There’s no more powerful mind-altering substance than a book. Five years ago, Michael Pollan wrote How to Change Your Mind, in which he described new research on psychedelic drugs, and how they can heal depression and anxiety while giving people the ultimate mystical experience. He tried the drugs himself, loved them and, thanks to the book’s phenomenal success, millions turned to psychedelics for relief and revelation. It was called “the Pollan effect”.
These days, psychedelic therapy has been legalised in Australia and the US states of Oregon and Colorado (with California poised to follow suit). Possession of psychedelics has been decriminalised in 20 US cities and municipalities, and the Food and Drug Administration appears to be on the verge of legalising the use of MDMA (ecstasy) and magic mushrooms in psychotherapy. Hundreds of psychedelic startups have launched, and dozens of books have been published. Most have flopped, like most of the startups.
It’s yet to be seen whether the same fate will befall David Nutt’s effort. A neuropsychopharmacologist at Imperial College London, Nutt has done more to advance the “psychedelic renaissance” than almost anyone. Here the professor opens his suitcase to reveal some of the wares soon to be available, and outlines the research on each. We hear about psychedelics for depression, addiction, anxiety, anorexia, pain, OCD, end-of-life anxiety and ADHD. I once heard him say psychedelics could even make you a better artist.
We also hear about Nutt’s long struggle to liberalise the laws governing these substances. He was the UK government’s “drugs tsar” in the noughties, until he was fired in 2009 after pointing out that fewer deaths were caused by MDMA than by horse riding. Undeterred, he launched an organisation called Drug Science, which would disclose “the truth about drugs, free from political or commercial influence”. It published an influential table showing the relative risks of different drugs – alcohol was rated by far the most dangerous, magic mushrooms the safest. At the same time, Nutt hired young postgraduate Robin Carhart-Harris, who restarted research into mushrooms after a 50-year hiatus in the UK. The two moved to Imperial College and established the world’s first academic centre dedicated to psychedelics.
A prophet is rarely listened to at home and Nutt’s libertarian attitude to drugs has enjoyed more influence abroad than in Tory Britain. He was instrumental in persuading Australia to legalise psychedelic therapy this year, having been flown over by a psychedelic charity, Mind Medicine, to present the benefits of psychedelics to Australia’s drugs regulator.
If the FDA approves MDMA and psilocybin therapy in the near future, then under a new reciprocal approach announced by the UK government, these treatments could also become accessible in Britain, and Nutt’s two- decade struggle will have succeeded. You have to admire his persistence in the years when no one was interested in psychedelic research. At one point, he tells us, his only option was to seek funding from Channel 4 to run a live TV trial of MDMA. Big Brother meets Brave New World.
Although the tag line for Drug Science is “the truth about drugs, free from political or commercial influence”, Nutt is not entirely without commercial interests. Having announced that alcohol was the riskiest drug, he went on to launch his own alcohol substitute. He’s now on the board or a scientific adviser to four psychedelic companies, and has received consulting fees from others. A man deserves to be paid for his toil, but the reader should keep in mind the book could be regarded as something of a sales pitch.
Nutt has said that the risks of psychedelics have been “grossly, grossly exaggerated and the benefits … deliberately minimized”. In this book, he does discuss some of the possible harms, but not at length. He says if you take them in the wrong setting, you could have a bad trip. But what about the fact that bad trips can happen in safe settings, or that they can lead to enduring difficulties like prolonged anxiety, derealisation or hallucinogen persisting perception disorder, lasting for months, years or decades? These dangers aren’t emphasised. When suicidality increased among some patients in a recent trial of psilocybin therapy, Nutt told the Guardian it was was probably unrelated to the drug.
There has been much excitement about the potential of psychedelics since the publication of How to Change Your Mind, and Nutt’s book will add to that hope and hype. For those with treatment-resistant depression or PTSD, psychedelics could indeed be a lifeline. The trouble is most people with mental health problems are unable to access psychedelic therapy under medical supervision. Instead, they take their chances with illicit use or at non-medical retreats in places such as the Netherlands or Peru. Some get hurt, and 20 years into the psychedelic renaissance, there is still no real research on what helps them.
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On one final point, Nutt is unarguably correct – the British government should reschedule psychedelic drugs to make scientific research easier, so we can better understand these molecules’ effects, for good or ill.