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Psychedelic drugs are still classified as Schedule 1 drugs, or drugs with no current accepted medical use and a high potential for abuse. But as regulations around these drugs are beginning to loosen, they’re becoming accepted treatments for a host of mental health issues—and fueling what many call a psychedelic renaissance.
Compass Pathways is one of the main biotech companies investing in research on psychedelics and hoping to cash in on their potential benefits for mental health. But Compass is certainly not alone. The market for psychedelics is growing exponentially, and some estimate the industry could be worth $10 billion in just a few years. A number of other pharmaceutical companies are hoping to find a cure for an array of mental health ailments, such as depression, end of life anxiety, and PTSD, thus replacing costly prescriptions for what they argue are ineffective drugs.
On Sunday’s Episode of What Next: TBD, I spoke with writer John Semley, who covers psychedelics and the pharmaceutical industry, about big pharma’s push into psychedelics—and the promises and critiques it carries. Our conversation has been edited and condensed for clarity.
Sonari Glinton: This new psychedelic renaissance has opened up the possibility of treatment for all kinds of mental ailments. Where could psychedelics potentially make a difference?
John Semley: I’ve heard everything under the sun, but the most serious indications have been for using MDMA to treat PTSD. The second idea is psilocybin [the active psychedelic ingredient in magic mushrooms] for depression. Psilocybin has proved pretty effective in treating end-of-life anxiety, which is people who have terminal diagnoses, who can’t get out of bed, who have crippling anxiety. They do a magic mushroom trip, and suddenly they feel that anxiety lifted. They can connect with their friends; they connect with their family. It doesn’t fix their stage four cancer, but it allows them to live out the last couple months of their life in relative peace and harmony.
Psychedelic therapy involves taking a managed amount of a psychedelic under supervision, and then processing what you’re experiencing with a professional. What’s the benefit of this?
People report all kinds of hallucinations, visuals, deep emotional feelings that they were not able to access—a sort of therapeutic, cathartic feeling by the end of it. A lot of people report drastic change. One thing that’s interesting is people might have the trip and be like, “Oh, that was weird, but it doesn’t really make sense to me.” But then maybe a couple weeks later, things will kind of click into place. Or they’ll find that they’re thinking about things differently. They’ll find that their mental state has shifted, without it necessarily being this light bulb, “Eureka, I’m cured,” and then leaping out of the bed.
Many people associate psychedelic drugs with the underground—but it wasn’t always like that. Researchers were examining psychedelics decades ago, until the law told them not to. What role have underground players had in the big pharma resurgence of psychedelics?
The Controlled Substances Act in the early 1970s made it far more difficult for scientists, for chemists, for researchers to get their hands on these drugs, to be able to conduct serious research around them. I think, to a certain extent, serious research had also been affected by the cultural perception of these drugs. For decades, the bulk of serious research was happening in the underground. I know some chemists these days who served jail time for manufacturing LSD, who are now consulting with psychedelics companies. But I think if anyone deserves to benefit from this new boon and the money coming into the psychedelic space, it’s people who not only propagated the taste and the widespread interest in a lot of these drugs, but who risked life and limb doing so.
A big tension in your recent WIRED piece deals with the for-profit nature of a lot of these companies. Can you talk a little more about that?
They’re essentially playing by the big pharma handbook, and big pharma doesn’t have a ton of fans. Nobody wants to see the magic mushroom Martin Shkreli showing up in the psychedelic space. Now, specifically with Compass Pathways, they were coming under fire because people were claiming, firstly, that they were trying to patent psilocybin, which is a thing that abounds in nature, and also that they were trying to patent sort of discrete elements of psychedelic therapy that were well known and were sort of shop-worn hippie wisdom. When you see patent land grabs, when you see corporations and big money coming into this space, it just scrapes against those values. If you want to say that these drugs were originally valued—at least in the ‘60s—as a form of escape from a corporate-eye, straight-laced, capitalist world, seeing them incorporated within that world just rubs people the wrong way. It just doesn’t jive, as one person says in my story. The other thing is that for many people, [psychedelics] facilitate feelings of love and togetherness and equality, and a sort of corporatized, capitalist model stands fundamentally opposed to that.
Where are we at in terms of government regulation of these drugs?
Oregon, for example, has psilocybin therapy that you can take legally. Colorado is putting a ballot measure in November for a similar model that seems pretty likely to pass. The Biden administration is putting together a task force to sort of fast-track therapies for MDMA and psilocybin. I think we will see a lot of this stuff being much more accessible within two years.
This is expected to be a $10 billion industry, and you can’t have capitalism without insurance. Where are the insurance companies at in this conversation?
As I understand it, insurance providers are the hottest under the collar for psychedelic therapies, because $10,000 for a magic mushroom treatment is nothing compared to putting someone on Zoloft or an anti-anxiety or an ADHD drug every day and having to pay for those [prescriptions] week after week. So even though, yeah, if you were to go out of pocket and pay $10,000 to take magic mushrooms, especially when you can get the same amount of magic mushrooms on the street for 75 bucks, I think people would say that seems weird. But from the insurance perspective, the total lifetime cost for a patient is going to be drastically less than the current psychopharmacological interventions.
One potential drawback in the current market is misinformation about what psychedelics can actually do. Some startups are claiming that psychedelics can cure almost everything, with little research to back them up. How can we sort through what to believe?
I think right now we’re still at the discovery stage, and the more things being investigated the better. I do think, fundamentally, this explosion in money in this space—the ceiling is already coming down. A lot of these big companies have lost 50 percent of their value since they went public, precisely because people just bought into the hype.
If you’re getting into this hoping to just make money, you need a bit of patience. I think probably 90 percent of these newcomers to the scene won’t exist in five years. I spoke to a chemist a while ago, a guy who knows more about LSD than anyone I’ve ever spoken to. And he goes, “I have all these meetings with these people. I would say 90 percent of the things you can use LSD for are never going to work. But if they’re going to pay us to investigate it, why not investigate it?”
State of Mind is a partnership of Slate and Arizona State University that offers a practical look at our mental health system—and how to make it better.