More than half of America’s unsheltered population lives in just three states—California, Oregon, and Washington—and West Coast voters are demanding a response. Homelessness ranked as the top concern in a recent poll of likely voters in the Los Angeles mayor’s race. Last year, Seattle residents replaced a long-serving progressive city attorney with a Democrat-turned-Republican who vowed to clear encampments. And San Francisco’s progressive district attorney may be headed for defeat in an upcoming recall election, in part because of spiraling crime rates in neighborhoods with large homeless populations.

Much of the policy debate about homelessness has focused on high costs of living and a lack of public services, while politicians and activists largely have avoided trying to curtail one of the most consequential factors of all: the misuse of drugs. Policymakers don’t seem to want to say it, but going all out to help some homeless people stop using drugs has to rank alongside housing as a top priority.

Chronic drug and alcohol use are major contributors to homelessness. In a 2019 national survey of unhoused people, more than half of respondents reported that “use of drugs or alcohol had contributed to loss of housing.” In Seattle, which conducts a detailed annual census of its homeless population, the top self-reported reason for chronic homelessness—lacking shelter for more than one year—was “alcohol or drug use.” A 2019 analysis found that close to two-thirds of chronically homeless individuals in San Francisco reported misusing drugs or alcohol, and a quarter cited “substance use as the primary cause of their homelessness.” Drug or alcohol overdose was the leading cause of death among homeless people in Los Angeles County in 2020, similar to findings in other major American cities.

Federally-funded permanent supportive housing initiatives are prohibited from mandating sobriety as a condition for shelter. The federal policy known as Housing First, adopted during the George W. Bush administration, prioritizes securing stable housing for homeless people, regardless of their drug use, mental health status, or ability to support themselves, as a prerequisite to solving other problems. Housing First has been effective at keeping people housed for at least a year and reducing emergency medical services use. But there’s little evidence it helps people resolve substance use problems, gain employment, or retain housing over the long term.

Lacking a federal plan for addressing drug and alcohol use among the homeless, cities and states have had to come up with their own strategies—and many have embraced harm reduction, an approach that dovetails with Housing First’s priorities by ameliorating the problems associated with drug use without requiring people to quit. Harm reduction seeks to reduce overdoses and communicable disease by relying on needle exchanges and other initiatives that make drug use safer, rather than punishing users. Public health experts embrace the approach, as do criminal justice reform advocates and proponents of drug decriminalization.

The San Francisco Department of Public Health formally adopted harm reduction as city policy in 2000; it is also the stated policy of L.A. County’s homeless services agency. Proponents say harm reduction is more effective than sobriety-based treatment because it shows respect for drug users’ autonomy and does not rely on law enforcement. Practitioners describe their work as engaging drug users “where they are” and fostering trusting relationships with service providers. During a 2019 presentation about the method, Nathaniel VerGow, now the Los Angeles agency’s deputy chief, reminded participants that “many drug users can be happy, loving, trustworthy, productive people! Many sober people are NOT!”

Harm reduction methods can be effective at keeping drug users alive and stopping the spread of disease. But nowhere have they been shown to help large numbers of problem drug users regain control of their lives. And they’re highly resource intensive. In a recent University of Washington evaluation of JustCARE, a harm reduction homeless services program in Seattle, providers described round-the-clock efforts to placate methamphetamine-using clients “running around naked” and “pounding a door at 3:00, 4:00 a.m.,” or disassembling televisions in the converted hotel rooms where they were being housed.

Leaders grapple with how to afford such service-intensive programs. Fully funded, JustCARE would cost roughly $20 million per year to serve up to 288 people. Since its start in 2020, the program has served 225 participants and moved fewer than one-tenth into permanent housing. There are close to 12,000 homeless people in Seattle and surrounding King County.

Politicians often promise simple solutions with splashy policy initiatives—crackdowns, shelters or, lately, expensive permanent housing. In his most recent State of the City speech, departing L.A. Mayor Eric Garcetti reaffirmed the value of a $1.2 billion homeless housing measure passed by voters in 2016. The measure, slated to fund construction of roughly 12,000 housing units by 2027, has been faulted in multiple audits for delays and cost overruns. Still, Garcetti insisted on permanent housing as a solution to homelessness: “[I]f we don’t double down on our housing momentum, the California Dream will be an old chapter in a history book.”

But drug treatment experts say cities need a multipronged approach. Psychiatrist Keith Humphreys, of Stanford University, said research shows that people with substance use problems are best helped with a combination of some harm reduction methods—especially medication-assisted treatment for opioid withdrawal—and an ultimate focus on getting and staying sober.  The odds of recovery from a substance use disorder “are at least 50 percent higher” in sobriety-based programs such as Alcoholics Anonymous or Narcotics Anonymous, he said. Scott Chin, president of the privately-funded Union Gospel Mission in Seattle and a former homeless heroin user himself, said that half of participants in his program, which requires sobriety, graduate and eventually find employment and stable housing.

Humphreys said cities relying solely on harm reduction should be aware of results in Vancouver, Canada, which pioneered the method in North America. The city reported a record number of overdoses last year and its homeless population grew by more than a fifth over the past decade.

There are signs of change. California Gov. Gavin Newsom recently proposed what he called a “Care Court” that would compel people with serious mental health or substance use disorders into treatment, for up to two years. The plan was immediately endorsed by a bipartisan group of big-city mayors and opposed by civil libertarians and advocates for the homeless. “We may have to use force to get [people] into treatment,” San Francisco Mayor London Breed said, in a recent podcast interview. Preliminary results from an annual nationwide homeless population count suggest that San Francisco’s efforts to battle homelessness have begun to pay off. The city recently reported a 15 percent decrease in its unsheltered population since 2019.

Josephine Ensign, a longtime homelessness researcher at the University of Washington who herself experienced homelessness as a young adult, said that amid all the debate, it is important to recognize two qualities essential to any effort to help homeless people: compassion and a healthy respect for complexity. Many forms of support for homeless drug users—Housing First, harm reduction, 12-step sobriety programs, faith-based services—can improve outcomes and save taxpayers money by keeping people off the streets and out of jail, Ensign said. The key is flexibility—finding the right service for each person and not getting stuck in ideological rigidity.

“Having choices for people is hugely important,” she said. “It’s getting the political will among voters to understand the complexities of homelessness, and address it.” In cities up and down the West Coast, contentious upcoming elections will show whether voters agree.

The post Why Won’t Policymakers Talk More About Drugs and Homelessness? appeared first on Zócalo Public Square.

With the possible exception of opium during the Opium Wars, no drug has ever received a bigger stimulus from armed conflict. “World War II probably gave the greatest impetus to date to legal, medically-authorized as well as illicit black market abuse of these pills on a worldwide scale,” wrote Lester Grinspoon and Peter Hedblom in their classic 1975 study, The Speed Culture. Whether in the air or in the trenches, the war enabled the rapid proliferation of a synthetic stimulant that was particularly well-suited to sleepless work and intense concentration.

Amphetamines—often called “pep pills,” “go pills,” “uppers,” or “speed”—are a group of synthetic drugs that stimulate the central nervous system, reducing fatigue and appetite and increasing wakefulness and imparting a sense of well-being. Methamphetamine is a particularly potent and addictive form of the drug, best known today as “crystal meth.” All amphetamines are now banned or tightly regulated around the globe.

While produced entirely in the laboratory, amphetamines owe their existence to the search for an artificial substitute for the ma huang plant, better known in the West as ephedra. This relatively scarce desert shrub has been used as an herbal remedy in China for more than 5,000 years and is often ingested to treat common ailments such as coughs and colds and to promote concentration and alertness—including historically by night guards patrolling the Great Wall of China.

