{"id":2148,"date":"2021-11-02T22:51:36","date_gmt":"2021-11-02T22:51:36","guid":{"rendered":"https:\/\/www.leafly.com\/wp-home\/?p=183403"},"modified":"2021-11-02T22:51:36","modified_gmt":"2021-11-02T22:51:36","slug":"would-psychedelic-therapy-work-without-tripping","status":"publish","type":"post","link":"https:\/\/thcinct.com\/?p=2148","title":{"rendered":"Would psychedelic therapy work without tripping?"},"content":{"rendered":"<p>  <title>Would psychedelic therapy work without tripping? &#8211; Leafly<\/title>     <!-- This is Index Exchange, a script\/\/3rd-party integration that interjects GAM. It needs to be 'ahead' of GTM in the DOM, which comes from Cephalopod. GTM loads GAM. This script needs to setup it's interjection stuff before GAM loads. --> <!-- End Index Exchange --> <!-- Quotes = strings--><!-- No quotes = boolean-->\t   <!-- This site is optimized with the Yoast SEO Premium plugin v17.1.2 (Yoast SEO v17.1) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->                  <!-- \/ Yoast SEO Premium plugin. --> <\/p>\n<p> <!-- BEGIN Sailthru Horizon Meta Information --><\/p>\n<p><!-- END Sailthru Horizon Meta Information -->  <!-- Google Publisher Tag --> <!-- End Google Publisher Tag --> <!-- Google Tag Manager --> <!-- End Google Tag Manager --> <!-- Chartbeat --> <!-- End Chartbeat --><br \/>\n <!-- Google Tag Manager (noscript) -->   <!-- End Google Tag Manager (noscript) -->   <title>Leafly<\/title>     <title>Leafly \u00ae<\/title>                                                                                                                                                                                                                                                                                                                                                                                              <title>Loading\u2026<\/title>     <\/p>\n<div class=\"bg-white fixed flex hidden inset-0 items-start md:h-auto md:items-center overflow-auto\" id=\"age-gate-container\">\n<div class=\"bg-white md:h-auto mx-auto p-lg text-sm w-full\" id=\"age-gate\">\n<p><label for=\"select-country\">Where are you from?<\/label><\/p>\n<div class=\"age-gate__info\">\n<p><button class=\"button\" data-testid=\"age-gate-no-button\" id=\"tou-cancel\">no<\/button><button class=\"button ml-md\" data-testid=\"age-gate-yes-button\" id=\"tou-continue\">yes<\/button><\/p>\n<p><label class=\"checkbox__label my-xl\"><span class=\"text-xs\" id=\"remember-user-label\">Remember me for 30 days. <br \/>I confirm that this is not a shared device.<\/span><\/label><\/p>\n<p class=\"error error--underage hidden\">Darn! You&#8217;re not old enough to use Leafly.<\/p>\n<\/div>\n<p class=\"hidden age-gate__loading\">Redirecting you to<span class=\"redirect-domain\"><\/span><\/p>\n<p class=\"text-xs mt-auto\">By accessing this site, you accept<br \/>\nthe <a class=\"py-xl\" data-testid=\"tou-link\" href=\"https:\/\/www.leafly.com\/info\/terms-of-use\">Terms of Use<\/a><br \/>\nand <a class=\"py-xl\" data-testid=\"pp-link\" href=\"https:\/\/www.leafly.com\/info\/privacy-policy\">Privacy Policy<\/a>.<\/p>\n<\/div>\n<\/div>\n<div class=\"container my-xl\">\n<div class=\"row\">\n<div class=\"col md:col-9\" id=\"article-content\">\n<h4 id=\"h-mind-matter-is-a-monthly-column-by-nick-jikomes-phd-leafly-s-director-of-science-and-innovation\"><em>\u2018Mind &amp; Matter\u2019 is a monthly column by <a href=\"https:\/\/www.nickjikomes.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Nick Jikomes, PhD<\/a>, Leafly\u2019s Director of Science and Innovation.<\/em><\/h4>\n<p class=\"has-drop-cap\">Therapy patients who\u2019ve taken a large dose of psilocybin often rate the experience as one of the most significant moments in their lives. Some compare it to an event like the birth of their first child. The hallucinatory experience, they say, allowed them to make a critical therapeutic breakthrough.<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-large is-resized\"><img alt class=\"wp-image-180908 has-ll lazyload\" width=\"221\" height=\"221\" data-srcset=\"https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-1.jpg,compress&amp;w=550 550w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-1.jpg,compress&amp;w=740 740w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-1.jpg,compress&amp;w=1100 1100w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-1.jpg,compress&amp;w=1480 1480w\"><\/figure>\n<\/div>\n<p>But did it really? As important as the trip itself actually <em>feels<\/em>, is it possible that the subjective experience is just a profound, mind-bending side-effect of the biochemical process that actually provokes the breakthrough?