OPEN Foundation

T. Noorani

Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison

November 18, 2021 / Anthropology, Neuroscience, Papers, Phenomenology, Psychiatry, Psychopharmacology, Psychosis / Leave a Comment / By / , , , , , , , , , , , , ,

Abstract

The recent renaissance of psychedelic science has reignited interest in the similarity of drug-induced experiences to those more commonly observed in psychiatric contexts such as the schizophrenia-spectrum. This report from a multidisciplinary working group of the International Consortium on Hallucinations Research (ICHR) addresses this issue, putting special emphasis on hallucinatory experiences. We review evidence collected at different scales of understanding, from pharmacology to brain-imaging, phenomenology and anthropology, highlighting similarities and differences between hallucinations under psychedelics and in the schizophrenia-spectrum disorders. Finally, we attempt to integrate these findings using computational approaches and conclude with recommendations for future research.

Leptourgos, P., Fortier-Davy, M., Carhart-Harris, R., Corlett, P. R., Dupuis, D., Halberstadt, A. L., Kometer, M., Kozakova, E., LarØi, F., Noorani, T. N., Preller, K. H., Waters, F., Zaytseva, Y., & Jardri, R. (2020). Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison. Schizophrenia bulletin, 46(6), 1396–1408. https://doi.org/10.1093/schbul/sbaa117

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Making psychedelics into medicines: The politics and paradoxes of medicalization

April 30, 2019 / Other subjects, Papers, Psychiatry, Psychology, Psychopharmacology, Psychotherapy, Publications / By /

Abstract

This commentary considers efforts to turn psychedelics into medications that can be administered through healthcare systems as examples of “medicalization.” I draw on ethnographic research both inside and outside of university-based clinical trials from 2014 to date, together with analogous examples from psychiatry and drug research and development. Rather than taking a normative stance on medicalization, I situate it in a wider political, economic, and cultural context to better understand its logics and effects. I begin by suggesting the resurgence of psychedelic science has been concerned with medicalization from the outset, recently prompting a crisis in the “psychedelics community” over its self-identity and values. Next, against the confident public messaging surrounding psychedelics, I consider how attempts to scale up and market psychedelic-assisted therapy could end up undermining the safety and efficacy of the therapy itself. I then outline the movements to decriminalize, legalize, and minimize the harms and risks of using psychedelics in their currently illicit therapeutic and recreational modalities. Finally, I explore how working toward psychedelic medicalization over the coming years may influence the movements toward decriminalizing and legalizing psychedelics use, focusing on the underarticulated ways in which medicalization may disregard or even hinder, rather than help, decriminalization and legalization efforts. I call attention to how the cost of gaining approval for therapies incentivizes the development of diluted-yet-profitable forms of psychedelic-assisted treatments, and how frameworks developed for “proper use” demarcate what counts as “abuse” and enable those with newly sanctioned access to psychedelics to condemn afresh their illicit use.

Noorani, T. (2019). Making psychedelics into medicines: The politics and paradoxes of medicalization. Journal of Psychedelic Studies, 1-6., https://doi.org/10.1556/2054.2019.018
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Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

June 25, 2018 / Addiction, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Psychotherapy, Publications / By / , , , ,

Abstract

Background:

Recent pilot trials suggest feasibility and potential efficacy of psychedelic-facilitated addiction treatment interventions. Fifteen participants completed a psilocybin-facilitated smoking cessation pilot study between 2009 and 2015.

Aims:

The aims of this study were as follows: (1) to identify perceived mechanisms of change leading to smoking cessation in the pilot study; (2) to identify key themes in participant experiences and long-term outcomes to better understand the therapeutic process.

Methods:

Participants were invited to a retrospective follow-up interview an average of 30 months after initial psilocybin sessions. Semi-structured interviews were conducted with 12 of the 15 participants. Data were analysed using thematic analysis.

Results:

Participants reported gaining vivid insights into self-identity and reasons for smoking from their psilocybin sessions. Experiences of interconnectedness, awe, and curiosity persisted beyond the duration of acute drug effects. Participants emphasised that the content of psilocybin experiences overshadowed any short-term withdrawal symptoms. Preparatory counselling, strong rapport with the study team, and a sense of momentum once engaged in the study treatment were perceived as vital additional factors in achieving abstinence. In addition, participants reported a range of persisting positive changes beyond smoking cessation, including increased aesthetic appreciation, altruism, and pro-social behaviour.

Conclusions:

The findings highlight the value of qualitative research in the psychopharmacological investigation of psychedelics. They describe perceived connections between drug- and non-drug factors, and provide suggestions for future research trial design and clinical applications.

Noorani, T., Garcia-Romeu, A., Swift, T. C., Griffiths, R. R., & Johnson, M. W. (2018). Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts. Journal of Psychopharmacology, 32(7), 756-769. 10.1177%2F0269881118780612
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Conducting Qualitative Research With Psychedelic Psychopharmacologists: Challenges of Co-Production in an Era of Interdisciplinarity

March 3, 2017 / Addiction, Mushrooms / Psilocybin, Papers, Psychiatry, Psychology, Psychopharmacology / By /

Abstract

From 2013 to 2015, I worked as a postdoctoral research fellow with a team of pharmacologists experimenting with psilocybin, an illegal psychoactive compound found in psychedelic mushrooms. The team had conducted an open-label clinical trial with long-term cigarette smokers, using psilocybin-assisted psychotherapy to help them quit. The smoking outcomes were very promising, occurring alongside many other profound positive life-changes. The team wanted to investigate further the mechanisms of change by which the study led to its effects. With my PhD training in qualitative research but little knowledge of psychopharmacology, I spearheaded a retrospective qualitative research project to identify participants’ perceptions of the mechanisms of change. This case study describes the challenges I experienced through my involvement with the pharmacology team and some of the solutions that emerged. The distance between collaborating physical scientists and social scientists ebbs and flows, and I begin by situating our interdisciplinary project in the context of the recent intellectual history of psychopharmacology. I then offer a twin analysis of working on the topic as a qualitative researcher and working in a team with pharmacologists. The case study ends with practical suggestions for getting the most out of interdisciplinary co-production.

Noorani, T. (2017). Conducting Qualitative Research With Psychedelic Psychopharmacologists: Challenges of Co-Production in an Era of Interdisciplinarity. 10.4135/9781526404862
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Long-term follow-up of psilocybin-facilitated smoking cessation: Abstinence outcomes and qualitative analysis of participant accounts

November 1, 2015 / Addiction, Mushrooms / Psilocybin, Papers, Psychology, Publications / By / , , , , , ,

Abstract

We assessed long-term (>12 months) outcomes of psilocybin-facilitated smoking cessation, and qualitatively analyzed participants’ accounts to inform potential psychological mechanisms of treatment efficacy.

Garcia-Romeu, A. P., Noorani, T., Griffiths, R. R., Johnson, M. W., Garey, L., Zvolensky, M. J., & Schmidt, N. B. (2015). Long-term follow-up of psilocybin-facilitated smoking cessation: Abstinence outcomes and qualitative analysis of participant accounts. Drug and Alcohol Dependence, 156, e78.  http://dx.doi.org/10.1016/j.drugalcdep.2015.07.1130
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30 April - Q&A with Rick Strassman

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