OPEN Foundation

Publications

Should psychedelic guides keep spirituality out of the therapy room?

While the use of psychedelics has been closely entwined with spiritual practice, prominent voices in psychedelic research have called for the demystification of these substances and the adoption of more secular approaches to psychedelic therapy. I sat down with OPEN Foundation collaborator and psychedelic chaplain, Daan Keiman, to discuss the ethical issues that have been raised around the introduction of spiritual frameworks in psychedelic therapy sessions. From his experience facilitating psilocybin truffle ceremonies at one of the many legal psychedelic retreats in the Netherlands, he thinks that rather than secularize psychedelic guidance and integration, we should tackle these concerns through an interfaith approach. If therapists acknowledge that they are not “existentially neutral” about the nature of the psychedelic experience and its meaning, they should therefore reflect honestly with patients on their therapeutic relation and their respective existential views.
 
The risk of imposing religious beliefs
In a recent viewpoint article about the pitfalls of psychedelic medicine, researcher Matthew Johnson has raised concerns around the possibility of imposing religious beliefs on patients undergoing psychedelic therapy. Johnson warns therapists about the risks of using concepts from Eastern or indigenous spiritualities in integration sessions or even displaying particular religious icons in the therapy room. In his own words, “in addition to other concerns about conflating religious beliefs with empirically based clinical practice, the introduction of such religious icons into clinical practice unnecessarily alienates some people from psychedelic medicine, e.g., atheists, Christians, and Muslims. It will ultimately interfere with the mainstream adoption of these treatments.”
Daan shares some of these concerns given that psychedelics may put patients in particularly vulnerable states that must be handled with care and responsibility. “Under the effects of psychedelics, the suggestibility goes up significantly and we know that people often have noetic experiences: a feeling that something is being revealed to them that is incredibly true.” Although we know that these experiences are deeply mediated by the context in which they are used, their noetic quality feels as unmediated, as completely independent from the set and setting.
Therapeutic work with this kind of deeply felt experiences of truth is proving challenging for psychedelic researchers concerned about the ethics of inducing or validating profound metaphysical beliefs in patients. They worry that such revelations facilitated by the combination of drug and setting may turn psychedelic therapy into a form of non-consented spiritual conversion. Therefore, as Johnson argues, researchers and clinicians should adhere to a secular approach and refrain from introducing any “non-empirically verified beliefs” into their therapeutic protocols.
Daan agrees with the difficulties of introducing elements from particular spiritual traditions in pluralistic settings such as the truffle retreats that he facilitates. In fact, the Buddhist teachings and stories that he used to share with participants in preparation for their ceremonies did not always resonate with everyone’s worldviews. In one of these stories, the Buddha is seduced by the demon god Mara during meditation and, instead of ignoring his calls, he accepts them and invites the demon to tea. With this story, Daan would encourage psychedelic journeyers to confront challenging experiences: “invite your demons to tea, and see what you can learn from them”. However, he recounts an occasion on which a couple of Christian retreaters felt incredibly uncomfortable with the idea of inviting their demons to tea.
“Although I had been trained as an interfaith spiritual caregiver, I had wrongfully assumed that the prevailing clinical and therapeutic best practices, those underlying the Buddhist story, were universally applicable. The incident made me realize that they can come with ontological or theological assumptions”.

Daan Keiman, MA

Empirically verified frameworks of meaning
While discarding religious iconography and language appears as an easy solution, the distinction between belief and empirically based clinical practice is not always so straightforward. As Daan shows, the main psychotherapeutic frameworks used nowadays in psychedelic research are shaped by spiritual beliefs and practice. “If we look at ACT and other third-generation behavioral-cognitive therapies, we see that they are based on mindfulness. A lot of Buddhist insights deeply inform the ways people are encouraged to go into psychedelic experiences”. Transpersonal psychology and existential psychotherapy are other examples of how psychedelic therapy draws from traditions that have their own ontological assumptions.
Some in the psychedelic community have expressed their criticisms to Johnson’s article. “Something that a lot of people take issue with,” explains Dann, “is what comes across as yet another white man pretending that his secular psychotherapeutic perspective is the position of no-position; as if it is neutral, as if it doesn’t come with its own baggage and its own set of assumptions which are not empirically verified.” Daan acknowledges that Johnson is actually much more nuanced than how he is depicted by critics. However, he also thinks that secularizing psychedelic therapy might not be the best solution.
 
There are good reasons to be careful when introducing spiritual frameworks as meaning-making tools in integration sessions.  Yet ruling them out completely due to the lack of evidence to support them seems premature. Daan adds: “Let’s not pretend that psychotherapeutic approaches are neutral. They are deeply informed by certain assumptions. The interesting thing is that currently accepted approaches, like mindfulness-based cognitive therapy or Internal Family Systems, were not empirically verified before they were put into practice and researched. They were met with scepticism, and it took effort to research them and show their validity.”
Excluding all spiritually oriented elements from therapeutic and research protocols would only perpetuate their non-empirical status. Instead, perhaps more research should be dedicated to questions about the ideal therapeutic setting and the necessary competencies to accompany the meaning-making process of patients of diverse existential orientations. 
In regards to such questions, Dann believes that “spiritual traditions, alongside with the richness of shamanic approaches and their accompanying ontologies, might provide fruitful and wholesome insights, and could inform contemporary psychedelic-assisted psychotherapy; as long as they are presented as exactly that: spiritual narrative or practice, not ultimate truth.”

The influence of society on the psychedelic experience (Interview with Ido Hartogsohn)

In contrast to this proposal, Johnson’s article seems to “naively suggest that if we just wear a white coat and strip our protocols of anything that remotely smells like meaning, we will be fine”. However, meaning pervades every element of the therapeutic protocols, from psychometric tests to music playlists, driving the psychedelic experience in subtle ways. This is something that researchers are still struggling to deal with.
Current research about the psychological mechanisms of action of psychedelics is running into the problems of shaping people’s expectations as they prepare for a trip. Along these lines, Daan wonders “to what extent the flight instructions are not some sort of descriptive tool but actually a primer for the experience”. Yet, rather than a mere source of confusion, these feedback loops may help us better understand the interplay of drug, set and setting that determines psychedelic effects.
“We need a deeper understanding of how everything we do is endowed with meaning. Therefore, it is more useful to be transparent, reflect on the meaning of what we do and work towards a more patient-centered approach based on informed consent.”
 
