brave new world of psychedelic science?
By the end of the 1960s most legitimate psychedelic research ground to a halt under the combined pressures of regulators, politicians, research critics, and counter-cultural enthusiasts. For half a century, psychedelic research lay dormant, while its reputation as a valid medical intervention suffered. Historically, despite the genuine research that filled scientific publications throughout the 1950s, drugs like d-lysergic acid diethylamide (LSD), mescaline (from the peyote cactus), and psilocybin (mushrooms), became popularly associated with mind-control experiments, shamanistic (read: non-Western and non-orthodox) rituals, and counter-cultural defiance. The effects of these drugs came to symbolize hedonism and violence. Scientific research on psychedelics and its investigators were lumped together as illegitimate or unethical purveyors of unscientific approaches that did more to disrupt progress, than to promote it.
But, that interpretation is beginning to change.
In February 2014 Scientific American called for an end to the ban on psychedelic drug research. The article criticized the mental health treatment industry for failing to advance therapies beyond the golden era of the 1950s, and lambasted drug regulators for prohibiting psychedelic drugs. As the editors pointed out, the situation created a paradox: “these drugs are banned because they have no accepted medical use, but researchers cannot explore their therapeutic potential because they are banned… The decades-long research hiatus has taken its toll.”
The reawakening of interest in psychedelics has created a methodological conundrum: the bulk of the most rigorous studies from the past are 50-70 years old, while the new studies have small cohorts producing limited clinical data for analysis. The historic trials were conducted at the very early stages of the pharmacological revolution that ushered in new methods for evaluating efficacy and safety, culminating in the randomized controlled trial. Prior to standardizing that approach, however, most pharmacological experiments relied on case reports and data accumulation that did not necessarily involve blinded or comparative techniques. Thousands of experiences conducted in laboratory or clinical contexts captured qualitative and quantitative information about doses, experiences, reactions, and insights. This information is valuable for understanding the nature of the experience, but not necessarily conducive to current experimental protocols. It was generated using hand-written documents, not computer generated data sets, nor readily comparable outcomes using databases, nor even simple statistical analyses. At the time that this data was generated, researchers were not doing cohort studies or analyzing trends across large data sets.
Scientific methods have evolved, but so too have historical ones. Historians have embraced digital humanities and developed methods for evaluating large data sets that were produced before computers allowed for systematized, comparative analysis. Using these new tools, historians can revisit the old clinical data to draw out more meaningful and comprehensive information from the case files created in the 1950s and 1960s. Historians might now have genuine opportunities to work alongside scientists to interpret historical clinical data that could influence contemporary research.
Historically, scientists were keen to separate pharmacological substances from their organic cultural, spiritual, and healing contexts – the randomized control trial is a classic representation of our attempts to measure reaction rather than to interpret experience. Our accumulated knowledge about psychedelics has demonstrated that psychedelics readily invoke reactions that are not necessarily reducible to scientific categorization. Perhaps a return to psychedelics also forces us to revisit how we understand, interpret, measure, and ultimately treat modern human experiences.
Neuroscience was in its infancy in the 1950s, when LSD researchers first postulated that neuroreceptors were involved in regulating psychotic symptoms, among other things. Reactions to LSD seemed to suggest that brain areas could be turned on and off, or that different levels of consciousness could be activated through the use of chemicals. These hypotheses were rather crude by today’s standards, but pointed scientists in that general direction. Today, neuroscience has exploded into a mega-discipline, with thousands of brain studies, more sophisticated instruments, expensive laboratories, and a pace of knowledge building that would be unrecognizable to the brain researchers of a generation ago. Despite these advances, taking time to ponder the intersections of spirituality, consciousness, and brain science remains beyond the grasp of even the most successful neuroscientists, whose time is increasingly devoted to securing grants, filling out ethics forms, and logging hours in a lab accumulating data. In other words, the context of modern science has refocused attention on data accrual and away from larger questions of ontology, consciousness, spirituality, or even the impact of science on how we think.
Perhaps a return to psychedelics is more than merely finding another pill. This psychedelic renaissance might be a productive moment for rethinking how we do science, and how we measure its impact.
Erika Dyck is a Professor and the Canada Chair in the History of Medicine at the University of Saskatchewan.
To learn more about psychedelic psychiatry, Professor Dyck will be giving a public lecture entitled “Who is Keeping Tabs? Psychedelics, Doing Science, and Policing History” October 12, 2017 at 7 pm in Alumni Hall at the University of King’s College in Halifax Nova Scotia. You can also read her book.