Psychedelic therapy in the Czech Republic : A theoretical concept or a realistic goal ?
Zuzana Postranecka, Čestmir Vejmola and Filip Tyls
Journal of Psychedelic Studies
Psychedelic research has been associated with the Czech Republic since the early 19th century and, after a long period of involuntary dormancy, it has recently gained new opportunities to follow up on its roots and evolve. This article briefly describes the history of psychedelic research in the Czech Republic, summarizes the role of the UN Drug Conventions, and discusses the Czech and international legislation pertaining to psychedelics. The discussion focuses on the dependence/abuse potential of classical psychedelics, their medical use, and their safety in medical versus non-medical environment. Despite the assertions of the UN and occasional media disinformation about the dangers of psychedelics, recent investigations have shown that classical psychedelics are not addictive, show great promise in a broad spectrum of medical uses, and have been repeatedly proven to be safe in a clinical setting. Finally, the authors suggest a procedure for the preparation and implementation of controlled psychedelic therapy in the Czech medical and legal system.
Keywords : psychedelics, abuse, dependence, addiction, drug legislation
The so-called classical psychedelics, or serotonergic hallucinogens, include mainly lysergic acid diethylamide (LSD), psilocybin, mescaline, dimethyltryptamine (DMT), and methoxy-N,N-dimethyl-tryptamine (5-MeO-DMT). Serotonergic hallucinogens are a subgroup of three classes of compounds: tryptamines, ergolines, and phenethylamines, of which the latter group also includes the so-called entactogens/empathogens (MDMA or 2C-B). In a broader context, the hallucinogen class could also include a selective kappa-opioid agonist salvinorin A found in Salvia divinorum, dissociative anesthetics (ketamine), cholinergic delirogens (tropane alkaloids and their plant sources such as datura or deadly nightshade), and sometimes also cannabis (marijuana and hashish). This article only discusses serotonergic hallucinogens, which will be referred to as psychedelics.
Naturally occurring psychedelics have been associated with various human societies since time immemorial. The ritual use of psychedelics has been preserved to the present times mostly in native South American tribes, typically in various naturally occurring forms (DMT in the hallucinogenic brew ayahuasca, psilocybin in magic mushrooms, mescaline in cacti, 5-MeO-DMT in the venom of hallucinogenic toads). The discovery of psychedelics by Western society in the 20th century sparked a surge of extensive research, mainly due to their potential in the treatment of psychiatric disorders, which showed great promise (Tylš, Pálenícˇek, & Horácˇek, 2014).
During that time, the Czech Republic was one of the focal points of psychedelic research. First self-experiments with psychotropic substances were conducted and later reported by Purkyneˇ in early 19th century, namely with the deadly nightshade, nutmeg, opium, and other substances. In 1947, psychiatrist Sveˇtozar Nevole published a book recounting his experiences with peyote and its ability to
expand consciousness, significantly inspiring many other Czech physicians including Stanislav Grof [American psychiatrist born in Prague, founder of transpersonal psychology. With his wife Christina, he developed the Holotropic Breathwork method and wrote several books about spiritual emergency. His famous works include LSD Psychotherapy (1980) or The Cosmic Game : Explorations of the Frontiers of Human Consciousness (1998)] or Milan Hausner (Czech psychiatrist who administered LSD to patients as part of psychotherapy in a psychiatric hospital in Sadská in the 1970s. He wrote a book named LSD: The Highway to Mental Health with Erna Segal; Winkler & Csémy, 2014). In addition, psychiatrist Roubícˇek (1961) started to self-experiment with LSD shortly after its discovery by Albert Hofmann. Psychedelic therapy in the Czech Republic started in 1954 and ended in 1974, making the country one of the very last to introduce the spreading ban on psychedelics, which effectively halted the research for many years. The main research sites included the Psychiatric Hospital in Sadská near Podeˇbrady and the Psychiatric Research Institute in Prague. In these institutions, hundreds of research subject underwent psycholytic and psychedelic therapy and Dr. Hausner personally conducted over 3,000 psychedelic sessions in the Sadská Hospital. Self-experimentation with psychedelics was an official part of psychedelic-assisted psychotherapy training, requiring five controlled LSD (or occasionally psilocybin) intoxications (Hausner & Segal, 2016).
In the 1960s, psychedelics started to gain significant popularity among the general public, mainly in the USA, and brought about a surge of panic in the rigid society of the time also due to their ability to affect the individual’s value system. Politically motivated prohibition, the so-called War on Drugs [The War on Drugs was another unsuccessful prohibition campaign (Austin & McVey, 1989; Blocker, 2006), directed against an inanimate object that has no agency of its own.], supported by the media, gradually led to a worldwide ban on selected psychedelics. During the entire duration of the ban, psychedelics were widely used by the alternative culture with relatively minimal negative effects on mental health (Krebs & Johansen, 2013).
In the scientific community, however, the discussion of the potential uses of psychedelics in the treatment of a broad spectrum of psychiatric disorder has been gaining more and more attention – from depression, post-traumatic stress disorder and obsessive–compulsive disorder (OCD) to addictions. Furthermore, psychedelics can be used as a tool for the study of severe psychiatric illnesses such as schizophrenia (Geyer & Vollenweider, 2008) or the unconscious processes that underlie various neurotic spectrum disorders (Viktorinová & Tylš, 2016). The Czech Republic remains in the forefront of psychedelic science even today – the Czech National Institute of Mental Health is currently conducting a clinical trial on psilocybin as a model of psychosis. To date, psilocybin has been administered to 20 healthy volunteers (Bravermanová et al., 2018). Moreover, a new multicenter research sponsored by Compass Pathways will study the use of psilocybin in a new sample of patients with treatment-resistant depression.
This review focuses on the legal, social, and medical status of psychedelics in research and therapy in the Czech context, aiming to illustrate the dysfunctional nature of the contemporary system of substance control and to reevaluate the current legislative position of psychedelics in light of the most recent scientific findings. Its goals include opening the discussion on the possibility of facilitating new psychedelic research and helping it reach the depths it needs to present the therapeutic and self developmental potential of these substances to the professional public.