From secular neutrality to interfaith positionality
Psychedelic researchers agree that therapists should empower patients to make sense of the metaphysical aspects of their experiences by themselves. “I am not against that idea,” says Daan, “but as a spiritual caregiver trained to talk about existential questions, I think you need particular competencies to discuss these issues with patients.”
Daan advocates the figure of the psychedelic chaplain, a guide who is fully equipped to help patients with the ontological shock that may be triggered by intense psychedelic experiences. In his view, “to have a psychotherapist helping you interpret those experiences from a purely secular standpoint might become very difficult and could actually harm the existential or spiritual integrity of the client.”
Instead of secularizing psychedelic therapy, Daan suggests  working within an interfaith approach that emphasizes the positionality of both therapist and patient. Deep awareness about the spiritual integrity of the patient and a clear agreement about the framework within which the therapist will guide the patient, therefore, become central in establishing trust in the therapeutic alliance. “Before you start to work with me, I am going to be honest about the fact that I am a Buddhist psychedelic chaplain. Even though I work with a client-centered interfaith approach, there are things that I am bringing into the psychedelic context which I cannot erase and which will influence your journey. If you are uncomfortable with this situation that we call “Daan”, then I might not be the right person to guide you.” 
This notion of positionality that Daan borrows from anthropology is aimed at promoting self-reflection and ensuring transparency in face of the potential ethical issues that may arise in situations where being neutral appears as a naive ideal. To Daan, this self-reflection is very much needed in psychedelic therapy given the position of power and authority that therapists and guides often hold in relation to their patients.
“It is very important that psychedelic psychotherapists are honest about the baggage that they carry in a much deeper way than just in terms of spirituality and ontology. Race, sex and gender play crucial roles in the power disparities between the guide and the person being guided. In the same way that Mathew Johnson identifies the risks of the spiritual orientations of therapists, we also need to become aware of the risks inherent to these power relations, by elucidating them, by articulating them and by reflecting on them with peers and supervisors.”
Should psychedelic therapists then keep their spiritual beliefs away from patients? Perhaps, a self-reflecting interfaith approach is better attuned to cultivate meaningful therapeutic encounters. Patients should have the last word about this.
Written by Alberto Cantizani López
Art by Anna Temczuk

Post-Marketing Safety Concerns with Esketamine: A Disproportionality Analysis of Spontaneous Reports Submitted to the FDA Adverse Event Reporting System

Abstract

Introduction: Esketamine nasal spray received approval for treatment-resistant depression in March 2019.

Objective: Using the FDA Adverse Event Reporting System (FAERS) database (March 2019-March 2020), we analysed esketamine-related adverse events (AEs) to detect and characterize relevant safety signals.

Methods: We used the consolidated case/non-case approach to estimate the reporting odds ratio (ROR) and information component (IC) with relevant confidence intervals (95% CI) for esketamine-related AEs with ≥4 counts. Comparisons between serious and non-serious AEs were performed using non-parametric tests.

Results: The FAERS database contained 962 cases of esketamine-related AEs, with signals detected for several AEs, such as dissociation (ROR = 1,612.64, 95% CI = 1,354.63, 1,919.79; IC = 8.19, 95% CI = 7.96, 8.35), sedation (ROR = 238.46, 95% CI = 202.98, 280.15; IC = 7, 95% CI = 6.75, 7.18), feeling drunk (ROR = 96.17, 95% CI = 61.42, 150.57; IC = 4.84, 95% CI = 4.09, 5.36), suicidal ideation (ROR = 24.03, 95% CI = 18.72, 30.84; IC = 4.31, 95% CI = 3.9, 4.61), and completed suicide (ROR = 5.75, 95% CI = 3.18, 10.41; IC = 2.25, 95% CI = 1.23, 2.94). Signals for suicidal and self-injurious ideation, but not suicide attempt and completed suicide, remained when comparing esketamine to venlafaxine. Females and patients receiving antidepressant polypharmacy, co-medication with mood stabilizers, antipsychotics, benzodiazepines, or somatic medications were more likely to suffer from serious versus non-serious AEs (χ2 = 125.29, p < 0.001, χ2 = 9.08, p = 0.003, χ2 = 8.14, p = 0.004, χ2 = 19.48, p < 0.001, χ2 = 25.62, p < 0.001, and χ2 = 16.79, p < 0.001, respectively).

Conclusions: Esketamine may carry a clear potential for serious AEs, which deserves urgent clarification by means of further prospective studies.

Gastaldon, C., Raschi, E., Kane, J. M., Barbui, C., & Schoretsanitis, G. (2021). Post-marketing safety concerns with esketamine: a disproportionality analysis of spontaneous reports submitted to the FDA adverse event reporting system. Psychotherapy and psychosomatics90(1), 41-48; 10.1159/000510703
Link to full text

Neurocognitive impact of ketamine treatment in major depressive disorder: A review on human and animal studies – PubMed

Abstract

Background: Most recent evidence support a rapid and sustained antidepressant effect of subanesthetic dose of intravenous ketamine in patients with major depressive disorder (MDD). However, clinical and animal studies investigating the effects of intravenous ketamine on specific functional domains disrupted by depression reported conflicting results. Therefore, the aim of this review is to provide an overview of the recent findings exploring the cognitive effects of ketamine in depression.
Methods: After a bibliographic search on PubMed, Medline and PsycInfo, we retrieved 11 original studies meeting our research criteria, 7 in humans with MDD or Treatment Resistant Disorder and 4 using rats models for depression.
Results: Overall the results showed that a) ketamine reduced activation and normalized connectivity measures of several brain regions related to depressive behaviors and reversed deficits in cognitive flexibility and coping response strategy in rats with depressive features, and b) ketamine leads to a no significant impairment on neurocognitive functions in most of the studies, with only three studies observing improvements in speed of processing, verbal learning, sustained attention and response control, verbal and working memory.
Limitations: The methodological heterogeneity, in terms of neuropsychological tests used and cognitive domain explored, of the studies included.
Conclusions: Most of the studies included showed no significant cognitive impairments in MDD patients after ketamine treatment. Furthermore, the results of the fMRI studies considered suggest that ketamine may have a normalizing effect on brain functions during attentional and emotional processing in MDD patients. However, further studies are needed to confirm these preliminary evidences.
Crisanti, C., Enrico, P., Fiorentini, A., Delvecchio, G., & Brambilla, P. (2020). Neurocognitive impact of ketamine treatment in major depressive disorder: A review on human and animal studies. Journal of Affective Disorders., 10.1016/j.jad.2020.07.119
Link to full text