In 1887, Japanese chemist Nagayoshi Nagai successfully extracted the plant’s active ingredient, ephedrine, which closely resembled adrenaline; and in 1919, another Japanese scientist, A. Ogata, developed a synthetic substitute for ephedrine. But it was not until amphetamine was synthesized in 1927 at a UCLA laboratory by the young British chemist Gordon Alles that a formula was available for commercial medical use.

The Benzedrine inhaler hit the market in 1932 as an over-the-counter remedy for asthma and congestion. Courtesy of Wikimedia Commons.

Alles sold it to the Philadelphia pharmaceutical company Smith, Kline & French, which brought it to market as the Benzedrine inhaler in 1932 (an over-the-counter product to treat asthma and congestion), before introducing it in tablet form a few years later. “Bennies” were widely promoted as a wonder drug for all sorts of ailments, from fighting depression to obesity, with little apparent concern for or awareness of their addictive potential, and of the risks of longer-term physical and psychological damage. And thus, the stage was set for large-scale pill pushing to reach the battlefield when the next war broke out.

German, British, American, and Japanese forces ingested large amounts of amphetamines during World War II, but nowhere did the drug’s use have a more long-lasting societal impact than in Japan. The Japanese imperial government sought to give its fighting capacity a pharmacological edge, and so it contracted out methamphetamine production to domestic pharmaceutical companies for use during the war effort.

The tablets were distributed to pilots for long flights and to soldiers for combat, under the trade name Philopon (also known as Hiropin). In addition, the government gave munitions workers and those laboring in other defense-related factories methamphetamine tablets to increase their productivity.

Japanese called the war stimulants “senryoku zokyo zai” or “drug to inspire the fighting spirits.” Defense workers ingested these drugs to help boost their output. In the all-out push to increase production, strong prewar inhibitions against drug use were swept aside. It is not difficult to understand why. As researchers such as political scientist Lukasz Kamienski have documented, total war required total mobilization, from factory to battlefield. Pilots, soldiers, naval crews, and laborers were all routinely pushed beyond their natural limits to stay awake longer and work harder. In this context, taking stimulants was seen as a patriotic duty.

Kamikaze pilots took large doses of methamphetamine, via injection, before their suicide missions. They were also given pep pills stamped with the crest of the emperor. These consisted of methamphetamine mixed with green tea powder and were called Totsugeki-Jo or Tokkou-Jo, known otherwise as “storming tablets.” Most kamikaze pilots were young, often only in their late teens. Before the injection of Philopon, the pilots undertook a warrior ceremony in which they were presented with sake, wreaths of flowers, and decorated headbands.

Although soldiers from many countries returned home from the war with amphetamine habits, the problem was most severe in Japan, which experienced the first drug epidemic in the history of the country. Many soldiers and factory workers who had become hooked on the speed during the war continued to consume it into the postwar years, when it was easy to get the drugs because the Imperial Army’s post-war surplus was dumped into the domestic market.

These stockpiles of the drug then brought about other dramatic changes in Japanese society. Upon surrendering in 1945, the country had massive stores of Hiropin in warehouses, military hospitals, supply depots, and caves peppered throughout its territories. Some of the supply was sent to public dispensaries for distribution as medicine, but the rest was diverted to the black market rather than destroyed. There, the country’s Yakuza crime syndicate took over much of the distribution, and the drug trade would eventually become its most important source of revenue.

Pervitin, a methamphetamine brand that German soldiers used during WWII, dispensed the tablets in these containers. Courtesy of Wikimedia Commons.

Any tablets not diverted to illicit markets remained in the hands of pharmaceutical companies. In the wake of the traumas and dislocations of the war, a depressed and humiliated population offered an easy target. As Kamienski noted, “The pharmaceutical industry advertised stimulants as a perfect means of boosting the war-weary population and restoring confidence after a painful and debilitating defeat.” The drug companies mounted advertising campaigns to encourage consumers to purchase over-the-counter medicine sold as “wake-a-mine.” The product was pitched as offering “enhanced vitality.” In No Speed Limit: The Highs and Lows of Meth, journalist Frank Owen reports that these companies also sold “hundreds of thousands of pounds” of “military-made liquid meth” left over from the war to consumers, who did not need a prescription to purchase the drug.

With an estimated 5 percent of Japanese people between the ages of 18 and 25 taking the drug, many became intravenous addicts in the early 1950s.

Another driver of the epidemic was the existence of large, new U.S. military bases on the islands, which had never previously been occupied by a foreign power. National newspaper Asahi Shinbun wrote that U.S. servicemen were responsible for spreading amphetamine usage from large cities to small towns. Indeed, the Japanese government’s Narcotics Section arrested 623 American soldiers for drug trafficking in 1953. However, according to historian Miriam Kingsberg, most drug scandals involving U.S. soldiers garnered little coverage by the major papers out of “deference” to “American-Japanese friendship.”

Surging methamphetamine use led to increasingly strict state regulation of the drug: The 1951 Stimulant Control Law banned methamphetamine possession, and penalties were increased three years later. But these increases did not stop the rise in arrests for amphetamine abuse, which jumped from 17,500 people in 1951 to 55,600 in 1954. During the early 1950s, arrests in Japan for stimulant offences made up more than 90 percent of total drug arrests.

In an anonymous survey by the Ministry of Welfare in 1954, 7.5 percent of respondents reported having sampled Hiropon. Meanwhile the Asahi Shinbun published an estimate that 1.5 million Japanese were methamphetamine users in 1954, out of a total population of some 88 million.

The high rates of amphetamine use in Japan started to subside by the late 1950s and early 1960s, once economic growth began to create more jobs. Nevertheless, methamphetamine would remain the most popular illicit drug in Japan for decades to come.

The post The World War II “Wonder Drug” That Never Left Japan appeared first on Zócalo Public Square.

But just as that year began, Mexico’s then-president Felipe Calderón, feeling pressured politically, declared a war on drug trafficking. So when I least expected it, instead of wandering around in Kenya, I abandoned my planned trip to Africa and instead found myself riding in a Mexican army assault vehicle, wearing a military helmet and a bullet-proof vest, crisscrossing the Tierra Caliente (Hot Lands) region of the south-central Mexican state of Michoacán.

A correspondent is one who sends news from somewhere far away from his own previous reality, or from the reality of others. I became a correspondent, filing dispatches about an outbreak of barbarism—but in my own country.

Ten years later, the statistics show that, since Mexico’s drug war exploded in 2006, nearly 200,000 people have been violently killed, 30,000 more have disappeared, and another 35,000 have been displaced. Mexico is by no means a dictatorship, but so far in the 21st century it has recorded a greater number of human rights violations than occurred under any Latin American dictatorship in the last hundred years. Many of us Mexican journalists leave our homes every day to seek out and tell others about the barbarity that coexists here with democracy.

Faced with such a peculiar situation, it is impossible to do our job with one set of skills. After this grueling decade’s experience, I believe that anyone who covers drug trafficking in Mexico must have the attributes of a military correspondent, a private detective, and a poet.

At times I have felt like a war reporter. I remember flyovers of military planes in Oaxaca that preceded a shootout lasting about two hours, during which I helped carry an injured photographer colleague out of the line of fire and witnessed the murder of the U.S. independent journalist Bradley Roland Will at the hands of paramilitary groups whose existence the authorities denied. As in any war, you cannot rely on official sources.

At other times, I have had to carry out my investigations with the cautious precision of a detective. The monitoring and tracking of people, covert infiltration, and the compiling of judicial and criminal profiles are necessary resources in the face of the challenges of our present situation, where you have to protect not only your own integrity, but also the lives of your contacts and sources. It wasn’t until this year, after taking a course at a U.S. detective academy, that I discovered the similarity between the two professions.

