Updated: Jan 26
I’d like to share my experience as a volunteer in an experiment that took place earlier this year. You’ll hear my story as well as reflections from my perspective as both research participant and ceremonialist on the issue of the medicalization of psychedelic substances. For those for whom some of the issues around medicalized psychedelics may be new this paper, is also available on my blog with links to relevant texts.
The date is Thursday the 17th of January, my third visit to the King’s College Hospital Clinical Research Facility in the London Borough of Southwark as a medical study participant. Today the research team would be dosing volunteers with an experimental medication intended to help people suffering from treatment resistant depression, a drug called psilocybin.
Having checked with the researchers it was okay, I’d brought a ‘lucky mascot’ along for the ride. ‘Izawa’ is the name given to the spirit who works for ‘the liberation of the psychedelic experience for the benefit of all beings’. A circle of chaos magicians in northern England created – or perhaps contacted – this entity in 2011 fashioning a representation of the spirit as part of their ceremony.
Today this ally would accompany me on my trip.
Participation in the trial had meant reducing my use of substances that might compromise the research. Since the December solstice I’d eschewed what, in the language of contemporary medicine are ‘drugs of abuse’. This includes methamphetamine, heroin and cannabis (only one of these three was an issue for me) but somewhat ironically not tobacco or alcohol. It was now January and I enjoyed being ‘straight edge’ for science for over a month.
Days before the dosing session I’d undergone detailed physical and psychiatric assessments. This necessitated completing various standardized, somewhat repetitive, questionnaires: are you feeling suicidal? (‘no’), have you thought about any means of committing suicide (‘no’), have you thought about where you might commit suicide (‘er…no’). Through to questions intended to identify Schizotypal personality disorder such as “Have you ever seen things invisible to other people?” (‘look, I know what you’re getting at here so, in the context of this evaluation, no’).
Blood and urine and physical tests had confirmed the absence of any drugs in my body. My general health was fine: we were all systems go.
The day before dosing I’d met the team of therapists who would be working with me and five other volunteer subjects. The therapists were an international cohort of mixed ages, genders and ethnic backgrounds all smiling, all clearly fascinated with the idea of psychedelic psychotherapy.
We assembled in the ward where, the following day, we would take the medicine.
One of the researchers explained how about 15 minutes after taking the drug, if we had received what they called the ‘active dose’ we might notice something:
“When you are wearing the eye-shades”, they explained “at first it will; be just like normal. Then after a while, if you have had the active dose, it will be as if you are looking into space, perhaps a space filled with stars or even images.” A delightfully simple and gentle way of describing the powerful visionary experiences that psilocybin can induce.
“If you find places in the experience that are dark or difficult don’t be afraid” they further counselled us. “The darkness is where the treasure lies, follow it and find the treasure”, more elegantly simple instructions, clearly from someone who knew this territory well. Our instructor amplified this advice by repeating the core message (some might say mantra or charm); ‘go in and through’. We were introduced us to a simple breathing pattern that would help the process; breathe in for a count of 4, hold for 4 then breath out for a count of 8.
The confidentiality of the session, housekeeping, safety, and other matters were all addressed and I left feeling confident that the experience would be held well by the team. I didn’t sleep much that night though. I was too excited. For me this event represented many things. It was a concrete opportunity to help in a process that I’ve worked for, in my own way, for many years. To help manifest what my magical colleagues from the north described as the ‘liberation of the psychedelic experience for the benefit of all beings’.
I arrived early on dosing day and made my way to a park adjacent to the hospital where I planned to do some tai chi, and generally spent time with the trees.
As I sat in the park I was visited by a robin, a bird which is a totem for my Dad who passed away a few years ago. I’d been with him during his final days. Prior to my participation in this experiment that was the last time I was in a hospital setting. I greeted this welcome visitor and asked for its blessing.
Once in the research department I chatted amiably with the receptionist. A nurse was busy preparing the ward in which six of us would simultaneously dosed. The window blinds were closed and lamps resembling candles glowed softly beside each bed. Large pale coloured rugs were laid on the floor to minimize the sound of footsteps and make the place feel as cozy as possible. Silk flowers decorated the room, a picture book of botanic illustrations by each bedside. Vaporisers gently perfumed the air with sandalwood. Screens were unfolded behind the beds, decorated with an abstract design reminiscent of dappled sunlight. I installed Izawa at my bedside and introduced the spirit to the person who would be my sitter, a smiling, thoughtful young man I’d met the previous day. I popped a catkin gathered from the park into one of the tubular structures protruding from Izawas’s body.
