SPOTLIGHT EDITOR’S PICK

• By Natalia Gurevich and Allyson Aleksey | Examiner staff writers |
• Aug 27, 2023 (SFExaminer.com)

Olivia Wise/The Examiner

Peter never thought his life would change in a single weekend.

But after spending more than half his life in the Navy, cycling through countless therapists, medications and treatments that left him depleted, he decided to try something radically different: psychedelics.

Shortly after retiring from a 24-year career with the Navy SEALS, Peter — who asked to be identified by his first name only due to privacy concerns — made the short trip from his home in San Diego to a clinic in Mexico in search of a new kind of treatment that he heard about through word of mouth, he said.

Throughout a three-day retreat, he told The Examiner, he was given ibogaine, a dissociative psychedelic derived from Tabernanthe iboga, a West African shrub. He also attended group therapy, daily meditations and yoga. On the last day, he was given a tryptamine psychedelic — 5-MeO-DMT, or O-methyl-bufotenin.

“It was a complete — what felt like a reprogramming of the heart and mind at the same time,” he said.

Peter is part of a growing movement among California policymakers, health officials, and interest groups advocating for psychedelics as an accepted treatment for mental health disorders, particularly post-traumatic stress disorder.

But despite emerging research, the health benefits of psychedelic drugs are understudied, leaving some worried about the risks of approving widespread use of such drugs before their benefits are better understood.

But what’s clear to those like Peter is that the potential benefits of psychedelics have barely scratched the surface, and support for its use in therapy isn’t slowing down any time soon.

Peter, who said he enlisted in the Navy at 19, said he had been struggling with his mental health for more than a decade. Adjusting to retirement last year only exacerbated his challenges with mental health, he said.

“I was still kind of in this old mind frame … a soldier’s mind frame of, like, where’s the enemy? Show me the target,” he said.

Before he embarked on his journey into alternative treatment, he said, he remembered meeting a fellow veteran following treatment of his own and was thrown off by his friend’s new attitude.

“An old buddy just came up to me and gave me a hug, and I was kind of weirded out by it,” Peter said. “I was like, ‘What are you doing, dude?’ And then he’s just like, ‘I don’t know, man, I just feel like you needed that.’”

Peter said he didn’t understand until he went through it himself.

“For me, a big thing was just forgiveness of the guilt,” he said. He said he witnessed friends endure a lot during his more than two decades of service.

But after taking the psychedelics, “A lot of the ruminating guilt and the ruminating anger that I felt about everything just seemed to have quieted down and given me access to new perspectives,” he said.

His treatment and the changes he felt as a result eventually brought him to TREAT, an initiative currently gathering signatures to get on the 2024 state ballot that seeks $5 billion in state funding to create an agency dedicated to researching psychedelic therapies. The organization advancing the TREAT initiative connected Peter with The Examiner to serve as a source for this story.

As for the research currently happening now, Peter’s experience mirrors what Dr. Jennifer Mitchell, a professor in the department of neurology and the department of psychiatry and behavioral sciences at UCSF, said she has seen in her work using MDMA, or ecstasy, as a treatment for PTSD.

“One thing that’s interesting about MDMA is it allows you to access really emotionally laden, emotionally challenging memories that typically instigate fear or shame or some sort of avoidance,” she said.

Mitchell and her team have been researching psychedelic treatments for seven years. The recent uptick in interest has been almost a “perfect storm,” she said, as the pandemic increased conversations around mental health.

The team is on the verge of submitting its MDMA treatment for FDA approval, likely by October, Mitchell said. “It’ll be the first psychedelic to be evaluated by the FDA for approval,” she said.

But there are hurdles ahead. MDMA and other psychedelics such as ibogaine are still federally classified as Schedule I drugs, which designates them as having “no currently accepted medical use and a high potential for abuse,” according to the Drug Enforcement Administration. Access to these drugs is limited due to their illegal status.

