Getting off the merry-go-round

Today's post is about the outcome of last week's election -- but a part of it you might not have heard about, given the media furore surrounding the race for president.

Last week Oregon became the first state to legalize psilocybin -- more commonly known as "magic mushrooms."

[Image licensed under the Creative Commons Arp, Psilocybe semilanceata 6514, CC BY-SA 3.0]

The change came about because of a pair of bills, Measure 109 and Measure 110, which (respectively) made the use of psilocybin legal in a therapeutic setting, including for reasons of "personal growth" (i.e. not to treat a specific condition), and decriminalized the possession of small amounts of a wide range of drugs, making it a minor non-criminal offense on par with a traffic ticket.  I'm not going to get into the second measure, by far the more controversial, except to say that Portugal did the same thing in 2001, diverting the money that would have been spent prosecuting and jailing drug users into treatment programs, and saw voluntary addiction treatment rates rise, and drug use amongst adolescents and deaths due to overdose both decline precipitously.

But passage of the psilocybin measure made me say, "About damn time."  Psilocybin was declared a "Schedule I drug" in 1970, meaning it was claimed to have "a high potential for abuse," "no currently accepted medical use," and "a lack of accepted safety."

All of which, in fact, turned out to be false.  It's non-addictive, rarely if ever causes deleterious side effects, and its efficacy for treating depression has been known for years.  Study after study has come out providing evidence that psilocybin works; so many that it's beginning to sound like the studies disproving the vaccination/autism connection, repeating the same protocol over and over, getting the same result, and saying, "SEE, WE TOLD YOU, IT HAPPENED AGAIN.  BELIEVE US NOW?"

In fact, just last week a study came out in the Journal of the American Medical Association showing that one or two administrations of psilocybin, in a controlled setting, triggered remission of the symptoms of treatment-resistant major depressive disorder for months, possibly years.

This kind of thing is a godsend, because the current state of treatment methodologies for depression resembles a blindfolded game of darts.  I went through three years of considerable hell trying to find an antidepressant that (1) actually mitigated my depression, and (2) didn't give me miserable side effects.  The frustrating part is that an antidepressant that works brilliantly for one person might not work at all for someone else, and no one knows why.  The first two I tried, citalopram (Celexa) and escitalopram (Lexapro), both made me sleepy and completely wiped out my sex drive.  The second one, lamotrigine (Lamictal) gave me thermonuclear-level acid reflux.  The worst was sertraline (Zoloft), which I know is a game-changer for some people, but made me feel like I was at the middle of a neural lightning storm.  I couldn't sit still, couldn't sleep, and couldn't stop out-of-control thoughts that included suicidal ideation.

I got off that stuff fast.

I was on the verge of giving up, but my doctor recommended trying one more, bupropion (Welbutrin).  Welbutrin doesn't give me side effects, which is kind of awesome.  I wouldn't say it erases my depression -- none of them really do that, pretty much for anyone -- but it blunts the edge of the worst of it.  On Welbutrin I don't have the crashing lows I used to get, and have experienced with clocklike regularity every four or five months for pretty much my entire adult life.

On the other hand, if psilocybin works for you (which it does for the vast majority), it works.  People report complete remission of symptoms, something I can't honestly imagine.  Best of all, it only takes one dose to get long-term positive effects.  

I take Welbutrin every day; for me it's a maintenance med.  The idea that I could take one dose of something and get off the merry-go-round of self-medication, to be able to throw away the little orange bottle I have to carry around with me when I travel, is incredibly appealing.

I find it somewhere between absurd and appalling that the government has dragged its heels on decriminalizing psilocybin and authorizing its use as a therapeutic.  Okay, fine, regulate it; allow it only under a doctor's orders and a doctor's care.  We can argue about whether recreational drugs should be legal another time.  But here we have something that could dramatically improve the lives of an estimated eighteen million people in the United States -- about seven percent of the population -- addressing the main reason for the sky-high suicide rate, averaging one person choosing to end his/her own life every twelve minutes.

Would I try it?

Damn right I would.  In a heartbeat.

