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Would the medical research benefits of reclassifying LSD outweigh the risks?

Would the medical research benefits of reclassifying LSD outweigh the risks?

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Psychedelic drugs should be reclassified to encourage new research into their medical applications, a researcher argues in an opinion piece published in The British Medical Journal today. Before substances such as LSD were stigmatized during the "war on drugs" in the 1970s, studies suggested they could be useful in dealing with psychiatric disorders, writes James Rucker, a psychiatrist at King’s College London. But a number of restrictions — some legal and some financial — have made studying potentially-helpful drugs far too difficult.

"Legal prohibition of some psychotropic substances continues to be a condition of UN membership," Rucker writes, "even though the original reasons for classifying them as such were largely fallacious."

It costs $150,000 to produce one gram of legal psilocybin

LSD and other psychedelics were classified as Schedule 1 drugs by the United Nations in 1971 — meaning their production and transportation is tightly controlled. For example, only one manufacturer in the world officially produces psilocybin for the "prohibitive" cost of $150,000 for one gram or 50 doses, Rucker writes. This means that "clinical research using psychedelics is 5-10 times that of research into less restricted (but more harmful) drugs such as heroin."

LSD, first synthesized in a pharmaceuticals lab in 1938, was tested in number of clinical trials in the ‘50s and ‘60s. Although not all of these trials were rigorous by today’s standards, a 2012 analysis of those that were more studiously conducted suggests that the scientists were on to something. A number of small studies in recent years have added to the body of evidence, making claims for LSD’s effectiveness in helping to treat everything from obsessive compulsive disorder to cluster headaches. However, larger clinical studies that might offer more conclusive evidence are impossible because of the "practical, financial, and bureaucratic obstacles," Rucker writes.

"Unpredictability makes them dangerous."

But for all the apparent potential of psychedelics, many scientists argue that the drugs are just too risky to be used in a clinical setting. "[Their] unpredictability makes them particularly dangerous," says Bertha Madras, a psychobiologist at Harvard University, in an email to The Verge. "Hallucinogens can produce perceptual distortions of reality and also intense emotional swings." This can lead to intense feelings of terror, panic, and the fear of insanity and death, Madras says.

The review that Rucker cites as showing little evidence that psychedelics cause harm in controlled settings is from 1984 and "much more has been added to the literature of hallucinogens since that time," Madras adds. Similarly, she notes that although controlled settings may reduce the more extreme consequences of using hallucinogens, we can’t predict "that introducing this class of drugs as a therapeutic will not result in their misuse subsequently." Madras says that Rucker’s assertion that the stigmatization of hallucinogens was politically motivated is "pure drivel," and that "politics [entered] the scene following alarms set off by health care professionals."

Despite the possible dangers of these drugs and the often fierce nature of the culture wars surrounding their image, it does seem like the tide might be slowly turning. The first studies on the medical use of LSD since the 1970s are now being published, and in the US, the swing of support for medical marijuana in recent years has shown that even the most maligned drugs can be rehabilitated over time. David Nutt, a drugs experts who was controversially sacked by the UK government after claiming that horse-riding was more dangerous than ecstasy, told The Guardian in March that psychedelics offer "the greatest opportunity we have in mental health," adding, "There’s little else on the horizon."