05 March 2021

Top drugs expert says number of people self-treating mental health problems with psychedelics is rising

05 March 2021

A leading drugs expert believes people are increasingly “self-treating” mental health problems with psychedelics, while research suggests large numbers would engage with treatments if they were made available in clinical settings.

Professor Adam Winstock, a consultant psychiatrist and addiction medicine specialist, said the latest recruits increasingly being viewed and used as medicine are psychedelics.

He is also the founder of the Global Drug Survey (GDS), the world’s largest drugs survey, which last year asked people what conditions they have tried to treat with psychedelics.

More than 20,000 people across the world provided information on LSD and magic mushroom use, and more than 6,500 people completed a section on the self-treatment of psychiatric conditions with psychedelics.

More than half of respondents who took LSD did so to enhance their well-being, 32.4% did so to deal with a specific emotional concern or worry, and 15.2% did so to address a psychiatric condition.

These were also the three most common reasons for use of magic mushrooms.

LSD, magic mushrooms and MDMA were the substances most commonly used for self-treatment of a psychiatric condition or emotional distress.

The most common problems people self-treated with psychedelics were depression, anxiety and relationship issues.

The findings suggests there are many people with common conditions “for whom existing treatment modalities are either insufficient or unattractive to engage with”.

He said: “The evidence for these substances in many areas is promising and is causing a headache for regulators who are having to revise the rhetoric that for decades was used to schedule many of these drugs out of therapeutic conversations.

“Although there is promising evidence for drugs such as LSD, (es)ketamine and MDMA in the treatment of defined psychiatric conditions, the delay in translating this early clinical research into treatment modalities that are accessible and widely affordable, leaves many tempted to self-medicate without guidance.”

Prof Winstock said delays in accessing psychedelics under medical supervision means people may be tempted to “figure it out for themselves” or seek support from less well-trained people who may be offering guidance and monitoring during the drug-taking.

Researchers say they are “pretty certain” that numbers of people seeking such experiences are on the rise due to an increasing number of psychedelic retreats and traditional healing groups.

Of those who took psychedelics under the supervision of another person to address a mental health condition or emotional distress, most were supervised by a friend, partner or shaman outside of a clinical setting, the survey found.

Conditions people sought to address were depression, anxiety, post-traumatic stress disorder, bereavement, substance misuse and eating disorders.

Not all respondents said they had undergone a mental health and medication screening and over 40% did not have an appropriate preparatory session, the survey found.

Despite this, 86% of the respondents reported positive outcomes.

The evidence for these substances in many areas is promising and is causing a headache for regulators who are having to revise the rhetoric that for decades was used to schedule many of these drugs out of therapeutic conversations

The researchers warn that, without such measures, some people with pre-existing mental health conditions may be exposed to “greater risks of harm”.

Prof Winstock said he is calling for such retreats to be regulated with guidelines over screenings, staff training and contingency plans if there is an adverse reaction.

The vast majority of those who had taken psychedelics under supervision said they would do so if it were a legally regulated and approved treatment, suggesting there is a “highly responsive market among those most in need of help”.

They write: “The longer the delay in rolling out these treatments through clinical services the greater the risk that vulnerable people will be tempted to access these drugs in situations that carry potential greater risk of harm.

“More scientific evidence is needed of course, but our data suggest that should these new treatments become available there will be a large of group of people keen to engage with them.”

Prof Winstock said negative outcomes from poorly supervised psychedelic episodes are not only bad for individuals but also risk hindering the “fledgling psychiatric renaissance”.

He said he has seen “mostly well-meaning” psychiatrists and clinical psychologists risking their careers to offer psychedelics “on the quiet” abroad, and would be surprised if there were not instances of this occurring in the UK.

He added: “Psychedelics are boom business. GDS wants to ensure that the amazing progress that has been achieved through rigorous trials are not derailed by random occasions of poor practice and that vulnerable people are not placed in harm’s way.”

People can participate in this year’s Global Drug Survey here: https://www.globaldrugsurvey.com/

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