But it has been poetry that has saved me from losing my mind during these trips to the abysses of reality. Thanks to poetry, I have been able to take care of my loved ones, despite my frenetic and at times neurotic work process. If at the end of the day there was not a poem by César Vallejo, or by Samuel Noyola, I never would have escaped the deep emotional chasms I have known during these years of keeping company with capos, generals, assassins, governors, businessmen, and other members of the savage wilderness. Without poetry, I could not do journalism.

“Worn, ragged, empty, words have become skeletons of words, phantom words; everyone chews them up and belches their sound,” wrote Arthur Adamov during World War II. Seeing that same distortion of language in my daily work—the inadequacy of words to describe what is happening in Mexico—in 2011 I wrote a manifesto of infrarrealist journalism. Infrarrealist journalism, in short, is a herd of solitary wolves.

The desire for survival also unites solitary wolves, and I am not speaking metaphorically: In 2016 there were 11 murders of journalists in Mexico, and in total there were 426 attacks. During the current government of Enrique Peña Nieto, 32 comrades have been killed. On average, every 20 days a Mexican journalist dies violently for completing his or her job. Only this year, so far, Carlos García has died in Colima; Cecilio Pineda in Guerrero; Ricardo Monlui in Veracruz; Mirosalva Breach in Chihuahua; Max Rodríguez in Baja California; Javier Valdez in Sinaloa; and right now, just as I am writing this, I read that they have found the oxidized remains of Salvador Adame, a journalist kidnapped and disappeared a few weeks ago in Michoacán.

Taking into account that I am an independent journalist—the lowest species on the media food chain, but probably the most joyful—the current situation has caused me to take more personal security measures, because I don’t have a big media company to back me up, or anyone else to watch out for me. These measures include keeping several backups of key documents, compartmentalizing sensitive information among friends and collaborators, avoiding certain subjects in emails, WhatsApps, and phone calls, and even now and then writing a kind of confidential will, where I register what I am doing so that in case of an extraordinary situation that information can be used against whoever is responsible.

Otherwise, I’m a Stone Age reporter, doing things the old-school way. So I record everything I can while doing field work. In fact, I fill up two notebooks: one where I put hard data, and another where I write down sensations or ramblings. I also take photos, to help me remember later, and I try to make video. I like to stay as long as possible in places. I return two or three times, if possible.

When I arrive for the first time, I look for a local colleague, but also for a local school teacher and a priest. When I am lucky I meet a poet, and I am very happy. Journalists, priests, teachers, and poets are often my gurus in the immersion process that is needed in order to write the chronicle of a dangerous and unknown location.

When I am not reporting, I get up early to drop off my child at school, and then lock myself away to write from 7 a.m. to 1 p.m. I almost always have too many things accumulated in my notebooks and in my memory, so I have to structure my texts. Then I write them out several times, and usually review them in order to prepare a risk analysis in the event that they are published. Almost all my books and long-form pieces are reviewed by lawyers.

Being a correspondent in your own home compels you to be creative—in your ways of devising a story, and of investigating, structuring, writing, and publishing it, but above all in your ways of surviving it. I am happy with the life that has fallen to me, and I wish to die of old age, writing in front of a computer. I have no vocation as a martyr. I am a person with more hopes than fears.

However, over these 10 years I have learned that each story has to take a risk. There should be no cowardice when writing in times like these. It is probable that I have written some failed texts, but I do not allow myself to write cowardly texts. When you are a correspondent of barbarism in your own home, your main duty is to take risks. In this way, I think, we can decipher one day this atrocious mystery into which we fell as a country, just when it seemed that democracy was going to save us.

The post How This Journalist Is Surviving Mexico’s Drug Wars appeared first on Zócalo Public Square.

This was not a normal psychotherapy session. During his 12-hour experience, designed to help stop his destructive drinking habit, King sat on the edge of the bed and looked at the photo of his son that he’d brought. Suddenly, the child became alive in the picture, which initially frightened him. Then King noticed that a lick of his son’s hair was out of place, so he stroked the photo, putting the errant strands back in place. His fear vanished. Later, Unger held out a small vase with a single red rose. King looked at the flower, which seemed to be opening and closing, as though it were breathing. At one point, Unger asked him whether he’d like to go out to a bar and have a few drinks. King didn’t say anything but was shocked when the rose suddenly turned black and dropped dead before his eyes. He never picked up another drink.

Arthur King was one of thousands of research subjects who were given LSD, psilocybin, and mescaline as therapeutic tools in the 1950s and 1960s, often with government support and with promising results. But by the time King was enjoying his sobriety, the backlash against psychedelic testing had already begun. By the mid-1970s, the legal exploration of the therapeutic benefits of psychedelic drugs was over.

This research is only now gathering momentum again in a new wave of U.S. clinical trials into other drugs with psychedelic properties. In recent years, university administrators, government regulatory agencies, and private donors have begun giving the stamp of approval and the money needed for new and expanding research into the use of MDMA, also known as ecstasy, and psilocybin, the active ingredient in magic mushrooms. In 2017, for instance, the Heffter Research Institute and the Multidisciplinary Association for Psychedelic Studies, two organizations leading the psychedelic psychotherapy revolution, will begin a final round of government-approved clinical trials in which hundreds of new patients with post-traumatic stress disorder, depression, and severe anxiety will undergo therapy sessions fueled by MDMA and psilocybin. Now, as we enter into a new age of experimentation, it’s worth looking back at the route that got us here.

LSD’s effects were discovered in 1943 by Swiss chemist Albert Hofmann, who accidentally dosed himself and was amazed by the powerful psychoactive effects of a drug he had labeled LSD-25. Hofmann had been working with ergot, a rye fungus, hoping to develop a new and improved cardiovascular stimulant. His employer, Sandoz Laboratories, soon made the drug available to doctors and researchers, advertising it as a tool to better understand psychosis and to possibly help patients in psychotherapy. The first wave of American psychedelic drug research—secretly funded by the CIA and the U.S. Army—began in Boston in 1949. By 1951, U.S. intelligence reports revealed that the Soviets had purchased 50 million doses of LSD from Sandoz. That discovery kicked off a decade of bizarre and sometimes horrific U.S.-sponsored research into the use of psychedelics as chemical weapons. There were tests to see whether LSD could be used as a truth serum or possibly be sprayed on enemy troops as a kind of weapon of mass distraction.

Meanwhile, brain scientists and psychotherapists were conducting more socially beneficial experiments in laboratories and medical offices around the world. Through the 1950s and 1960s, more than 1,000 research papers were written about LSD, psilocybin, and other psychedelic drugs. Some 40,000 subjects were given these mind-expanding agents, and great progress was made in the understanding of how they might help people suffering from depression, alcoholism, and the psychospiritual distress that often comes with the diagnosis of a life-threatening illness.

Researchers in Canada and the U.S. showed that psychedelic-assisted psychotherapy could be more effective in treating alcoholism than existing treatments, including the 12-step program of Alcoholics Anonymous. In the late 1950s and 1960s, even AA co-founder Bill Wilson advocated the cautious use of LSD, experimenting on himself and a small circle of friends. Theologians and psychologists studied how psychedelic drugs could inspire creativity and evoke life-changing mystical experiences in healthy volunteers.

On the East Coast, a Harvard University researcher dosed seminary students with psilocybin to show that the active ingredient in magic mushrooms could inspire an authentic religious experience. On the West Coast, the International Foundation for Advanced Study in Menlo Park, California, did research indicating that LSD could be used to improve cognitive functioning and problem solving.

