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Club Drugs Are Having a Moment

Here are five that have made their way into the hearts of medical researchers.

Kevin Franciotti

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When the Drug Enforcement Administration decides it really doesn't like a drug, your odds of learning anything useful about it become very, very slim. Take marijuana, for instance: The DEA still classifies it as a schedule 1 substance, which means it has "no recognized medical use and a high potential for abuse." That puts weed in the same league as dangerously addictive narcotics like heroin.

For decades, as a result, researchers have been limited in their ability to study marijuana, but that could change due to a loosening of those restrictions in recent months. While the stigma around marijuana use has all but faded, several other drugs are still hampered by negative and mostly outdated perceptions—despite a growing body of new research that supports their effectiveness for treating everything from depression and anxiety to PTSD. Over the past year or two, many of these drugs have been studied in controlled environments, with controlled dosages, which means people's reactions have scientific merit—and are notably different from when they're taken recreationally. Here are five that are showing way more promise than simply making Coachella more fun.  

Ayahuasca
The mystical brew from the Amazon has exploded into popular consciousness. South American jungle expeditions now offer the chance to take the drug in its native setting—but soon, you might not need to book a flight. Ayahuasca is traditionally prepared as a brew, combining the DMT from the Chacruna plant—typically found in the Banisteriopsis caapi vine—with another ingredient that prevents the drug from being broken down by stomach acids, called monamine oxidase inhibitors. Several recent studies have suggested that Ayahuasca could be useful for treating depression and addiction, and while the research is still in its early stages, human neuroimaging and petri dish studies (not performed on humans or animals) are shedding new light on how the drug works. Of the greatest interest to western medicine, however, is Ayahuasca's apparent ability to trigger the production of new human brain cells. MRI scans of people on the drug showed alterations in the brain's resting state activity and normal connectivity patterns—both of which may play a role in treating symptoms of depression. 

MDMA
A component of ecstasy that acts as both a stimulant and a psychedelic, you'd be hard-pressed to find someone unaware of the popular feel-good drug of choice for your average EDM festival. But the Multidisciplinary Associations for Psychedelic Studies, an organization that sponsors clinical trials to investigate the treatment of PTSD, announced in November that they got the green light from the FDA to move to phase 3—the final stage of the prescription-approval process. MAPS estimates that those trials will be completed by 2021. If MDMA-assisted psychotherapy continues to show success in treating PTSD as it did in phase 2—with rapid symptom relief and sustained improvements from less than a handful of doses—it may be rescheduled. 

Ketamine
Another club drug with a notorious reputation, ketamine is currently available as an off-label treatment for serious depression (as long as you have the money to pay out-of-pocket for it, at least) and pain. Studies continue to show effectiveness even in people who have failed to respond to other treatments. Although the effects only last for a couple months at a time, ketamine treatment produces immediate benefits—as little as 40 minutes—unlike antidepressants, which can take weeks to kick in. Trials are currently underway to expand ketamine's usage, including for treatment of bipolar disorder and addiction.

LSD
Once heralded as a revolutionary tool for psychiatry, LSD was later blacklisted from research—due in no small part to its recreational role in the counter-cultural upheaval of the late 1960s. The drug has now come full circle, with at least one psychiatrist permitted to treat his patients medically. Earlier this year, results from the first-ever human neuroimaging study showed neural correlates of what any acid user has long known: Under LSD, the brain's visual cortex communicates with other regions in the brain more than usual, which may explain the vivid and complex imagery of the experience. (It could also explain the reduced blood flow to brain networks at rest, especially in subjects who claimed to lose their sense of "ego self.") 

Currently the Imperial College at London is the only lab testing LSD in humans for therapeutic purposes, as well as searching for insights into the mechanisms of consciousness. The researchers feel the drug could hold promise for treating depression, anxiety, and substance use disorders.

Psilocybin
Early in December, psilocybin mushroom research headlined every major news site, showcasing the results from simultaneously published studies out of NYU and Johns Hopkins. Combining the data from both studies, 80 patients with cancer-related anxiety and depression were treated with a single dose of psilocybin. Sixty to eighty percent of them showed immediate and long-term positive effects—including relief of existential distress and anxiety, and improvement in quality of life up to six months later.

Currently, psilocybin joins MDMA as being one of the closest drugs to be approved as prescription medicine. Researchers will meet with the federal Food and Drug Administration to seek approval to submit a final set of experiments—known as phase 3—involving several study sites and hundreds of subjects to replicate their findings. If psilocybin is approved for treating cancer-related anxiety or depression, the FDA may move more quickly on its other uses for major depression and addiction