Researchers in Switzerland have completed a controlled study on the effective use of lysergic diethylamide (LSD) for end of life treatment; the first such trial undertaken using LSD in forty years. The study used a randomized double-blind protocol to study safety and effectiveness of LSD-assisted psychotherapy for the reduction of anxiety in 12 patients nearing end of life. The patients underwent drug-free psychotherapy sessions, as well as two LSD-assisted sessions spaced two to three weeks apart. Eight participants received either 200 mcg of LSD – the experimental dose – or 20 mcg of LSD as an active placebo. Peter Gasser, the Swiss psychiatrist leading the investigation, and his colleagues, found a 20 percent improvement in standard measures of anxiety in the subjects who received the full dose. The negative control patients (i.e. those who received the placebo dose) got worse. The findings persisted for a year in the patients who survived. The researchers published their results in a recent article in the “Journal of Nervous and Mental Disease.”
LSD, a psychoactive drug first synthesized in 1938 by Swiss chemist Albert Hofmann, produces vivid hallucinations, enhanced sensory perception, synesthesia, intensified affectivity, among many other effects. The altered conscious state has been compared with daydreaming, but with profound affectivity and enhanced inner stimuli and can last for six to 18 hours.
The tumultuous history of LSD can be broken down broadly into three main chapters.
The first chapter…
…is longest in duration, but easiest to summarize, and comparatively least well documented. Long before LSD was invented, shamans in indigenous cultures were using hallucinogenic substances in ritualized context for thousands of years; their religious significance is well established in anthropological and modern accountings. An element of shamanic practice relevant to this topic includes the guiding of the souls of the dead to their proper abode. Native Americans make use of psilocybin, a psychoactive similar to LSD, in religious rituals and in their healing practices.
The second chapter…
In modern times, although not specifically used for end of life treatment, LSD-assisted psychotherapy was extensively explored as an investigational drug for psychiatric research, and found effective for the treatment of alcoholism, depression, neurosis, obsessive compulsive disorder, PTSD and psychosomatic disorders. In Southern California in the early 1950s and 60s, notables such as Cary Grant, Anaïs Nin, Alan Watts, Aldous Huxley, Jack Nicholson, Rita Moreno, Andre Previn, and many others took part in studies involving the legal use of LSD under the supervision of a psychiatrist and making use of the drug in acid salons. Research involving psychedelic drugs administered to approximately 40,000 patients was performed in several countries; dozens of books were written, and six international conferences were held on its use; nearly 1000 peer-reviewed clinical papers were published by the mid-1960s.
Around this time, the US Central Intelligence Agency was conducting experiments involving the use of LSD to develop techniques of mind control in the notorious MK Ultra program. The subjects of these experiments were often dosed without their knowledge or consent (a violation of the Nuremberg Code), and included mental patients, drug addicts, prostitutes, and prisoners. LSD was also tested on CIA employees, military personnel, government agents, doctors, and the general public, frequently with tragic consequences. The CIA was primarily interested in the potential to distort a person’s basic loyalties, for example, encouraging defectors from the Soviet Union.
The third chapter…
In the 1960s, the acid underground surfaced in San Francisco in the form of the hippie movement. Ken Kesey, author of One Flew Over the Cuckoo’s Nest, was a volunteer in MK Ultra experiments on LSD as a student at Stanford University. Kesey was then inspired to promote recreational use of the drug leading to the development of hippie culture.
Robert Hunter, a lyricist, translator, poet, and singer-songwriter associated with Jerry Garcia and the Grateful Dead, was also an early volunteer in the MK Ultra tests at Stanford University, and considered his experiences formative and inspiring to his creative work. Timothy Leary, noted psychedelic researcher, saw the potential for hallucinogens to alter an individual’s fundamental personality structure or subjective value-system, for beneficial purposes. He experimented with prison inmates to attempt to reduce recidivism in short, intense sessions of psilocybin use along with biweekly group therapy sessions.
The mid-sixties saw a backlash against the use of LSD, perceived as a threat to the values of the Western middle class, leading to governmental action making any use of it illegal. Despite the extensive research on its judicious use under controlled circumstances, LSD was listed as a Schedule 1 drug, defined as having a “high potential for abuse” and without any “currently accepted medical use in treatment”. LSD was removed from legal circulation and became illegal in California in 1966, eventually followed by other US states, abruptly halting any further research into LSD-assisted psychotherapy in the US for a long period. Some LSD-assisted psychotherapy continued in Czechoslovakia, German, and the Netherlands during the 1970s; the Swiss researcher who published the current study had also conducted experiments on LSD in Switzerland from 1988 to 1993. More recently, a US pilot study of psilocybin-assisted psychotherapy performed with advanced-stage cancer patients that showed promising results was published in 2011; other studies are currently ongoing at Johns Hopkins and New York University.
Given the oceans of data produced over the years demonstrating conclusively the potential utility of LSD and other hallucinogens for beneficial purposes, it would be a tremendous waste for the research already done on these drugs to be prohibited entirely. Even the trials on the use of LSD for malevolent purposes by the US military and the CIA might be found redeeming if the information thus obtained can be used to inform researchers working with hallucinogens on the potentially dangerous misuse of these substances. Given the plethora of nervous disorders for which LSD-assisted psychotherapy has been effective, it should surprise no-one that it may be useful for end of life treatment.
By Laura Prendergast