By 1963, however, these drugs had escaped from the carefully controlled domain of the researcher’s laboratory and psychotherapist’s office. Millions of baby boomers were coming of age and starting to experiment on their own with LSD, magic mushrooms, peyote, and other hallucinogens. A charismatic Harvard University psychologist named Timothy Leary reinvented himself as the “high priest” of the psychedelic counterculture. In California, a promising novelist named Ken Kesey gathered a Dionysian troupe of Merry Pranksters and put on a series of huge parties called acid tests, where revelers dosed themselves and danced to a new band called the Grateful Dead.

By the end of the decade, LSD and other psychedelic drugs, along with marijuana, were linked in the public imagination with the 1960s counterculture, the antiwar movement, the crusade for sexual liberation, and the rising popularity of Eastern mysticism, yoga, and meditation. It was the decade of sex, drugs, and rock ’n’ roll. President Richard Nixon called Timothy Leary “the most dangerous man in America.” His administration’s crackdown on psychoactive drugs became part of a broader political reaction against the liberation movements on the 1960s. Leary’s mantra of “turn on, tune in, drop out” was seen as a direct threat to the corporate establishment and the consumerist, materialist mindset.

In the 1970s news of the destructive, sinister research conducted in secret by the Army and the CIA began to get out. Back then, one of my first major stories as a young San Francisco journalist detailed how one of these tests, dubbed Operation Third Chance, destroyed the life of a U.S. solider who was falsely accused by being a spy, given massive doses of LSD, and “interrogated in a hostile environment.” Back in 1953, one Army scientist who specialized in biological warfare, Frank Olson, killed himself (or according to some conspiracy theorists, was murdered) following a psychotic incident that may have been exacerbated by LSD.

The crackdown on both recreational and therapeutic use of psychedelics was not simply a political reaction. It was part of a broader re-examination of the loose standards applied to all kinds of drug research in the 1950s and early 1960s. Today, there is a greater appreciation for the rights of patients and research subjects to be fully informed of the potential dangers and side effects of these compounds. LSD was and is an unpredictable tool when used carelessly—a fact that was discovered by both CIA operatives and counterculture crusaders.

These consciousness-raising substances are finally coming out of the drug culture and into the mainstream laboratories of universities and medical centers. Researchers are building on the findings from the first wave of research. Today, scientists and therapists are more cautious in their screening of patients and the use of double-blind, placebo-controlled research to try to separate the effects of the psychedelic experience from other therapies patients get. More emphasis is placed on follow-up work to integrate the insights from psychedelic drugs into one’s everyday life.

Over the last several years, I’ve interviewed scientists, therapists, and patients involved in this new wave of research into psychedelic-assisted psychotherapy. There was Nigel, a U.S. Marine and MDMA patient who’d struggled with psychological demons since returning from the war in Iraq; Carroll, a hardcore drunk who got her life back following treatment with psilocybin; and Richard, a cancer patient who was treated for depression at Johns Hopkins.

Their stories illustrate how the powerful mind-altering effects of these drugs—along with the gentle guidance of trained therapists—can lead to real psychological healing, often accompanied by experiences of oneness, awe, and wonder that are traditionally associated with dreams or religious excitation. Exactly how these substances work remains a mystery, but to my unscientific mind, it has something to do with the loosening of the ego and the opening of the heart.

What’s happening in many of these experimental circles is the coming together of psychology and spirituality. Even the self-proclaimed secularists in the psychedelic-assisted psychotherapy movement employ rituals that draw from Native American shamanism and the sacramental rites of the Roman Catholic Church. Atheists pound on drums and ring Tibetan Buddhist bells. Medical doctors with priestly decorum present MDMA and psilocybin pills to patients in special chalices.

Advocates of both the therapeutic and the spiritual use of psychedelics are already celebrating the start of the “post-prohibition era.” That party may be a bit premature, but the government crackdown in the 1970s and 1980s on scientific research and personal use of psychedelic drugs has certainly declined. Marijuana may be the model for changing attitudes and public policies about LSD, magic mushrooms, ecstasy, and other psychedelic drugs.

But much will depend on how all this will play out in the administration of President-elect Donald Trump. It’s not hard to see how the psychedelic research could, once again, be slowed by a renewed “war on drugs” by such hard-liners as Alabama Sen. Jeff Sessions, the man Trump wants to serve as the attorney general. On the other hand, decisions about the medical use of these compounds by the Food and Drug Administration are supposed to be based on science, not politics, and the Veterans Administration is desperately seeking new treatments for returning soldiers suffering from PTSD.

For Arthur King, the positive effects of LSD-assisted therapy are undeniable. King, whose story was first told in a 1966 television documentary produced by CBS News, was tracked down decades later by filmmaker Dennis McDougal. In 2009, Arthur was still sober and married to the same woman who helped him through his battles with the bottle. King was asked to look back and assess the long-term impact of psychedelic psychotherapy. He didn’t mince words.

“It saved my life,” he said.

The post Long Before It Was Groovy, LSD Was a Medicine and a Weapon appeared first on Zócalo Public Square.

What is driving this problem and how can we combat it? In front of an engaged audience at Downtown Independent on Wednesday night, people immersed in the legal, medical, and cultural aspects of this problem offered their experiences, research, and thoughts, beginning with the origins of the epidemic.

UCLA legal scholar and health policy expert Jill Horwitz, who has been studying the laws that regulate doctors, patients, and pharmacies, said that the causes are multifaceted and include the economy, addiction, bad medicine, and corrupt pharmacists.

Sam Quinones, author of Dreamland: True Tales of America’s Opiate Epidemic, pointed to two separate causes. The first is OxyContin, which was promoted as a cure-all for pain beginning in the mid-1990s. The second is that in the 1980s, heroin—which had previously come from the Far East—started coming into America from Colombia or Mexico, making it much cheaper. “It’s potent, it’s cheap, and it’s extraordinarily mortal,” said Quinones. “It is deadlier than any epidemic we’ve ever had.”

Turning to Assistant U.S. Attorney for the Central District of California Benjamin Barron, Girion asked how law enforcement is trying to attack opioids.

Barron, who said deterring corruption among doctors is a primary focus, likened stopping opioid addiction to cutting off a many-headed monster. You can stop doctors from prescribing drugs, but you still have to deal with the black market. You can stop the abuse of prescription drugs, which has plateaued in recent years, but heroin use skyrockets. At the same time, stronger synthetic drugs are coming in from labs in China and Mexico.

Many states have instituted prescription drug monitoring programs to ensure that one person isn’t getting the same prescription from three different doctors, Girion said. But is it working?

Horwitz said that her research, including a paper she co-authored in the New England Journal of Medicine on opioid use among disabled adults, hasn’t found evidence that legal interventions make much difference.

Barron, however, disagreed. “From our perspective this has made a huge difference in taking bad actors off the market,” he said, adding that the data these programs provide is vital to his work. Furthermore, “every time we get a conviction it sends a message to doctors.”

What about helping people get medical treatment?

“The gold standard of treatment for opiate addiction is medication treatment,” said UCLA Addiction Medicine Clinic Director Larissa Mooney—drugs like methadone and naltrexone that “take the place of and break the cycle of intoxication, withdrawal, chasing the high, and trying to recover from the low.”

Another much-discussed solution, especially during the recent presidential election, is stopping the flow of heroin into the U.S. from Mexico. Girion asked Quinones, would a wall have an effect?

Walls won’t work because heroin is very easy to conceal and traffic, he said. “What we really need to do it seems to me is not alienate [Mexico],” he said. “We need to be pushing them to make the kind of changes that will make that country a kind of place that people aren’t dying to leave,” which includes better systems of law enforcement and criminal justice.

