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Psychedelics and Doing Good

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We are living through a psychedelic renaissance. Spearheaded by academic research and increasingly of interest to media, government and business, substances like psilocybin, LSD and MDMA are returning to our culture after a 40+ year hiatus.

So why all the excitement? How much of this is hype, and how much is potential for real positive impact?

This presentation is about ways psychedelics may be able to do a lot of good. It covers:

- Current efforts towards psychedelic mainstreaming (an overview of the landscape)
- The problems of trauma, depression, anxiety, and addiction, and how psychedelics can help
- How psychedelics might change our personality traits and values
- Long-termist arguments for why psychedelics could improve the future of human health, wellbeing, and flourishing
- What Aaron is working on in the psychedelic space

Learn more about Aaron here: https://anesmithbeck.com

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First link in the presentation that doesn't work on SlideShare: https://psychedelic.support/resources/how-to-join-psychedelic-clinical-trial/

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Psychedelics and Doing Good

  1. 1. Psychedelics and Doing Good Aaron Nesmith-Beck EA Toronto - 13/05/2020
  2. 2. What we’ll cover ⪢ Psychedelic Renaissance ○ Research ○ Policy change ⪢ How psychedelics can do good ○ Mental health ○ Trauma ○ Addiction ⪢ The long-term future ○ Potential benefits of psychedelics ○ Moral circle expansion ⪢ What Aaron is working on 2
  3. 3. Psychedelic Renaissance Research ⪢ MDMA for PTSD (MAPS) ○ Granted “Breakthrough Therapy” designation by the FDA ○ Currently in phase 3 ⪢ Psilocybin for depression (MDD & TRD) ○ Granted “Breakthrough Therapy” designation by the FDA ○ Currently in phase 2 ⪢ Psilocybin for smoking, alcoholism & more ○ Johns Hopkins, NYU, Imperial College London, Yale ⪢ A list of ongoing psychedelic clinical trials 3
  4. 4. Psychedelic Renaissance Policy change ⪢ Medicalization ○ FDA & EMA approval processes ⪢ Decriminalization ○ Denver, Oakland, Santa Cruz, Washington, Chicago & more ○ Canada (sign the petition here) ⪢ Legalization ○ Oregon ballot initiative (IP 34) 4
  5. 5. How psychedelics can do good Mental health ⪢ Mental health problems responsible for 7-14% of global DALY burden1 ⪢ Cause profile: mental health (Michael Plant) ⪢ Depression & anxiety ○ NYU & Johns Hopkins gave psilocybin to end-of-life cancer patients ○ 60-80% showed clinically significant reductions at 6 month follow-up2,3 5
  6. 6. How psychedelics can do good Mental health ⪢ Psilocybin for treatment-resistant depression (TRD) ○ TRD patients are depressed for years or decades & no treatment works ○ Imperial College London pilot study: “...eight (67%) of the 12 patients achieved complete remission at 1 week and seven patients (58%) continued to meet criteria for response (50% reduction in BDI [Beck Depression Inventory] score relative to baseline) at 3 months, with five of these (42%) still in complete remission”4 6
  7. 7. How psychedelics can do good Mental health ⪢ MDMA for PTSD ○ 54% success rate in MAPS phase 2 trials5 ○ Success = “no longer qualify for PTSD diagnosis” ⪢ Treating trauma in general ○ High ACE scores -> worse health outcomes6 ⪢ Research to treat OCD, eating disorders, cluster headaches ongoing ⪢ Naturalistic psychedelic users have better long-term mental health outcomes; reduced psychological distress; reduced suicidality7 7
  8. 8. How psychedelics can do good Addiction: tobacco ⪢ Smoking accounts for 6% of all ill-health globally, more than HIV and malaria combined8 ⪢ WHO estimates as the largest cause of preventable death in the world ○ 7M deaths per year, loss of 140M life years annually9 ⪢ Psilocybin for smoking cessation ○ 80% quit rate after 6 months, 67% after 12 months10 ○ Psilocybin probably at least twice as good as current standard of treatment (RCT ongoing) ⪢ Naturalistic psychedelic use reduces smoking11 8
