This was originally an essay I wrote for an assignment on the topic of neuroethics. I’ve posted it here because a friend was interested in reading it. Sorry if the style is a little drier than my usual stuff.
Clinical Neurohacking: Ethics of the Availability of Psychedelic-Assisted Therapy
Humans have been using psychedelic drugs for centuries – recreationally, ritualistically, and therapeutically. The last decade, however, has given rise to the practice of “neurohacking”: personal application of brain stimulation for the purpose of self-improvement (Wexler, 2017). A subset of neurohacking involves microdoses of both legal and illegal drugs, some of which are known psychedelics. The intention is to change the practitioner’s brain functions, either for a temporary boost in creativity or productivity, or a more permanent positive change (Wexler, 2017). Neurohacking, of a sort, is practiced commonly to treat psychiatric disorders using prescription mood-stabilizing or -altering drugs. However, psychedelics – despite their potent effects on the brain – are not commonly used for this purpose due to their legal status in developed nations. In this paper, I argue that the illegality of potentially beneficial psychedelic substances hinders psychiatric research and prevents some sufferers of psychiatric disorders from receiving the help they need – an unethical situation. I will touch on the historical reasoning for the restriction of certain substances, modern research showing their beneficial therapeutic use, and discuss arguments supporting their decriminalization.
In Canada, some substances occupy a semi-legal gray area. For example, possession of Psilocybin (i.e., magic) mushrooms is illegal without a prescription or license, as is their sale and transport, but the sale of microdoses is rarely prosecuted and the purchase of spores and grow kits is legal (Canada Legislative Services Branch [CLSB], 2019). The same is true of lysergic acid diethylamide (LSD) – both are psychedelics that are prohibited by Schedule III of the Canadian Controlled Drugs and Substances Act (CLSB, 2019). Both substances were added as a result of the UN Convention on Psychotropic Substances in 1971, and have remained there since (Ninnemann & Andersen, 2011). The Convention originally listed both LSD and tetrahydrocannabinol (THC) as Schedule I drugs, due to their perceived threat to public health and lack of therapeutic value (Ninnemann & Andersen, 2011). This made legal exceptions for research difficult to acquire, meaning that these substances are likely understudied and their effects not yet fully explored (Nutt, 2016).
Although research has been historically hindered by legal issues, there is still a body of knowledge regarding the use of psychedelics both recreationally and therapeutically. This body continues to grow as the beneficial effects of psychedelic use, particularly in combination with cognitive behavioural therapy, shows its face (Aday et al., 2020). When considering psilocybin, research results have shown “enduring changes in personality/attitudes, depression, spirituality, anxiety, wellbeing, substance misuse, meditative practices, and mindfulness”, with only limited aversive side effects (Aday et al., 2020, pg 2). When used in a clinical setting, 3,4-methylenedioxymethamphetamine (MDMA) and ketamine have been demonstrated to significantly reduce symptoms of PTSD in only a few sessions (Krediet et al., 2020). Usage safety can be supported through controlling both their administration and surrounding environment (Krediet et al., 2020). There is still a long way to go and an uphill legal battle, but we may one day see small doses of psychedelics as an important psychiatric treatment option.
As demonstrated by this research, the rationale for the illegality of drugs such as psilocybin is not necessarily supported by empirical evidence. At least, the idea that they should be illegal because their use is inherently dangerous is contradicted. Appropriately small doses in safe, controlled environments have shown no overt harms (Goodwin, 2016). As the body of research grows, the fear of these substances should shrink. Responsible use, then, becomes a question of education instead of one of legality. The fairly recent Canadian decriminalization of cannabis shows that attitudes can shift, and laws can change without causing societal collapse. Similar to the medical uses of cannabis, the growing evidence of therapeutic uses of psychedelic drugs means that eventually we may need to reconsider their legality. A PTSD sufferer should not be deprived of a treatment modality with long-lasting positive effects simply because of legal historical baggage.
But history marches onward, and research on illegal drugs happens, albeit more slowly than on legal ones. It appears that psychedelics could have benefits that we have ignored for almost half a century due to their legal constraints. Refusing to reevaluate the legal status of some of these drugs is doing a great disservice to the people that they could be helping. Regulating their recreational use could be done while still allowing their responsible, therapeutic use. The longer we take to make these changes, the more people needlessly suffer from symptoms that may be treatable through clinical neurohacking.
Aday, J. S., Mitzkovitz, C. M., Bloesch, E. K., Davoli, C. C., & Davis, A. K. (2020). Long-term effects of psychedelic drugs: A systematic review. Neuroscience and Biobehavioral Reviews, doi:10.1016/j.neubiorev.2020.03.017
Canada Legislative Services Branch. (2019). Consolidated Federal Laws of Canada, Controlled Drug and Substances Act, Schedule III. Retrieved from the Canada Legislative Services Branch https://laws-lois.justice.gc.ca/eng/acts/C-38.8/section-sched95602.html
Goodwin, G. M. (2016). Psilocybin: Psychotherapy or drug? Journal of Psychopharmacology, 30(12), 1201-1202. doi:10.1177/0269881116675757
Krediet, E., Bostoen, T., Breeksema, J., van Schagen, A., Passie, T., & Vermetten, E. (2020). Reviewing the potential of psychedelics for the treatment of PTSD. The International Journal of Neuropsychopharmacology, doi:10.1093/ijnp/pyaa018
Ninnemann, A., Stuart, G. & Andersen, S. (2011). Convention on psychotropic substances, 1971. In M. A. Kleiman & J. E. Hawdon (Eds.), Encyclopedia of drug policy (Vol. 1, pp. 170-171). Thousand Oaks, CA: SAGE Publications, Inc. doi:10.4135/9781412976961.n78
Nutt, D. (2015). Illegal drugs laws: Clearing a 50-year-old obstacle to research. PLoS Biology, 13(1), e1002047. doi:10.1371/journal.pbio.1002047
Wexler, A. (2017). The social context of “do-it-yourself” brain stimulation: Neurohackers, biohackers, and lifehackers. Frontiers in Human Neuroscience, 11, 224. doi:10.3389/fnhum.2017.00224