DMT and near-death experiences

Being one of the most powerful psychedelics we know, it is not strange that DMT has become the subject of numerous speculations over the years. Theories linking this molecule to near-death experiences have circulated persistently among users and researchers – yet the scientific evidence just doesn’t seem to be there. 
Enzo Tagliazucchi is a neuroscientist and professor at the University of Buenos Aires. He will be speaking at ICPR 2020 about his research and the first neuroimagery study of DMT in naturalistic settings.
This is the final part of a three-part interview series with Prof. Enzo Tagliazucchi
Part one: The Science and Folklore of DMT
Part two: Psychedelics: key to consciousness
Part three: DMT and near-death experiences
Enzo, you have experience researching NDEs. How is this phenomenon approached from a scientific perspective?
NDEs are really fun to investigate because they are simultaneously a very strange phenomenon, and something that does indeed happen to people in robust and reproducible ways.
There are several things that are common features to most reported NDEs, such as the feeling of floating around, feelings of extreme bliss and transcendence, life review, and the sensation that you are about to cross a visible or invisible threshold, among others. It seems that different cultural backgrounds are not a huge factor determining the specific contents of NDEs. This is somewhat controversial, but apparently at least some of these features could be, in a certain sense, universal.
Then comes the question of why this is happening, and this has been the source of a lot of bullshit, unfortunately. Some insist that everything that happens during NDEs is the manifestation of your soul leaving your body and entering into the afterlife or other realms of existence, which is something that many people would love to believe. Researchers have tested this experimentally: for instance, they have hidden an object in a room and then have somebody experience an out-of-body experience (a defining feature of NDEs) and float around. Needless to say, they never find the object, and they don’t find it simply because they are not floating around in any meaningful interpretation of those words.
People do not even know whether some NDEs happen in the moment someone flatlines, or before or after the event. It could happen moments before you wake up: there is simply no known way of proving that NDEs take place when you are sort of dead for a moment. Even worse than that, people can report NDEs when they think they are going to die but they aren’t really at risk. For example, if you fall from a chair, you might report a flash experience that is indistinguishable from a NDE, but you weren’t even unconscious for a moment.
What are the main explanatory theories of NDEs and how would you assess Strassman’s DMT hypothesis?
Nobody knows for certain why NDEs occur. And maybe there is not simply just one answer, it could be several different factors. But as scientists like to have simple explanations, they have tried to come up with one factor underlying all the different aspects of NDEs.
Perhaps the most attractive one-factor theories are related to the potential presence of endogenous chemicals. Some came to believe that there is a kind of chemical imbalance during NDEs that can lead to the experience, and here Strassman proposed that a massive release of DMT when you are close to death is what is behind the strange phenomenology of NDEs.
As an alternative, Karl Jansen proposed that there is some ketamine-like compound in the brain that blocks NMDA receptors in a similar way to ketamine, a substance whose acute effects can lead to NDE-like phenomenology. At some point in the last couple years, I started to read Jansen and Strassman, became interested in this discussion, and eventually published a paper in which I tried to put their hypotheses to test for the first time.
Using computational semantic analysis, we compared drug reports from Erowid to the narratives of patients who had NDEs, and we confirmed that ketamine was actually way above in similarity to those experiences compared to DMT. Actually, if you think of what the DMT experience is like, it is not this solemn-going-to-the-light-in-bliss but rather a confusing but festive colourful state. People do not really report these things in NDEs at all. And if you have been in the K-hole you already know that it is probably the closest to feeling dead, whatever that means. But that is not the point… this is science and I try to be scientific about it, haha!
In the last paper I read by Strassman, he conceded that there might be some release of a ketamine-like substance when you are close to dying, but the question remains: Why does this substance lead to this strange state of consciousness? Whatever the function of this molecule, why can’t it just shut off your consciousness instead of giving rise to NDEs?
The answer given by Jansen is that a ketamine-like compound could have neuroprotective effects. If there is a massive release of glutamate, an excitatory neurotransmitter that makes neurons fire at a high rate, neurons might die because they are basically too activated, a phenomenon known as excitotoxicity. So if ketamine or a related compound blocks that process, it can extend the life of neurons and increase the likelihood of survival. It sounds reasonable that you have that kind of process built into your brain as a mechanism to cope when you are close to death.
But at this point, Strassman argued something like: OK, but why has evolution given us this very strange experience that happens when we block the glutamate receptor? Why can’t the brain just block the glutamate receptors and protect itself with no experience at all? He concluded that maybe it is not that these receptors get blocked and then you have this experience. It is something different, something like you have a soul and the moment your soul starts to leave your body, the receptors get blocked.
For me that is very difficult to swallow. I am a physicist, and I cling to a scientific worldview. At some point I think Strassman lost that worldview and I actually haven’t read much of his theories since then. I respect him nevertheless, he is a pioneer in this field of research.
So what happened in the search of an endogenous chemical behind these experiences? Again, not conclusive. My guess is that it is a combination of several factors, and that people are really misled when they believe something related to the proximity of death is behind all these experiences.
What about other non-ordinary phenomena such as mystical experiences?
Mystical-type experiences, on the other hand, you can investigate more easily, because you can induce these experiences in safe and reproducible ways. That is what the Johns Hopkins group has been showing over the last years, focusing on psilocybin as an induction agent.
Griffiths’ group repeated the famous Good Friday experiment by Panhke, but under more controlled and rigorous conditions, and they showed that you can induce these experiences with psilocybin combined with the proper set and setting in 60% of the participants. The likelihood of induction is dose-dependent, so the higher the dose the higher the chances of having this kind of experience. They also showed that if you are undergoing treatment for tobacco cessation or if you are an oncological patient with anxiety related to the end of life and you are treated with psilocybin, the likelihood that you are going to get better increases if you have a mystical-type experience. In other words, the potential therapeutic properties of the psychedelic experience are apparently tied to mystical-type experiences. I believe these findings are really interesting from a clinical perspective and, again, in contrast to NDEs this is something that you can induce reliably in a controlled setting.

