Psychedelic-assisted therapy has a long history of use and research. Hallucinatory plants have been used in Indigenous medicine for centuries. Modern research began after lysergic acid diethylamide (LSD) was synthesized in 1938 and ended in the 1950s after the Controlled Substances Act was passed.
After decades of persistent advocacy and education, there is renewed interest in researching and using psychedelic-assisted therapy in nursing. We unpack how three psychedelics have risen to the forefront by showing impressive results and a strong safety profile.
We spoke with two nurses involved in psychedelic-assisted therapies to get their insight on how the drugs are used and the role nurses play in this mental health therapy. These psychedelics are used for healing along with consistent mental health support like therapy.
Vianey Ariadna Perez works with ibogaine to aid in healing around substance use. She joined the staff at Clear Sky Recovery after years of nursing in the emergency room and intensive care units.
“I have witnessed ibogaine support countless patients in looking at and opening up about traumatic events and seeing these experiences from a different point of view,” Perez says.
Andrew Penn is a psychiatric nurse practitioner who studies psilocybin and MDMA in the Translational Psychedelics Research lab at the University of California San Francisco. Penn has lectured to diverse audiences and published on psychedelic-assisted therapy in the American Journal of Nursing, Frontiers in Psychiatry, and The Journal of Humanistic Psychotherapy.
1. Psilocybin and Rewiring Behavioral Patterns
Psilocybin is a hallucinogenic compound found in some mushrooms that experts believe may have been native to areas of Northern Africa and Central America. In the 1950s they were “discovered” by Westerners. It was an editor from Life Magazine that coined the term “magic mushrooms,” and it has been used ever since.
In the past several years, several local and state campaigns have moved to decriminalize psilocybin. Evidence reveals the effectiveness of psilocybin in treating several mental health conditions. This has led companies to seek ways to mass-produce a pharmaceutical-grade drug faster and more efficiently.
Penn describes using psilocybin in the treatment of disorders that require the patient to change their thinking and behavior patterns. These include:
- Eating disorders
- Chronic pain
- Obsessive-compulsive behaviors
The brain becomes locked in a fairly rigid thinking pattern. Penn describes these as “stuck” patterns. They are visible on brain scans in areas called functional connectivity networks.
“If you ask a person with depression if they suspect they’ll still feel depressed next week or next month, they’ll likely say yes,” Penn says.
Psilocybin appears to disrupt the “stuckness” during the dosing session. These last between 4-6 hours. The drug causes the patient to have strong emotions and profound imaginings, which may bring back personal memories.
“When the drug wears off, it appears that some of those stuck patterns are sometimes able to shift,” Penn says, “especially if the patient is helped to put those learnings into action through integration therapy that happens in the days and weeks following the drug session.”
Therapists have found the changes in thinking patterns, and therefore the changes in depression or substance use, can persist for weeks or even years.
2. MDMA and PTSD
MDMA is a synthetic hallucinogen with the street names Molly and Ecstasy. Researchers have described it as an entactogen, a drug that increases self-awareness and empathy.
Studies of its effects have found it produces a partially controllable state in which the individual can experience:
- Peaceful feelings
- Enhanced insight
Post-traumatic stress disorder (PTSD) develops in some people who have experienced or witnessed a traumatic event. Symptoms last more than one month and must be severe enough to interfere with daily activities. Some of the symptoms include:
- Bad dreams
- Dissociative reactions
- Difficulty sleeping
- Easily startled
- Avoiding situations that remind the person of the event
According to Penn, researchers have not yet determined the mechanism of action in psychedelics and PTSD. They theorize that the limbic system that registers danger after a severe traumatic event may stay overactive.
This may help explain the symptoms of insomnia and an easy startle reflex. At the same time, they believe that the prefrontal cortex, which makes sense of experiences, is underactive.
It appears that MDMA can turn down activity in parts of the limbic system while turning up the activity in the prefrontal cortex, Penn says.
