OPEN Foundation

Author name: OPEN Foundation

Integrating Psychedelic Medicines and Psychiatry: Theory and Methods of a Model Clinic

Abstract

The past two decades has seen a significant increase in both popular and scientific interest in psychedelic substances and plants as therapeutics for mental illness, addictions, and psychospiritual suffering. Current psychiatric practice privileges a biological paradigm in which the brain is considered the locus of mental illness and symptom-focused treatments are delivered to patients as passive recipients. In contrast, a psychedelic healing paradigm, constructed through examination of different ontologic understandings of plant medicines, is based on a complex multidimensional perspective of human beings and their suffering. This paradigm actively engages the sufferer in addressing root causes of illness through healing on multiple levels of existence, including spiritual and energetic domains. Numerous theoretical, methodological, and ethical challenges complicate the integration of the psychedelic healing paradigm into psychiatric practice. These include developing coherent therapeutic narratives that account for the complex processes by which psychedelic healing occurs and overcoming reductionist tendencies in the medical sciences. Tasked with overcoming such challenges, a model clinic is proposed that seeks to implement and study the psychedelic healing paradigm in a critical, interdisciplinary, and reflexive manner. Such “critical paradigm integration” would employ multimodal patient formulation and treatments, as well as a range of knowledge generation and sharing practices. Outcomes-oriented research would seek to establish an evidence base for the model, while critical dialogues would advance understandings of psychedelic substances and plants and related practices more generally. The clinic would serve as proof of concept for a new model of studying, conceptualizing, and treating mental illness.

Sloshower, J. (2018). Integrating Psychedelic Medicines and Psychiatry: Theory and Methods of a Model Clinic. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 113-132. 10.1007/978-3-319-76720-8_7
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Psychedelic Naturalism and Interspecies Alliance: Views from the Emerging Do-It-Yourself Mycology Movement

Abstract

Do-it-yourself (DIY) mycology is a movement that has emerged in the last decade in North America. DIY mycologists specialize in easy and accessible methods of mushroom cultivation and mycological experimentation and mobilize a discourse of alliance with the fungal kingdom. They draw primarily on home cultivation methods innovated by Psilocybe cultivators in the 1970s and on creative applications popularized by commercial mycologist and psychedelic enthusiast Paul Stamets in the 2000s. As a counterpoint to the newfound visibility and legitimacy of lab-synthesized psilocybin in clinical psychiatry, DIY mycology exemplifies an alternate history of this multispecies engagement. Drawing on ethnographic fieldwork in the San Francisco Bay Area and the Pacific Northwest, this chapter begins with the tacit premise of the psychedelic/entheogenic movement that the use of psychedelics fosters ecological concern. Many DIY mycologists express biocentric ethics and eco-spiritual principles, but interviews revealed a diverse and nuanced relationship to psychedelics. I argue that DIY mycology is best understood as an interspecies (or cross-kingdom) engagement that is part of an emergent ecological ethics and deep ecology worldview, one that subsumes psychedelic experiences as one manifestation of that engagement. DIY mycology exemplifies how the spread of mycological know-how, fascination, and enthusiasm has fostered an engagement with fungi that extends far beyond psychedelics. To understand this engagement, I contextualize it within wider social and cultural shifts, particularly those that reformulated our practical, ethical, and conceptual relationship with the natural world. This movement attests to the existence of multiple means to enact these ethics and to foster meaningful relationality with nonhuman life in contemporary North American society and culture.

Steinhardt, J. (2018). Psychedelic Naturalism and Interspecies Alliance: Views from the Emerging Do-It-Yourself Mycology Movement. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 167-184. 10.1007/978-3-319-76720-8_10
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Plant Knowledges: Indigenous Approaches and Interspecies Listening Toward Decolonizing Ayahuasca Research

Abstract

The ayahuasca research community is familiar with the concept of plant intelligences; however, they have yet to be adequately accounted for by commonly used research practices. This chapter is a call to examine the ontological and epistemological assumptions that underlie research practices and how these practices and assumptions may reinforce hierarchies of knowledge and animacy. The first part of this chapter describes some absences created by following a “methods as usual” approach when researching ayahuasca, based on ethnographic fieldwork at the World Ayahuasca Conference in 2016 (AYA2016). This highlights the need for researchers to acknowledge the methodological, disciplinary, and identity-based limitations on our abilities to produce and represent certain knowledges. Secondly, this chapter is a call to seriously and humbly engage with Indigenous sciences and epistemologies. This requires an honest reckoning with how research has contributed to colonial appropriation and marginalization of Indigenous knowledges. Indigenous ways of knowing have precedent for collaborating with teacher plants in producing knowledge and have much to contribute to discourse on multispecies perspectives. Lastly, I discuss possibilities for including multispecies sensibilities and Indigenous standpoints in research practices to create more collaborative and decolonial knowledges.