What microdosing did for the perception of psychedelics

Over the past decade, the phenomenon of ‘microdosing’ has had outsized implications for the perception of psychedelics. Before this phenomenon, narratives around psychedelics always assumed a large dose and a full psychedelic experience. After the popularization of the concept of microdosing, the idea that psychedelics could be taken in small quantities -as a cognitive enhancer- became more prevalent and accepted. Ever since, they’ve been hailed as valuable tools for enhancing various aspects of cognition, creativity, emotion and neuroplasticity.
This article takes notes from Aleksi Hupli’s upcoming PhD dissertation in Sociology at the University of Tampere called: Smarter with Drugs. Cognitive enhancement drugs from users’ perspectives. In it, he partly explores why psychedelic microdosing should be included in the pharmacological neuroenhancement discussion and debate.
Albert Hofmann – the discoverer of the psychoactive properties of LSD – already mentioned in an interview with High Times in 1976 that “very small doses, perhaps 25 micrograms, could be useful as a euphoriant or antidepressant” (Horowitz 1976). The current renaissance of psychedelic microdosing research is usually accredited to Dr. James Fadiman, who dedicated a small chapter to describe experiences with “sub-perceptual doses” in The Psychedelic Explorer’s Guide, published in 2011. Prior to Fadiman, we have to go back to early research done in the 1950s and 60s – especially by the US military – on low doses of LSD. These studies were reviewed by another ICPR2020 speaker, Dr. Torsten Passie (MD) and partly republished in his book The Science of Microdosing Psychedelics (2019), arguably one of the most comprehensive publications on the issue of microdosing to date.
The “very small dose” of 25 micrograms mentioned by Hofmann is not technically considered a microdose or “sub-perceptual dose” as described by Fadiman (2011). As the “common” recreational dose of LSD ranges from 50 to 150 micrograms (Passie et al. 2008), and in contemporary clinical settings from 20 to 200 micrograms, it is still fairly unclear what a “microdose” really is compared to a very low dose or “minidose” (Kuypers et al. 2019; Passie 2019, p. 9-10). According to Fadiman, Hofmann called microdosing “an under-researched area” (Fadiman 2011, p. 211; see also Passie 2019, p. 23-25) and it did take over 45 years for the topic to be picked up by modern mainstream media and research.
Not accepted yet
Some psychedelic researchers remain sceptical about microdosing (e.g. Nichols, Roseman & Timmerman 2018, p. 83) while others acknowledge that “This role of psychedelics as cognitive enhancers is certainly an area in need of more research” (Sessa 2017, p. 276). It is important to note that ‘microdosing’ has several different meanings: for instance, in pharmacokinetic studies, microdosing is being used as a method in novel drug toxicology research. In addition, microdosing is also used as a novel technology in agriculture as a method of distributing plant nutrition (Passie 2019, p. 4).
Lack of research did not prevent a certain “media-hype” from developing, as there were plenty of media reports around the topic of microdosing. These reports described microdosing as a “Revolutionary Way of Using Psychedelics” (High Existence 2014) and, in a “brief history of microdosing” written by Vice in 2015, stated that “while the idea hasn’t yet catapulted itself into the mainstream, it’s getting there”. The following years indeed saw more mainstream media outlets writing about how LSD microdosing “became the hot new business trip” (Rolling Stone 2015) and “the new job enhancer” (Forbes 2015). Microdosing was affiliated with work productivity as a “new brain booster” (The Times 2017) especially in the technology hub Silicon Valley located in California (Wired 2016; Huffington Post 2017; also Mishra 2018; Hupli 2019). These media reports usually included mainly positive reports from people practicing or experimenting with psychedelic microdosing despite that for a long time there was indeed a lack of published research available, as still remains the case.
The definition on Microdosing
In their comprehensive overview of the current literature Kim Kuypers and colleagues, many of whom are presenting at ICPR2020, state: “the term ‘microdosing’ appears to consist of three components: 1) The use of a low dose below the perceptual threshold that does not impair ‘normal’ functioning of an individual. 2) A procedure that includes multiple dosing sessions. 3) The intention to improve well-being and enhance cognitive and/or emotional processes” (Kuypers et al. 2019). Thus, firstly, the dose should be low enough so it does not at least impair “normal” functioning, and in the publication the authors offer a table which includes varying doses (Microdose, Very low Dose, Low dose, Medium dose, High dose) of varying psychedelic compounds (psilocin, LSD, DMT and Ibogaine) that have been studied both in preclinical and clinical research. The authors write that “These doses are approximate values” which were presented as “Per kilogram dose values” which had been “converted to values for a 70-kg person” (Kuypers et al. 2019, p. 3), thus their applicability to ‘real-life settings’ requires careful consideration.
The second component of microdosing according to Kuypers et al., included a procedure with multiple dosing sessions for which there is no unified protocol. This multiple dosing of psychedelic compounds, which is something that usually does not take place with higher doses, is one of the issues that has raised concerns of potential cardiovascular risks associated with nearly daily activation of serotonin receptors with potent partial serotonergic agonists like LSD and psilocin (Kuypers et al. 2019;  Nichols, Roseman & Timmerman 2018, p. 83; Passie 2019). Kuypers et al. (2019, p. 8) conclude that “the possible effects and implications of microdosing remain largely unknown.” While online forums have a vast database of reported effects, from Youtube (Hupli et al. 2019a) to Reddit (Lea, Amada & Jungaberle 2019), according to Kuypers et al. (2019) “the true amount of active substance in these is unknown”. From a research and public health perspective this is, of course, problematic to say the least.