“This combination, when held in a therapeutic environment, may allow the person with PTSD to process their experience without becoming overly activated (or ‘triggered’) by talking about it,” he says.
3. Ibogaine, Trauma, and Addiction
Ibogaine is a naturally occurring psychoactive drug found in the root of the plant family Apocynaceae. Although the compound is hallucinogenic, it has been effective in the treatment of opioid addiction. One study found a single treatment reduced withdrawal symptoms. Participants were also able to stop or reduce opioid use for 12 months.
Perez has considerable experience administering ibogaine, monitoring patients, and observing the results to help with substance misuse. This includes the use of psychedelics and PTSD.
“I personally have witnessed its success in helping not only interrupt addiction and face trauma with compassion but also in giving patients a whole new outlook on life,” she says.
The change in the patient’s perception moves from victimization to empowering them to reclaim their life. In Perez’s experience, the therapy has helped patients see their traumatic experiences from a different point of view. She has found this difference in perception helps them move through trauma therapeutically with the support of trained therapists.
“Apart from that, ibogaine also helps regulate the dopaminergic and serotonergic systems, which can aid in the treatment of patients suffering from PTSD,” she says.
10 Ways Nurses Can Learn About Psychedelic-Assisted Therapy
This is a novel and exciting field of study in mental health. It’s important for all nurses to learn about psychedelic options for patients and the opportunities for nurses. Several resources can open doors to further education and training.
Consider conferences like the Sana Symposium that share research breakthroughs and strategies.
OPENurses, the Organization of Psychedelic and Entheogenic Nurses, was cofounded by Penn. It advocates for and educates nurses about treatment options. On the website, there are research links, networks and communities, and clinical resources.
Training programs link to over 35 training programs, experiential opportunities, conferences, and modalities that complement psychedelic therapy.
MAPS (Multidisciplinary Association for Psychedelic Studies) is an organization committed to psychedelic research. The organization collaborates with several large universities and healthcare centers. This includes the University of California San Francisco, NYU Langone Health, and Emory Healthcare.
There are links to published studies on several psychedelic medications and resources for nurses interested in pursuing the field.
UC Berkeley Center for the Science of Psychedelics is a collaborative effort at the University of California, Berkeley that uses an interdisciplinary approach to research the short- and long-term effects of psychedelic-assisted therapy. The team includes social scientists, doctors, pharmacologists, and experts in the mind-body connection.
The center also offers a nine-month training for psychedelic facilitators.
The California Institute of Integral Studies Center for Psychedelic Therapies and Research is run by a clinical psychologist with the goal to teach and certify licensed psychotherapists and healthcare professionals to become researchers.
The center has built strong partnerships with other universities, medical centers, and researchers. Bringing together top researchers has opened collaborative opportunities to build a cohort of licensed therapists.
Fluence offers professional education in psychedelic-assisted psychotherapy and integration. The group consists of researchers and therapists with experience in clinical trials. The organization’s mission is to provide education and equip practitioners with relevant skills. To this end, they offer continuing education and certificate programs.
Integrative Psychiatry Institute offers a year-long training for therapists to be certified as a psychedelic-assisted therapy provider. They collaborate with MAPS, the American Society of Ketamine Physicians, Psychotherapists, and Practitioners, and with the Usona Institute.
Naropa University offers a certificate in psychedelic-assisted therapies. The program leverages the contemplative and psychotherapeutic expertise at the university to expand the potential in the field.
Applications are now closed for 2022, but candidates can subscribe to the newsletter to receive updates.
Psychedelic Support offers resources for paid and accredited courses, free online courses and articles, helps patients find a mental health provider or clinical trial, and helps others find a community of like-minded people.
The Synthesis Institute is a leader in the psychedelic movement. They work to advance education and research for integrative healing. They also offer an 18-month professional certification program. The program includes coursework, a five-day retreat, 50 hours of practicum, and the opportunity to connect with other professionals from many backgrounds.