Microkhan by Brendan I. Koerner

Not-So-Deadly Nightshade

June 25th, 2010 · 11 Comments

One of the most controversial aspects of AA’s history is the role that psychedelics may have played in Bill Wilson’s creative process. As I discuss in the Wired piece, when Wilson experienced his spiritual epiphany in December 1934, he did so at a New York City drying-out facility. Part of his treatment there consisted of something called the Belladonna Cure, in which detoxing alcoholics were given hourly infusions of a potentially hallucinogenic drug. A recent New York Times piece gives some backstory on the Cure, including its many shortcomings—particularly the fact that it didn’t seem to impact the relapse rate (typically quoted at around 90 percent during the first 12 months of sobriety).

The fact that belladonna was coursing through Wilson’s veins during his spiritual awakening raises an important question: Can psychedelics play a role in the treatment of psychological disorders? My answer, which I posted on comments yesterday, is a qualified yes, though I think we’re many decades away from employing such tools in the medical realm. An effective drug must have predictable results when used among a broad cross-section of patients, and the odds of catastrophic side effects must be small. This cannot be said of psychedelics at the moment, though that is in large part due to the dearth of research—something we can blame on the War on Drugs. It’s probably high time that we heed the words of LSD’s creator and acknowledge that psychedelics aren’t worthless just because they can be abused.

Wilson’s psychedelic exploration did not end with belladonna, of course. Years later, while suffering from deep depression, he tried LSD. A 2005 article from Modern Drunkard relates some details, which seem to have been plucked from Francis Hartigan’s exhaustive biography:

One of his therapeutic journeys lead him to Trabuco College in California, and the friendship of the college’s founder, Aldous Huxley. The author of Brave New World and The Doors of Perception introduced Wilson to LSD-25. The drug rocked Wilson’s world. He thought of it as something of a miracle substance and continued taking it well into the ‘60s. As he approached his 70th birthday, he developed a plan to have LSD distributed at all AA meetings nationwide. The plan was eventually quashed by more rational voices, and a few years later the Federal government made the point moot by making the drug illegal.

It’s probably for the best that Wilson’s plan didn’t come to fruition. But that doesn’t mean he wasn’t on to something.

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11 Comments so far ↓

  • Jordan

    The tricky thing is that it’s more or less impossible to predict how psychoactives are going to operate from person to person. Too many variables involved, both internal (mental state, underlying issues) and external (the ever important set and setting). Most of the reports I’ve read make it sound like if you give a dozen people the same compound in the same room, they’re all going to respond to it differently.

    With that said, it shouldn’t prevent further research from being done. There were already a fair number of therapists and psychiatrists who were effectively using compounds like MDMA in their work back in the 60s and 70s that there’s enough justification for moving forward. If nothing else, the toxicity profiles of most of these compounds means that physical harm should be almost nil if they’re being administered in a controlled fashion. People like Alexander Shulgin have demonstrated that pretty effectively. I still can’t believe he didn’t do any harm to himself over the years, but he was also an incredible careful person when it came to tasting his experiments.

  • Dan Morrison

    There were studies in Europe looking at the use of ecstasy, in conjunction with analysis, as a treatment for PTSD. I spoke years ago to shrinks who said it did wonders. There were also people who were using it as a palliative.

    Here’s a link, though it’s behind a paywall in Suffolk County. http://www.newsday.com/ecstasy-from-overseas-to-our-streets-psychotherapeutic-role-examined-1.446047

  • Dan Morrison

    I just noticed the comment by Jordan. Shulgin was great. A pioneer of the mind.

  • shaun

    First of all, the Wired article was great, Brendan, easily the definitive look at the mystery of why AA works for many people.

    Secondly, while Jordan is correct that different people respond differently to hallucinogenics, the body of research is now large enough (Shulgin, Leary, Alpert, Hubbard, Osmond, etc.) that there is no question that these low-toxicity, non-addictive drugs can be of some and sometimes enormous help in the treatment of alcoholism, drug dependence, personality disorders and even cancer. But of course can land the provider or user in jail.

  • Brendan I. Koerner

    @shaun: Many thanks for checking out the AA piece. Glad you dug it.

    The central issue here seems to be the clinical thresholds for safety and efficacy. For hallucinogens to be used in professional medical environments, they would have meet the same standards as any FDA-approved drug. (Yes, those standards have betrayed us before, but let’s go with it.) And as Jordan notes, we’re a long ways away from that goal, due to the dearth of rigorously controlled research.

    That said, hallucinogens could be used in a non-professional context, assuming the users were willing to accept liability for the risks. One example that pop to mind is ibogaine, which I wrote about for U.S. News & World Report many moons ago. It has been used to help heroin users kick their habits, and there is certainly evidence that it works better than placebo. But its effects are highly unpredictable, and I do fear that psychological trauma could occur in some patients. Yet my heart says that people should be free to try the treatment, as long as they understand the risks–and that, like health-store supplements, that the treatment has yet to pass clinical-trial muster.

  • scottstev

    I wonder if, as we go further into individualized treatment plans, these types of quandaries will fade. Once you start getting highly customized genetically engineered medications, will you be able to try treatments that are highly unpredictable but have shown great results in those for whom the drug is efficacious? One would hope so, but somehow I don’t think the paradigm’s will change that easily.

  • Jordan

    @scottstev

    Unfortunately the whole “personalized medicine” business has been pretty over-hyped. It made for a really good justification for the millions of dollars spent on the Human Genome Project, but so far it just hasn’t panned out very well. There are very few genetic diseases and traits with simple +/- characteristics and a lot where we’ve found genes that make small but noticeable contributions to the risk profile. Unfortunately the vast middle hasn’t been easy to figure out given current laboratory and statistical techniques. That’s not to say that personalized medicine is a bad idea in the long run, just don’t hold your breath.

  • Brendan I. Koerner

    Let me use an anecdote from my ibogaine reporting to comment on the debate above.

    In the course of writing the story (sadly offline), I had an occasion to meet a South African ethnobotanist who had participated in a Gabonese ibogaine ceremony. He did so not in order to research the drug’s potential to treat heroin withdrawal, but rather to investigate its spiritual effects. And he made a point that has stuck with me: ibogaine is useful in treating addicts not because it ameliorates withdrawal, but rather because it forces them to step outside themselves and confront the sad state of their lives.

    In other words, ibogaine works in the same manner as AA–it is meant to assist in the patching up of a spiritual hole, rather than address the immediate symptoms of withdrawal. And that means that it must be used outside the realm of medical science, at least for now.

  • Ashlee Rosenberger

    There are still studies on ectasy used in alleviating symptoms during PTSD therapy sessions being conducted. There has been problems with it though because no one wants to fund it even though it proved itself to be effective when it was originally used, and contrary to belief there has been no documented cases where a patient died using it as prescribed. I think it’s something worth looking into!

  • Brendan I. Koerner

    @Ashlee: Thanks for the comment. I remember a colleague of mine writing about this a few years back, when the first wave of veterans returned from Iraq. I’d be curious to know about the current state of the research–it does seem like there’s potential, but the caveats above (esp. re: unpredictability of results) apply. How might therapists guide the experience so that negative side effects are avoided? I think that’s the primary question that needs to be answered.

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    [...] there would be a spiritual component to the treatment to addiction. And Bill W. who started AA, tried LSD when he was sober in the 1950s, and he thought that it had tremendous potential for the treatment [...]

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