  9. 9. How psychedelics can do good Addiction: alcohol ⪢ Psilocybin for alcoholism ○ NYU pilot study showed significant increase in abstinence12 ○ Currently in phase 2 at NYU ⪢ MDMA for alcoholism study results coming soon ○ “A significant number stopped drinking completely”13 ⪢ LSD appears effective in treating alcoholism14,15 ⪢ Research to treat opioid and cocaine addiction ongoing 9
  10. 10. How psychedelics can do good Wellbeing, personality traits & values ⪢ Increase in Big Five trait Openness16 ○ Hasn’t been replicated ○ Potentially good ⪢ Psychedelic use predicts liberal and anti-authoritarian political views17 ⪢ Increased nature-relatedness and care for the environment18 ○ Lifetime psychedelic use predicts pro-environmental behaviour19 ○ Strong connection between nature-relatedness and wellbeing20,21 10
  11. 11. The long-term future Potential benefits of psychedelics ⪢ Nature-relatedness & pro-environmental behaviour good for climate change ⪢ Interrupt cycles of intergenerational trauma ⪢ Increase set of well-intentioned & capable people (Griffes) 11
  12. 12. The long-term future Moral circle expansion ⪢ Moral progress entails expanding the circle of moral concern (Singer) ⪢ Rivalrous games + exponential tech = self-extinction (Schmachtenberger) ⪢ Psychedelics can change sense of personal identity by altering propositional & ontological qualia (Emilsson) ○ From closed to open individualism 12
  13. 13. The long-term future Moral circle expansion ⪢ Psychedelic users care more for others than users of other illicit substances & users of no illicit substances22 ⪢ Participants in Johns Hopkins research rated by community observers as more altruistic (locally)23 ⪢ Psilocybin for TRD patients report more “connectedness” and “acceptance”24 13
  14. 14. The long-term future Moral circle expansion ⪢ "This sense of connection to people often extended to strangers such as shop assistants, people on trains and in the street" ⪢ "Many patients described how the sense of connection seemed to spread wider, a “deep connection to everyone” ⪢ “Four patients described having powerful insights about the European refugee crisis during the dose, which was unexpected and uncharacteristic for them (P9, P12, P15, P4), and some others reported becoming more concerned about global issues in the months after their treatment”25 14
  15. 15. What Aaron is doing Atman ⪢ Legal psilocybin retreats in Jamaica ○ Helps individuals directly ○ Helps mainstream psychedelics ○ Builds groundwork for further development ⪢ Future direction: practitioner training ○ Bottleneck in psychedelic space ⪢ Exploring remote ketamine during COVID-19 ⪢ More about Aaron: https://anesmithbeck.com/ 15
  16. 16. 16 Thanks for listening! Any questions?
  17. 17. 17 References 1. EA Concepts: Improving Mental Health and Happiness. https://concepts.effectivealtruism.org/concepts/improving-mental-health-and-happiness/ 2. Ross, Stephen & Bossis, Anthony & Guss, Jeffrey & Agin-Liebes, Gabrielle & Malone, Tara & Cohen, Barry & Mennenga, Sarah & Belser, Alexander & Kalliontzi, Krystallia & Babb, James & Su, Zhe & Corby, Patricia & L Schmidt, Brian. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial. Journal of Psychopharmacology. 30. 1165-1180. 10.1177/0269881116675512. 3. Griffiths, Roland & Johnson, Matthew & A Carducci, Michael & Umbricht, Annie & Richards, William & Richards, Brian & P Cosimano, Mary & Klinedinst, Margaret. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology. 30. 1181-1197. 10.1177/0269881116675513. 4. Carhart-Harris, Robin & Bolstridge, Mark & Rucker, James & Day, Camilla & Erritzoe, David & Kaelen, Mendel & Bloomfield, Michael & A Rickard, James & Forbes, Ben & Feilding, Amanda & Taylor, David & Pilling, Steve & H Curran, Valerie & Nutt, David. (2016). Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. The Lancet Psychiatry. 3. .10.1016/S2215-0366(16)30065-7. 5. Mithoefer, Michael & Feduccia, Allison & Jerome, Lisa & Mithoefer, Anne & Wagner, Mark & Walsh, Zach & Hamilton, Scott & Yazar-Klosinski, Berra & Emerson, Amy & Doblin, Rick & Com, Alli@mapsbcorp. (2019). MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology. 236. 10.1007/s00213-019-05249-5. 6. Hughes, Karen & Bellis, Mark & Hardcastle, Katherine & Sethi, Dinesh & Butchart, Alexander & Mikton, Christopher & Jones, Lisa & Dunne, Michael. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health. 2. e356-e366. 10.1016/S2468-2667(17)30118-4.