The panelists also all agreed that America’s attitude toward prescription opioids needs to change. Until the mid-1990s, doctors were reluctant to prescribe these drugs to patients unless they had terminal pain or cancer, said Girion. “Doctors’ prescribing tendencies shifted,” she said. “It got to the point where doctors were prescribing opiates quite frequently for all kinds of pain, including dental extractions and short-term pain.”

Mooney recalled seeing this “dramatic” transformation take place in medical school. “Doctors were told actually that opioids for pain are both effective and had minimal risk of addiction,” she said. “We’re learning that that is not true.”

Quinones said that the change isn’t simply limited to doctors and pointed to a larger cultural shift. “We became a country that really above all wanted comfort, convenience, and a lack of pain,” he said, citing padded playgrounds and trigger warnings in college classrooms as examples. It’s also a “story about the end of community and isolation in America,” he said. The crack epidemic largely took place in public housing, in “crack houses” where people gathered; by contrast, this epidemic is taking place in private bedrooms. “This is not a story about dope. It’s a story about who we are as a country, who we are as Americans, and what we think will lead us to happiness,” he said.

Quinones called football “a gateway to heroin addiction in America.” He found, anecdotally, that athletes with injuries are often prescribed pain pills; they’re considered the cool kids at school and on campus, and thus the drugs spread.

Girion said that her reporting supported this idea. “You go from the surgeon in the hospital to your family practitioner and your rehab, and no one pays attention to how many refills you’re getting,” she said.

“This is a supply story,” said Quinones. “If you multiply [one prescription] by millions of doctor visits and millions of surgeries over a 20-year period, that’s what creates this massive supply of opiates that transitions to heroin.”

The audience question-and-answer session pulled at one thread the panelists had touched on at various points in the discussion: race and opioid abuse. Quinones had called it a problem primarily in white America, and the panelists had all agreed that unlike other drug epidemics, this one cuts across class, affecting both affluent and poor, primarily white, Americans.

Medicare and Medicaid are contributing factors, particularly in impoverished areas. But why is there a market, asked one audience member, in more affluent places?

Quinones said that it is the result of “a generation of doctors accepting the idea that these pills can be prescribed with virtually no risk,” thanks to the work of pharmaceutical companies and pain specialists. “It was a magnificent piece of marketing,” he said.

Another audience member asked if the panel thought the level of attention given to this issue would be different if it wasn’t mainly in white communities.

Barron cautioned that at least in Los Angeles, he sees opioid addiction crossing ethnic groups, a point with which Horwitz agreed.

“It’s not that people of color cannot get hurt from this, and people of color are getting hurt from this,” she said. What’s shocking is that opioid addiction has caused a massive turnaround in the life expectancy of white people for the first time in 75 years, one that’s not seen in other racial groups, she said. As to the question about attention being paid, she wasn’t sure. “We have a fairly lousy history with dealing with problems that hit some racial groups and not others,” she said.

The post The Painful Truth About America’s Opioid Addiction appeared first on Zócalo Public Square.

In July, three people were found dead at the Hard Summer Music Festival near Los Angeles. During the two-day festival, which drew a record 147,000 attendees, an additional six people were hospitalized. Prior to these deaths, the Los Angeles Times counted 26 rave-related fatalities in the American Southwest since 2006. That doesn’t include non-fatal overdoses, a number which could easily reach triple digits if tallied across the country.

The reaction by lawmakers in cities like Los Angeles has been to clamp down on the events themselves, either banning them entirely or demanding strict control over the crowds. Promoters have instituted stricter security policies, while contending that at such large-scale events, drug use is inevitable. But the recent deaths suggest that these “solutions” haven’t solved anything.

Even though this latest tragedy is fresh, the problem is so familiar—and so unchanged—that a Los Angeles Times write-up of the Hard Summer deaths didn’t even bother to find a new doctor to talk to. They just recycled a quote from last year, in which a doctor frets that “there’s something about these events that leads to this rampant drug abuse,” but is unable to put his finger on why.

I’ve been going to raves for six years, and I don’t find the current approach to addressing the problem convincing. What I am convinced of is that it’s possible to have raves without any deaths at all.

Why has it been so hard to “fix” raves? Because we have not accurately identified the problem, which to my mind does not stem from kids disregarding their own lives, but rather from the fact that they never learned how to handle the spectacular, seductive freedom offered by raves.

Future Music Festival, Sydney, Australia, 2013.

The way I see it, the danger presented at raves stems from the fact that more than a few attendees are the products of our culture of over-protective parents. These ravers grew up highly supervised without the chance to be left to their own devices. Add to that the subtly influencing hand of teenage hormones and it’s almost surprising that there aren’t more tragedies.

Our society has become increasingly afraid of letting children run wild, and young kids today don’t have the same opportunities as previous generations to venture out into the world on their own, to learn how to handle the small freedoms of youth, to take risks, make mistakes, and learn from them. Instead, children are funneled from an early age into a myriad of adult-monitored activities such as team sports, school dances, and summer camps.

As teenagers, these hothouse kids begin to break out of their confinement. Raves are the perfect venue for youthful experimentation. Even the word “rave” sounds new and different from the “concerts” or “shows” of which adults hold fond memories.

Rave culture has always celebrated the illicit. The very definition of the word “rave,” meaning “to talk wildly or incoherently, as if one were delirious or insane” conjures intoxication. The first raves were born as a mutation of 1970s and ‘80s discotheques, the distinction being that raves were held in basements, lofts, and abandoned warehouses, rather than established venues. These parties often lasted for upwards of 10 straight hours, and people could bring in their own substances hassle free.

At raves, kids are given a shot at unmonitored social interaction, and the chance to finally partake in all sorts of risk-taking away from hovering parents. Unfortunately, these are not the baby-step risks of younger years. And without past lessons to guide them, it’s easy for bad choices to escalate without anyone realizing.

The question of rave safety is not a narrow one. In the past few years, the American electronic dance music (or EDM) scene has exploded, with longer, multi-day festival events routinely pulling in crowds of over 100,000 people. EDM has penetrated the heart of the musical world; it has its own category at the Grammys, and heavily influences the sound of contemporary pop music.

When I got into raving in 2010, I had always felt like a social outcast, but raves connected me with a group of likeminded people who I would never have met otherwise. It wasn’t long before I started going out more, getting into trouble with my parents, and having more fun than ever before.

Since then, the rave scene has become firmly cemented in the realm of popular culture. But that didn’t mean the end of drugs or danger. Even as security checks have gotten stricter, drugs have been present at every rave I’ve ever been to. And security checks haven’t prevented deaths.

The good news is that thoughtful alternative approaches have emerged. Some raves are starting to protect their attendees, often by bringing together people who understand how raves work and getting them to work together in the crowds.

The Bunk Police, a group now a few years old, built a strategy on the insight that most overdoes happen after kids at raves take mystery drugs they bought from strangers. Many of these drugs are actually harmful chemicals masquerading as popular club drugs.

The Bunk Police show up at events armed with tests kits that can tell whether a bag of powder is real MDMA, or one of the countless synthetic chemicals that have flooded the rave scene since the popularization of online drug dealing websites, such as the fabled “bath salts” scare of years past. Since their existence acknowledges the presence of drug use, festivals have tried to ban groups like The Bunk Police. Despite this, members hop fences, bribe security guards and risk jail time so that they can keep other people safe.