That morning I had drawn a tarot card, The Wheel of Fortune, an apposite symbol. This study was double blind; neither researchers nor volunteers would know whether participants would receive a placebo, or 10mg of synthetic psilocybin, or the ‘active dose’ or 25mg.
The Wheel of Fortune spins; the nurse moves to each bedside, opening the randomly selected medicine pots, pouring their contents into tiny paper cups at each bedside.
The researcher who had so thoughtfully described the psilocybin experience the previous day reminded us of the breathing pattern: In for a count of four, hold for four, out for eight, relax. Accept what arises and go ‘in and through’.
I cradled the paper medicine pot in my hands, made a prayer over the contents and swallowed the cluster of tiny pills. Putting on the headphones and eye mask I lay down and relaxed and waited.
The music was a classical piano piece, deeply textured and beautiful. I listened intently.
I’d only had a light breakfast and knew that if this was an active dose, I’d start to feel something within 20 minutes.
Then it started.
Something was happening, that unmistakable sensation of the wyrd and the wonderful. This was at least 10 milligrams. Quickly I revised my estimate upwards; this was the ‘active dose’. Fortuna had smiled.
With eye-shades on and the music playing I began to sing quietly as I lay on the bed while rushes of energy moved through my body. Little flutterings and stutterings and twitches and yawning, the kind of effects I’ve come to expect with this medicine. As the music changed to drum beats and textured electronic sounds, I found myself rapidly ascending into the psychedelic state.
The trip was profoundly influenced by my setting. Not the calm room, transformed from daytime ward into twilight psychedelic ceremonial space, but the very fact that I was in a hospital. I brought to mind the people I’d seen in the days during the preparatory sessions in its corridors: harassed looking medics, confused visitors, earnestly conversing relatives, patients – their bodies sprouting tubes – being pushed on beds between wards . I felt repeated shivers of energy moving through me and wondered if I was somehow detecting the bustling auric field of the place. The injured arriving in blue-lit, siren-shrieking vehicles, patients receiving their life-changing news, people dying, people being born.
My body twitched and danced, an organic layer lying orthogonal to a stream of energy connecting heaven and the deep that was my whole being. Yellow hi visibility jacketed police thronged my inner vision. Here I was, legally taking psilocybin in the heart of London while out there the police, who of course, have got much better things to do, were tasked with busting people for using the same substance that I had consumed in a licensed setting.
This tension had a personal relevance. I thought about my Mum, who worked as a nurse in Accident and Emergency for over a quarter of century. Of my Dad who had been both a military medic and a senior member of the St John’s Ambulance Brigade. I thought of how this therapy might help members of my own family were it to be accessible in a conventional medical context. Perhaps they could then benefit from the psychedelic insights and healing that I’ve discovered in ‘traditional’ and underground settings?
My sitter was immediately and gently by my side as I removed the headphones, eye-shades and sat up in order to visit the bathroom. The short corridor from the ward to the toilet was dimly lit with LED nightlights. Once inside I regarded myself briefly in the full-length mirror. Yep, eyes like saucers. Returning to the ward I glanced through the window. Outside the car park was full of scurrying people, ambulances, police cars and taxis. I was tripping pretty hard as the carpet undulated beneath me. I quipped to my sitter, “It’s about 3am in this club!’ He grinned.
We’d taken the medicine at 10:30am and by 3:45pm I was beginning to come down. By 4pm I was sitting up in bed, eye shades and headphones off, the music quietly audible through speakers in the room. I glanced at the other beds. One person seemed to have left – I guessed they’d received the placebo. Another volunteer was weeping. This individual was being ably supported by their sitter. Their tears had a gentle cathartic quality, soon replaced with wry laughter at the cosmic joke of it all. Later I discovered that this volunteer has never taken any psychedelic drugs before.
I poured myself some water, sitting up on the bed, my blanket wrapped around me. In my imagination I offered the water to the important people in my life. Wishing that all beings could have access to clean water. I sprinkled a little on the floor and acknowledged the spirit of the place before finally taking a sip. Turning to my sitter I asked; “Is there any tea on this spaceship?’ he smiled and went to prepare a brew.
Later I ate, breaking my fast with fruit and salad and bread. As evening fell I was interviewed by the team, provided my initial reflections on the experience, and was pronounced fit to go.