  18. 18. 18 References 7. Hendricks, Peter & Thorne, Christopher & Clark, Charles & Coombs, David & Johnson, Matthew. (2015). Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. Journal of psychopharmacology (Oxford, England). 29. . 10.1177/0269881114565653. 8. 80,000 Hours Problem Profile: Smoking in the Developing World. https://80000hours.org/problem-profiles/tobacco/ 9. World Health Organization Tobacco Fact Sheet. (July 26, 2019). http://www.who.int/en/news-room/fact-sheets/detail/tobacco 10. Garcia-Romeu, Albert & Griffiths, Roland & Johnson, Matthew. (2015). Psilocybin-Occasioned Mystical Experiences in the Treatment of Tobacco Addiction. Current drug abuse reviews. 08. . 10.2174/1874473708666150107121331. 11. Johnson, Matthew & Garcia-Romeu, Albert & Johnson, Patrick & Griffiths, Roland. (2017). An online survey of tobacco smoking cessation associated with naturalistic psychedelic use. Journal of psychopharmacology (Oxford, England). 31. 269881116684335. 10.1177/0269881116684335. 12. Bogenschutz, Michael & Forcehimes, Alyssa & A Pommy, Jessica & Wilcox, Claire & Ribeiro Barbosa, Paulo Cesar & J Strassman, Rick. (2015). Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study. Journal of psychopharmacology (Oxford, England). 29. . 10.1177/0269881114565144. 13. Thoricata, Wesley. (2020). How Medical Science Grapples with Psychedelic Plants like Ayahuasca and Ibogaine: A Conversation with Professor David Nutt. Psychedelic Times. https://psychedelictimes.com/psychedelic-plants-david-nutt/ 14. Krebs, Teri & Johansen, Pål-Ørjan. (2012). Lysergic Acid Diethylamide (LSD) for Alcoholism: Meta-Analysis of Randomized Controlled Trials. Journal of psychopharmacology (Oxford, England). 26. 994-1002. 10.1177/0269881112439253.
  19. 19. 19 References 15. Garcia-Romeu, Albert & Davis, Alan & Erowid, Fire & Erowid, Earth & Griffiths, Roland & Johnson, Matthew. (2019). Cessation and reduction in alcohol consumption and misuse after psychedelic use. Journal of Psychopharmacology. 33. 10.1177/0269881119845793. 16. MacLean KA, Johnson MW, Griffiths RR. (2011). Mystical Experiences Occasioned by the Hallucinogen Psilocybin Lead to Increases in the Personality Domain of Openness. Journal of psychopharmacology (Oxford, England). 25(11):1453-1461. 10.1177/0269881111420188. 17. Matthew M. Nour B.M., B.Ch., M.A., Lisa Evans M.Sc. & Robin L. Carhart- Harris B.Sc., M.A., Ph.D. (2017). Psychedelics, Personality and Political Perspectives. Journal of Psychoactive Drugs. 10.1080/02791072.2017.1312643. 18. Forstmann, Matthias & Sagioglou, Christina. (2017). Lifetime experience with (classic) psychedelics predicts pro-environmental behavior through an increase in nature relatedness. Journal of Psychopharmacology. 31(8):975-988. 10.1177/0269881117714049. 19. Ibid. 20. Renate Cervinka, Kathrin Röderer, Elisabeth Hefler. (2011). Are nature lovers happy? On various indicators of well-being and connectedness with nature. Journal of Health Psychology. 17(3):379-388. 10.1177/1359105311416873. 21. Capaldi CA, Dopko RL, Zelenski JM. (2014). The relationship between nature connectedness and happiness: a meta-analysis. Frontiers in Psychology. 2014;5:976. 10.3389/fpsyg.2014.00976. 22. Lerner, M. & Lyvers, M. (2006). Values and beliefs of psychedelic drug users: a cross-cultural study. Journal of Psychoactive Drugs. 38(2):143-7. 10.1080/02791072.2006.10399838
  20. 20. 20 References 23. Griffiths, Roland & Richards, William & Johnson, Matthew & McCann, Ud & Jesse, Robert. (2008). Mystical-Type Experiences Occasioned by Psilocybin Mediate the Attribution of Personal Meaning and Spiritual Significance 14 Months Later. Journal of psychopharmacology (Oxford, England). 22. 621-32. 10.1177/0269881108094300. 24. Watts, Rosalind & Day, Camilla & Krzanowski, Jacob & Nutt, David & Carhart-Harris, Robin. (2017). Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression. Journal of Humanistic Psychology. 57. 002216781770958. 10.1177/0022167817709585. 25. Ibid.

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