The third component of microdosing described by Kuypers et al., “having an intention to improve well-being and enhance cognitive and/or emotional processes”, is indeed something that users often seem to have when they practice psychedelic microdosing (e.g. Lea et al. 2020; Fadiman & Korb 2019; Hutten et al. 2019; Polito & Stevenson 2019). However, “while in these anecdotal reports the user deliberately ingests a substance for a reason, expecting positive effects, it is difficult to distinguish between expectation ‘placebo’ effects and the effect of a microdose.” (Kuypers et al. 2019, p. 8). From user’ perspectives, however, there is ‘an effect’, whether due to pharmacology or the excitement of doing some thing, even something illegal, but at least something that might improve one’s life-situation which is more than understandable.
Thus, this trend begs for more research on the topic to distinguish “the actual from the imaginary effects of microdosing” (Passie 2019, p. 46), not only for therapy but also for pharmacological neuroenhancement. According to a recent review of psychedelic microdosing, focusing specifically on its potential as a cognitive enhancer, Rifkin, Maraver and Colzato (2020, p. 9, italics added) “conclude that microdosing psychedelics is a promising means for enhancing various aspects of cognition, creativity, and emotion recognition, and that they may be valuable tools to augment cognitive flexibility and neuroplasticity.” However, they also acknowledge that “These findings imply that psychedelics should not be treated as a uniform class of drugs, particularly with respect to microdosing. Various psychedelics, with their distinct receptor affinities, will almost certainly prove to be better for cognitive enhancement in small doses than others.”
Although some users experience also unwanted effects, psychedelic microdosing is more often claimed to bring relief for such conditions such as depression and ADHD (Fadiman & Korb 2019; Lea et al. 2020), which were already mentioned by Albert Hofmann for what ‘very small doses of LSD’ could be useful for, decades ago. The vast list of effects psychedelic microdosing is claimed to produce, now confirmed by an increasing amount of user and preclinical studies (Polito & Stevenson 2019; Hutten et al. 2019; Rifkin, Maraver & Colzato 2020) with some clinical ones completed (Yanakieva et al. 2019; Ramaekers et al. 2020) and others underway (MindMed Press Release 2020; see also Hupli et al 2019a; Wired 2019) require further attention in this field (Hupli 2019).
Fadiman together with Sophia Korb will present some unexpected results from their crowd-sourced research at ICPR2020.
Written by Aleksi Hupli as part of his upcoming PhD Dissertation in Sociology at the University of Tampere titled Smarter with Drugs. Cognitive enhancement drugs from users’ perspectives.
References:
Fadiman, J. (2011). The psychedelic explorer´s guide. Safe, therapeutic and sacred journeys. Park Street Press
Fadiman, J. & S. Korb (2019). Might Microdosing Psychedelics Be Safe and Beneficial? An Initial Exploration. Journal of Psychoactive Drugs, 51(2), 118-122.
Horowitz, M. (1976). Interview with Albert Hofmann. Available at: https://hightimes.com/culture/albert-hofmann-lsd-interview/
Hupli A., M. Berning, A. Zhuparris & J. Fadiman (2019a). Descriptive assemblage of psychedelic microdosing: netnographic study of Youtube™ videos and on-going research projects. Performance Enhancement & Health, 6,( 3–4), 129-138.
Hupli, A. (2019). ECR Spotlight: Psychedelic Microdosing – From Silicon Valley Hype towards Placebo-Controlled Science. In HED Matters, Vol 2, Issue 2. Available at: https://humanenhancementdrugs.com/wp-content/uploads/HED-Matters-Issue-3.pdf
Hutten, N., Mason, N., Dolder, P. & K. Kuypers (2019). Motives and Side-Effects of Microdosing With Psychedelics Among Users. International Journal of Neuropsychopharmacology, 22(7), 426–434.
Kuypers, K., Ng, L., Erritzoe, D., Knudsen, G.M., Nichols, C.D., Nichols, D.E., Pani, L. Soula, A. & D. Nutt (2019). Microdosing psychedelics: More questions than answers? An overview and suggestions for future research, Journal of Psychopharmacology, 33(9), 1039-1057.
Lea, T., Amada N. & H. Jungaberle (2020). Psychedelic Microdosing: A Subreddit Analysis. Journal of Psychoactive Drugs, 52, 101 – 112.
Lea, T., Amada, N., Jungaberle, H., Schecke, H., Scherbaum, N. & M. Klein M (2020). Perceived outcomes of psychedelic microdosing as self-managed therapies for mental and substance use disorders. Psychopharmacology, 237,1521 -1532.
Mishra, S. (2018). Microdosing at Work: Reworking Bodies and Chemicals. Essay part of an online supplement to the Openings collection on “Chemo-Ethnography” edited by Nicholas Shapiro and Eben Kirksey in the November 2017 issue of Cultural Anthropology. Available at: https://culanth.org/fieldsights/1307-microdosing-at-work-reworking-bodies-and-chemicals
Nichols, D., Roseman, L. & C. Timmermann (2018). Psychedelics: from pharmacology to phenomenology. An interview with David Nichols. ALIUS Bulletin, 2, 75-85.
Passie, T., Halpern, J.H., Stichtenoth, D.O., Emrich, H.M. & A. Hintzen (2008). The pharmacology of lysergic acid diethylamide: A review. CNS Neuroscience & Therapeutics, 14, 295–314.
Passie, T. (2019). The Science of Microdosing Psychedelics. Psychedelic Press.
Polito, V. & R.J. Stevenson (2019). A systematic study of microdosing psychedelics. PLoS ONE, 14(2): e0211023
Ramaekers JG, Hutten N, Mason NL, et al. A low dose of lysergic acid diethylamide decreases pain perception in healthy volunteers. Journal of Psychopharmacology. August 2020. doi:10.1177/0269881120940937
Rifkin, B. D., Maraver, M. J. & L. S. Colzato (2020). Microdosing psychedelics as cognitive and emotional enhancers. Psychology of Consciousness: Theory, Research, and Practice. Advance online publication. https://doi.org/10.1037/cns0000213
Sessa, B. (2017). Psychedelic renaissance. Reassessing the role of psychedelic drugs in 21st century psychiatry and society. 2nd edition. Muswell Hill Press.
Yanakieva, S., Polychroni, N., Family, N., Williams L.T.J., Luke D.P. & D.B. Terhune (2018). The effects of microdose LSD on time perception: a randomised, double-blind, placebo-controlled trial. Psychopharmacology,  236(4), 1159-1170.