The other volunteer who also appeared to have received the ‘active dose’ and I were last to leave. We spoke for a while as they waited for their taxi. “It was like I could see it all,” they said “all the past and future, all the connections. All the horror and all the beauty and even the joke of it all. It was amazing!”
And so it is, this psychedelic state. This remarkable form of awareness where our minds perceive the embodied truth that ‘everything is interconnected’. And while this realization may be ecstatic it may also provide us with challenging material – and to meet these challenges we need to consider the wider context of my trip in the hospital that day.
The King’s College Hospital Clinical Research Facility is funded by the National Institute for Health Research who get their cash primarily from the UK government’s Department of Health and Social Care and also by The Wellcome Institute, that is Big Pharma. The trial I specifically participated in was funded by Compass Pathways, a for-profit company developing psilocybin therapy in Europe and North America. These facts may give us pause for thought.
Today there are commentators in the psychedelic community who are moved to warn us about the problematic aspects of psychedelic medicalization. Some have wondered if the whole psychedelic renaissance is doomed (though they remain happy to sell their books, artworks or workshops to us as it crumbles). In the opinion of some pundits by taking part in this trial I am at least a dupe if not an active conspirator in a sinister deep state plot.
Now we should certainly aware of how sociopathic tendencies in our culture may wish to deploy these drugs. History teaches us how the Roman military encouraged the culture of wine drinking in order to subdue barbarian tribes. We may recall the deplorable tale of how in the 19th century the British East India company weaponized opium against the Chinese Empire and there are those more recent attempts in the 20th century to weaponize mescaline, LSD and the rest. These days may fear that we shall become numb to our pain; medicated with Mac Mindfulness and anesthetized by esketamine nasal spray, docile, unable and unwilling to rise up again oppression. These fears need to be acknowledged as entirely plausible – for the Moksha medicine of Huxley’s Island to become the debilitating Soma of his Brave New World.
We also know that simply using psychedelics does not necessarily make you a good person. On a scale smaller than that of shadowy governmental departments, things can go very wrong within the psychedelic community. One may take iboga and only come away with pinchbeck revelations, or encounter shocking abuses while under the influence of toad venom. These bad things happen well outside of state actors. It is therefore essential that – as people who love and appreciate these substances – we are alert and ready to address such problems in compassionate and intelligent ways, wherever they emerge.
Concerns about the medicalization and state use of psychedelics seems most often expressed by people (as far as I can tell predominantly white men) living in The United States of America. This makes sense to me. The USA is a nation with a proud tradition of individual liberty, an impressive pioneering spirit and wary attitude towards governmental power. It is also a nation with many serious challenges and wounds which express themselves in draconian drug laws, rampant militarism, and in my view a, barbaric and economically exploitative approach to medicine. Meanwhile psilocybin and MDMA treatments in the UK will be delivered through the National Health Service making them free of charge at the point of provision. I therefore wonder if the fears of capitalist exploitation of psychedelics in the USA would be better addressed not by problematizing developments in psychedelic medicine but by campaigning for accessible healthcare in that nation.
While some commentators rail against any state involvement in psychedelics it’s worth remembering that some of these sacraments were originally products of commercial enterprise. Big Pharma, for all it’s faults, gave us psychedelic medicine too. And though we may distrust the re-emergence of a licensed capitalist psychedelic economy (which we should remember existed in the early and mid 20th century) these medicines cannot remain underground and only available to wealthy guys, rolling around on Adam in the privileged playgrounds of Esalen and Burning Man.
However I don’t believe that physicians should be the only people with a lawful right to use these drugs and admitting psychedelics into medicine settings should, in my view, go hand in hand with other changes to make these substances more widely accessible.
As someone who lives in one of the most oppressive and closely monitored countries in the world (the UK) I appreciate the American appetite for decentralization and personal liberty. I support moves to change the laws around psychedelic drugs, and in some respects America is leading the way through developments such as the vote to decriminalize entheogenic plants in Oakland. That people should have access to psychedelics in settings other than medical ones is obvious, especially to those like me who use these substances in ceremonial and recreational settings. There is no reason why the shaman and the scientist and the clinician and the private individual could not all have access to these materials. In fact the ironic thing is that the private individual and the shaman already do, though they may operate within a culture of fear and repressive legislation which hardly serves to support good practice or intelligent use. It is our doctors, our healers, who are forbidden from using these valuable medicines.