<\/p>\n<h2 id=\"h-the-role-of-psychoplastogens\">The role of \u2018psychoplastogens\u2019<\/h2>\n<p>We are living through a renaissance in the scientific study of psychedelic drugs. From psilocybin to ketamine to MDMA, these drugs are being studied for their potential to treat severe mental disorders\u2014everything from addiction to end-of-life anxiety, treatment-resistant depression, and PTSD.<\/p>\n<p>Early studies indicate that patients typically see beneficial results when these substances are used to assist psychotherapy, not merely taken on their own. <\/p>\n<blockquote class=\"wp-block-quote has-text-align-left\">\n<p>Psychoplastogens allow the brain to rewire itself.<\/p>\n<\/blockquote>\n<p>The drugs seem to act as psychoplastogens\u2014compounds that induce neuroplasticity, allowing the brain to physically rewire itself.<\/p>\n<p>Recent studies indicate there may be a two-part system at work here: The drug effect of enhanced plasticity offers the potential for change, while psychotherapy directs that change appropriately.&nbsp;<\/p>\n<h2 id=\"h-the-advantage-of-psychedelics-fast-plasticity\">The advantage of psychedelics: Fast plasticity<\/h2>\n<p>The drug-induced boost in neuroplasticity seems to outlast the presence of the drug itself. This means the brain can remain in a state of enhanced malleability for extended periods, allowing psychotherapy to be extra effective even after the drug exits the body.<\/p>\n<p>Traditional antidepressants like SSRIs (Prozac, Zoloft) also promote plasticity, but it can take weeks to manifest. With psychoplastogens, new connections start sprouting quickly. In lab animals, psilocybin elicits such a rapid response that we can<a href=\"https:\/\/www.youtube.com\/watch?v=9qmaDJmFjpM&amp;list=PLrEAWLADcneZMnDlYoUFPyeysgL0Bu8-x&amp;index=8&amp;t=461s&amp;ab_channel=NickJikomes\" target=\"_blank\" rel=\"noreferrer noopener\"> literally watch<\/a> new neural connections form overnight.<\/p>\n<p>These plasticity-enhancing effects are thought to be crucial for the therapeutic benefits of psychedelics. But the question remains: Are the subjective effects\u2014the psychedelic trip\u2014a necessary part of the process that induces neural plasticity?<\/p>\n<figure class=\"wp-block-image size-large\"><img width=\"1024\" height=\"640\" alt=\"psychedelic-mushrooms\" class=\"wp-image-152540 has-ll lazyload\" data-srcset=\"https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-2.jpg,compress&amp;w=550 550w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-2.jpg,compress&amp;w=740 740w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-2.jpg,compress&amp;w=1100 1100w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-2.jpg,compress&amp;w=1480 1480w\"><figcaption>Psilocybin, the active ingredient in magic mushrooms, offers a faster way to induce neuroplasticity. (AP Photo\/Peter Dejong, File)<\/figcaption><\/figure>\n<h2 id=\"h-why-does-it-matter\">Why does it matter?<\/h2>\n<p>It\u2019s important to understand whether the subjective effects of psychedelics are necessary, because that knowledge can help us better allocate scientific resources, including research grants and investment capital.<\/p>\n<p>If the subjective and therapeutic effects are separable, we might be able to design new substances that are non-hallucinatory variants of classical psychedelics. Such drugs could produce therapeutic benefits without triggering hallucinations. That would allow large numbers of patients to take them without the need to train and deploy healthcare professionals to monitor patients, one at a time, while they have a multi-hour psychedelic experience.&nbsp;<\/p>\n<p>If the psychedelic experience itself <em>is<\/em> crucial to the positive clinical outcome, however, we should focus more effort on designing therapeutic protocols mindful of this constraint.