Hallucinogen therapy is coming
“If hallucinogens prove effective in treating substance abuse, they would address a massive unmet need. They’d also possibly force a change in how we think about the dysfunction that underlies these conditions.”
In the past, addiction was cast as a moral failing. Today it’s variously seen as a psychiatric condition, a learning disorder, or a disorder of the brain. Given that dependency on one’s drug of choice eventually emerges, a common treatment approach is to wean addicts off their drugs by, in the case of smoking, giving ever smaller quantities of nicotine in patches or gum. Hallucinogen therapy dispenses with this gradualist approach, instead seeking a more sudden transformation. That’s in part because many studies, including the Johns Hopkins trial Kreitman participated in, suggest those who have mystical experiences while on psilocybin have the best outcome. This kind of sudden, divine-seeming insight, what William James termed a “conversion,” is central to many religious and meditative traditions. It can also occur in more prosaic contexts—a phenomenon one psychologist has dubbed “quantum change.” People can quickly and inexplicably, often after a profound epiphany, change. The question of how, precisely, hallucinogens trigger these transformations has sent neuroscientists down an intriguing rabbit hole. They have observed similarities between what happens in meditators’ brains and people on hallucinogens. Neural networks that serve as control centers—the neural correlates of the old Freudian ego—may loosen their grip, freeing other regions of the brain. Researchers often use an unusual language to talk about this transformation, one that emphasizes meaning and subjective experience over molecular pathways and neurotransmitters. Hallucinogen therapy seems to recast addiction not only as a disorder of the brain, but as a disorder of meaning—of framing and how we see ourselves.