When it comes to “illicit” drugs as medicine, the first thing that often comes to mind is medical marijuana. There’s been a surge of support in states across the country in recent years, making cannabis available to people with certain conditions – like epilepsy or dementia.
But the potential for therapeutic drug use doesn’t end with weed. For mental health conditions, including depression and PTSD, psychedelic drugs are increasingly showing promise in easing symptoms. Researchers are now exploring how and why substances like MDMA and psilocybin are able to help some people who haven’t responded to traditional psychiatric treatments.
It’s a topic New York Times reporter Ernesto Londoño has been exploring both on a personal and a professional level. His new book is called “Trippy: The Peril and Promise of Medicinal Psychedelics.”
Londoño began his reporting career at the Dallas Morning News and his book is being featured at the upcoming Texas Book Festival. He joined Texas Standard to discuss the state of psychedelic medicine in the United States and beyond. Listen to the interview above or read the transcript below.
This transcript has been edited lightly for clarity:
Texas Standard: Well, tell us about how you went about reporting this book – who you chose to interview and why.
Ernesto Londoño: Sure. Well, I went on a psychedelic retreat myself in early 2018. And this was during a period when I was struggling with depression. And I found that it was hugely effective in relieving the symptoms of what had been a really, really challenging time.
But I walked away with a lot of questions. First and foremost: is this going to be durable? And secondly: is it replicable?
And then, you know, the more I started looking at this renaissance of interest in these mind-altering compounds, I realized there was a Wild West out there. And, you know, journalistically, that was really, really interesting to explore.
So you mentioned your exposure to these Indigenous practices with psychedelics in South America. How did that influence your view of their therapeutic potential?
Yeah, I think Indigenous people have been using these drugs in rituals and ceremonies for centuries, if not millennia. And I was really interested in understanding their worldview and their approach to these compounds.
And I think what I found is, you know, for them, this is first and foremost sort of a spiritual intervention. And what’s really interesting is we find ourselves at a time when researchers and scientists have become really interested in these traditions.
But, you know, they’re looking at them first and foremost in terms of what they do to the mind. But the science is not really kind of nailed down in terms of understanding precisely what these compounds do and what kind of patients they may be right for.
Well, what are we talking about exactly? I mentioned depression, but what conditions show the most promise in responding to psychedelic treatment?
So there’s a handful of compounds that have been studied – they include psilocybin, which is the psychoactive compound in magic mushrooms. There’s a plant from Africa called iboga, which has shown significant promise for people struggling with addiction to things like opioids. And the main thing I tried is called ayahuasca, which is a plant-based brew that contains DMT.
And, you know, so far, a lot of the research has been into whether these compounds may be useful to treat people with PTSD. So people who are sort of in a state of trauma and who have really difficult experiences to overcome and process, but also people who have depression and especially people for whom the conventional treatments for depression – things like antidepressants – have not shown effect.
You were asking yourself after, your experiences, whether this would be long-lasting. What have you found in your own experience with psychedelics?
Sure. I think in the aftermath of either a psychedelic session or a retreat, you know, people have a more malleable state of mind.
There is something called “neuroplasticity,” which is kind of the interconnectedness of the brain, which becomes enhanced for a period of weeks or months after a psychedelic experience. So if you combine this with therapy or with other modalities, it gives you kind of a window of opportunity to reimagine a set of problems you’re struggling with – to see things more clearly and maybe to change some of the behaviors that got you into a dark place.
So it’s important for people to realize that this is not a silver bullet. This is not a one and done. It may crack the door open, but then there’s a lot of work that you need to put into the long process of actually healing and changing.
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Well, not a silver bullet, as you said, but a crack in a window– an opening in a door – seems like a very optimistic space to be in. What would you qualify as some of the limitations of this treatment so far?
We know that for some people, these experiences – which can be destabilizing in the short term – may also be destabilizing in the long run. You know, also because these compounds continue to be illegal under federal law, accessing them in very safe and controlled spaces can be a challenge.
So oftentimes, unfortunately, the people who are the most desperate end up in the care of practitioners who have the least, in the way of safeguards or skills. So that can be a recipe for disaster, if somebody who’s in a really vulnerable state puts himself in the care of somebody who’s really not equipped to help them or may actually even be a predator in this space.
Well, where do you see the research in psychedelics going from here? And are there particular developments you’re most optimistic about?
Yeah, well, there’s actually been a few setbacks.
You know, the compound that was furthest along in the regulatory process was MDMA, the drug more commonly known as ecstasy, which was being studied as an intervention for PTSD. And a few months ago, the federal government took a hard look at clinical studies that were done in the pursuit of FDA approval [and] decided that the studies weren’t quite as solid and as nailed down as federal regulators needed in order to sort of get the green light to reschedule MDMA and to allow doctors to start prescribing it.
The second compound that I think is furthest along in the regulatory process is psilocybin, which again, is the compound in magic mushrooms. And, you know, I think we could see federal regulators taking a fresh look at whether or not they want to get the green light for magic mushrooms as an intervention for depression in the next couple of years.
But none of this tends to happen quickly. It takes a lot of work, and it’s very expensive to run these trials. So for the time being, these treatments are available mainly sort of in the underground or in spiritual communities or at retreats overseas.
Well, we’ve been speaking about this on a very factual level, and there is a lot of research and interviews and facts that went into your book. But there’s also a narrative – and the story is really your story. Could you talk just a little bit as a journalist and what it was like to share that with the world?
Yeah, I am somebody who comes from a family where there is a long history of mental health challenges. Two of my grandparents struggled with depression to a pretty severe degree.
And I think one of the things that was really helpful for me in my own journey was kind of understanding my own struggles and my depression as part of a lineage of minds that go through periods of significant turbulence, but also kind of creating a clear narrative of my life – kind of being able to reconstruct memories from childhood, from adolescence, from really difficult periods of my life.
And it’s almost like you’re able to sort of peel back some of the layers of pain and maybe shame that, you know, were sort of attached to those memories and kind of makes it easier to carry them. It just kind of gives you the ability to go through life a little lighter.
