One scary adverse event could cripple the whole enterprise

Tuesday, September 10th, 2019

Tim Ferriss has put aside many of his other projects to advance psychedelic medicine:

“It’s important to me for macro reasons but also deeply personal ones,” Mr. Ferriss, 42, said. “I grew up on Long Island, and I lost my best friend to a fentanyl overdose. I have treatment-resistant depression and bipolar disorder in my family. And addiction. It became clear to me that you can do a lot in this field with very little money.”

Mr. Ferriss provided funds for a similar center at Imperial College London, which was introduced in April, and for individual research projects at the University of San Francisco, California, testing psilocybin as an aide to therapy for distress in long-term AIDS patients.

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Experiments using ecstasy and LSD, for end-of-life care, were underway by the mid-2000s. Soon, therapists began conducting trials of ecstasy for post-traumatic stress, with promising results. One of the most influential scientific reports appeared in 2006: a test of the effects of a strong dose of psilocybin on healthy adults. In that study, a team led by Roland Griffiths at Johns Hopkins found that the volunteers “rated the psilocybin experience as having substantial personal meaning and spiritual significance and attributed to the experience sustained positive changes in attitudes and behavior.”

At least as important as the findings, which were exploratory, was the source, Johns Hopkins, with all its reputational weight, and no history of institutional bias toward alternative treatments. “I got interested through meditation in altered states of consciousness, and I came into this field with no ax to grind,” said Dr. Griffiths, the director of the new center.

By late 2018, the Hopkins group had reported promising results using psilocybin for depression, nicotine addiction and cancer-related distress. Others around the world, including Dr. David Nutt at Imperial College London, were producing similar results.

Mr. Ferriss, who organized half the $17 million in commitments and contributed more than $2 million of his own for the new Hopkins center, said he approached wealthy friends who he knew had an interest in mental health. The new venture, he said he told them, “truly has the chance to bend the arc of history, and I’ve spent nearly five years looking at and testing options in this space to find the right bet. Would you have any interest in discussing?”

Mr. Ferriss said he met Dr. Griffiths in 2015, became intrigued with the research, and began thinking about the Hopkins group as he might an investment bet. He launched a crowdfunding campaign for a small depression study, to see how efficiently the Hopkins team used the money. “Essentially it was a seed investment,” Mr. Ferriss said. “I ran a beta test, and they really delivered.”

Craig Nerenberg, one of those friends and the founder of the hedge fund Brenner West Capital Partners, quickly agreed to contribute. “I have lost a family member to addiction and have felt the pain of loved ones who struggled through depression,” Mr. Nerenberg said by email. “It’s hard for me to imagine a contribution that I can make which — if the research data continues to bear out — will have a greater impact over the next decade.”

The remaining half of the commitments for the center came from the Steven & Alexandra Cohen Foundation and is earmarked for treatment of Lyme disease. Mr. Cohen is a billionaire investor; the foundation focuses on eduction, veterans issues, Lyme disease and children’s health, among other things. In an email, Ms. Cohen wrote, “I strongly believe that we must dare to change the minds of those who think this drug is for recreational purposes only and acknowledge that it is a miracle for many who are desperate for relief from their symptoms or for the ability to cope with their illnesses. It may even save lives.”

Investigators at the Hopkins center, its counterpart at Imperial College London and elsewhere still have an enormous amount of work to do to learn which mind-altering substances are beneficial for whom, at what doses, and when such treatment is dangerous. The same concerns that shut down similar research in the 1970s are audible in the caution expressed by many psychiatrists today: These are powerfully mind-altering substances, and administering them to people who are already unstable is uncertain work, to put it mildly. One scary adverse event could cripple the whole enterprise.

Comments

  1. Harry Jones says:

    Uncertain work? People already self medicate with alcohol. Could this be any worse?

    Prohibition tried to save people from themselves. That didn’t turn out so well.

  2. Kirk says:

    I’m all for doing what we can to help the mentally ill and psychically damaged, but… Good grief, this is at the level of “Whack it with a hammer, see if that helps…”.

