Presenter: Katherine Lodge
Guest: Stephen Bright
Guest Bio: Stephen Bright is a Sessional Academic and Course Coordinator of Addiction Studies at Curtin’s School of Psychology and Speech Pathology, Stephen writes and delivers curriculum pertaining to the use of Alcohol and Other Drugs (AOD) in society and treatment of AOD-related issues.
Stephen joins us to discuss synthetic drugs and the use of illicit drugs, such as LSD, to combat mental illness disorders such as PTSD.
Health Professional Radio
Katherine Lodge: Thank you for listening to Health Professional Radio. I’m Katherine and today our guest is Stephen Bright, a Sessional Academic and Course Coordinator of Addiction Studies at Curtin’s School of Psychology and Speech Pathology. Stephen writes and delivers curriculum pertaining to the use of Alcohol and Other Drugs in society and treatment of Alcohol and Other Drugs related issues. Stephen joins us today to discuss synthetic drugs and the use of illicit drugs such as LSD to combat mental illness disorders such as post-traumatic stress disorder. Welcome to our show Stephen.
Stephen Bright: Thanks for having me.
K: Now Stephen just to give us a little bit of background, can you tell us about some of the research that you’ve been involved with?
S: So the research, I’m involved in a research group called Psychedelic Research in Science & Medicine or PRISM which has recently established in Australia and what we’re wanting to do is replicate studies that have occurred overseas. It’s actually not been in any psychedelic research in Australia for at least many years and if there was some going on in 60’s, there’s not any good documented evidence of that. So a lot of substances or drugs such as cannabis even heroine have had medical uses in the past. And I guess could say overseas particularly with medicinal marijuana, an increase in interest in using drugs for medicines. And there’s a fine line between what we consider to be at an illegal drug that had no medical utility and a drug which model to be used as a medicine. So this Ketamine for example, is a drug that’s used in emergency medicine, it’s a highly scheduled drug, and it’s also used recreationally. When it’s used recreationally is often referred to as a horse tranquilizer but it’s actually used in emergency medicine. And it’s been found to have a psychotherapeutic benefit as well, particularly with regards to depression so number of studies had come out demonstrating that it has a powerful anti-depressant effect that comes on very rapidly, peering with in the nail and some blasting for at least a week or two.
K: Right, I see.
S: With the LSD there’s I guess a lot of research that was happening back in the 60’s are looking at sort of the therapeutic benefits of using LSD. However due to it being associated with the counter culture movement in the 60’s, in which you had people like Timothy Leary coming out, and telling the world to “tune in, turn on and drop out.” They become a lot stigma attached to it and all the research was really shut down by the 1970’s. And this created an absence of research that sort of starting again quite recently overseas with Psilocybin, the active ingredient in magic mushrooms and now very recently a study conducted into LSD with 12 patients who were anxious about some serious medical conditions that they had. Some of which who were with terminal cancer were given LSD in a therapeutic context but that’s the first stay of kind in 40 or 59 years.
K: I see. Yeah and see you bought up a few things that I wanted to get back to but firstly I’ve always want to ask this question, and like you said this type of study hasn’t been done in Australia, not a kind of in a formal way, so therefore they have to be done before it can be introduced as a therapy, but you mentioned that it has been done overseas. So my question is a lot of the times when things have been proven overseas, I kind of think “Well obviously we’re humans as well.” You know what I mean? Surely all these aren’t very different from British or Americans, you know what I mean? So when it comes to studying and doing charge in Australia because it has been proven overseas, is there kind of a fast track to getting it approved here in Australia?
S: Well I think the difficulty with this area of research and the role of psychedelics as medicine, because there’s been such as a hiatus in research program and the research is only really starting up again, there’s actually only a small pieces of evidence that are coming out at the moment. And I guess what we would like to see is Australia come on board in that research project so that when there are opportunities to use these substances in a more therapeutic context outside of a research program, that we have people in Australia that are trained to do that. Because one of the limitations to using some of these substances in the therapeutic context in Australia is that we don’t, the way which they use it is very different to the way an anti-depressant might be used for example, where you give the patient a pill to take and they take it for a long term period and the effects sort of takes 3-4 weeks to come on after commencing the drugs. The therapeutic benefits of these drugs occur very shortly after taking them and they do create significant changes in a person’s consciousness. So you can’t just give them a tablet and send them on their way. The therapeutic process actually takes place with the person while they are under the influence of the drugs.
K: Right, I understand what you mean. And in terms of mental illness I mean it’s such a wide area. What are you focusing, what are some of the focused at the moment? Is it a post-traumatic stress syndrome or?