<\/p>\n<figure class=\"wp-block-image size-large\"><img width=\"1024\" height=\"683\" alt=\"photo-of-therapist-and-patient\" class=\"wp-image-183496 has-ll lazyload\" data-srcset=\"https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-3.jpg,compress&amp;w=550 550w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-3.jpg,compress&amp;w=740 740w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-3.jpg,compress&amp;w=1100 1100w, https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping-3.jpg,compress&amp;w=1480 1480w\"><figcaption>If the psychedelic trip is essential to the healing process, we may want to invest more resources in therapists and accompanied sessions. (AdobeStock)<\/figcaption><\/figure>\n<h2 id=\"h-this-is-your-brain-on-a-psychedelic-trip\">This is your brain on a psychedelic trip<\/h2>\n<p>We don\u2019t yet have definitive evidence for whether the human clinical effects of psychedelics require a psychedelic trip. But we do know how psychedelics initiate the experience.<\/p>\n<p>Classic psychedelics (e.g. LSD, psilocybin, DMT) activate the brain\u2019s serotonin 2A receptors (5-HT2A), which triggers the non-ordinary brain states that underlie the psychedelic effects. Here\u2019s a key observation: 5-HT2A receptors also mediate the plasticity-inducing effects of these drugs. This means that the subjective effects\u2014the trip\u2014and the enhancement of neuroplasticity depend on the same receptor.<\/p>\n<p>If you block the brain\u2019s 5-HT2A receptors with another drug and then administer one of these compounds, the subjective effects are absent. Enhanced neuroplasticity is also absent\u2014because you\u2019ve blocked the receptor that makes it happen.<\/p>\n<p>This is an important constraint. It suggests that if we\u2019re looking to enhance plasticity without inducing hallucinations, we may need a drug that boosts plasticity through a different receptor.&nbsp;<\/p>\n<h2 id=\"h-exhibit-a-tripping-might-be-necessary\">Exhibit A: Tripping might be necessary<\/h2>\n<p>That\u2019s what we know at the neural level. What about the subjective personal experience of a psychedelic trip?<\/p>\n<p>This is where we turn to human studies where people have been given psychedelics. In many of the positive outcomes recorded in these studies, patients often credit the hallucinatory experience as a critical part of their improvement. They find the experience of the psychedelic trip so emotionally salient that it often becomes the focal point for a patient\u2019s subsequent \u201cintegration sessions\u201d with a therapist.<\/p>\n<p>While such testimony is powerful, it doesn\u2019t necessarily prove that the hallucinatory experience was strictly necessary.&nbsp;<\/p>\n<p>Further data fills in more of the puzzle. Scientists have defined a specific component of psychedelic experiences as a \u201cmystical-type experience.\u201d These are experiences rated as especially profound and ineffable, and are separable from the intensity of the drug effect <em>per se. <\/em>In other words, it\u2019s possible to have an intense mushroom trip without having a mystical-type experience.<\/p>\n<p> <a href=\"https:\/\/www.leafly.com\/news\/science-tech\/death-and-psychedelics-how-science-is-reviving-this-ancient-connection\" class=\"wp-block-leafly-blocks-leafly-single-inline-block leafly-inline-related-story\"><\/p>\n<div class=\"border border-deep-green-alt border-l-0 border-r-0 my-xl p-md font-bold\">\n<p>Related<\/p>\n<p>Death and psychedelics: How science is reviving this ancient connection<\/p>\n<\/div>\n<p><\/a> <\/p>\n<h2 id=\"h-how-do-we-know-a-trip-is-beneficial\">How do we know a trip is beneficial?<\/h2>\n<p>Here\u2019s the evidence: Across a number of different studies, the strength of each patient\u2019s mystical-type experiences tended to predict the size of clinical outcomes, including reductions in cigarette cravings, anxiety, and depression. (Yes, psychedelics are a potential nicotine-cessation tool.) Patients with more intense mystical-type experiences tended to see greater improvement.&nbsp;<\/p>\n<p>One way to test this question would be to administer a psychedelic to patients so sedated that they have no memory of the trip, similar to what a surgery patient experiences. If the subjective effects are necessary for the full therapeutic benefits, heavily sedated patients should have diminished therapeutic outcomes. If subjective effects are unimportant, then sedated patients should see benefits equal in strength to previous studies.<\/p>\n<p>This test may or may not be carried out, as patients may not be keen to participate in a study where the outcome could be a <em>lack<\/em> of therapeutic benefit. A more likely route: Novel drug variants can be tested in lab animals before moving on to trials involving human subjects.