At Steez Promo’s Moonrise Festival in Baltimore, Maryland, volunteers make sure attendees stay safe while they’re partying. They check on people who look sick or zoned out, and hand out gum, water, and fruit. The best thing about the volunteers is that they’re also ravers, and can be considerably less intimidating than the security staff. In the event of an emergency, a volunteer can help you feel better, whereas a security guard might just detain you. When things get too rough for volunteers, Moonrise is also equipped with two medical tents near high traffic areas, staffed by a team of emergency medical technicians.

While unsupervised spaces like raves inevitably invite dangerous activity, they also provide a place for youths to grow, experiment, and flourish, free to make mistakes away from the judging eyes of adult society. Regardless of what the law says, the youth will continue to party on. The best thing we can do is to ensure the spaces they party in are as safe and nurturing as possible.

The post Why Is It So Hard to Stop Rave Overdoses? appeared first on Zócalo Public Square.

Her boyfriend was bluish and slumped over the passenger side of the van when he arrived. Brittney, a caseworker, administered Narcan and he survived.

Sternal rubs. Rescue breathing. Intra-nasal application of Narcan. These are the lexicon of emergency personnel—people whose job it is to save lives during desperate times. Increasingly, and unexpectedly, these words have also become part of the unofficial job description for me and other social workers at the Preble Street Resource Center in downtown Portland, Maine.

With so many clients at risk of heroin and opiate addiction, we are the new first responders.

We are also the last responders: We’ve had so many clients die that we’ve gotten good at compassionate grief. We’ve become experts at the well-staged memorial service. Two hundred and fifty Mainers reportedly died of heroin and opiate overdoses in 2015, up from 176 in 2013. Over the past six months, we’ve responded to more than a dozen overdoses in our space, and held roughly the same number of memorial services for people we know who died on the street.

I began my career as a social worker with high ideals. Fresh out of Africa and the Peace Corps in the late 1980s, I wanted to apply “practical idealism” to alleviate the suffering of others, especially homeless people. I started working in a New York City children’s shelter in the South Bronx, moved to running shelters in other cities, and finally came to work in Portland, population 66,000, five years ago. Preble Street is a shelter where people can breathe and find connection, community, and support. We serve 1,100 meals a day and work with 1,200 clients a year. By providing a pair of socks, a shower, and a hot meal, we strive to create meaningful connections with struggling people. We’re guided by our founder Joe Kreisler, who said: “Part of my job, part of being alive, is making sure that other people are, too.”

The high risk of death by heroin and opiates has changed our work—and in a way changed who we are. We’ve had to modify bathrooms that promised a homeless person some modicum of privacy, by cutting 10 inch gaps at the bottom of the doors and installing a light system that lets us know if someone has stopped moving. We didn’t want to do this, but we’ve simply had too many people who stopped breathing in those bathrooms. The pressure we feel as the final stop before someone dies is too real to stick with our ideals about dignity.

In October, we had a woman who—sitting on the toilet, pants around her ankles, needle in neck—was unresponsive and barely breathing. We screamed her name, scraping our knuckles across her sternum. Quick-thinking staff, the overdose response protocol, and another client with Narcan saved her life. Later that week, she came back, embarrassed, sorry for causing us such worry, and said she’d secured a rare bed in a detox unit and was on her way to recovery and a changed life. The near-miss reminded us that dead addicts don’t recover—that’s our mantra these days.

Maybe heroin used to be perceived as an inner city thing, but today, high rates of drug overdoses are occurring in rural and impoverished counties. Nearly 90 percent of people who tried heroin for the first time in the past decade were white, and the highest use rates were among those making less than $20,000 per year.

Maine is poor, rural, and white—and at the epicenter of what we call an “epidemic.” The number of people addicted to heroin nationally has more than doubled in a decade, from 214,000 in 2002 to 517,000 in 2013, according to a study released this year by the Substance Abuse and Mental Health Services Administration. But we do not respond to this epidemic the way we would if, say, the number of measles deaths had more than doubled in the same period. Instead of a medical response, the opiate-heroin epidemic gets a moral one: Calls for more arrests, punishment, shaming, the suggestion that offering Narcan will “just encourage them.”

Scandalously, the cause of our current problem is not a virus but a series of deliberate policies that combined into disaster. Between 1996 and 2002, pharmaceutical companies marketed opiates as safe, long-term pain relievers. By 2010, the United States, with about five per cent of the world’s population, was consuming 99 percent of the world’s hydrocodone (the narcotic in Vicodin), along with 80 percent of the oxycodone (in Percocet and OxyContin). Mainers were prescribed opiates at twice the national rate and soon pain pills were circulating across the state.

When Obamacare began, Maine was the only New England state that did not expand Medicaid, forfeiting more than $300 million in federal funds yearly. Then in January 2013, spending on MaineCare, Maine’s Medicaid program, was reduced and 20,000 low-income Mainers lost coverage. Without Medicaid funding, the number of beds in detox programs fell. Now, in Portland, there are only 10 beds for the uninsured.

For those who couldn’t get off the opiates, heroin arrived, often cut with more potent and cheaper fentanyl. The number of people who died from heroin in Maine rose from 7 in 2010 to more than 70 in 2015. This has created real dilemmas for my colleagues and me.

The day before yesterday a long-time client asked for $4. He knew we would refuse but he was desperate. With his MaineCare cut, he was no longer able to fill his prescription for suboxone—widely used by people trying to kick heroin. His choice? Find $4 to buy some suboxone off the street—or go get some heroin, which his dealer would undoubtedly provide for free, welcoming back an old customer with open arms. We held our breath until we saw him the next day, knowing that there was always the chance that we would never see him again.

We’re watching the gap between public policy and human need grow wider every day.

In 1848, the great German scientist Rudolph Virchow said that medicine is a social science and politics is nothing more than medicine on a grand scale. That has been the case with opiates and heroin. The people caught between these policies and politics need an alternative to death as a way out.

The first step should be to respond to this crisis like a real epidemic, not a moral failing. We do not need a “war” on addiction.

We need, first of all, to make Narcan more readily available. We need more detox beds, obviously, but also programs that employ, house, and support people who’ve come out of detox. And we need rational policies from government, business, and medical leaders that improve the health of everyone. The fact that so many Mainers were prescribed opiates in the first place speaks to deeper issues in our health care system.

The most significant thing we can do is take the federal money to expand Medicaid/MaineCare—almost 70 percent of Mainers agree that this makes sense. This one policy would mean more treatment, and more saved lives. This epidemic is taking place not just at my workplace, but in your community and, increasingly, in your family.

The post The Heroin Epidemic Is Turning My Soup Kitchen Into an Emergency Room appeared first on Zócalo Public Square.

Edwards said that the first months of Proposition 47 have raised a number of questions that are slowly being answered. But the law is being received with a great deal of excitement among people with felony convictions, many of whom “are chomping at the bit” to be resentenced. Getting a felony conviction off your record clears ex-offenders to receive public housing and employment support.

Andy Furillo, who covers crime and punishment for The Sacramento Bee and served as the evening’s moderator, asked Judge Manley to talk about what kind of sanctions work to prevent recidivism in the offenders he sees in drug court.

“I have never found that punishment works at all” in motivating people, said Manley. The question is, “how do you motivate someone to do something they may not want to do?” The threat of state prison isn’t helpful, he said. Rather, people need “multiple chances”—and “six to seven rewards for every one sanction.” People do better in their lives if you encourage them rather than holding the threat of jail over their heads, he said.

So what do you offer in lieu of sanctions?

Support services, said Edwards. Substance abuse counseling and mental health and legal services. The challenge is getting the money allocated for those services and making sure it’s well spent.