I know whereof I speak about this.  I'm lucky to be alive.  I attempted suicide twice, ages seventeen and twenty, only pulling back from going through with it at the last minute out of fear.  I had another serious period of pretty much continuous suicidal ideation in my mid-thirties, and that time was saved by the knowledge of what it would have done to my kids.  I still struggle some days, but with the love and care of my wife and friends, and a medication that takes away the deepest lows, I'm on an even keel most of the time.  But the worst of what I've experienced I wouldn't wish on anyone, and it's unconscionable that our government is creeping along in addressing a disorder that is a direct contributor to the horrifying statistic that suicide is the second leading cause of death in the United States of people between the ages of ten and twenty-four, and the tenth leading cause of death overall.

It's time to start pushing our leaders into doing something, into following Oregon's lead, and into getting correct information to voters that "decriminalizing drugs" doesn't mean "encouraging everyone to become an addict."  That all current Schedule I drugs aren't the same -- lumping heroin, marijuana, ecstasy, and psilocybin in the same category is somewhere between scientifically inaccurate and downright idiotic.  That people with major depressive disorder should have a choice to try something showing tremendous promise not as a maintenance treatment, but something damn close to a cure.

Please write letters, make calls, get involved.  It could change lives.  Hell, it could save lives.  And I'll end with doing something I rarely do: ask my readers to share this post.  Link it, retweet or repost it, email it.  The word needs to get out there.

If we can get one person out from under the black shadow of depression, help one person to step out into the light, it'll be worth it.

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This week's Skeptophilia book-of-the-week is about our much maligned and poorly-understood cousins, the Neanderthals.

In Rebecca Wragg Sykes's new book Kindred: Neanderthal Life, Love, Death, and Art we learn that our comic-book picture of these prehistoric relatives of Homo sapiens were far from the primitive, leopard-skin-wearing brutes depicted in movies and fiction.  They had culture -- they made amazingly evocative and sophisticated art, buried their dead with rituals we can still see traces of, and most likely had both music and language.  Interestingly, they interbred with more modern Homo sapiens over a long period of time -- DNA analysis of humans today show that a great many of us (myself included) carry around significant numbers of Neanderthal genetic markers.

It's a revealing look at our nearest recent relatives, who were the dominant primate species in the northern parts of Eurasia for a hundred thousand years.  If you want to find out more about these mysterious hominins -- some of whom were our direct ancestors -- you need to read Sykes's book.  It's brilliant.

[Note: if you purchase this book using the image/link below, part of the proceeds goes to support Skeptophilia!]

Devil's advocate

New from the "Not Poe's Law" Department, we have: some evangelical Christians who are concerned that demons are now "legally allowed to be" in Denver, Colorado.

I'm not making this up, but I wish I was.  Christian Post, which is usually marginally sane even if virulently anti-LGBTQ, posted a piece last week by Brandon Showalter that expressed concern for the legalization of "magic mushrooms" in the city.  And the problem, Showalter says, isn't just over what people might do when they're high; it's that this makes it legal for demons to get in:

The city of Denver is set to decriminalize psychedelic mushrooms, a move a former drug addict says is opening the city up to demonic activity, just as it does in the life of a drug user...  Seattle-area restaurant manager Shannon Twogood, who is the incoming president of the ministry Hope for Addiction and Dependencies (HAD) in Gig Harbor, Washington, believes that the spiritual ramifications that come with the use of potent drugs are often absent in discussions about legalization...  Policies like what will likely be implemented in Colorado may help a few people but it fails to consider the larger picture for the community, and the social ills that are invited in as a result which will require cleaning up later, she stressed, adding that culture cannot open doors for the demonic realm under the guise of "care" for anything. 

The Greek word for sorcery in the Bible is "pharmakeia," from which the word pharmacy is derived. 

When Twogood learned that, it transformed how she saw drug use, particularly given how occult practices and witchcraft often involve the smoking of illicit substances or using them to make teas and potions that cause hallucination. 