&nbsp;<\/p>\n<h2 id=\"h-exhibit-b-tripping-might-not-be-necessary\">Exhibit B: Tripping might not be necessary<\/h2>\n<p>We can\u2019t know a mouse\u2019s perceptions. A mouse can\u2019t verbally tell us it\u2019s tripping. But we can look for what are known as behavioral correlates.<\/p>\n<p>When you give lab mice known hallucinogenic drugs, they display <a href=\"https:\/\/www.youtube.com\/watch?v=U_Uo-9iReJI&amp;t=1829s\" target=\"_blank\" rel=\"noreferrer noopener\">\u201chead twitch response.\u201d<\/a> So if you give a novel drug to lab mice, and their heads twitch in similar ways, our best guess is that the drug is hallucinogenic. If the mice don\u2019t head-twitch, the drug might not be hallucinogenic. This behavioral correlate is an indication, not absolute proof.<\/p>\n<p>As it happens, scientists recently created just such a drug. It was derived from ibogaine, a powerful psychedelic tryptamine. <\/p>\n<h2 id=\"h-ibogaine-s-close-cousin\">Ibogaine\u2019s close cousin<\/h2>\n<p>Ibogaine has shown promise for treating addiction and depression, but also has undesirable properties: It can have toxic effects (including cardiovascular abnormalities, i.e. heart problems), and induce intense hallucinatory experiences that last an entire day.<\/p>\n<p>To create this new variant, scientists basically took ibogaine and chemically removed different pieces of it. One of the resulting drugs, called ibogalog, retained many of the therapeutic properties of ibogaine (in mice) but didn\u2019t have the nastier effects. It also didn\u2019t cause head twitching in mice. Tentatively, this means ibogalog could be safer than ibogaine, without intense hallucinations. But we don\u2019t know for sure. Ultimately, we need to test it on humans.&nbsp;<\/p>\n<h2 id=\"h-non-hallucinogenic-variations-may-help-but-not-as-much\">Non-hallucinogenic variations may help, but not as much<\/h2>\n<p>My suspicion is that we <em>will<\/em> create non-hallucinogenic drug variants of psychedelics that have medical benefits, such as anti-inflammatory or antidepressant effects. However, these drugs may not work as well, or have effects as enduring, as those we have seen in humans taking psychedelics. This may be especially true for treatment-resistant forms of psychiatric conditions like major depression, PTSD, and end-of-life anxiety.&nbsp;<\/p>\n<p>By definition, treatment-resistant conditions are those that have failed to respond to approved medications. While non-hallucinogenic variants will likely be created, I share the intuition of medicinal chemist<a href=\"https:\/\/www.youtube.com\/watch?v=9i4PXyJqii0&amp;t=0s\" target=\"_blank\" rel=\"noreferrer noopener\"> David Nichols<\/a> and wouldn\u2019t bank on them having the same level of efficacy as psilocybin or MDMA, at least for severe human psychiatric conditions.&nbsp;<\/p>\n<p>Dr. Nichols has been studying the effects of psychedelics for decades. In a recent conversation of the Mind &amp; Matter podcast, he summarized his thoughts:<\/p>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<p>\n[embedded content]\n<\/p>\n<\/figure>\n<h2 id=\"h-working-through-the-problems\">Working through the problems<\/h2>\n<p>Psychotherapy involves engaging in dialogue with a therapist. A psychedelic trip is often a kind of internal dialogue with oneself. Aspects of your psychology that don\u2019t normally get a chance to speak up become front-and-center. If you spend time listening to patients describe the content of their psychedelic experiences, you find that (a) the imagery they experience is often directly relevant to their affliction; (b) they use language such as \u201cworking through\u201d or \u201cconfronting\u201d their problems. This is exactly what a therapist does.<\/p>\n<p>Can psychedelic drug variants be as therapeutically potent when the drug does not elicit this effect? It\u2019s conceivable. But consider an analogous question: would psychotherapy be as effective if you just sat in a room with your therapist but never said anything? <\/p>\n<p>Sure, it might provide some benefit compared to being by yourself, but it\u2019s difficult to imagine how it could be as effective as talking through your experiences and verbally working through their root causes.