As the psychedelic renaissance unfolds there are naturally difficult ethical choices to be made. There was the choice I made when I signed up for the Compass Pathways trial, the choice that MAPS made to accept money from the Mercer Family. Rick Doblin gives a clear account of the thinking behind that decision, just as I can explain why I decided to participate in the Compass research. Sure Rick and I could be part of some great MKULTRA/MOSAD false-flag operation of The New World Order but I propose another reading. As Terence McKenna said: ‘we’re not dropping out here, we’re infiltrating and taking over’.
Some might argue that my taking part in this trial makes me a collaborator with the evil machine of imperialist-capitalist violence which is cheerfully doing it’s thing while the ice-caps melt. But then I think of my Dad and of the apparent contradiction in his role as an army medic; the contradiction between healing medicine and the harms of war. But this contradiction is also a connection.
MAPS have chosen to work with veterans as a stratagem to speed the development of MDMA therapy that will eventually be open to everyone (allowing for America’s poor healthcare provision). And while we may be dismayed at the deplorable contexts in which people have developed PTSD, we cannot morally ignore their wounds. Would it be a compassionate response to argue: ’I’m sorry, but you chose to go to war so you’re not getting a blood transfusion because otherwise I’ll just be supporting the war machine’. Clearly not, and while some detractors of the medicalization of psychedelics recognize this they don’t appear able to propose any answers.
I also wonder whether, even though sanctioned by the military, psychedelic therapy may have other effects than just fixing people’s PTSD. Perhaps soldiers treated with MDMA are unlikely to return to work shouting “kill kill kill’. Are they perhaps more likely to oppose militarism, less likely to send their kids to war, more likely to support attempts at dialogue as a means of conflict resolution? Time I guess will tell.
I would also argue as does physician Gabor Mate that healing, at it’s best, is a process that inevitably has a radical social dimension:
“In essence, healing is a highly subversive act in our culture. Whether in a medical or more direct psychotherapeutic sense, our work with people is about subverting their self-image as isolated, simply biological or simply psychological creatures, and helping them see the connections among their existence, the nature of the culture we live in, and the functioning of all of humanity. It’s about challenging the idea that someone’s value is dependent on how well they fit into an abnormal, unhealthy culture. Ideally, as healers in the broadest sense, that’s what we should be doing.”
Psychedelic therapy may also help us heal by fundamentally changing how medicine is done. Now the therapist must learn to sit, like the shaman of old, with the patient and facilitate the conditions in which they can do their own healing. A far cry from the bumbling pharmacology of sedation and the ubiquitous 10-minute consultation. We may be witnessing a transformation from psychiatry as a discipline with ‘labels for everything and cures for nothing’, into an approach to healing that successfully combines ancient knowledge and modern science.
For western psychedelic medicine is indebted to the wisdom of ancient cultures, and not only by having learnt about psilocybin through Maria Sabina’s generous gift the sacred mushrooms. In 1953 two psychiatrists, Abram Hoffer and Humphrey Osmand took part in a Native American Church peyote ritual. They observed first hand how psychedelic ceremony was helping First Nations people overcome their dependence on whiskey. In the light of this observation they wondered if they could use LSD to treat addiction. So when our medicine people; our doctors and nurses and clinicians, sit in psychedelic therapy with their patients, they do so in a lineage that includes the Red Pheasant First Nation people of Saskatchewan. Moreover in their report to the government not only did Hoffer and Osmond argue for the safety and healing power of the peyote ceremony but they also acknowledge the ethical limitations on the rights of the medical profession to stake a claim these substances:
“We believe most medical men would object if asked to judge whether to allow or prohibit members of any church from practicing their religion and enjoying their sacrament. It does not seem to us that, as medical men, we have any competence to decide upon these matters.”
But it is clearly in the competence of physicians to determine whether psychedelics could be a valuable part of their practice.
On a personal level my trip that day in the hospital was about connecting my own passion for psychedelics and their transformative power with the opportunity that licensed therapy could provide to my own family and many other people; the kind of people who don’t undertake ayahuasca pilgrimages, people who don’t dance away their cares on the ecstatic dance floor, and who don’t attend conferences like this one. But people nevertheless who could be healed by the sensitive use of these ancient sacred medicines and who would be able to access these treatments through the NHS. As an advocate of psychedelic inclusion I hope that I have helped to medicalize the mushroom medicine which I also regard as a sacrament.
May this marvelous opportunity, these magical medicines, help heal those in pain and heal too the disconnections and addictions within medicine itself. May these medicines be available in many ways so that they are accessible to all who might benefit from them. May our culture be transformed for the better by the liberation of the psychedelic experience for the benefit of all beings.