Psychedelic drug use in healthy individuals : a review of benefits, costs, and implications for drug policy
James W.B. Elsey
Drug Science, Policy and Law, 2017, Vol 3, 1-11
The potential of psychedelic drugs in the treatment of mental health problems is increasingly being recognized. However, relatively little thrust has been given to the suggestion that individuals without any mental health problems may benefit from using psychedelic drugs, and that they may have a right to do so. This review considers contemporary research into the use of psychedelic drugs in healthy individuals, including neurobiological and subjective effects. In line with findings suggesting positive effects in the treatment of mental health problems, such research highlights the potential of psychedelic drugs for the enhancement of wellbeing even in healthy individuals. The relatively low risk associated with usage does not appear to align with stringent drug laws that impose heavy penalties for their use. Some policy implications, and suggestions for future research, are considered.
Keywords : Psychedelics, ayahuasca, psilocybin, DMT, LSD, drug policy, drug use, healthy participants
Researchers and clinicians are becoming increasingly open to the possibility that psychedelic drugs might prove useful in the treatment of mental health problems. Studies conducted primarily in the 1950s and 1960s furnished a wealth of (methodologically imperfect) clinical findings to suggest beneficial effects of psychedelic drugs in the treatment of mood, anxiety, and addictive disorders (Grinspoon and Bakalar, 1979; Sessa, 2005). However, due to highly restrictive drug laws that effectively foreclosed research into psychedelic drugs in the 1960s, their possible benefits have been widely overlooked (Nutt et al., 2013). More recent studies have begun to corroborate the suggestion that treatments involving psychedelic drugs may be effective in the alleviation of a range of mental health problems (see Vollenweider and Kometer, 2010 for a review). In light of such findings, several authors have argued for changes in drug policy in order to facilitate basic research and treatment innovation regarding psychedelics (Gross, 2013; Nutt et al., 2013).
However, relatively little thrust has been given to the argument that even healthy individuals can experience considerable benefits from consuming psychedelics, and that they may have a right to experience these (Walsh, 2016). Bioethical discussion of the use of drugs in the healthy population to improve wellbeing has typically focused on the use of pharmaceuticals such as selective serotonin reuptake inhibitors (SSRIs) and other antidepressants as a means of improving mood (Kramer, 1993; Schermer, 2015). Either through the true lack of effects or due to inadequate research designs, evidence
for strong mood enhancing effects of such substances in healthy individuals is scarce (Ilieva, 2015; Repantis et al., 2009). Without evidence for clear effects, and with the necessity for relatively long-term, daily usage before any such effects are likely to be apparent (Harmer, 2008), coupled with the possibility of unpleasant side effects further deterring usage, it seems unlikely that a large number of otherwise healthy individuals would seek to use these pharmaceuticals for the purpose of improving their lives. In contrast, over 30 million people in the United States are estimated to have experimented with psychedelic drugs (Krebs and Johansen, 2013a), and with new research garnering considerable attention and suggesting positive effects, it seems possible that more individuals may seek out psychedelic
experiences. Use of psychedelic drugs in this way may prompt not only bioethical, but legal discussions. It is essential that such discussions proceed in a way that takes current scientific research into account.
The purpose of this review is to provide an up to date overview of current knowledge regarding psychedelic drug effects in healthy individuals, with the hope of grounding future discussion of psychedelics in the existing evidence base. I first describe the psychedelic state and present research on its neurobiological underpinnings. I then review contemporary research on the effects of psychedelic drugs in healthy individuals. This is followed by consideration of possible adverse effects. Finally, I consider some implications of such research for drug policy.