On 3rd October, Edgbaston Park Hotel welcomed a group of academics and intellectuals from across the country and beyond, for a workshop discussing the exciting field of psychedelic science. Bringing the dialogue to the University of Birmingham for the first time, the group – an assembly of experts from disciplinary-diverse fields – aimed to extend awareness about the current state of psychedelic medicine, and add to the conversation about how it could (or if it should) be progressed into mainstream clinical use.

The workshop was organised by University of Birmingham’s Muireann Quigley (Department of Law) and Matt Hayler (Department of English and Literature), alongside Tehseen Noorani from the University of Auckland. Titled ‘Reimagining Barriers to Psychedelic Use: Law, Culture, Research and Practice’, the day was focused towards rethinking what the future of psychedelics could look like, given that their illegal status remains fixed. However, what are psychedelics, and why is their use so controversial?

An Overview of Psychedelics

Psychedelics are a class of psychoactive drugs which can alter your thoughts, mood, and perception by changing how your brain processes your internal and external world, and are often associated with visual and sensory experiences, as well as life-changing revelations. Substances can be split into 1) classical psychedelics (e.g., LSD and psilocybin) which produce typical hallucinations commonly linked with psychedelics, and 2) non-classical empathogens/entactogens (e.g., MDMA/ecstasy) which are characterised by increasing empathy for oneself and others. Research has begun to accumulate into their potential for treating mental and emotional disorders like PTSD, major depressive disorder and bipolar disorder. Trial applications have multiplied for Psychedelic-Assisted Psychotherapy (an established variant of talk therapy involving one-on-one sessions for behavioural modification), or ‘PAP’, for short.

Research has begun to accumulate into their potential for treating mental and emotional disorders

Despite this, regulatory boards in Europe, as well as the USA and Canada, remain steadfast against approving these interventions for medical use. A recent rejection by the USA’s Food and Drug Administration (FDA) of a Phase 3 clinical trial testing MDMA-assisted psychotherapy for PTSD reflects a scepticism within the wider scientific community, around whether the enthusiasm held for a ‘cure-all therapy’ is premature. What has been described as the ‘bursting of the psychedelic hype bubble’ has led many to reconsider what steps are needed to help PAP fit into the future of mental health treatment.

It is clear that such a complex issue requires a multifaceted approach. By hosting a number of discussions, each led by speakers with disparate specialisms, the workshop began to peel away the layers of confusion surrounding a topic at the intersection between science, culture, and policy.

The Workshop

The day was split into: 1) regulation and industry; 2) non-clinical perspectives; and 3) psychedelic futures, with four presentations from Quigely and Hayler, Henry Fisher (Clerkenwell Health), Noorani, and James Thompson (UoB, Department of Psychology). Although each brought a unique perspective to the debate, there were consistent themes regarding the need for (and difficulty of) licensing and how this is affected by the opinion of both regulators and the public.

It was apparent from the start how far perception influences policy. As most psychedelics are under Schedule 1 in the UK, they have ‘no inherent medical value’ in the eyes of the law. Despite having ‘fast-track status’ from MHRA (UK medical regulatory board), the absence of a regulatory safety net makes them difficult to source and costly to research. Adding to this, overly positive results from research have not been withstanding scrutiny, thinning reliability on future studies and superficially padding public opinion.

…the absence of a regulatory safety net makes [psychedelics] difficult to source and costly to research

The environment this creates makes it very hard to objectively evaluate their therapeutic potential. For clinical researchers, there’s an added concern as psychedelics don’t fit into the classic double-blind trial format: given the intensity of the psychedelic experience, it becomes quickly obvious which treatment arm participants have been assigned to. Whilst practical ways to minimise this were outlined, the question was nevertheless asked: should we?

Following the FDA’s recent rejection, pharmaceutical groups are divided on where to turn to next – do they remove psychotherapy, redesign the trial process, or focus on entirely new drug targets? Interesting research into ‘neuroplastogens’ has begun, which looks to remove the subjective component of psychedelics. However, in order for this question to be answered, greater efforts need to be made towards diversity in the decision-making process. Noorani’s talk, for example, introduced the idea that ‘agnotology’, or ignorance, has shaped how science is sought after and produced, and this has silenced many smaller voices which don’t fit into the Western model. Considering the rich history of Indigenous uses of psychedelic drugs for healing and non-healing purposes, how this could be celebrated in a non-performative way should be addressed. 

James Thompson also touched on how (users of) psychedelics are often treated separately to other illegal substances, reflecting an association with a white middle-class population – called ‘psychedelic exceptionalism’. Not only does this contradict the idea that psychedelics have ended the war on drugs, but it also feeds into ‘snowball sampling’, where the people who participate in trials already exist within the psychedelic community, producing data only representative of this narrow demographic. For the future of psychedelic medicine to remain promising, collaboration between researchers, industry, and non-mainstream groups needs to become the default for Big Pharma companies looking to get involved.

Although the future remains uncertain, there was an optimism in the air as the day drew to a close. Aptly ending in a sharing circle, the workshop achieved its aims to spread awareness of how different disciplines might approach the same questions. What might come of it remains to be seen, however it’s an exciting start to Birmingham’s foray into the world of psychedelic healthcare.

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