<\/p>\n<h2 id=\"h-fda-approval-as-a-breakthrough-therapy\">FDA approval as a \u2018breakthrough therapy\u2019<\/h2>\n<p>Multiple forces are now converging to approve and fund more research. Academic researchers are working hard on the science, venture capitalists are funding a wave of new psychedelic startups, and the FDA has designated psilocybin a \u201cbreakthrough therapy.\u201d Real scientific data and new treatment protocols should start emerging faster than ever.&nbsp;<\/p>\n<p>It\u2019s been half a century since Richard Nixon declared a War on Drugs and halted nearly all psychedelic research. In the coming months and years we should have a clear answer to many unanswered scientific questions\u2014including whether psychedelic trips are truly necessary to realize the most profound and long-lasting mental health benefits.<\/p>\n<div class=\"my-xxl wp-block-leafly-blocks-leafly-related-articles\">\n<p><h2>More from Dr. Nick Jikomes<\/h2>\n<\/p>\n<\/div>\n<div id=\"author-box\" class=\"p-lg my-xxl bg-white rounded border border-light-grey elevation-low\">\n<div class=\"mb-lg\"> <img decoding=\"async\" src=\"https:\/\/thcinct.com\/wp-content\/uploads\/2021\/11\/would-psychedelic-therapy-work-without-tripping.jpg\" alt=\"Nick Jikomes, PhD's Bio Image\" class=\"lazyload inline-block mr-md rounded-full border border-light-grey\"> <\/p>\n<p>Nick Jikomes, PhD<\/p>\n<\/p><\/div>\n<p class=\"text-sm\">Nick is Leafly&#8217;s Director of Science &amp; Innovation and holds a PhD in Neuroscience from Harvard University and a B.S. in Genetics from the University of Wisconsin-Madison. He is the host of a popular science podcast, which you can listen to for free at: www.nickjikomes.com<\/p>\n<p> <a class=\"text-sm font-bold underline text-green\" href=\"https:\/\/www.leafly.com\/news\/author\/nick-jikomes-phd\">View Nick Jikomes, PhD&#8217;s articles<\/a> <\/div>\n<div class=\"leafly-sailthru-signup p-lg my-xl bg-white rounded elevation-low border border-light-grey\">\n<p class=\"text-xs pt-lg\">By submitting this form, you will be subscribed to news and promotional emails from <a href=\"https:\/\/www.leafly.com\">Leafly<\/a> and you agree to Leafly&#8217;s <a href=\"https:\/\/www.leafly.com\/company\/tos\">Terms of Service<\/a> and <a href=\"https:\/\/www.leafly.com\/company\/privacy-policy\">Privacy Policy<\/a>. You can unsubscribe from Leafly email messages anytime.<\/p>\n<\/div><\/div>\n<\/p><\/div>\n<\/div>\n<p> <!-- Chartbeat --> <!-- End Chartbeat -->  <!--\nPerformance optimized by W3 Total Cache. Learn more: https:\/\/www.boldgrid.com\/w3-total-cache\/ Served from: _ @ 2021-11-02 16:35:45 by W3 Total Cache\n--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Would psychedelic therapy work without tripping? &#8211; Leafly Leafly Leafly \u00ae Loading\u2026 Where are you from? noyes Remember me for 30 days. I confirm that this is not a shared device. Darn! You&#8217;re not old enough to use Leafly. Redirecting you to By accessing this site, you accept the Terms of Use and Privacy Policy. \u2018Mind &amp; Matter\u2019 is a monthly column by Nick Jikomes, PhD, Leafly\u2019s Director of Science and Innovation. Therapy patients who\u2019ve taken a large dose of psilocybin often rate the experience as one of the most significant moments in their lives. Some compare it to an&#8230; <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"fifu_image_url":"","fifu_image_alt":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-2148","post","type-post","status-publish","format-standard","hentry","category-marijuana_information"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/thcinct.com\/index.php?rest_route=\/wp\/v2\/posts\/2148","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thcinct.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thcinct.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thcinct.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/thcinct.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2148"}],"version-history":[{"count":0,"href":"https:\/\/thcinct.com\/index.php?rest_route=\/wp\/v2\/posts\/2148\/revisions"}],"wp:attachment":[{"href":"https:\/\/thcinct.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2148"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thcinct.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2148"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thcinct.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2148"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}