Compassionate use of psychedelics

Abstract

In the present paper, we discuss the ethics of compassionate psychedelic psychotherapy and argue that it can be morally permissible. When talking about psychedelics, we mean specifically two substances: psilocybin and MDMA. When administered under supportive conditions and in conjunction with psychotherapy, therapies assisted by these substances show promising results. However, given the publicly controversial nature of psychedelics, compassionate psychedelic psychotherapy calls for ethical justification. We thus review the safety and efficacy of psilocybin- and MDMA-assisted therapies and claim that it can be rational for some patients to try psychedelic therapy. We think it can be rational despite the uncertainty of outcomes associated with compassionate use as an unproven treatment regime, as the expected value of psychedelic psychotherapy can be assessed and can outweigh the expected value of routine care, palliative care, or no care at all. Furthermore, we respond to the objection that psychedelic psychotherapy is morally impermissible because it is epistemically harmful. We argue that given the current level of understanding of psychedelics, this objection is unsubstantiated for a number of reasons, but mainly because there is no experimental evidence to suggest that epistemic harm actually takes place.
Greif, A., & Šurkala, M. (2020). Compassionate use of psychedelics. Medicine, Health Care, and Philosophy.,
Link to full text

Matthew Jonhson: psychedelics are brain plasticity-inducing

MatthewJohnson
Matthew Johnson is associate director of the Center for Psychedelic and Consciousness Research at Johns Hopkins University – a center created last year. Johnson is one of the world’s leading researchers in psychedelic science. The Open Foundation asked him to reflect on some hot topics in psychedelic science today – like the mystical experience, business players entering psychedelic research and new avenues of clinical research.
In September of 2019, Johns Hopkins launched its Center for Psychedelic and Consciousness Research. Just a few months earlier, Imperial College in London had started its own Centre for Psychedelic Research. The creation of the Hopkins center seemed like a ‘response’, in a way. Is there some rivalry we need to know about?
The seeds were being sown long before we were aware of the Imperial center, so I wouldn’t say so. There’s far more room for synergy and collaboration than for rivalry in this field. Of course, you always like to be the first to publish a paper on a given subject, that’s just human. But in the big picture, it’s really great that there are two large, very credible centers in the world, and the hope is that it’s going to keep growing. There’s even a third center in South Carolina now, with Michael Mithoefer and others.
What’s the added value of dedicated centers for psychedelic research?
The center is a term used in academics to mean a certain level of funding that allows for an increased concentration and focus on a research area. Functionally, the important thing is that it’s dramatically increasing the throughput of our work on psychedelics.
Your group at Hopkins seems to place a good deal of emphasis on the mystical experience and considers it the mechanism of action for therapeutic outcomes of psychedelic therapy, whereas Imperial focuses more on imagery and neuroscience. Where does this focus on the mystical experience come from?
I think there’s a focus on the biology and the neuroscience at both sites. I’m conducting a study with 80 people on smoking cessation where subjects are undergoing fMRI with a variety of tasks before and after the experience. Fred Barrett in our group is a neuroscientist, and he’s conducting a number of studies right now. In terms of the psychology, the Imperial group has used more of a Freudian model and we have focused more on the mystical experience, but I think empirically we’re likely talking about the same thing. The term ‘ego loss’ has a high correlation to the mystical experience of unity. The focus on mystical experience dates back to William James, and I see it as continuing a thread of interest in this kind of experience that human beings, around the world and throughout time, have consistently reported. It seems that psychedelics prompt those types of experiences, so that interest is far larger than the therapeutic use of psychedelics, which in itself is very important. It taps into the idea that these can be tools for understanding the biology and the very nature of these extraordinary human experiences, and their ability – however occasioned – to prompt behavior change.
The Hopkins Center is set to research interesting new indications: anorexia, distress associated with Alzheimer’s, and aftercare for Lyme disease.
We have started the first two. We’re actively recruiting for the anorexia treatment study, and we’ve actually run participants through that study, but not enough to discern any results yet. We’re also actively recruiting for the mood within Alzheimer’s disease study. We have the funding for the other study, on post-treatment Lyme disease syndrome, as it’s come to be known, and we’re preparing the regulation to be able to conduct it. We should be starting it within a few months.
What exactly is the aim regarding Alzheimer’s?
The primary aim is clearly the mood of patients, through the lens of cancer research, where the focus is not on treating the disease, but the psychological suffering that so often comes with it, and the existential distress that is also there with dementia. But we’re also going to look at the cognitive outcomes, because there are some interesting animal studies that suggest that there are potential positive cognitive effects of these compounds. Also because having a profound psychological reorientation, where you have reductions in depression, might in itself lead to improved cognition and slow the disease process. We’re not holding our breath that we’ll see something there, but it’s worth a look.
Both the center in Baltimore and the one in London are funded by private donors: do you understand the concerns of people who are wary of the increasing interference of big business with psychedelic research?
There are many opinions out there, so I’m not sure what the concerns exactly are. The Center is funded through a non-profit model and it’s 100 % philanthropy, so I think it’s unrelated to any concerns about business involvement in this area.
Well, people like Tim Ferriss raise some questions. He’s an investor, and investors are known to seek some kind of return on their investments. Some people are quite suspicious of that.
At the surface level I can understand the concerns, if people don’t know the details. From knowing the details, I can say that if his goal was to have a financial return on investment, he’s done a very poor job at setting things up. However, he’s been very clear that the goal was to leverage the growth of an area and the advancement of science.
Humans are interested in leaving a legacy, and being known for having had an impact, so that may be relevant to anybody who makes an investment in an area with a hope for its growth. I think he wants to see this area take off, and a lot of people look to him as someone who sees what’s coming in the future. I also think this has already been an advantage in terms of people paying attention to this area.
Are you concerned that, once legal, psychedelic therapy might turn into big business? The business press is already touting psychedelic therapy as the next big cash cow.
If we’re on to something – and I think we are – then this will happen. There are niches to fill. So the real questions become: What are the actions of any particular entity? Are they operating ethically or unethically? The commercialization of psychedelics raises concerns about the potential for bad actors, but there can be bad actors in pure non-profit and in pure academia. The potential on the monetary side is obviously increased once you introduce a business model. So I think there’s a rationale for increased concern about bad actors. But the fact that business is jumping into this is not a bad thing in itself. It’s a 100 % expected outcome, and overall it’s a good thing. We just have to keep our eyes on the way people are operating.
The title of your ICPR talk will be: “Psychedelics as behavior change agents.” What can we expect?
I want this to be a big-picture presentation that draws from multiple lines of evidence. Not about the treatment of this or that disorder, or this or that effect, but really drawing across all that. The overall point is that psychedelics can occasion behavior change. They seem to be powerful ways to induce mental and behavioral plasticity. We have a whole lot more to figure out on the biology of that and how to most properly leverage psychedelics towards those aims. There’s also a lot to figure out about so-called ‘integration’, but it’s probably that people are left in a state of increased neuroplasticity, which can depend on many mechanisms. So I’d like to present the basic argument that, in the broadest sense, these are plasticity-inducing agents.