Dev, L. (2018). Plant Knowledges: Indigenous Approaches and Interspecies Listening Toward Decolonizing Ayahuasca Research. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 185-204. 10.1007/978-3-319-76720-8_11
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Placebo Problems: Boundary Work in the Psychedelic Science Renaissance

Abstract

The revitalization of clinical trials with psychedelics has produced an array of studies investigating different combinations of therapeutic substances and diagnoses. In addition to the bureaucratic negotiations to gain approval for this research, this new wave of studies is also negotiating a new methodological landscape of clinical research. Mid-twentieth century research with drugs like LSD and psilocybin involved both case studies and double-blind studies. However, today, placebo-controlled randomized controlled trials (RCTs) are the institutional standard for research with psychopharmaceuticals. Because psychedelic therapy seeks to induce a radical change in consciousness—to make a subject feel different from her everyday self—blinding these studies using placebo controls has emerged as a methodological sticking point. However, this chapter argues, it is also a rich site for interrogating boundary work around science and psychedelics. While anthropologists have examined placebos as examples of the power of symbolic healing within Western medicine, or as ethically fraught territory of nontreatment, this chapter examines placebos as a research technique around which the scientific status of a study is negotiated. While psychedelic therapy challenges the model of pharmaceutical intervention used in psychiatry today, it must do so while also working within psychopharmacology’s evidentiary norms.

Hendy, K. (2018). Placebo Problems: Boundary Work in the Psychedelic Science Renaissance. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 151-166. 10.1007/978-3-319-76720-8_9
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Bubbling with Controversy: Legal Challenges for Ceremonial Ayahuasca Circles in the United States

Abstract

The use of ayahuasca has been spreading rapidly worldwide; however, no current statistics are available to provide a comprehensive understanding of the scope or pace of this expansion. In the United States, the expansion has included the appearance of the Brazilian ayahuasca religions Santo Daime and União do Vegetal (UDV), underground ceremonial circles, workshops with itinerant Amazonian shamans, and spiritual retreat centers. This trend has included the recent emergence of groups and organizations that publicly advertise “legal” ayahuasca ceremonies and retreats. This chapter maps the existence of a series of organizations and actors who have controversially claimed legal protection through incorporation as “branches” of the Native American Church (NAC). The legality, religious character, and sincerity of these churches are reviewed in light of governing law, such as the First Amendment of the US Constitution, the Religious Freedom Restoration Act (RFRA), the Controlled Substances Act (CSA), and pertinent court cases involving the UDV and the Santo Daime, as well as ethnographic accounts of the historical Native American Church. Finally, it examines a petition for a religious exemption from the CSA from Ayahuasca Healings and speculates on the possibilities of the future of ayahuasca legality in the United States.

Feeney, K., Labate, B. C., & Hudson, J. H. (2018). Bubbling with Controversy: Legal Challenges for Ceremonial Ayahuasca Circles in the United States. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 87-111. 10.1007/978-3-319-76720-8_6
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Undiscovering the Pueblo Mágico: Lessons from Huautla for the Psychedelic Renaissance

Abstract

The people of the Sierra Mazateca region of Mexico became internationally known in the 1950s for their ritual use of psilocybin mushrooms, and the Mazatec town of Huautla became a destination for mushroom seeking visitors. This chapter provides an overview of changing Mazatec and “outsider” discourses about mushrooms and the Sierra Mazateca over the last 60 years. It argues that “outsider” representations of the Sierra Mazateca and mushroom use—whether framed in terms of spiritual journeys or scientific research—tend to recapitulate some consistent patterns common to other forms of cultural tourism that owe more to the role of substances in marking distinctive cultural identities than to the effects of the substances themselves. It concludes by suggesting lessons from this history for the current moment, in which a discourse framing the use of psychedelic substances through universalizing narratives of science and individual health is becoming ascendant.

Feinberg, B. (2018). Undiscovering the Pueblo Mágico: Lessons from Huautla for the Psychedelic Renaissance. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 37-54. 10.1007/978-3-319-76720-8_3
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Who Is Keeping Tabs? LSD Lessons from the Past for the Future

Abstract

Psychedelics fell from medical grace nearly half a century ago, but recent activity suggests that some researchers are optimistic about their return. Are they at risk, however, of facing the same historic challenges with a new generation of psychedelic enthusiasts, or have the circumstances changed sufficiently to allow for a new path forward? The twenty-first-century incarnation of psychedelic research resurrects some anticipated hypotheses and explores some of the same applications that clinicians experimented with 50 years ago. On the surface then, the psychedelic renaissance might be dismissed for retreading familiar ground. A deeper look at the context that gave rise to these questions, though, suggests that while some of the questions are common, the culture of neuroscience and the business of drug regulation have changed sufficiently to warrant a retrial. A close look at the history of psychedelics encourages us to think carefully about the roles of regulators, the enthusiasm of researchers, and our cultural fascination and/or repulsion with mind-altering molecules.

