1

Psychedelic Research and the Medical Mainstream

When Albert Hofmann first isolated LSD in 1938 from a bit of ergot fungus, the Swiss chemist had no idea he’d discovered one of the most powerful psychedelics the world had ever known. When initial tests of the study material revealed nothing of obvious medical value, it was shelved in the Sandoz pharmaceutical company archives and forgotten.

Five years later, Hofmann had a “peculiar presentiment” that compelled him to revisit that archived batch, and a specific molecule he’d labelled LSD-25.1 During handling, the scientist inadvertently ingested some of the substance. Then he went home and “sank into a not unpleasant, intoxicated-like condition, characterized by an extremely stimulated imagination.”2

After further self-experimentation, Hofmann knew he’d found an extraordinarily powerful psychoactive drug. Less clear, though, was what it could be used for.

The LSD Conundrum

Hofmann called the new drug a psychotomimetic: something that induced a psychotic-like state. Perhaps it could be helpful for psychiatrists wanting a glimpse into the minds of some of their patients?

Appealing to the scientific hive mind of the day, Sandoz offered to send samples of LSD to any researcher or therapist willing to take a stab at identifying an application for the new drug, either by using it themselves or on their patients. With this act of corporate generosity, the first wave of psychedelic research was launched.

Across Europe and the US, clinicians answered the call. One scientist who took Sandoz up on at least part of that offer was an anesthesiologist and pain researcher named Eric Kast. It was the early 1960s and Kast, an émigré from Vienna working at the University of Chicago, was studying the emotional underpinnings of physical pain. If LSD was able to disrupt the brain’s ability to focus on pain, he reasoned, it might have some kind of lasting analgesic effect. Kast administered LSD to fifty severely ill cancer patients. Many of them reported significant and enduring pain relief. But to his surprise, several of the study subjects also described moments of euphoria and reductions in their depression and fear of death.

Peace in the Face of Death

Meanwhile, in Baltimore, researchers at Spring Grove State Hospital were studying LSD as a potential treatment for alcoholism. Aware of Kast’s work with cancer patients, when a social worker on staff named Gloria was diagnosed with advanced breast cancer, they decided to offer her the experimental drug.

Of her LSD session, Gloria recalled:

. . . in the void, alone without the time-space boundaries.

Life reduced itself over and over again to the least

common denominator . . . I became poignantly aware

that the core of life is love . . . I wept long for the

wasted years, the search for identity in false places, the

neglected opportunities, the emotional energy lost in

basically meaningless pursuits . . .

What has changed for me? I am living now, and

being. I can take it as it comes. I am still me, but more

at peace.3

Inspired by Gloria’s experience, Spring Grove expanded its psychedelic research program to include the existential distress of cancer patients. In 1967, Walter Pahnke, a young psychiatrist with an interest in psychedelics, was recruited to lead the studies.

Pahnke and the Good Friday Experiment

In addition to his medical credentials, Pahnke held advanced degrees in divinity and the history and philosophy of religion, all from Harvard. His PhD dissertation* hypothesized that a psychedelic (in this case, psilocybin) could facilitate a mystical experience similar to those described by religious mystics around the world.

In 1962 Pahnke recruited twenty divinity graduate students and brought them to Harvard’s Marsh Chapel for Good Friday services. Half of the volunteers were given a large dose of psilocybin and the rest a placebo. By administering the drug to subjects who were religiously attuned, in a church on one of the holiest days of the Christian calendar, Pahnke hoped to show that a conducive mindset (Set) and physical setting (Setting) would result in a transcendent religious experience.

After their journeys, Pahnke had the volunteers fill out a questionnaire he devised measuring different characteristics of mystical experience. These included transcendence of time and space, intuitive knowledge, deeply felt positive mood, feelings of sacredness, and a sense that was indescribable in words. From the completed questionnaires, Pahnke concluded that most of the volunteers who received psilocybin did in fact have profound religious experiences (although one manifested acute anxiety requiring medical attention). The volunteers also reported positive changes in well-being that lasted for months afterwards.