She now teaches in prisons and centers for recovering addicts that it is important to understand that they are operating in the courtroom of heaven, that God is the judge and Jesus is our intercessor and advocate.  Until the sin of drug use is repented from, the demons are legally allowed to be there through the open door of drug use.

Well, first of all, let's clear up the etymological issue.  Yes, φάρμακον can mean "poison" or "enchanted potion."  The problem is, it also means "medicine," "drug," and "dye."  Implying that pharmaceuticals are somehow evil because the word root once meant "magic spell" is as idiotic as thinking that someone left-handed is sinister.  (Yes, that's actually the root of the word "sinister."  And, as much as it pains me to admit it, there are people who say we should avoid medications because pharmacies are literally sorcery -- based solely on the fact that they share a common etymology.)

The Temptation of Saint Anthony (Martin Schöngauer, ca. 1485) [Image is in the Public Domain]

But what puzzles me most about Showalter's article is the whole thing about demons being legally allowed to enter Denver.  Since when do demons care about laws?  Aren't they demons because they don't give a shit about sinning and breaking rules and so on?

Lucifer:  Ha ha!  We shall enter Milwaukee and possess its inhabitants!  They shall suffer the fires of hell! 

Beelzebub:  Um, boss?  We can't do that.  Milwaukee has a strict no-demon policy. 

Lucifer:  Dammit!  I hate it when that happens!  Perhaps we should attack Denver instead. 

Beelzebub:  No problem there.

In all seriousness, there's a piece of this that pisses me right off, and that's the implication that all illegal drugs are equally bad.  This is especially egregious in this case, because psilocybin -- the active ingredient in "magic mushrooms" -- has shown tremendous promise in ameliorating treatment-resistant depression.  As a person who has suffered from depression my whole adult life, and for whom medication and therapy have had equivocal results at best, I would take psilocybin in a heartbeat.  The idea that these people are adding yet another layer to peel back before the medical establishment will be able to use this chemical to help people for whom nothing else has worked is profoundly infuriating.

But there you have it.  The legalization of drugs and/or demons.  It's getting so I can't tell the actual websites these people create and the ones that are parodies.  Or maybe that's just the legal demons clouding my mind.  You can see how that could happen.

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When the brilliant British neurologist and author Oliver Sacks died in August of 2015, he was working on a collection of essays that delved into some of the deepest issues scientists consider: evolution, creativity, memory, time, and experience.  A year and a half ago, that collection was published under the title The River of Consciousness, and in it he explores those weighty topics with his characteristic humor, insight, and self-deprecating humility.

Those of us who were captivated by earlier works such as The Man Who Mistook His Wife for a Hat, Musicophilia, Awakenings, and Everything in its Place will be thrilled by this book -- the last thoughts of one of the best thinkers of our time.

[Note:  If you purchase this book using the image/link below, part of the proceeds goes to support Skeptophilia!]

Psychedelic uplift

In a study released last week by a team of psychologists working at the University of British Columbia, we find that in an extensive survey of 1,266 men from the ages of 16 to 70, guys who had used psychedelic drugs (specifically LSD or psilocybin) had a statistically significant lower likelihood of abusing their partners.

In "Psychedelic Use and Intimate Partner Violence: The Role of Emotion Regulation," by Michelle S. Thiessen, Zach Walsh, Brian M. Bird, and Adele Lafrance, the authors write:

Males reporting any experience using lysergic acid diethylamide and/or psilocybin mushrooms had decreased odds of perpetrating physical violence against their current partner (odds ratio=0.42, p<0.05).  Furthermore, our analyses revealed that male psychedelic users reported better emotion regulation when compared to males with no history of psychedelic use.  Better emotion regulation mediated the relationship between psychedelic use and lower perpetration of intimate partner violence.

Given the role of psychedelics in changing levels of activity of serotonin -- a major mood-regulating neurotransmitter -- it's unsurprising that this correlation exists.

