Illustration by Seba Cestaro

Going Underground

The resurgence in clinical trials into the effectiveness of LSD, MDMA, and psilocybin in treating depression and trauma has received widespread publicity. But outside the labs, regular people are taking psychedelic therapy into their own hands.

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Dec 10 2018, 3:00pm

Illustration by Seba Cestaro

This story appears in VICE Magazine's Burnout and Escapism Issue. Click HERE to subscribe.

Anita’s stepfather was a dark force in her life. He would concoct inventive punishments for the children if they didn’t do his bidding. One night, he drove them out to a quarry and left them there for an hour. Another time, he made Anita strip in front of a mirror while he sat and watched. When Anita turned 15, she says he started raping her.

“I honestly don’t think I would be alive without MDMA and LSD,” Anita, a pastry baker from Maine, told me.

But they weren’t her first choices. At 16, she’d started self-medicating with the benzodiazepine Klonopin, snorting it until she passed out and had to be dumped on the doorstep by friends. She got into pot. She smoked four packs of cigarettes a day.

That routine continued until she was 24, when she started to experience extreme anxiety. “I had agoraphobia so bad it was a struggle to leave my home,” says Anita, now 32. “I just wanted to die, and I began obsessing over how.”

A guy she was seeing, Josh, had been experimenting with LSD. He seemed happier, calmer, more optimistic. One night he brought over a couple of tabs. At first she was cautious. She was into obliteration, not mind expansion, and she was completely unaware of the scientific research into the therapeutic value of psychedelics that has been stacking up since the 1950s. “I would have thought that was ridiculous,” she says, “because taking acid had always been described to me as going into this nightmare world where you look into your deepest darkness.”

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She kept waiting for the trip to turn into a PSA nightmare, or that TV movie she saw once, Desperate Lives, where Helen Hunt took PCP, the hallucinogenic anesthetic also known as angel dust. Instead she began feeling calm, and more connected to nature. She and Josh followed up with a few more trips over the next few weeks, then he brought over some MDMA. “This made me relive my experiences, and some might consider it a ‘bad trip,’” she says. “But even so, I noticed I felt more resilient. I faced things, head-on, with fascination. At times it felt like I was an exorcist, peering into the void and letting it speak through me.”

Into this new regimen she introduced meditation, wrote letters to herself, and took bike rides into the country, before reaching a point where the drugs were no longer necessary. “I do not feel fully cured of my PTSD,” she says. “But my experience gave me a set of tools to cope with my downs in a healthy, positive manner, and it taught me self-love and self-care.”

The past few years have seen a psychedelic renaissance thanks to the progress of clinical trials of substances such as LSD, psilocybin, and even ayahuasca to treat PTSD, depression, anxiety, and addiction. In trials conducted in 2016 by the Multidisciplinary Association for Psychedelic Studies (MAPS), 61 percent of the 108 participants no longer qualified for a PTSD diagnosis two months after receiving three sessions of MDMA-assisted psychotherapy. Similarly, researchers at John Hopkins University have found that psilocybin reduces depressed mood and anxiety in patients with cancer.

But what does that mean for the general population? The FDA granted Breakthrough Therapy Designation to MDMA in 2017, and with phase 3 trials now underway, MAPS predicts, perhaps optimistically, that MDMA could be regulated as a medicine by 2021. Still, it’s likely that MDMA-assisted therapy will be limited to people experiencing PTSD. The same is true of psilocybin and other substances—they will likely be targeted at end-of-life patients rather than those with anxiety and depression, or just good old-fashioned stress.

And so, an increasing number of people who’ve been following the progress of these trials have gone off-grid and found sympathetic therapists to facilitate illegal sessions. As previously reported by Motherboard, VICE’s technology site, one psychotherapist in her 60s, Friederike Meckel Fischer, was arrested by Swiss police back in 2010 and received a 16-month suspended sentence for giving her patients LSD and MDMA as tools to help them reconnect with their feelings. Her case wasn’t helped by the fact that she’d supplied the illegal highs.

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The benefit of using a professional therapist is that they can safely guide the client toward a particular traumatic event, responding to whatever the client brings up. The therapist provides minimal intervention during the trip, because the hard work comes afterward. In the follow-up integration sessions—which are conducted without psychedelics—the client and therapist process what came up during the trip.

But there are downsides for a patient seeking to use underground therapists. First, an individual needs to be well connected to even find one in the first place. Secondly, there’s the expense—picture a therapist’s hourly rate and apply that to an eight-hour session. It is also frowned upon by institutions. When I contacted the British Psychological Society and the American Psychological Association for their stance on DIY psychedelic use, the former commented that “the use of psychedelic drugs in psychological therapy is illegal,” while a spokesperson for the latter told me they “do not have an official stance on this.”

Many people, then, choose to go it alone, or with a friend as a kind of trip-sitter. They might get their information on doses and substances (or just read first-person accounts) from forums like Reddit, Bluelight, and Erowid, or from books such as Julian Vayne’s Getting Higher, Michael Pollan’s How to Change Your Mind, and Stanislav Grof’s Realms of the Human Unconscious.