Dyck, E. (2018). Who Is Keeping Tabs? LSD Lessons from the Past for the Future. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 1-17. 10.1007/978-3-319-76720-8_1
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Peyote’s Race Problem

Abstract

In the years since peyote became a controlled substance in Mexico and the US, a steady stream of advocates and activists have laid claim to two types of exemption, rooted in both US Law (the First Amendment) and International Law (the 1971 Vienna Convention on Psychotropic Drugs). Indigenous peyotists in particular have been largely successful in making a claim to a legal right to be exempt from national prohibitions on peyote possession and consumption. This has represented a significant advance in indigenous rights, yet in both contexts it has had the unpleasant effect of signaling that a drug that is otherwise so dangerous as to be prohibited should be permitted for Indians, because they are somehow essentially different from all other citizens. This, then, is Peyote’s Race Problem. The ways in which we have created a legal framework that makes peyote use licit among indigenous peoples has hardened a certain notion of profound, an unalterable difference to the point that Indian bodies are said to be incommensurably different from the bodies of others who might desire to consume peyote, but for whom it is deemed too dangerous. This notion of difference has been exacerbated by the increasing scarcity of peyote in the US and Mexico, which as further racialized the spaces where peyote grows.

Dawson, A. (2018). Peyote’s race problem. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 19-35. 10.1007/978-3-319-76720-8_2
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The Use of Salvia divinorum from a Mazatec Perspective

Abstract

Salvia divinorum is a medicinal and psychoactive plant endemic to the Sierra Madre Oriental of Oaxaca, Mexico. The Mazatec people have been using the leaves for centuries in ceremonies for its psychoactive properties and as a treatment for arthritis and inflammation, gastrointestinal problems, headaches, and addictions, among other uses. The active principle of Salvia divinorum, the terpene salvinorin A, is a uniquely potent and highly selective kappa-opioid receptor agonist and, as such, has enormous potential for the development of valuable medications. Among them, the most promising include safe and nonaddictive analgesics, neuroprotectors, short-acting anesthetics that do not depress respiration, antidepressants, anti-inflammatories, medications for the treatment of addiction to stimulants and alcohol, and drugs to treat disorders characterized by alterations in perception. The Mazatec consider Salvia divinorum to be a very powerful plant spirit that should be treated with utmost respect, and the preparation for the ceremony requires a strict regimen. They chew the fresh leaves at night while chanting and praying. In the Western use, the dry leaves are potentiated in extracts to be smoked. A lack of information about the appropriate doses and other considerations while smoking the extracts could result in overwhelming experiences due to the high potency and fast onset of the substance. For the Mazatec, smoking the plant is not the preferred mode. How could we create a bridge between the two perspectives? In this chapter, I will try to clarify the best ways to use Salvia divinorum for medicinal, psychotherapeutic, and inner exploration purposes.

Maqueda, A. E. (2018). The Use of Salvia divinorum from a Mazatec Perspective. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 55-70. 10.1007/978-3-319-76720-8_4
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Ibogaine Acute Administration in Rats Promotes Wakefulness, Long-Lasting REM Sleep Suppression, and a Distinctive Motor Profile

Abstract

Ibogaine is a potent psychedelic alkaloid that has been the focus of intense research because of its intriguing anti-addictive properties. According to anecdotic reports, ibogaine has been originally classified as an oneirogenic psychedelic; i.e., induces a dream-like cognitive activity while awake. However, the effects of ibogaine administration on wakefulness (W) and sleep have not been thoroughly assessed. The main aim of our study was to characterize the acute effects of ibogaine administration on W and sleep. For this purpose, polysomnographic recordings on chronically prepared rats were performed in the light phase during 6 h. Animals were treated with ibogaine (20 and 40 mg/kg) or vehicle, immediately before the beginning of the recordings. Furthermore, in order to evaluate associated motor behaviors during the W period, a different group of animals was tested for 2 h after ibogaine treatment on an open field with video-tracking software. Compared to control, animals treated with ibogaine showed an increase in time spent in W. This effect was accompanied by a decrease in slow wave sleep (SWS) and rapid-eye movements (REM) sleep time. REM sleep latency was significantly increased in animals treated with the higher ibogaine dose. While the effects on W and SWS were observed during the first 2 h of recordings, the decrement in REM sleep time was observed throughout the recording time. Accordingly, ibogaine treatment with the lower dose promoted an increase on locomotion, while tremor and flat body posture were observed only with the higher dose in a time-dependent manner. In contrast, head shake response, a behavior which has been associated in rats with the 5HT2A receptor activation by hallucinogens, was not modified. We conclude that ibogaine promotes a waking state that is accompanied by a robust and long-lasting REM sleep suppression. In addition, it produces a dose-dependent unusual motor profile along with other serotonin-related behaviors. Since ibogaine is metabolized to produce noribogaine, further experiments are needed to elucidate if the metabolite and/or the parent drug produced these effects.
González, J., Prieto, J. P., Rodríguez, P., Cavelli, M., Benedetto, L., Mondino, A., … & Torterolo, P. (2018). Ibogaine Acute Administration in Rats Promotes Wakefulness, Long-Lasting REM Sleep Suppression, and a Distinctive Motor Profile. Frontiers in pharmacology9. 10.3389/fphar.2018.00374
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Functional Mushrooms: Ecological Allies for Whole-Body Health - February 18