What to Expect
If you are on medication for mental health conditions, it is essential to consult with a medical professional before pursuing psychedelic therapy, as some psychedelics can be contraindicated with antidepressants or other types of psychotropic drugs. Moreover, similar to cannabis use, psychedelic treatment has, in some cases, led to psychotic breaks or an exacerbation of psychosis among individuals with mental illness or a family history of mental illness. Any reputable psychedelic clinic will review your personal and family medical history before beginning treatment in order to avoid any of these issues.
Psychedelic clinics provide a controlled environment in which a trip facilitator assists the participant through a psychedelic experience. These facilitators are trained professionals, oftentimes in both traditional Western psychotherapy and also spiritual practices, though not always the latter. These psychedelic sessions are also often paired with psychotherapy, both before and after the journey, to address any mental health issues and encourage a synthesis between what happened during the trip and everyday life afterward.
As with psychedelic retreat centers, an individual’s experience at a psychedelic clinic will be highly individual. Lead researcher at Johns Hopkins University School of Medicine, Roland R. Griffiths, Ph.D., has noted that one-third of cancer patients who underwent psilocybin therapy found it the single most spiritually significant experience of their lives. However, we must recognize that “spiritually significant” is a subjective term: what is “significant” to you might not be “significant” to someone else.
The experience of psychedelic therapy in a clinical setting was recently captured in the Netflix documentary, Fantastic Fungi: “It’s a feeling of such immense power that you can’t even imagine,” said one patient, Tony Head. “I’ve never felt anything like it before. It was about being in a place of infinite space and just being there. The most glorious part was that it made me feel more comfortable with living because I’m not afraid of dying.”
In an episode of the Joe Rogan podcast, Multidisciplinary Association for Psychedelic Studies (MAPS) founder and Executive Director, Rick Doblin, Ph.D., spoke about recent research in which MDMA was used to treat PTSD in combat veterans. According to Doblin, one veteran in a clinical trial said MDMA helped him reimagine the death of fellow soldiers in Iraq. Under the influence of MDMA, he discovered a way to honor the friends who had died, show loyalty, and maintain a connection with them.
While there are ongoing clinical trials for psilocybin, LSD, MDMA, and ketamine, the most common psychedelic substance, which has been in clinical use over the past decade, is ketamine. First synthesized in the 1960s, ketamine has been used as an anesthetic ever since. The US Food and Drug Administration (FDA) approved the s-enantiomer of ketamine, esketamine (Spravato), as a nasal spray for treatment-resistant depression in 2019.
At a ketamine clinic, you typically receive the medicine as an infusion intravenously from an IV bag or digital syringe pump. Many clinics tout the painlessness of the procedure, as they use tiny needles to insert the IV, then replace it with a soft tube so there is no discomfort. The infusion takes approximately 50 minutes, with the patient seated in a comfortable chair the whole time and monitored for blood pressure, oxygen, pulse, and EKG. The amount of medicine can be fine-tuned for the duration of the procedure. The treatment has proven to be widely successful with 70% of patients experiencing a significant decrease in depressive symptoms.
The FDA designated both MDMA and psilocybin as “breakthrough therapies” in recent years, indicating that more resources may soon become available to further explore these drugs’ uses in healthcare. Currently, some of the leading facilities in psychedelic research include the Johns Hopkins Center for Psychedelic & Consciousness Research in Baltimore and the Centre for Psychedelic Research at Imperial College London, both of which accept volunteers for clinical trials. Additionally, the University of California, San Francisco has conducted a pilot study on the effects of psilocybin-assisted group therapy for male AIDS survivors. Lastly, New York University has conducted promising research around psilocybin treatment for alcohol dependence.