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The Need to Destigmatize Enhanced Therapy

In 2018, a combination of bad luck and idiocy landed me in the hospital with a spinal and sciatic nerve injury leaving me unable to walk for the next three months. In addition to having to temporarily move to my parents’ house (where I relied on my 90-something grandmother’s borrowed walker to shuffle around) I found myself in the most excruciating physical pain I’d ever experienced. My doctor prescribed a low dose opiate that didn’t even come close to touching the pain I was in 24 hours a day, and I resisted a higher dose knowing that addiction was a risk (one that I’m genetically susceptible to). The only medicine that eased the nerve pain, allowing me to sleep and eat, was cannabis, which was at that time legally available for medicinal purposes and enhanced therapy (later that same year it became legal across Canada for recreational use as well).

I don’t like thinking about how I would have dealt with my injury had I not had THC and CBD to treat the pain. My access to these medicines depended on timing and luck and the fact that the legalization process in Canada had been part of the media conversation about cannabis for years. I didn’t face stigmatization for the decision to use one particular type of medicine over another, and it’s distressing to think that other people’s judgment might have, at one time, caused me to bar my own access to the only medicine (save for the single dose of morphine the emergency room doctor gave me) that worked.

Currently, people suffering from treatment-resistant mental health conditions face not only limited access to the relief that psychedelics have been shown to provide but also a level of stigmatization compounded by the intersection of our ideas about mental illness and our perception of psychedelics.

Where does psychedelic stigmatization come from?

“The stigma around psychedelics (and, by extension, enhanced therapy) is entrenched in the North American psyche because for decades, all drugs have been treated as equal under federal drug policy,” says Cybin CEO Doug Drysdale whose biopharmaceutical company is partnering with Deepak Chopra to increase awareness about the therapeutic uses of psychedelic medicines. “Laws are meant to reflect public perceptions, but in the case of psychedelics, the policy itself informed the way people think and feel about psychedelics. We know that many psychedelics that were once classified as dangerous have incredible therapeutic value,” he explains, “but we are working against decades of shutdowns to science, misinformation, and social stereotypes, all which have served as threat-signals.”

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Many of the federal drug policies Drysdale references have their roots in former US president Richard Nixon’s so-called War on Drugs, a failed prohibition campaign that criminalized and stigmatized select segments of society while resulting in the mass incarceration of others. A toned-down version of the policy continues today, standing at odds with decriminalization and legalization movements elsewhere on the globe.

Along with outlawing drugs considered harmful to both users and the public in general, the War on Drugs blocked access to psychedelics despite early research demonstrating their efficacy in using enhanced therapy to treat mental health conditions like PTSD and depression.

Ethnobotanist and psychedelic advocate Terrence McKenna hypothesized that “Psychedelics are illegal because they dissolve opinion structures and culturally laid down models of behavior and information processing. They open you up to the possibility that everything you know is wrong.”

McKenna’s statement hints at the increase in neuroplasticity that researchers have found during clinical trials with psychedelic medicine. David Nutt, a psychopharmacologist at Imperial College London says that people with certain types of mental illness “get locked into disorders like depression because they develop this system of thinking which is efficient, but wrong.” An increase in neuroplasticity can open up new pathways in the brain that present new ways of thinking.

There’s a keen irony behind the idea that psychedelics are stigmatized for the precise reason that they are so useful in treating mental health conditions.

How should we talk about psychedelic medicine?

“I hate that we remove access for ourselves because we’re afraid of what other people will think,” says Amanda, a 30-year-old mother of a young son who says she’s faced judgment for treating her endometriosis, fibromyalgia, and ongoing nerve pain issues with cannabis containing high levels of THC which, she feels, has its own stigma attached to enhanced therapy because of the related psychoactive effects. “Everyone talks about how CBD is so great because it has no psychoactive effects, but the THC is what actually helps my pain.”

“One instance that I can remember very clearly was early in my son’s life — he was about one. I was talking to another mom about cannabis use. She said it’s still very taboo for her, and that she’d never let her children see her using it. I was basically silent because I was so uncomfortable. I was in this conversation with a mom who has three kids. I’m a new mom and I think, ‘Oh, she’s done this twice before. Maybe she has a point that I could be somehow harming my child.’ But I realized it was a lot more harmful for him not to see it and for it to be hidden,” she says, adding, “If we talk about cannabis or other therapeutic substances as medicine and we approach the topic the same way we would with medicine for any other illness, their understanding increases exponentially.”

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For many people, the legalization of psychedelics for medicinal use will provide a platform for a more comfortable discussion. “For a lot of people, as soon as they can say that something is approved by their doctor, it somehow becomes okay,” says Amanda. “That was a fallback for me too. If somebody asked me if I use cannabis, I would automatically say, ‘Yes, but it’s for medical reasons.’ I even find myself doing that sometimes now,” she explains, despite the fact that cannabis is legal for recreational use across Canada.

She’s aware of the irony behind her continued apprehension. “For that particular mom,” she says, referencing the woman she felt judged by, “she takes antidepressants. I don’t understand how it’s any different and she can talk about that with her mom group or joke about drinking wine all day and everyone is supporting that. But when I’m doing something that’s actually making me a better parent, I still feel like I can’t bring it up in regular conversations unless I know people really well.”

Experience, however, has taught her how to manage the stigmatization of enhanced therapy, and Amanda says that the growing body of research supporting ketamine’s efficacy in treating the kind of chronic nerve pain she experiences is exciting. “I’m really hopeful personally. Especially because I’ve seen how positively THC has affected my conditions and knowing that that is based a lot in the brain. We don’t have a great understanding of the human brain, or why pain centers are set off. So thinking about psychedelics, which are actively working with your brain, could be used to alleviate that pain is revolutionary to me”

Efforts to decrease stigmatization and signs of progress

The stigmatization of medicines ranging from cannabis to psychedelics affects anyone who seeks these treatment paths but is compounded when those people are suffering from mental health issues and even more so if they belong to marginalized communities. Steps to alleviate the stigma around psychedelic medicines are making progress, however, as research efforts pick up steam with the backing of federal governments.

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This first step — scientific confirmation of psychedelics as a breakthrough therapy in the treatment of mental illness — goes a long way. Media coverage, which has increased exponentially over the past few years, also helps to amplify the voices of experts and researchers working in the field of enhanced therapy. Finally, there are the stories from those who’ve had personal and often life-changing experiences with psychedelics — from NBA player Lamar Odom to author Deepak Chopra to country music star Kacey Musgraves. And while celebrity endorsements aren’t a platform on which to base your own health decisions, “At least it gets the conversation started for people,” says Amanda.  “And once we have the conversation started, it expands our horizons. We can connect and maybe more people will start benefiting from these medicines because of that connection.”

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