Manley added that many of the people he sees in court again and again are drug abusers and the mentally ill; their underlying issues need to be addressed in order to keep them out of prison. He said that Proposition 47 has not, in his view, allocated enough money to this end, but if California stops building jails and puts the money into treatment, recidivism will decrease. “The legislature likes to score savings ahead of time to justify spending money,” said Manley. But they need to save and spend simultaneously to make real progress.

Turning to Bell, who works to get former prisoners a college education, Furillo asked if offenders are aware of the changes in California’s criminal justice system and the public’s shifting perception of prison’s role.

For the most part, no, said Bell. A lot of people in the prison system develop “a sense of learned hopelessness.” However, there is excitement among some offenders about Proposition 47, especially among people who have committed crimes like writing bad checks, which is one of the redefined felonies. Most of these offenders should not have been in prison in the first place, said Bell. They “have no business” being incarcerated alongside people serving 300-year and double life sentences. He pointed to a prisoner serving time for a drug conviction who earned a life sentence “for survival reasons.” That’s not healthy, said Bell. Changing laws are offering people a shot of not being considered felons—and these people in particular know how much is riding on their reentry.

Bell said the most successful ex-offenders he works with are between 25 and 60 years of age; they’re not looking back, while younger people need more time to figure things out. He also has a great deal of success with prisoners with longer sentences. They are coming back to society at a completely different time in their lives, said Bell—and have a 1 percent recidivism rate as a result.

Manley agreed, adding that research shows that the “biggest bang for the buck” comes from working with those offenders who are at the highest risk for reoffending and have the most need for services.

“We don’t do a good job when we simply say, because we gave someone eight years in prison, we solved the problem with that person,” he added.

In the audience question-and-answer session, Edwards was asked to delve into the most important questions raised by Proposition 47.

She said that complex legal questions—expungement versus reclassification of certain crimes, processing offenders with multiple convictions—are still being worked out. And then there are policy questions: How easy should it be to get a felony reclassified? How do you reclassify people and make sure they still receive the same services?

Bell was asked what on-the-ground problems he’d like to see addressed. He said that one problem is that the groups that have built many of California’s prisons are now getting involved in reintegration. He also said that there is a great need for transitional housing, particularly for women being released from prison.

The post When a Felony Is No Longer a Felony appeared first on Zócalo Public Square.

This study is part of a recent wave of clinical research on psychedelic substances like LSD and psilocybin—the psychoactive component of “magic mushrooms.” Although psychedelics are illegal for the general public, researchers at some of our most reputable academic centers are securing the government’s permission to study them as a powerful new generation of drug therapy for a host of illnesses for which our current pharmacopoeia does not always work, including post-traumatic stress disorder, cluster headaches, and alcoholism.

It is worth revisiting how they were introduced to the general American populace and how they were made illegal in 1968 and classified as “Schedule I” drugs, which are considered unusually risky and lacking in medical benefits. Why they were outlawed—and our long-held attitudes about them—have more to do with the culture wars of the 1960s and ’70s than their medical harmfulness.

I study psychoactive drugs in the U.S. as an anthropologist and historian. I try to understand what roles they play in our lives, and imagine how we might improve our relationships with them. I am especially concerned with two simultaneous trends: the proliferation of legal antidepressants whose efficacy has recently come under scrutiny and the continued criminalization of psychedelics, MDMA, and marijuana.

Psilocybin-containing mushrooms were introduced to the U.S. mainstream in the late 1950s by R. Gordon Wasson, an American banker turned mycologist (or biologist who studies fungi). Wasson and his wife, Tina, made the first of 10 trips to Mexico in 1953 to conduct fieldwork on the Mazatecs—a group indigenous to Oaxaca—who used a certain kind of mushroom for sacred ceremonies. These mushrooms were said to have “personalities” that communicated with special community members known as curanderos, or healers, who used them to divine causes of illness and misfortune, among other things.

It took a couple of years of networking with the locals, but by 1955 Wasson was eventually introduced to the curandera María Sabina. She allowed Wasson and photographer Allan Richardson to eat the sacred mushrooms. As far as we know, they were the first Westerners ever to do so intentionally.

Wasson wrote enthusiastically about his experiences for Life magazine in 1957. “Seeking the Magic Mushroom” was the first article on a psychedelic substance to appear in a mainstream publication in the U.S. It inspired Timothy Leary to visit Mexico to take the mushrooms. Leary then established the first academic research center for psychedelics at Harvard University, conducting studies that included examining whether psilocybin could induce religious states in divinity students or reduce recidivism in prison inmates.

Wasson’s initial popularization of magic mushrooms also dovetailed with the new ideals of self-exploration associated with the growing counter-culture movement whose most visible emblems were beatniks and hippies. By the early 1960s, a number of Americans made pilgrimages to see Sabina and partake of the Psilocybe mexicana.

The way Westerners thought of the mushrooms as drugs, however, divorced them from their specific cultural context. The Mazatec healer Sabina initially welcomed the pilgrims seeking magic mushrooms but later wrote in her autobiography that foreigners took “the children”—the mushrooms—“simply to find God.” She lamented that hedonistic use of the mushrooms sapped their purity and force.

As for LSD, it was first synthesized from a fungus that grows on grain in 1938. After Swiss scientist Albert Hoffman discovered its psychoactive properties, Sandoz Laboratories manufactured a version. The CIA got wind of LSD in the early 1950s and secretly experimented with its use for mind control. (That effort was abandoned in part because the effects of LSD were too unpredictable, sometimes inducing paranoia and at other times feelings of omnipotence.)

As Leary and others proselytized for psychedelic experimentation, the potent and easy-to-distribute LSD was increasingly seen as a fast track to the personal and psychological liberation seen as necessary for true rebellion against political authoritarianism and social repression. By the mid-1960s, the new “counter-cultural” life of LSD led the American mainstream media to label it as a dangerous, insanity-causing drug. In essence, LSD became the prime chemical proxy for political and cultural dissidence.

But even among Western proponents of psychedelics, there were tensions. Humphry Osmond, a pioneer of clinical psychedelic research, vocally criticized Timothy Leary for his insistence that psychedelics should be given to as many people as possible to catalyze mass spiritual discovery. Osmond accused Leary of “insisting on the right to use psychedelic substances for psychologic enquiries without medical support,” as described in Erika Dyck’s Psychedelic Psychiatry.

Osmond’s more practical fear—that the popular, widespread use of psychedelics would run afoul of governmental authorities and torpedo clinical research programs—proved to be well-founded. Once a part of mainstream academic psychiatry with over 1,000 publications describing their clinical uses, psychedelic substances were outlawed in the U.S. in 1968, as tensions between the American counter-culture movement and the government came to a head.

After psychedelics were classified as “Schedule I” drugs, there was a steep drop in scientific literature on their effects. Of course, people continued to use them. Knowledge about the use and effects of psychedelics since then has consisted significantly of online data generated anonymously by users and curated on sites like Erowid. Researchers who have used these self-reported data have found no overdose deaths associated with LSD, and just a few deaths associated with behavior after taking LSD. Likewise, there has been only one death associated with psilocybin—an episode of cardiac arrest in a heart transplant patient.

But after a generation had passed, the public panic surrounding LSD had largely abated. And continued legal research demonstrating the safety of psychedelics on non-human animals—which in the interim had become much more practical to conduct—led emboldened researchers to petition the National Institute on Drug Abuse and the Food and Drug Administration successfully to allow for new human studies in the early 1990s.

Supporters of wider availability for psychedelics are proceeding cautiously. They are taking a page out of the successful marijuana playbook: medical need. This was acknowledged by Rick Doblin, founder and director of the Multidisciplinary Association of Psychedelic Studies (one of the organizations that funded the recent LSD study): “I am trying to pick a strategy that will lead to the widespread availability of the legal use of psychedelics. I think it will come through psychedelic prescription medication.” Why not turn to pre-existing substances that already have anecdotally helped conditions that conventional medicine still struggles to treat, such as severe anxiety and alcoholism?