    I do not trust the level of knowledge we’re at with anything as delicate as a human mind. We just don’t know enough, and the fact that a lot of these experimenters think they do is mind-bogglingly frightening. It’s not just that they’re screwing around with things they don’t understand, it’s that they’re actively telling people that they do know what the hell they’re doing. Which they don’t.

    The way that a lot of this “cutting-edge research” winds up being implemented ought to give us pause; out in the real world, where “medical professionals” are prescribing these psychoactive substances, it’s usually something like “OK, here’s a prescription for 3mg of X, try it for three weeks, then come back and we’ll evaluate…”. Trouble is, the doctors aren’t out actually observing the actual real-world effects of the drugs, they’re relying on the patient self-reporting–And, that patient is the one on the drugs!! Nobody goes out to ask peers/managers/spouses if they’ve seen any changes in behavior, or what those might have been.

    Frankly, I think that anyone prescribed psychoactives of any kind ought to be in a residential program with full-time observation by professionals. The way they do it now, for “therapeutic purposes” is completely bug-f*ckingly insane. I’ve watched guys I worked with in the Army go on this inexplicable hell-ride on a roller-coaster of emotional and cognitional changes, only to later discover that my “disciplinary problem” had its roots in some quack with a white jacket conducting free-form biochemical experiments on them.

    I remain highly dubious of the entire proposition, and would not under any circumstance suggest that it’s either ethical or wise to inflict these “cures” on the general public the way they are. The really frightening thing is when you go into the literature and research the crap they’re using, and you find that most of it is highly suspect and with really abysmal numbers behind it all.

  3. Harry Jones says:

    Far be it from me to defend the psycho-pharmaceutical racket. But what’s the alternative? When you’re out of ideas, whack it with a hammer.

    I’ve known a few people who ought to have been locked up, but society lacks the will to lock them up. All in all, I prefer the authorities err on the side of civil liberties rather than err on the other side. But they do err.

    I’ve known people with issues tell me there should be more mental health care. When I press for details, it turns out they mean more of the same. More drugs, at lower cost. No one has any better ideas.

    Human, all too human.

  4. Kirk says:

    All I’d advocate for is keeping people on medical observation under controlled circumstances until you’re done whacking them on the side of the head with chemical hammers.

    The free-form open-area experiment methodology that they seem to be so fond of? I’m not too happy with that crap, especially since they use medical privacy laws to keep everyone around them from knowing what’s going on.

    You want to screw with brain chemistry, you need to be doing it under controlled medical supervision, not out in the public sphere.

  5. Harry Jones says:

    My approach to the liberty dilemma: let the patient have it either way he wants so long as he’s not allowed to have it both ways. An experimental treatment will be entirely voluntary, and with the patient confined to a secure facility. He can choose to quit any time and walk out the door, but he can’t walk out the door without quitting first.

    Have him sign an agreement to the effect to keep the lawyers at bay.

  6. Kirk says:

    We marvel at the casual and cavalier way the Romans used lead in everything, and in how much lead wound up in their diet/environment.

    I strongly suspect that future generations are going to look at our casual and unthinking use of estrogen-like compounds in our industrial operations as being the equivalent–And, that they’re going to look at what we’re doing with the brain chemistry of our mentally ill as being tantamount to the trepanning and bizarre ideas of Medieval medicine regarding humours and other such-like fantasies.

    None of this sh*t strikes me as being well-advised; we just don’t know enough. I look at the current behavior patterns I observe in young males everywhere, and the effeminacy/dysfunction I see in what a lot of them are doing strikes me as possibly being hormone-related. Likewise, the females; they’re having their natural levels of testosterone suppressed by all the estrogen-like compounds, and are fudging up their natural balances between the two yin/yang sides of the equation, and that’s where a lot of the dysfunction we see around us derives from.

    Give it a few generations, and I bet we start to see studies proving that all out. What to do about it? No idea, but I think production and use of a lot of these compounds needs to be curtailed severely.

  7. CVLR says:

    Well, over the past half-century or so, sperm production has taken a massive dive, and the water, in the immortal words of Alex Jones, really is turning the frickin’ frogs gay. There’s no shortage of studies to either effect on Google Scholar.

    It’d be a pretty ingenuous way of suppressing discontent, if it were intentional.

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