Plant-based psychedelics have been used for centuries in ceremonial and religious settings. But psychedelic therapy still has an air of criminality — “which completely suppresses any sort of conversation, understanding, education, or training around it,” said Jesse Gould, a veteran and founder of the Heroic Hearts Project, an organization that helps veterans access psychedelic treatment.

The lack of research also gives some doctors pause. Dr. Anna Lembke, an addiction medicine specialist at Stanford University, said she feels pushing for this acceptance of psychedelics is too much, too soon.

“If you want to use psychedelics to treat people with mental illness, then you’ve got to really have very convincing evidence that benefits outweigh the risks,” she said. “What we’ve seen throughout medicine is that the risks associated with psychoactive substances are typically worse in people with mental illness.”

Lembke said her research has found that the benefits of psychedelics in treating mental health are preliminary. The studies thus far have been short-term, less than 12 weeks, typically have a non-robust control group or no control group at all, she said, and they don’t assess the harm caused by the treatment.

“There’s even evidence that some of these published studies are leaving out some of the adverse events,” she said, including increased suicidal thinking, self-harm, persistent hallucinations, psychosis and suicide attempts. “We need a lot more data on potential harms.”

And despite widely held beliefs, Lembke said that people can become addicted to psychedelics.

“As oxycontin was prescribed more readily and became more accessible, we saw more and more people getting addicted to it,” she said. “Prior to that, oxycontin was marketed as nonaddictive just the way psychedelics are talked about now.”

Mitchell said there are benefits to moving away from drugs that mask pain.

“A lot of the drugs that we have that we use regularly for treating mental health conditions just blunt everything,” she said. “You’re treating the symptoms, you’re not treating the cause, and this is why they can also be scary — psychedelics go to the cause.”

While it’s difficult to overdose on these drugs, people with cardiac conditions should not take them, Mitchell said, and she is aware of the risks that psychedelics can pose. But her concern is less about the drugs themselves and more about whether or not they’re taken responsibly and ethically.

“I was here in San Francisco in the early ’70s; I remember quite well what psychedelics look like when they’re free range,” she said. “What I think is that we need regulatory oversight of these drugs.”

Such oversight might be on the horizon. A bill authored by state Sen. Scott Wiener sought to decriminalize the use of MDMA and ibogaine, but it died in the 2021 legislative session. This time around, Wiener nixed the push to legalize synthetic substances such as MDMA and instead zeroed in on plant-based substances such as ibogaine and psilocybin, a compound found in more than 200 species of mushrooms.

“Frankly, mushrooms are sort of like the dominant substance at issue here. And so we thought that made sense,” he told The Examiner.

While local lawmakers in Oakland, Santa Cruz and even San Francisco have passed resolutions in recent years that lessened the penalty for using mushrooms, DMT and ibogaine, Wiener said no California city has decriminalized it.

“Cities are not allowed to decriminalize,” he said. “Only the penal code can only be changed by the state. So San Francisco, Oakland, Santa Cruz, have passed ordinances basically asking their police department to deprioritize enforcing the law.”

If passed, the new bill — SB-58 — would decriminalize personal use and possession, triggering a regulatory process to develop parameters for access for facilitated and group use.

If passed, such legislation would be welcome news for veterans such as Gould, who said he battled alcohol abuse, depression, and severe hypervigilance when he returned home from combat. Estimates place the number of veterans diagnosed with PTSD at more than 600,000 from the last 20 years of war alone.

“The vast, vast majority of those are not getting effective relief,” he said. “So there’s a huge pool, just within the veteran community, that needs effective treatments that we just don’t have right now outside of psychedelics.”

But Lembke said she feels that legislation like Wiener’s is premature and that too much is at stake without more research into the use of psychedelics and their potential risks.

“We have a mental health crisis, and people are desperate for solutions,” she said. “But if we’re too hasty in identifying solutions that are not evidence-based, we may end up with a worse problem.”