It seems all but inevitable that, through mainstream medicine, psychedelics will have new, socially sanctioned roles in Western societies. Even if their main risk today is not to inspire a hippie revolution, the new research into psychedelics does seem to hold the potential to change the way we treat mood and behavioral disorders. Currently, the treatment involves a regular regimen of patented antidepressants or anti-anxiety drugs. But psilocybin and LSD can’t be patented. And researchers have found that these psychedelics have long-lasting positive effects after just a few sessions.

A hint of this has already come to pass in a current New York University study using psilocybin to treat anxiety associated with terminal illness. “Xanax doesn’t get rid of your anxiety,” one of the participants told a reporter for The Atlantic. “Xanax tells you not to feel it for awhile until it stops working and you take the next pill. The beauty of psilocybin is: it’s not medication. You’re not taking it and it solves your problem. You take it and you solve your problem yourself.”

This patient’s observation brings to life that historical tension between specific medical uses of psychedelics and their potential to change the very ways in which we experience society and ourselves. What is not yet clear is if and how this newly legitimized research will stay within the bounds of the laboratory, and how it will accommodate decades of self-reported psychedelic experiences that took place outside of the laboratory. But psychedelics do hold the potential to change the goals of Western medicine—to address bodily illness in a way that involves spiritual self-discovery. Welcome to the front lines of “existential medicine.”

The post LSD’s Long, Strange Comeback appeared first on Zócalo Public Square.

Thanks in part to the mommy lobby, the Utah State Legislature recently passed a bill to legalize the administration of Alepsia, a cannabis extract taken as oral droplets. Advocates celebrated earlier this week as Utah Governor Gary Herbert held a ceremonial public signing of the bill, ensuring the law will go into effect July 1. Alepsia contains ultra-low amounts (less than 0.3 percent) of tetrahydrocannabinol (THC), the psychoactive element in marijuana, but high amounts of cannabidiol (CBD), a chemical that has demonstrated potential for significant seizure control.

Amelia experienced her first seizure when she was only 4 months old. One day, as my mother was holding her, Amelia’s leg and arm on one side began jerking mildly. By age 1, she was experiencing hundreds of little seizures—myoclonic jerks lasting just a few seconds—each day. The seizures would cause her to fall on her bottom. Undeterred, she just got right back up, over and over again. We playfully started calling them her little booms. “Ah, boom”—there she goes again. I was 9 years old, and the only thing I could do for Amelia was construct a stuffed animal fort to cushion her falls. As we grew up, my younger brother and I became trained in caring for her more seriously, and our three youngest siblings pitched in where they could. Abby, the youngest, for instance, would sit next to Amelia and stroke her hair while she seized.

Amelia’s neurologist reassured us that kids often outgrow seizures, but it became clear early on that my sister was experiencing developmental delays. At age 2, Amelia had a full-body convulsion that lasted for 45 minutes. Realizing she wasn’t going to stop convulsing on her own, my parents rushed her to the hospital. A massive dose of Ativan stopped the seizure but sent her spiraling into respiratory arrest. With a respiratory therapist squeezing a bag, pumping oxygen into her lifeless lungs, my parents stood by, helpless. After 20 minutes, my terrified mother braved a question: “Do you ever get … tired?” He paused for a moment. “Yeah. Sometimes.” It was the wrong answer.

Treatments went nowhere. Amelia tried basically every FDA-approved anti-convulsive medication, and even surgery, with little success and often experienced major side effects. One drug did not let her sweat, causing her to overheat severely. Another triggered a life-threatening allergic reaction that required a 12-day hospital stay.

The only treatment that had any noticeable effect on her seizure control was a high-fat, high-protein regimen called the ketogenic diet. Amelia’s daily seizures fell from the hundreds to just a few dozen. But she stopped eating. After other medications failed, my parents eventually decided to give the diet another shot. Truth be told, I found this annoying. All the careful measuring and weighing that made the diet work sometimes made dinner late. Worse, to make Amelia feel like we were all in this together, my mom adapted her dishes for the whole family—which meant I had to eat quiche. Luckily for me (at least I selfishly thought back then), the diet did nothing for her seizures this time around, and I could go back to eating things like burgers and pizza.

Amelia’s seizures have evolved; she seldom convulses for more than a few minutes at a time now. But her developmental delays have become increasingly pronounced, and she has fleeting myoclonic jerks hundreds, even thousands of times a day. Soon those ubiquitous seizures garnered their own pet names: Little seizures became “blinkies,” and full-body ones were dubbed “big ones.” But what’s more difficult sometimes for my parents and me is her zombie-like post-convulsive state, in which, exhausted, she sleeps, drools, and then stares off into nothingness for an hour or two. In other words, she gets “zoney.” I once forgot the real names, telling a stranger that Amelia had “a bad spell in which she had several ‘big ones’ in a row and then was basically ‘zoney’ for two days.”

My parents have struggled mightily to fend off discouragement, mostly by engaging the enemy that is this disorder. My mother, who had planned on giving up her previous work to care for her young family, soon found herself mobilizing full-time on Amelia’s behalf. Exasperated by the lack of answers from doctors, she checked out every medical textbook on epilepsy in our local university library to become an expert on neurology. She diagnosed Amelia with Dravet syndrome three years before a real neurologist confirmed the diagnosis. My father supported her activism, using his vacation days to hold down the fort when she traveled to conferences a few times a year. After working with the Epilepsy Association of Utah for four years, my mom helped found a national nonprofit support group for other families like ours, Dravet.org.

But most of her time today, as it has been for the past 19 years, is spent taking care of Amelia’s needs—from administering rectal Valium (an emergency drug Amelia takes three times a day) and making sure she doesn’t fall too hard when she’s seizing (which has happened a number of times) to bathing and dressing her each day. Amelia will live under the care of parents or siblings for the rest of her life—we just have very little idea how long that might be. As the oldest sibling, I had to bring up the real possibility of eventually needing to care for Amelia before I could propose to my (now) wife.

It’s surreal how routine seizures have become for us after all these years. When Amelia has a convulsion in the tub now, instead of panicking, my mom just keeps bathing her. But if ubiquitous seizures have somewhat desensitized us, they have also opened our eyes to a different world. When a family from out of town with a child with disabilities sat in the pew behind us at church, the mother was touched when my brother and I actually talked to her son. My first job in college was working with adults with disabilities.

Occasionally Amelia has good days, too. She smiles and teases, and we catch fleeting glimpses of her radiant personality, of what might have been. She once appointed herself the language police of the household. “We don’t say ‘stupid’s or ‘shut up’s,” she would chastise her older brothers. She loves spinning, twirling, and being tossed upside down, so naturally, theme parks are her heaven. After so many seizure-related injuries, she rarely feels pain and has no fear. She thinks roller coasters are hysterical—and everyone loves sitting by her because she laughs the whole time.

Cannabis isn’t a substance my family—under just about any circumstances—would have an interest in legalizing, but what we call normal keeps changing. Alepsia has emerged as a source of legitimate hope for Amelia. Currently, 80 percent of children being treated with Alepsia in Colorado have experienced at least a 50 percent decline in seizures. Although still preliminary, those results vastly outstrip all the FDA-approved medications Amelia has tried. Other states are taking action, and that’s a good thing. While Alepsia won’t “save” Amelia, it might mean more days smiling and laughing, and fewer sitting on the couch drooling. And it might mean a new routine for my family—which would be more than enough, for us.

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