[Image licensed under the Creative Commons: This image was created by user Caleb Brown (Joust) at Mushroom Observer, a source for mycological images.You can contact this user here., 2013-10-22 Psilocybe cyanescens Wakef 378614, CC BY-SA 3.0]

What is more surprising is that apparently, it only takes one use.  Consider, too, that one use of another psychedelic drug -- ketamine -- has been found to relieve many cases of intractable depression, acting in as little as thirty minutes and providing dramatic improvements that last for months.

If you've checked out the links, you may have noticed that none of these studies took place in the United States.  The first one was done (as I mentioned) in Canada; the research on ketamine was the result of two studies done in China.  Here in the United States it's extraordinarily difficult even for neuroscientists to obtain permission to experiment with psychotropic drugs, and there's been strong resistance to easing up these regulations by a group I can only describe as being the Morality Police.  Odd, isn't it, that alcohol -- a clearly mood-altering drug that is responsible for (by estimates from the National Institute of Health) 88,000 deaths yearly -- is legal.  Tobacco, which kills even more than that, is not only legal but is federally subsidized.

Psychedelics are unequivocally illegal in all fifty states.  At least some motion forward has happened with marijuana, which has been known for years not only to be effective for pain relief in terminal cancer patients, but has shown promise as an anti-anxiety medication.  The problem seems to be that marijuana and psychedelics have both become associated with recreational use, and I guess there's a sense that therapeutic agents shouldn't be fun.

I dunno.  Maybe there's a better reason, but if so I've never been able to figure it out.  It seems to me that careful administration of chemicals that can potentially alleviate depression and anxiety shouldn't be dependent on people moralizing about what amounts to this century's version of Demon Rum.

This is brought into sharper relief by the suicide last week of Kate Spade and Anthony Bourdain.  Depression is reaching epidemic proportions.  I use the word "epidemic" deliberately, and not as hyperbole.  Another study, released just three days ago by the US Center for Disease Control, has found that since 1999 there's been a thirty percent increase in suicides in the United States.  Only one state -- Nevada -- had a decrease, and that was by only one percent.  Twelve states had an increase of between 38% and 58%.  The result -- suicide has become the third highest cause of death, and is so frequent it's actually contributed to a statistically significant drop in American life expectancy.

This is a personal one for me.  As I've mentioned before in Skeptophilia, I've suffered from moderate to severe depression and serious social anxiety for as long as I can recall.  The depression is being controlled reasonably well by medication; the anxiety is still a work in progress.  But if I could knock out my depression -- potentially get off antidepressants permanently -- by one hit of ketamine, one use of LSD or psilocybin -- I'd do it in a heartbeat.  And I'd like to hear, if any of my readers are in the no-way-no-how column of the legalization controversy, a cogent argument about why I should not be allowed to do that.

Interestingly, I was asked that very question by one of my oldest friends, even before the tragic suicides of Kate Spade and Anthony Bourdain.  Would I be willing to try it?  Would I do so even before it was legalized?  My answer was an unequivocal yes.  Given a reasonable dosage, and friends to make sure I didn't do anything stupid while high, what exactly would be the risk?  Speaking perfectly honestly, if a 57-year-old middle-class science nerd with no social life had any access to the chemicals in question, I'd already have done it.

Perhaps we're waking up, though.  Like I said, there is an increasing push to legalize certain drugs, and that's encouraging.  (Nota bene: I'm not saying these drugs should be completely unregulated.  There are very good reasons for keeping them away from children, and for making sure that they're not used before someone gets behind the wheel of a car.  But if we can handle those challenges with alcohol, we can handle them with other chemicals.)  It's to be hoped that we'll see reason -- and potentially do something to alleviate the suffering of people whose illnesses have heretofore been essentially untreatable.

And maybe, in the process, reduce some of those suicide numbers, which are absolutely horrifying.

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This week's Skeptophilia book recommendation is a classic: the late Oliver Sacks's The Man Who Mistook His Wife for a Hat.  It's required reading for anyone who is interested in the inner workings of the human mind, and highlights how fragile our perceptual apparatus is -- and how even minor changes in our nervous systems can result in our interacting with the world in what appear from the outside to be completely bizarre ways.  Broken up into short vignettes about actual patients Sacks worked with, it's a quick and completely fascinating read.