In the UK, psychedelic drugs such as LSD and psilocybin are more legally restricted than heroin and cocaine. In an editorial in the BMJ medical journal, one psychiatrist writes that it’s time that changed.
James J H Rucker of Kings College London calls for psychedelics to be reclassified, so that researchers can more easily conduct trials with the drugs as potential treatments for psychiatric disorders such as anxiety, depression, and addiction.
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He writes that the classification of psychedelic drugs in 1967 as schedule 1, class A substances—the most strictly controlled—”denoted psychedelic drugs as having no accepted medical use and the greatest potential for harm, despite the existence of research evidence to the contrary.” The drugs are placed in schedule 1 in the US, too.
Rucker told me that he was motivated to push for reclassification owing to his experience as a clinical psychiatrist specialising in mood disorders. “I feel as though there are a lack of avenues for treatment for some people with mood disorders, and I became interested in psychedelic drugs because I was looking to see what other treatment possibilities might be out there,” he said.
“The cost of clinical research using psychedelics is 5-10 times that of research into less restricted (but more harmful) drugs such as heroin.”
He came across work led by Robin Carhart-Harris and David Nutt at Imperial College, who are leading research in this area such as the first imaging study of the brain on LSD. Rucker is now working with the group as a medical supervisor on trials using psilocybin, the psychedelic compound found in magic mushrooms.
But one of the reasons this kind of work is so uncommon is because of the schedule 1 classification of the drugs in question. As schedule 1 drugs, LSD and psilocybin are considered to have no therapeutic value. In the UK, heroin and cocaine are schedule 2 drugs because, though they are still class A substances (meaning they’re considered the most harmful), they have recognised medical uses. Rucker isn’t suggesting legalisation; he wants to see psychedelics reclassified into schedule 2, so researchers have a little less bureaucracy to deal with to run clinical trials.
In his opinion piece, he writes that the necessary licenses and the cost of getting such restricted drugs made to the correct standards “mean that the cost of clinical research using psychedelics is 5-10 times that of research into less restricted (but more harmful) drugs such as heroin—with no prospect that the benefits can be translated into wider medical practice.”
Rucker argues that LSD and psilocybin are less damaging than cocaine and heroin because they have not shown to be harmful in controlled settings nor to be habit-forming. Many of the concerns around psychedelics back in the 60s now seem to be largely down to rumour and speculation.
The potential benefits of psychedelics are hard to pin down with any certainty, given the lack of research in the current environment. Before the drugs were classified, work from the 50s and 60s suggested potential medical applications, but Rucker explained that the trials from back then wouldn’t meet today’s standards. “So really all that work needs to be re-done, but we are finding it incredibly difficult to do it because of the legal restrictions implicit in schedule 1, class A, and all the bureaucratic problems we’ve met because of that.”
The call-to-arms comes amidst a small but noticeable revival in interest around psychedelics for scientific research and medical applications. In the US, MDMA has been investigated in relation to post-traumatic stress disorder (PTSD), and LSD for end-of-life anxiety. In Norway, researchers are trying to raise money to produce MDMA and psilocybin for the purposes of study.
Reclassifying would ultimately be down to regulators, not scientists, but Rucker hopes that bringing the stigmatised and controversial topic into discussion will help push for change.
“If we can stimulate open and honest debate then maybe we can come to a reasonable, evidence-informed decision about what’s best for society,” he said.