Ido Hartogsohn on the influence of society on the psychedelic experience

collective set and setting
Ido Hartogsohn is one of the first and few researchers to focus on psychedelic research from a social technological perspective. The assistant professor from the Science, Technology and Society program at Bar Ilan University in Israel has just published a new book called American Trip, in which he explores how the social conditions of the 1960s shaped the American psychedelic experience itself. 
In his recently published book he inquires how the LSD experience was shaped by the social conditions and predominant values of the fifties and sixties, portraying LSD as a “psychopharmacological chameleon” dependent on culture. With this move, he expands the traditional meaning of set & setting in psychedelic therapy to include the broader contexts in which these substances are used. He calls this the “collective set and setting”: the broader cultural and social contexts in which these substances are used. 
His work brings a sociological perspective that invites us to rethink psychedelic drugs beyond their mere pharmacological properties.
How do your views challenge conventional understandings of drug effects in pharmacology?
One of the defining ideas of pharmacology is an often implicit notion which scholar Richard DeGrandpre termed pharmacologicalism: the assumption that a drug is exclusively defined by its inherent pharmacological qualities – that it has one type of discrete effect independent of any variables.
The closer we look at the effects of drugs, the more we see that they do not work like that at all. The effects of drugs, not just psychedelics, can change radically depending on the social and physical environment.
Think of the example of US soldiers returning from Vietnam in the 1970s. The American army tried numerous plots to help these soldiers kick their heroin habit while they were in Vietnam, but all of these ultimately failed. Then, as the soldiers returned home, suddenly 90% of them were able to kick the habit spontaneously, without going through any kind of treatment.
Once the setting changed we could see that – even in the case of the supposedly most rigid, inflexible and essentially physical drugs, effects were highly dependent on the set and setting of use.
This is something that pharmacological discourse has been reluctant to acknowledge over the years. It makes sense because once you acknowledge that, it complicates drug trials and discussions around drugs. It forces us to think about not only the very chemical product that we give to patients but how we give it to them and the whole clinical environment. It also forces us to forsake these very naive ideas of drugs as magic bullets that have one specific effect and one specific and highly discrete application.
The cultural malleability of psychedelic experiences has great implications for drug policy. How do you think that prohibitionism and anti-drug propaganda could have infiltrated the very experiences of psychedelic users?
There is this classic study by the sociologist Richard Bunce about the dramatic increase of bad trips at the end of the 1960s as authorities were pushing different scare theories such as the idea that LSD creates chromosome damage or that it will “fry your brain”. All of that stuff was completely debunked later on but once you have these ideas percolating inside the culture, they can easily penetrate people’s experiences. Given this type of ‘collective set and setting’, levels of paranoia shot up among users. Experiences that could be interpreted as quite benign and pleasant turned in a way that is very scary.
This kind of effect is something anthropological literature was predicting already a decade earlier. In the late 1950s, anthropologist Anthony Wallace argued that psychedelic users in the West were more liable to have negative experiences than those that had them in traditional or indigenous societies. Societies, like in the West, that conceive of hallucinations as something that is inherently dangerous and meaningless increase the chance for harmful experiences.
I believe that there have been so many psychedelic trips gone awry as a result of prohibition; so much mental energy that has been squandered; so many positive experiences of users over the years that took a bad turn when they for example encountered police during a trip or were somehow perturbed by the ideology, propaganda and policy of the war on drugs.
So, if we are to take a harm reduction approach to drug use, what can we do to improve the collective set & setting of psychedelic use today and in the future?
One of the most beautiful things that is happening today in the so-called “psychedelic renaissance” is this burgeoning culture of set and setting: the growing awareness of the importance of preparation, intention, and integration – of knowing your substance, your set and your setting.
Psychedelic users today are much more “psychedelically literate” than the ones in the 1960s, and that’s a result of a very rich culture of discourse and practice informed by the idea of set and setting. So we now have safezone organizations which provide for example psychedelic first aid or peer support in festivals like Burning Man or Boom; we have online trip-sitting services run by volunteers; books and websites guiding about the principles of safe and transformative psychedelic voyaging, and there are more and more studies that aim to study how set and setting work.
These are all very hopeful signs that the appreciation of the importance of set and setting is more and more widely recognized in the field of psychedelics, for the broader community as well as for the clinical community.
Governments that want to approach this subject from a progressive perspective need to realize that outmoded, ideologically rigid approaches to drug use fail their citizenry and ultimately the entire society. Governments are betraying their role when they prosecute users. What they should be doing is helping the general public get the know-how, the information and the resources that could help minimize harmful experiences and maximize the potential for safe, positive and meaningful experiences.
You argue that the placebo effect can be understood as a form of meaning response, in which clinical improvement follows from the mere manipulation of meaningful cues in the therapeutic process. Accordingly, the meaning-enhancing properties of psychedelics turn them into some kind of “super-placebo”. What would be the consequences of this reconceptualization for current clinical trials with psychedelics and their placebo-control methodologies?
Over the years the pharmaceutical industry has been invested in the attempt to minimize or eliminate placebo effects. If you are selling a drug like they are, you probably want to give a decisive answer about its effects. But once [the placebo-effect] enters the picture, it appears much more uncertain what the drug actually accomplishes by itself.
After clinical trials, we see that the efficacy of that same drug diminishes from year to year of use in the market, or from culture to culture, because of the changes in the placebo response and in the meaning attributed to the drug. We can therefore see that drug effects are much more fluid than we are led to believe.
Medical anthropologist Daniel Moerman draws our attention to the fact that placebo response can more intelligibly be conceived as just meaning response. When you bring this insight into contact with the field of psychedelics something quite interesting emerges, because one of the main effects of psychedelics is to enhance the perception of meaning.
This then raises the possibility that psychedelics may enhance the placebo response by enhancing our perception of meaning. This potential of psychedelics to enhance placebo really holds a valuable alternative to the classic pharmacological model and an opportunity to think about how meaning intervenes in therapeutic processes.
I don’t think that we are about to see the end of the blind trials paradigm anytime soon. But rather than looking for an objective response to a drug and leaving it at that, we would achieve better results if we focused our energy at examining the nexus between drug, set and setting, to optimize the overall therapeutic process in a way that transcends commonplace flat and impoverished conceptions of the drug responses.
You have approached psychedelics from a science and technology studies (STS) perspective. What has that taught you?
When you look at LSD and psychedelics in general, you have a technology whose effects are highly malleable. Depending on the set and setting, a hallucinogenic agent like LSD can be a psychotomimetic (psychosis mimicking) and it can be therapeutic. It can be anxiety-inducing and it can be mentally soothing.
The effects of LSD are so radically transformed in relation with user’s mindsets and settings that you could argue that LSD, as a technological artifact, is recreated every time it is used. This recognition leads to the concept of psychedelics as a technology that is culturally and socially constructed in a radical way.
One of the main takeaways that I am trying to convey in my book is the idea of a “psychedelic technology”. Going back to the very meaning of the word psychedelic as “mind-manifesting”, the category of “psychedelic technology” would then refer to technology that is shaped in accordance with the mind-set and the environment (hence the idea of an ecodelic) of the user. This is an interesting way to think about technology that is a radical extension of the social constructivist way to think about technologies in the field of STS.
My perspective on psychedelics later shifted to the STS idea of co-production, the question of how the effects of LSD and other psychedelics are shaped and formed by social values, norms and conditions, and how LSD and other psychedelics simultaneously bring about changes in social and cultural movements creating a kind of positive feedback loop, an idea that I explore in my book.
What will be the major takeaways that potential attendees of ICPR might expect from your talk or about your book?
One of the main things my book tries to do is to really expand our understanding of set and setting in order to transcend that more narrowly defined, individualized concept of set and setting. I think the book makes clear that no factor in the individual, specific or concrete set and setting of a psychedelic experience is independent of the larger social and cultural picture, and so I try to answer the question how our collective historical and social forces worked to shape the psychedelic experience in the West since the 1960s and to this day.
Ido Hartogsohn talk at ICPR 2020 will explore the relationship between set and setting, meaning-enhancement and placebo as a central axis on which the psychedelic experience can be interpreted and understood.

Janis Phelps on training the first psychedelic therapists

Professor Janis Phelps PhD
Janis Phelps is the founder and director of the CIIS Center for Psychedelic Therapies and Research, which conducts the first academically accredited, professional certificate training programme for psychedelic-assisted therapy and research. 
At ICPR 2020, Dr. Phelps will address her experience in setting up a licensed training program for people working in research and therapy with psychedelics. 

You founded the first licensed training program for psychedelic therapists. How did this come about ?
The genesis of this program came about in 2014 at a Heffter Research Institute board meeting, where one of the trustees of our college heard the dire need for psychedelic therapists to be trained.
Our university has been training about 250 therapists a year in 6 different programmes for over 30 years. Stan Grof, Ralph Metzner and other psychedelic researchers have been teaching at CIIS for decades. CIIS trustees gave us seed money for a 3-year grant. I was the founder and creator of the programme, and the opportunities for this were very rich.
We wanted to bring in indigenous ways of knowing as well as the approach typically used in the research protocols for both psilocybin and MDMA.
What are the challenges you faced in this process ?
Well, we were creating something in a vacuum. There were no guidelines yet for how to do this, because no-one had done it before. For a year, I consulted with researchers, underground and above-ground therapists, and in related areas such as hospice care centres and emergency rooms, on how to work with people in altered states.
To devise the programme, we drew from anthropology, clinical and transpersonal psychology, psychoanalysis and ceremonial uses. The challenge was to try to integrate all these in the best possible way.
However, we chose to emphasise the research approach for now, because of the need for therapists to be in FDA-approved clinics. This is a compromise we made, but the upside is that now our graduates get hired by these research entities and they’re opening clinics that will be ready to use MDMA and psilocybin in the next couple of years.
Things seem to be progressing quite fast these days. Are you sometimes concerned they may be going too fast?
I’m concerned about the decriminalisation movements in the US. They’re going quicker than I’m comfortable with. The general public is not sufficiently aware of the hazards and the benefits of the use of plant medicines. Even physicians and nurses don’t know enough, and neither do school teachers.
So we’re working on scaling up our programme to include the general public and give them information online for free: interactions with medications, incompatibilities with certain psychological difficulties, how parents can talk to their kids about psychedelics, etc. I’m concerned there might be another backlash like we had in the sixties if these medicines are not used responsibly.
My other concern is that we’re training only 75 people a year, about 300 so far. MAPS has only trained about 250. We need thousands of therapists trained. I’m concerned that when the medicines get rescheduled, there won’t be enough therapists, with resulting insufficient access to the medicines for patients. So we’re looking to scale it up and develop affiliations with other universities.
What have you taken away from this whole adventure so far?
I’ve been delighted to witness the integrity of the therapists and medical doctors wanting to come into this space. They want to see healing happen, they’re concerned about what’s happening on the planet in terms of politics, genocides and global warming.
They know that psychedelics are not the only way for people to heal, of course, but the kind of therapy we can do is augmented tremendously by the use of plant medicines. I see them changing psychiatry and psychology for nothing but the good.
On average, the professionals who apply for the programme have 15 years of licensed practice, so they’re quite experienced in their work. Some were retired medical doctors who reactivated their license in order to do this work. I also witnessed our students building community with each other, creating associations, building salons, and it’s very exciting to see this flourish across the United States, into Canada, South America and the EU. I realised once again how desperate people are for community. And finally, it’s been wonderful to meet the new generation, I’m very happy to pass the hat to younger people.
Dr. Phelps’ talk at ICPR 2020 will be titled: “Training future psychedelic therapists

