RIYADH: Psychedelic researcher Stanislov Grof once wrote that “psychedelics, used responsibly and with proper caution, would be to psychiatry what the microscope is to biology and medicine or the telescope is to astronomy.” .
For many, this may seem like a far-fetched claim, but now more than ever it is proven to be true and could very well become a frontier in the practice of medicine.
Saudi Arabia was undergoing a mental health epidemic and the psychological strains of the pandemic were exacerbating this. People are desperately looking for ways to cope. One of the newest methods of psychotherapy in the region, although stigmatized, is psychedelic-assisted psychotherapy. A recent study published by Neuropsychopharmacology showed that the substances were proven to have long-term positive effects on mental health and their efficacy, safety and tolerability in the treatment of major depression, post-traumatic stress disorder, obsessive- compulsive and certain addictions.
I’m getting more people contacting me asking how they can get this treatment, and it’s really heartbreaking to tell them, I’m sorry, but you’re going to have to wait. It is not yet available.
Haya Al-HejailanSaudi wellness practitioner and specialist in psychedelic integration
It is also associated with improved creativity and problem solving, according to an article published by the Journal of Psychoactive Drugs in 2019.
While stigma around mind-altering substances, both in the region and globally, is inevitable, researchers and scientists argue that if these drugs are regulated and used only for medical purposes, what is the harm?
The term “psychedelics”, a class of hallucinogens, comes from the Greek words “psyche”, which means mind, and “delia”, which means to manifest. Psychoactive substances are intended to alter the mind and create an alternative cognitive perception.
Psychedelics are categorized into classics, which include lysergic acid diethylamide (LSD), psilocybin (commonly known as magic mushrooms), mescaline, and others, and non-classics, such as methylenedioxymethamphetamine (MDMA or ecstasy) and ketamine.
“(These are) very good tools for us to better understand the brain and the study of consciousness,” Haya Al-Hejailan, a Saudi wellness expert and specialist in psychedelic integration, told Arab News . His work centers on psychedelic research and the treatment of borderline personality disorder.
This point may seem counter-intuitive: how to treat an addiction with a substance likely to cause another addiction? But psychedelics are, in fact, anti-addictive in nature.
“They have anti-addictive properties, which means they are not physiologically addictive, but one can become psychologically addicted to anything,” Al-Hejailan said, referring to addictions unrelated to drugs. substances such as coffee or mobile devices.
However, the use of psychedelics can present certain dangers, which makes it crucial to undergo treatment strictly under professional medical supervision, which can only be accessed through clinics. Psychedelic therapists are trained to create a controlled environment for patients undergoing psychedelic therapy, with sessions prior to the administration of the treatment dose to identify red flags or possible risks that would otherwise create a greater margin for error. Patients who self-dose could potentially be subject to health risks, retraumatization, depersonalization, and dissociation.
“More and more people are contacting me asking how they can get this treatment, and it’s really heartbreaking to tell them, ‘I’m sorry, but you’re going to have to wait. It’s not available yet,'” Al-Hejailan said “But I’m optimistic about the word ‘again’ being highlighted.”
An article published by The Lancet have shown that most antidepressants are ineffective and can be harmful to adolescents and children.
In order to address this medical need, several research efforts and trials have been undertaken to evaluate alternative pathways, such as psychedelic-assisted therapy.
A study published by the National Library of Medicine found that small IV doses of ketamine can have positive and long-lasting antidepressant effects in patients. Although scientific research regarding the psychotherapeutic use of psychedelics in the region is insufficient, Saudi Arabia has facilitated its use for other purposes. Last year the Saudi Journal of Emergency Medicine published an article describing a successful case of refractory epilepsy, a life-threatening condition, in a child treated with a single dose of ketamine.
Despite its growing popularity in the mainstream media, psychedelic science is one of the cutting edge neurosciences, producing insufficient research compared to other sciences. The 1950s saw the first published report in English of LSD, and research continued into Richard Nixon’s US presidential term, ending in the 1970s. However, research efforts were soon banned on the grounds that the War on Drugs was a declared public enemy of the US President. However, it was buoyed by other factors, such as lack of funding for psychedelic research and failed medical trials, according to an article published by the Cambridge University Press.
This field of medicine was considered niche until recently. In 2017, MDMA received “Breakthrough Therapy” designation from the Food and Drug Administration, meaning it received an expedited review process. In 2018, the FDA granted the same status to a group of psychiatrists seeking psilocybin-assisted therapy for treatment-resistant depression.
That same year, Michael Pollan’s book “How to Change Your Mind” created a public space for people to think differently about psychedelics and expanding mind awareness. Ketamine was granted the same status a year later. This is arguably when psychedelics came into their own, although their resurgence in clinical research and trials resumed in the 1990s.
“(Before that) I encountered a lot of skepticism. People literally thought I was talking about something crazy,” Al-Hejailan said in reference to the discussion of psychedelic-assisted psychotherapy before 2018.
“There is a lot of interest, enthusiasm and curiosity that I encounter now when I talk about my work.”
With a Masters in Applied Positive Psychology and Coaching Psychology from the University of East London, Al-Hejailan’s work also includes the integration of positive psychology and psychedelic education, providing training in therapy psychedelics and in ketamine-assisted psychotherapy. She also co-directed and co-produced a documentary called “Psychedelic Renaissance”, focusing on the re-emergence of the psychedelic movement in the world and its cultural significance.
Al-Hejailan said raising awareness of psychedelic studies was the first step in creating a regional environment that allows for alternative psychotherapy methods.
“I think we need, in general, to focus more of our energy and attention on psychoeducation, educating the public about mental health and wellness. The more we do this, the more likely people are to continue to accept and be interested,” she said.
The next steps to normalize the use of psychoactive drugs include actively training clinicians and therapists in their uses and benefits and, eventually, establishing specialty clinics and research centers.
“My goal is to have presentations specifically on psychotherapy and to meet with therapists, psychologists, psychiatrists and other doctors, and policy makers at some point. To show them what’s going on at the abroad, what science shows and discuss how we can replicate that here in a safe way that respects our culture and respects our specific or unique needs,” Al-Hejailan said.
“I really want to open a clinic and a research center here. My colleagues and I would love to see the Saudi pioneer of psychedelic research in the region, and perhaps the world.