The prevailing narrative surrounding psychedelic drug use depends on the out-of-body, out-of-mind experience that most believe is inevitable.
When individuals confront the idea of a psychedelic experience, they typically imagine a completely altered state of consciousness including:
- Potent visuals. From bright luminous colors to complex geometric patterns to astonishing environmental transformations, the images that come to mind are far from ordinary.
- Auditory hallucinations. From hearing flashes from the past to having conversations with the deceased to listening to striking sounds, people assume that psychedelic compounds induce a false sense of reality.
But, recent interest in non-psychoactive, psychedelic drug use is beginning to challenge the status quo.
The psychedelic drug experience is no longer seen to be casual. Recent research publications along with the anecdotes of thousands of users position psychedelic drugs to be the next wave of mental illness treatment. The Multidisciplinary Association for Psychedelic Studies (MAPS) is among one of the many organizations and institutions conducting FDA clinical trials with ibogaine, LSD, and MDMA for indications such as drug addiction, depression, anxiety, and PTSD.
Psychoactive compounds have not only been demonstrated to be useful for those with mental illness diagnoses, but have also been demonstrated to improve the quality of life for all. A new market is emerging, a psychedelic drug market, and with staggering rates of mental illness and an imploding health and wellness market, the audience may as well be… everyone.
As the idea that psychedelic drugs induce an array of benefits becomes more widely acknowledged, the idea that psychedelic drug use is contingent upon a psychotropic trip is challenged.
For example, microdosing, or taking an extremely small, sub-hallucinogenic amount of a psychedelic substance, has become mainstream. Although they don’t experience the notorious, consciousness-altering effects of the substance, microdosers still claim to garner mental health and wellness benefits including improved focus, energy, creativity, connection, and reduced anxiety.
With a new paradigm of mental health treatments and wellness standards on the horizon, many questions remain unanswered as to how to best integrate psychedelics into a safe and effective therapeutic framework. Among one of those questions is:
Is it necessary to ingest a dose high enough to induce psychoactive effects?
Thus, as pipeline companies yearn to capitalize on the emerging psychedelic-assisted therapy and psychedelic health & wellness industry, drug development agencies are scrambling for answers.
And so the debate begins around the necessity of a psychedelic “trip.”
Why the Psychedelic Experience May Be Necessary for the Patient
On the one hand, psychedelic drugs’ healing properties may be directly tied to the psychoactive experience itself. Many patients report that their 5-8 hour psychedelic journey is equivalent to years of therapy for reasons including:
- The resulting dissolution of the ego. Individuals can finally process their repressed traumas without fear. With access to the subconscious mind, they can gain insight into unconscious memories, the cause of their suffering, and with the ability to resolve any pain that surfaces.
- The social aspect. Many report that their hallucination increased their forgiveness and deepened their capacity for understanding, empathy, and acceptance.
- Spirituality. Many note that their journey allowed them to deeply connect to spirituality, a higher power, and/or God, which eliminated their depression, anxiety, and/or desire to use substances of abuse.
All of these psychological, social, and spiritual mechanisms require an altered state of consciousness. It is essential then, many argue, for psychedelic compounds to be psychoactive in order to be therapeutic.
Why the Psychedelic Experience May NOT Be Necessary for the Patient
On the other hand, the answer may be no. Individuals who microdose, or don’t “trip”, may benefit because psychedelic compounds also target physiological mechanisms. They…
- Activate poignant brain areas. Many compounds activate the HPA axis, the hippocampus, and the amygdala – regions of the brain involved in emotional processing and memory formation.
- Produce neuroplastic changes. Essentially, psychedelic compounds rewire the brain. For example, in individuals with drug addiction, psychedelics interfere with the maladaptive habits that support substance seeking behaviors and create new neural pathways that instead support productive ones.
- Act as serotonin agonists. Stimulating serotonin activity positively impacts anxiogenic and depressive symptomatology across a wide range of mental health indications.
Thus, it may not be necessary for psychedelic drugs to be psychoactive in order to be curative; the neurochemical and neuroplastic changes that they cause may be sufficient on their own.
The Major Implications for the Future Of Psychedelic Drug Development
The answer to the looming question will have significant implications for the future of the emerging psychedelic landscape.
If the psychedelic experience is indeed necessary, then pipeline companies must develop drugs with high doses, must establish lines of clinics for guided sessions, and must create therapy training programs.
Due to the mind-altering nature of a psychoactive journey, a clinical setting with trained professionals would be essential to not only ensure safety, but to also ensure an optimal therapeutic experience.
Despite the incredible healing potential of the psychedelic experience, however, this approach would be less likely to become a first line treatment. It is inconvenient for individuals to drive to clinics and block out the time “to trip”, which ranges from multiple hours to a day. All in all, psychedelic-assisted therapy is a time consuming, resource intensive, and costly treatment modality.
Contrarily, if the “psychedelic” component to psychedelic drugs is unnecessary, pipeline companies may either develop drugs with sub-hallucinogenic doses or create new, psychedelic-inspired chemical entities that omit psychoactive properties. These compounds would be more likely to become not only the first-line treatment for mental health indications, but also for individuals seeking general health and wellness. People would be able to ingest the drug in the comfort of their own homes, without needing to knock out hours of their days or pay expensive clinical fees. Also, individuals who would otherwise not qualify for treatment due to risk of psychosis, like those with a bipolar disorder or schizophrenia diagnosis, may now qualify. As a result, non-psychoactive psychedelic compounds would be more widely accessible to the general public.
The Answer May Not Be So Binary
It could be that both compounds are effective, but merely require different time periods to relieve symptoms and achieve desired results. Due to the non-ordinary states of consciousness that high, psychoactive dosages induce, they may be more likely to result in immediate therapeutic breakthroughs and symptom relief. The benefits of non-hallucinogenic dosages may instead be seen over the course of a few weeks/months, as the doses are lower and rely solely on physiological mechanisms.
The answer may also change depending on the individual context. For those who are equipped to handle a powerful psychoactive experience and process whatever may arise, a high-dose psychedelic experience may be optimal. For those who are not prepared to enter another realm of consciousness but still hope to reap neurochemical benefits, non-hallucinogenic doses may be optimal.
There will likely be room for both types of psychedelic compounds in our evolving therapeutic framework. The path that individuals decide to pursue will depend on their individual preferences and needs.
There is much we do not know about psychedelic compounds and their miraculous capability to heal. Despite the compelling arguments that support all sides of the debate, much more research, and time, is necessary to determine the answer.