Is There Really Magic in Those Mushrooms ? Do Psychedelics Have Real Potential as Medicine ?
by JOHN J . WERNERT , MD , MHA
Very few medical topics have captured the attention and imagination of our populace as the therapeutic use of hallucinogens and cannabinoids in treating a myriad of medical conditions . The popular press has touted the potential benefits of cannabinoids and psychedelics for treating common and complex conditions which prompts our patients to ask us about these compounds . Indeed , physicians have had to take note and understand the potential of psychedelics as real medicine .
Consider how our attitudes about marijuana and cannabis have evolved over the past 10 years . In spite of all the CDC , National Institute on Drug Abuse and professional warnings of the dangers of marijuana , the perception has become reality that marijuana is helpful and therapeutic in self-treatment of many conditions that traditional medicine has failed to advance . Consider the recent published poll that compares American ’ s abuse of nicotine compared to marijuana use :
Only 11 % of adults in the U . S . say they smoke cigarettes nowadays , compared with 45 % in the same poll in the 1950s . On the flip side , marijuana use has been up across the board on the wave of legalization in many U . S . states . Sixteen percent of Americans in the poll indicated they smoke marijuana , including 48 % who say they have tried it over their lifetime . Compare that number to just 4 % in the same poll from 1969 . And a Gallup poll in July revealed that 53 % of people say marijuana has positive effects . -July 26th poll published 8 / 30 in USA Today
Since the publication of Michael Pollan ’ s book , How to Change Your Mind : What New Science of Psychedelics Teaches Us About Consciousness , Dying , Addiction , Depression and Transcendence 2018 ( Penguin Books ), hardly a medical conference goes by without a reference to , or a lecture on , this topic . Physicians naturally take an inveterate interest in this topic as our profession is rooted in the pursuit of “ nature ’ s cures ” for our more perplexing ailments . Do we have the science that proves that psychedelics have real potential as medicine ?
I would submit that perceptions about psychedelics will evolve along a similar pattern to marijuana , with gradual acceptance as a “ legal ” and acceptable alternative to traditional Western medicine . In fact , psychedelics have been used by most cultures throughout history . There is fossil evidence dating back as far as 10,000 years and historical references of use dating back 5,000 years . This includes religious / spiritual rituals and medicinal purposes – not just recreational use .
What is the magic in these compounds ? Most classical psychedelics are 5HT2A receptor agonists . 5HT2A receptors are expressed widely throughout the CNS and are found in high concentrations in layer V of the cortex and may modulate cognitive processes , working memory and attention . Scientists have identified that psychedelics have a profound impact on neuromodulation through the Default Mode Network ( DMN ). The DMN is thought of as the conductor of the brain ’ s orchestra of different functional subunits . It exerts “ top down ” control over visual processing , motor activity , emotion , memory , etc . The DMN may be the structural basis for
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