Do psychedelics make you more creative?


Creativity and psychedelics have been closely allied ever since recorded history began. We can find ancient mushroom art that was likely inspired by the psychedelic experience, and in more recent history, we have reports of inspiration from psychedelics abound from the Beatles to Steve Jobs to microdosing tech enthusiasts. 
James Fadiman (one of the speakers at ICPR) studied creativity with engineers and architects in the 1960s. Although the studies [1] weren’t up to today’s standards of double-blind, placebo-controlled, they did provide a first hint of what was to come.
The participants noted that they found solutions to problems they had been working on for months. In the studies they were given a moderately high dose of LSD or mescaline (100ug and 200mg respectively). Their inhibitions were reduced, ideation flowed more easily, and they could see the problem from different perspectives.
“Looking at the same problem with (psychedelic) materials, I was able to consider it in a much more basic way, because I could form and keep in mind a much broader picture.” – study participant
Creativity itself is a tricky concept to define and measure. It can be defined as the ability to produce original and unusual ideas, or to make something new or imaginative. You can see creativity as a process that happens by combining information in new ways. This process is most commonly divided into two parts: divergent (generating ideas) and convergent (evaluating ideas) creativity.
Ben Sessa asked in 2008 if it was time to revisit psychedelics and creativity [2], as the creative process and the psychedelic experience shared many characteristics. But that since the 1960s, not many studies had looked into psychedelics and creativity.

Findings

Since 2008 there have been many studies on both the perceived effects (at macro- and microdoses) of psychedelics on creativity. A preliminary conclusion could be that psychedelics help with divergent creativity during the psychedelic experience, and possibly with convergent creativity during the integration afterward. A small selection of them found the following:
During a psychedelic experience with Ayahuasca, divergent creativity was slightly enhanced on one measure [3]. Participants in the study were more creative in identifying novel connections between pictures (PCT test).  Measuring one [4] and two [5] days after a psychedelic retreat with respectively a macrodose of psilocybin and ayahuasca, divergent creativity was also found to be enhanced.
In the study of the psilocybin retreat [4] however, the convergent creativity was impaired during the psychedelic experience. In the test they were worse at identifying a set connection between pictures. But convergent creativity was higher when they measured it seven days later. So although this measure of creativity was worse during a macrodose, it seemed to have improved a week later.
At the microdosing level, many people report being more creative. A survey study that included a test of creativity, on which Rotem Petranker worked, confirmed this [6]. The study found a weak correlation (r = 0.15) between microdosing and creativity.
How psychedelics lead to creativity is still being studied and Ido Hartogsohn points towards the meaning-enhancing properties of them as a possible mechanism [7]. If you’re not as critical of yourself, he states, then you might have more divergent ideas which can then be valuable after evaluation (convergent).
“By magnifying the perceived significance of creative challenges and insights, psychedelics provide users with the impetus to pursue new, less obvious lines of ideation that they might otherwise have ignored; and with enhanced motivation to explore new creative directions to their fullest ramifications.” (p. 129)

Chemistry 

How this happens at the level of brain chemistry is currently being investigated by researchers like Leor Roseman. One study [8] he worked on showed more general coherence and lower frontoparietal network activity whilst on a macrodose of psilocybin.
 


 
The coming decades will shed more light on what aspects of creativity psychedelics can influence. Retreats that work together with researchers, like the one Daan Keiman runs, may help provide insights.
The speakers above are among the 60+ speakers at the Interdisciplinary Conference on Psychedelics Research – taking place from the 24th to the 27th of September. Here, top researchers will showcase the latest multi-disciplinary insights from psychedelic science. More information at icpr2020.net.
 
[1] Harman, W. W., McKim, R. H., Mogar, R. E., Fadiman, J., & Stolaroff, M. J. (1966). Psychedelic agents in creative problem-solving: A pilot study. Psychological reports, 19(1), 211-227.
[2] Sessa, B. (2008). Is it time to revisit the role of psychedelic drugs in enhancing human creativity?. Journal of Psychopharmacology, 22(8), 821-827.
[3] Kuypers, K. P. C., Riba, J., De La Fuente Revenga, M., Barker, S., Theunissen, E. L., & Ramaekers, J. G. (2016). Ayahuasca enhances creative divergent thinking while decreasing conventional convergent thinking. Psychopharmacology, 233(18), 3395-3403.
[4] Mason, N. L., Mischler, E., Uthaug, M. V., & Kuypers, K. P. (2019). Sub-acute effects of psilocybin on empathy, creative thinking, and subjective well-being. Journal of psychoactive drugs, 51(2), 123-134.
[5] Frecska, E., Móré, C. E., Vargha, A., & Luna, L. E. (2012). Enhancement of creative expression and entoptic phenomena as after-effects of repeated ayahuasca ceremonies. Journal of psychoactive drugs, 44(3), 191-199.
[6] Anderson, T., Petranker, R., Rosenbaum, D., Weissman, C. R., Dinh-Williams, L. A., Hui, K., Hapke, E., Farb, N. A. (2019). Microdosing psychedelics: personality, mental health, and creativity differences in microdosers. Psychopharmacology, 236(2), 731-740.
[7] Hartogsohn, I. (2018). The meaning-enhancing properties of psychedelics and their mediator role in psychedelic therapy, spirituality, and creativity. Frontiers in neuroscience, 12, 129.
[8] Girn, M., Mills, C., Roseman, L., Carhart-Harris, R. L., & Christoff, K. (2020). Updating the dynamic framework of thought: Creativity and psychedelics. NeuroImage, 116726.