Using drugs for good

with Dr George Greer, Heffter Research Institute, Dr Charles Grob, Univeristy of California Los Angeles

Research into medical uses for certain illegal drugs has been picking up pace in

the past few years. But there are still a number of barriers, this means that globally the amount of work in this area is minimal. George Greer is the medical director of the Heffter Research Institute in the United States and he explained to Connie Orbach why psychedelic drug research is such an underfunded area...

George - We there's a couple of problems: one is these drugs cannot be patented so there's no commercial interest in investment, so the drugs are too late to get a patent

Governments, with the exception of the UK, have been reluctant to fund this research, and we can all speculate why, but I assume it's because they're schedule 1 abused is part of the mindset. So that's the biggest limiting is the lack of government funding which means the lack of researchers who can expect to be funded for a career, so they have to do other research for their career path that has more stable funding.

And then being schedule 1 does create more expense by having to go through more hoops because of the drug enforcement agencies which require security and paperwork and that sort of thing. So that's an inhibition too and just the stigma that people think these drugs are bad. So there's a lot to overcome.

Connie - Schedule 1 is a class of drug that is deemed to have high abuse potential and no medical use. Drugs that sit in this category vary from country to country, but in the USA they are things like heroin, LSD, marijuana, MDMA, and a whole host of other obscure things.

But, by putting these substances into schedule 1, a sort of catch 22 is created. Drugs that have no medical use are under harsher restrictions making them harder to research, therefore, making it more difficult to determine any medical use for them.

This has stifled research for a long time but, luckily, things are changing...

Charles - An opportunity arose at the beginning of the early 90s to do research investigations on normal volunteers - that was the first opening.

I had the second permitted study, which was with MDMA at Harbor-UCLA Medical Centre. Once we established the feasibility, our group and other groups were able in the early 2000s to obtain regulatory approvals to conduct clinical research in a population that was presenting because of a particular psychiatric condition.

Connie - That's Charles Grob from UCLA and, despite the difficulties, he's been researching possible medical uses for section 1 drugs for years. One particular study, funded by Heffter of course, examined the potential of psilocybin, that's the thing that makes magic mushrooms so magical, to treat extreme anxiety in cancer patients.

Charles - They were provided a number of screenings and also preparatory psychotherapy sessions. They came in for two separate treatment sessions; one session was active medicine psilocybin, another session was a placebo.

We sat with them for the entire 6-8 hour psilocybin experience and afterward, we did some rather intensive integrative psychotherapy sessions to help them assimilate their experiences. And then we followed them for the next six months just examining their anxiety, their mood, other aspects of their quality of life, and we found very good results.

We found that, over time, there is a significant improvement in levels of anxiety at particular points in time. And, having got to know many of these subject quite well, we also observed that there were clear and distinct improvements in their quality of life in the time they had remaining.

Connie - And you're now working on, actually not a hallucinogenic, but MDMA or ecstasy?

Charles - Yes, MDMA is related to hallucinogens but with clearly distinctive differences and is really in a different class altogether. We've had a study going for the past two years where we've had permission to treat a population of autistic adults who have severe, and often incapacitating, social anxiety with an MDMA treatment model.

We haven't quite finished the study; we're still looking to recruit two final subjects so we haven't done our final data analysis. But just having gotten to know our subjects very well and having been in the room for all of the treatments, it's my impression that we will observe some positive results that this treatment model may have merits when utilised under optimally safe conditions.

Connie - So it sounds like what we're talking about with both the psilocybin and also this one is real changes in quality of life?

Charles - Yes, absolutely! A clear observation in all of the studies done with psilocybin and MDMA over the last 12-15 years.

Connie - So clearly things are moving on but it does may be think. I mean this sounds a bit of a faff. How feasible is it really to give controlled substances to people? Here's George again...

George - Psilocybin - it's never going to be a drug that a person is sent home with a prescription or sent home with capsules of psilocybin because they always have to use it with supervision. So, in terms of distribution it's only going to the clinics who are administering the drug. It's a big procedure, you know, that takes many meetings and none of that is because it's a schedule 1 drug, that's all because of just the effects of the drug.

Connie - But still, either way, any drug that requires this amount of supervision seems a little unfeasible..

George - Yes, but the benefits that we're seeing with one or two sessions can last for weeks or months as opposed to taking a drug every day.

Connie - I guess my other question is - if it's so difficult to study these things, if there's so little funding, for researchers there's a lot of work they have to go through - why aren't we focusing our attention on maybe pre-existing drugs for anxiety which aren't within this section 1 area?

George - Drug companies are doing that all the time; they're researching and looking for new drugs that are similar to the ones that we have on the market now. In psilocybin, because it works in a different way, it has an effect that the current drugs like them are not going to have because they all require daily use.

Connie - So given all this, so given that these drugs act in a different way that isn't actually available on the market, does it make you sad that we've potentially been sitting on these drugs for a long time and not used them as early as we could, maybe, when we knew that they could be effective?

George - Well sure. I mean, I think those of us in the field have gone through that grief process a long time ago of the loss of these decades that people could have been helped and much more could have been learned, and we're focused on going forward and doing the research which is being done now and private people are coming forward to pay for it. So I think the mood amongst the research community is very positive though recognising soberly that there are going to be frustrations and difficulties, and stops and starts, but I think people are all feeling very optimistic that this is going to start benefiting people in the next several years, certainly by 10 years. I think Europe, the US, and the UK, these will be available treatments for people.