Pahnke brought his insights about Set and Setting and the benefits of a mystical experience to the cancer program at Spring Grove. Working alongside him was Bill Richards, a psychologist colleague and friend with a similar background in divinity and shared interest in psychedelics. Together they focused on creating an optimal Set and Setting in their trial designs, increasing the likelihood of a profound experience.

Patients received preparatory therapy sessions before the psychedelic drug was administered. The drug sessions themselves usually took place in a private hospital room decorated with flowers, pictures, and meaningful objects the patient brought from home. Two co-therapists, typically a male doctor and a female psychiatric nurse, were present to support them throughout the session. Afterward, both the patient and family members received follow-up therapy to integrate the experience.*

In 1971, when he was only forty years old, Pahnke died in a diving accident. Stanislav Grof, a psychiatrist and émigré from Czechoslovakia who had studied LSD in Prague, took over the cancer studies. He was joined by his then wife, cultural anthropologist Joan (now Roshi Joan) Halifax.

Grof and Halifax were influenced by Joseph Campbell and fascinated by the similarities between the transcendent experiences of patients during their LSD sessions and the mystical traditions of ancient and preindustrial cultures. They also shared an appreciation of the psychedelic experience as a symbolic rite of passage into death.†

Countering the Counterculture

The War on Drugs

While psychedelic research was underway in hospitals across the country, the peace and love generation was busily conducting its own acid tests. On college campuses, in music and literature, and in the media, psychedelics infused virtually every aspect of the counterculture. Challenging the establishment with long hair was one thing, but when the hippie vision threatened traditional family values and the Viet Nam War effort, the backlash was inevitable.

In 1971, Richard Nixon launched the infamous War on Drugs and created its regulatory strong-arms, the Controlled Substances Act and the Drug Enforcement Agency. LSD, psilocybin, and other psychedelics were bundled with cannabis, heroin, and cocaine and classified under Schedule 1, the most extreme category of highly dangerous drugs with high potential for abuse and no medical value, where, as of this writing, they remain.

The draconian restrictions imposed by the Controlled Substances Act made finding funding and approvals for psychedelic research virtually impossible. In 1973 Grof and Halifax left the East Coast for the more permissive atmosphere of California. In Baltimore, Richards was left to hold down the fort, and in 1977, he administered the last dose of an experimental psychedelic drug to a cancer patient. With that, the first wave of psychedelic research ground to a halt.

The Second Wave

In the late 1980s, research into psychedelics with human subjects quietly resumed. It was clear in the scientific community that working with substances so mired in stigma demanded impeccable research standards. Any study involving humans and a psychedelic drug had to conform to a stringent, placebo-controlled, double-blind study design. Decades worth of findings from the first wave of psychedelic studies conducted under the more lax standards of the times were summarily disqualified.

In this new, second wave of psychedelic research, LSD was largely replaced by psilocybin as the study drug of preference (more about psilocybin in chapter 3). Psilocybin offered brevity—an LSD journey can take ten to twelve hours, but psilocybin’s effects last about half that time, while still opening access to profoundly altered states of consciousness.

For study participants, psilocybin entailed a shorter period of physical and psychic engagement. For researchers, the shift to psilocybin reduced the amount of time and associated costs involved in the studies.

Back to Baltimore

By the early 2000s, Baltimore was once again an epicenter for psychedelic research. At Johns Hopkins University, the psychedelic research program was relaunched by an esteemed psychopharmacologist named Roland Griffiths. Because he had no prior experience studying psychedelics, Griffiths brought in the veteran psychedelic researcher, Bill Richards, to help run the studies. Richards, in turn, hired a social worker named Mary Cosimano.

In 2006, the Johns Hopkins team published the first in a string of landmark studies: “Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance,” in the prestigious Journal of Psychopharmacology. 4

The study, which effectively revisited Pahnke’s Good Friday experiment, gave healthy volunteers who regularly participated in some form of religious or spiritual activities a high dose of psilocybin. Once again, a clear majority described their psychedelic experience in terms consistent with naturally occurring mystical experiences. Followed up several months later, most reported enduring positive changes in moods, attitudes, and behaviors, and over half rated the experience as one of the top five most spiritually significant and personally meaningful events of their lives.