That’s exactly what Cameron, a consultant in London, does when he suffers burnout or has some kind of emotional problem that won’t shift. The 30-year-old had read about clinical trials in the media; now he looks up doses on forums and sets an intention. Sometimes he goes solo, sometimes he drops a dose with a friend. He’s used LSD and mushrooms, but for a breakup that had been bothering him for 18 months, he took MDMA. “I don’t usually come to any conclusion during the trip, but it tends to crystallize afterwards,” he told me. “In this instance, I was able to understand why my ex-girlfriend did what she did, and to empathize. Afterwards, I went from having no contact with her to us being quite close friends.”

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Dan, a former soldier in his 40s, is also London-based. He is part of a psychedelic community that he describes as being populated by academics and intellectuals. During his time in the military he had many near-death experiences that led to him to develop PTSD. “At the time, I didn’t think they were having any emotional impact on me,” he says. “I had a typical macho response of ‘Look what I can put up with and I’m fine.’ I had no idea it would be contributing to a mental illness so many years later.”

Dan had enjoyed Aldous Huxley’s essays about psychedelic use, and he later came across the work of Canadian researchers that took place between the 50s and 70s who had phenomenal results treating alcohol dependence using LSD. He’d always dabbled with psychedelics for stress relief, but when he read a book about tryptamines, called TIHKAL: The Continuation (by Alexander and Ann Shulgin), he decided to try 4-AcO-DMT. “It’s a close analogue of psilocybin but also dramatically different,” he claims. “Whereas mushrooms operate in a part of the brain that could be considered about language or intellect, 4-AcO-DMT acts on the emotional thought processes.”

Dan finds that 4-AcO-DMT helps him understand how his emotions have become warped. “People can have a horrific time on mushrooms, and if you fall down that hole there’s no real limit to how far you can go. With 4-AcO-DMT you bounce. It’s a lighter, safer experience. I am still stuck with these symptoms—it’s chronic—but I can manage them. I might only need to use it once every two months.”

Before this, Dan had been prescribed an SSRI antidepressant, which worked well for the first year, but then he realized that just as the medication was preventing him dipping too low, it similarly put a cap on his pleasure in life. By contrast, 4-AcO-DMT allowed him to experience happiness and connection. As a result, he found his reliance on alcohol tapering off.

Without expert supervision, using psychedelics and other therapeutic substances relies on trial and error. The exclusion criteria for John Hopkins studies using psychedelics include a history of schizophrenia, a psychotic disorder, or bipolar I or II disorder. Studies using psychedelics to alleviate depression in terminal patients usually exclude people with borderline personality disorder or schizophrenia. But there are no such precautions in the DIY world. And even those wanting to treat depression and anxiety may find that their inexperience around integration doesn’t bring good results.

Back in 2015, Kirsty, then 33, was receiving ketamine treatment in Sydney for her 15-year history of depression. She’d read about the treatment in a news story and put out a Google alert for it starting in Australia, then managed to sign up as a patient at Aura Medical Corporation. Aura had its clinics shut down later that same year for not supplying adequate psychiatric support and for handing out self-injecting packs—including ketamine—for clients to use at home.

“After the clinic shut, I went ‘off-book’ for six months, in that I was buying K from dealers,” Kirsty told me. “I was snorting rather than injecting, but I tried to re-create the experience, sitting quietly for an hour. I definitely felt a bit high, which made it hard to process my thoughts.”

In recent years more and more people have been microdosing LSD or psilocybin as way to improve productivity and mental health. Paul Austin, founder of the Third Wave, a resource center to educate the public about “practical, measured use” of psychedelics, thinks regular small doses give the advantage of experiencing the present more fully. “Microdosing is something that someone can do twice or three times a week. Depression is often linked to a rumination on the past, and anxiety to a focus on the future. Microdosing puts us in the here and now.”

But Dan, the former soldier, thinks achieving “ego death”—when the lines between the self and the outside world drop away—is most beneficial. “You can’t become at one with yourself and connected with all things through microdosing,” he says. “I’m dubious when people talk about doing it every day. The tolerance builds so quickly—and there’s a cross-tolerance between all the serotonergic hallucinogens—that the classic view is you don’t dose more than every two months.”

Dr. Prashanth Puspanathan is a medical doctor and neuropsychiatry fellow at a major Melbourne hospital, and a clinical adviser to the Australian Psychedelic Society. He’s pleased that interest in clinical trials is reducing stigma around psychedelic use and is overwriting old headlines about hippies and people thinking they can fly out of windows.

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“If nothing else, these trials are the first step towards changing preconceived notions towards psychedelics,” he says. “I do think psychedelic psychotherapy is quicker [than regular talking therapy]. When you see it work in trials with trained therapists the results are pretty fascinating. But the thing that really works is the integration afterwards with the same therapist—that’s the hard work you need to put in. You don’t walk away from the transcendental experience knowing all the answers.”

For Anita, the psychedelic effects have lasted years beyond her final dose. The downside, she says, is that while they gave her a connection to everything around her and offered a way out of her hellish personal narrative, it has become impossible to stop caring about her impact on the rest of the world, and that can be exhausting.

“There’s such a stigma associated with LSD,” she says. “But I was just a deeply broken girl who wanted to get closer to nature, get closer to herself, and find some peace through whatever nonharmful means.”

Mindfully using psychedelics for their therapeutic benefits used to largely be the domain of those plugged into the psychedelic lifestyle. It seems only logical that now, as news headlines mount up about the progress of clinical trials, public experimentation has similarly slipped into the mainstream. DIY therapy is likely to only gain momentum as we wait out the long scientific and legislative process necessary for these substances to become legitimate medicines.

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