Most of us have fixed views about drugs like ecstasy or LSD. The majority of us think they are dangerous and should remain illegal. Fear of these drugs is understandable. Their effects are unpredictable and, beyond adjusting the dose, we have limited control over their effects. That’s very different to the ever-popular alcohol and cannabis which are far more predictable in the way they make us feel, behave or think.
Trials using psychedelic drugs such as psilocybin, LSD or 3,4-methylene dioxymethamphetamine (known to most of us as ecstasy) are well underway and showing promising results. One such trial reached a milestone when it was approved to treat people with post-traumatic stress disorder in America. This could be good timing as some experts are predicting a surge in health care staff and patients who will experience PTSD due to Covid-19.
While research into the therapeutic potential of psychedelics has been hampered in the past there is a resurgence in interest. The drivers of this change are difficult to discern but there are some probable reasons. Across the western world, rates of mental health problems are on the rise, yet we don’t know why and can only guess what the potential causes are. The search for treatment is clearly urgent and potentially profitable for the pharmaceutical industry. I’m not being critical of the industry, as without their investment in research and development we wouldn’t have the anti-depressants or other medicines that we rely on today – but we can’t forget that pharmaceuticals are not charities, they are businesses.
Another possible motivation is the pandemic. Some people are predicting that NHS staff involved in treating patients with Covid-19 will experience psychological problems like post-traumatic stress disorder. The estimated numbers at risk are staggering: 10 per cent of the workforce doesn’t sound like a lot but given there are 500,000 nurses and 300,000 doctors, that’s tens of thousands who are potentially in need of help.
Another possible motivation is the dire need to change the way we treat mental health, generally. Most of the evidence we have about treating problems points to combining medicines with some form of talking treatment for any chance of success. Giving out pills is relatively easy but combining this with a trained therapist isn’t; there are capacity issues.
For all the government’s rhetoric about creating parity between mental and physical health, your chances of timely intervention are much better with a physical rather than psychological problem. Of course, for many people, this separation between physical and mental health problems is an unhelpful delineation as they are connected. Life expectancy is reduced for people with mental health problems due to the elevated risk they have of developing diabetes for example.
Although we are all united in our vulnerability to mental health problems at some point in our lifetimes, men and women differ in how psychological problems manifest and progress. When it comes to mental health, the language used to describe soldiers has been adopted during the Covid-19 pandemic for nurses and other health and social care staff, despite their experiences and motivations for taking on their roles being radically different.
An added problem is that most soldiers are men and most nurses are women: research and treatment generally has been biased towards men and it looks like this new research into the potential of psychedelics is conforming to that tradition.
While there are tantalising potential benefits of these psychedelics to be discovered and proven, the research base used to investigate them needs some attention if the results are to be of any benefit to a workforce dominated by women. We also still have a long way to go with the majority of the public being fixed in their views, as well as questions of morals and culture which often err on the conservative side.
Unfortunately we’re more likely to see a psychedelic-based medicine being licenced before the world of research involves and recognises the role of women. Therefore we could end up just as much in the dark about the power of certain drugs as we are right now.
Ian Hamilton is associate professor of addiction at the University of York
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