S: We would like to replicate a study of several studies now that have occurred overseas, looking at MDMA which is often referred to as ecstasy. So it’s important to recognize that ecstasy that people take on the street may or may not contain MDMA and may contain other adulterants. So there is a difference between giving someone a clinical therapeutic dose of MDMA and taking an ecstasy pill, very … replicating research using MDMA to treat post-traumatic stress disorder. We believe that there’s’ quite, there this I guess there is a good body of evidence now indicating the efficacy of MDMA and there’s also a lot of good research indicating that it’s not particularly harmful. Prior to it being banned in the US in 1986, MDMA was being used in psychotherapy. It was being used in couple’s therapy and had a history of use as a therapeutic agent. However I guess once it has left the psychotherapeutic office and became a recreational substance, the drug enforcement agency felt that they needed to do something about it and they banned the substance and consequently there has been probably $300M of research looking at what harms MDMA might cause and there’s actually not a lot of, evidence indicating that it’s particularly harmful, particularly if it’s taken in frequently and in a therapeutic dose rather than a really high dose. So I guess it’s a good drug to work within that respect, the effects are very predictable unlike something like LSD or Psilocybin with their potentially unpredicted effects that might come from it. And it’s a good rational for as well because MDMA creates, it increases trust and it increases empathy so they can be useful in terms as the therapeutic relationship. It reduces the fear of exposure to the traumatic event so it will allows people to talk about it. Now people can drink alcohol for example and they may talk about a traumatic event, but the difference with MDMA is it allows them to still process that event.
K: Oh, I see.
S: When a person is intoxicated with alcohol and they talk about the events, they actually aren’t processing. They’re not processing and habituating to the anxiety associated with the event. And what’s really helpful as well is it increases self-acceptance so if somebody got survival skills, it helps them to come to terms with the experience that they had and accept that they did everything within the circumstance and stop questioning their efforts. It’s extremely powerful and what it does it sort of … it can provide 12, 18, 24 sessions of therapy in a single session, because of the way in which it allows people to process the traumatic events.
K: That’s really interesting to hear that because we hear therapy and treatment talking so long and obviously the longer it takes, the more people suffer and also the cost as well. So that’s great to hear. I guess my final question would be, excuse my ignorance and I don’t know too much about the addiction to some of these drugs, but firstly it’s a two part question. Firstly, how can we prevent people from outside the doctor’s office, self-meditating and also wouldn’t giving people certain drugs may help cure or help with their stress disorders or mental disorders but it can breed another problem in maybe not addiction but – do what I’m trying to say? Outside of the doctor’s office…
S: I think it depends what drugs we’re talking about.
S: I mean people already self-medicate with alcohol… with opiates, with opioids like heroine and it’s actually not really a self-medication because while it reduces some of the symptoms that they might have as a result of their PTSD, it might take away some of the initial anxiety that actually creates the problems in the long term. And so using a drug like MDMA on sort of 2 or 3 occasions within a context of psychotherapy is quite different to that self-medication. More broadly I guess the first part of that question was around … how do you prevent medication being diverted and being used for other intensions and purposes. And I think that is a broader issue that we have in our society, I think it’s really interesting to know most people today who are dependent on an opioid, are actually dependent on a prescription opioid, that they may have access through various means. They may have initially you know access that through a doctor as a treatment for pain but we actually see more people experiencing problems with prescription drugs now than we do with illegal drugs. I’m based in Victoria and there are more deaths now associated with prescription drugs than there are from illegal drugs. And it is a really difficult situation because we want to make sure that people are able to access medicines that are able to assist them, but at the same time manage the risk of other people accessing those medications or paper using them in a manner contradictory to that for which it’s prescribes. I’m not sure I have an answer to that, other than it’s a very delicate balance between two problems in ensuring access to the people who made it and preventing access from those who may do harm. In terms of these substances causing problems, I guess you know the second part of the question, using substances what potential is there, is there for to cause additional problems outside. Given the time it’s being administered to the once or twice in a therapeutic setting, the studies that are being conducted so far have shown that most, of all but one participant I’m aware of had not had any inclination to seek out MDMA or other substances on completion of the therapy. And there was one participant in one of the studies that did seek out ecstasy after having being administered that within the context of psychotherapy, wanting to re-experience what they experienced in the context of taking it in psychotherapy. And they actually reported that they had a bad time and they wouldn’t take it out again. Something thing is really, so it’s really interesting about MDMA, LSD, Psilocybin and other psychedelics is that they don’t have the potential for addiction in that if a person takes the substance on successive occasions, they rapidly build tolerance to it so that the substances no longer work. So in many respects, they’re quite a good drug to work, we’ve acquired safe drug to work with because the person can’t become addictive to them. So unlike with opiates which we see a lot of problems, with prescription diversion. We less likely to say people develop ongoing problems associated with use of these substances. Unlike some of the other drugs that are out there, alcohol is maybe a good example in that it’s toxic to the brain, it’s toxic to the liver. Substances like LSD and Psilocybin don’t have any significant physiological toxicity even in a very large dose. LSD doesn’t cause a whole lot of physical problems, it might cause a person taking it in a very large dose into anguish but it doesn’t actually cause significant physiological problems. There is a case in the US in 1972 to where a couple of guy walk into a friend place they saw some white powder on the table and they thought it was cocaine, so they wrapped up a few lines and snorted it, and that was actually pure LSD, so they’ve taken somewhere between 1,000 and 10,000 times the normal dose of LSD. So they were taken to the hospital and discharged 24 hours later without any significant physiological problems.
K: Right. Oh, I see. Alright well I’m so glad you cleared that up for us Stephen because I didn’t know how addictive LSD and other psychedelic drugs were. So thanks for clearing that up for us and thank you so much for your time today. Fascinating study and best wishes with it.
S: No problem, thanks very much.