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Michael Winkelman
and Ben Sessa, Editors
Advances in
Psychedelic
Medicine
STATE-OF-THE-ART
THERAPEUTIC APPLICATIONS
Advances in Psychedelic Medicine
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Advances in Psychedelic Medicine
State-of-the-Art Therapeutic Applications
Michael Winkelman and Ben Sessa, Editors
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Copyright © 2019 by abc-clio, llc
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, except for the inclusion of brief quotations
in a review, without prior permission in writing from the publisher.
Library of Congress Cataloging-in-Publication Data
Names: Winkelman, Michael, editor. | Sessa, Ben, editor.
Title: Advances in psychedelic medicine : state-of-the-art therapeutic applications /
Michael Winkelman and Ben Sessa, editors.
Description: Santa Barbara : ABC-CLIO, LLC, [2019] | Includes bibliographical
references and index.
Identifi ers: LCCN 2018053052 (print) | LCCN 2018053771 (ebook) |
ISBN 9781440864117 (ebook) | ISBN 9781440864100 (hardcover : alk. paper)
Subjects: | MESH: Mental Disorders—drug therapy | Hallucinogens |
Hallucinogens—therapeutic use
Classifi cation: LCC RC483 (ebook) | LCC RC483 (print) | NLM WM 402 |
DDC 616.89/18—dc23
LC record available at https://lccn.loc.gov/2018053052
ISBN: 978-1-4408-6410-0 (print)
978-1-4408-6411-7 (ebook)
23 22 21 20 19 1 2 3 4 5
This book is also available as an eBook.
Praeger
An Imprint of ABC-CLIO, LLC
ABC-CLIO, LLC
147 Castilian Drive
Santa Barbara, CA 93117
www.abc-clio.com
This book is printed on acid-free paper
Manufactured in the United States of America
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Contents
Acknowledgments ix
Chapter 1 Introduction: The Psychedelic Renaissance
Continues 1
Michael Winkelman and Ben Sessa
Part One Psychiatry 11
Chapter 2 Psychedelics and Psychiatry: A New Treatment
Model for the 21st Century 13
Charles S. Grob and Gary Bravo
Chapter 3 Therapeutic Applications of
3,4-methylenedioxymethamphetamine (MDMA) 38
Ben Sessa
Chapter 4 Psilocybin Therapy for Major Depressive Disorder 59
James JH Rucker
Chapter 5 Ketamine Therapy for Treatment-Resistant
Depression 81
L. Alison McInnes and Marc Ettensohn
Chapter 6 Evidence for the Therapeutic Effects of Ayahuasca 102
Dráulio Barros de Araújo
Part Two Substance Abuse 125
Chapter 7 Psilocybin for the Treatment of Substance
Use Disorders 127
Ishani Rao and Greg Lydall
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vi Contents
Chapter 8 Potential Applications of Cannabis and
Cannabinoids in the Treatment of Substance
Use Disorder and in Harm Reduction 148
José Carlos Bouso, Rafael G. dos Santos,
and Jaime Hallak
Chapter 9 Psychedelic Therapy as a Complementary
Treatment Approach for Alcohol Use Disorders 170
Peter Eischens and William Leigh Atherton
Part Three Medical Hypotheses 191
Chapter 10 Effects of Psychedelics on Infl ammation and
Immunity 193
Attila Szabo
Chapter 11 The Protective Role of Dimethyltryptamine against
Ischemia-Reperfusion Injury 214
Ede Frecska, Attila Kovacs, and Attila Szabo
Chapter 12 Psychedelic Treatment of Disruptive Personality
Patterns 232
Petr Winkler and Rita Ko cˇ árová
Part Four Treatment and Training 251
Chapter 13 Guidelines in Applying Psychedelic Therapies 253
Friederike Meckel
Chapter 14 Training Psychedelic Therapists 274
Janis Phelps
Part Five Societal Engagement with Psychedelics 295
Chapter 15 Community-Based Full-Spectrum Harm
Reduction Approaches When Caring for
Psychoactive- and Psychedelic-Related Problems
at a Transformational Festival 297
Maria Carmo Carvalho, Cristiana V. Pires,
Ana Luísa Costa, Daniel Martins, Helena Valente,
Inês Macedo, Paula Frango, and Raquel Lira
Chapter 16 Microdosing Psychedelics 318
James Fadiman and Sophia Korb
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Contents vii
Chapter 17 Bringing Psychedelics and Entactogens
into Mainstream Pharmaceuticals:
A Focus on MDMA 336
Anne C. Wagner, Michael C. Mithoefer,
and Rick Doblin
About the Editors and Contributors 357
Index 000
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Acknowledgments
The editors would like to thank our contributors for their work in bring-
ing to you a state-of-the-art understanding of the potential for the imme-
diate therapeutic applications of psychedelics. The editors thank Tom
Roberts for his perspicacity in recommending that Ben Sessa join the
project when he was committed to other publications. We also thank
Praeger/ABC-CLIO acquisitions editor Debbie Carvalko for her persis-
tence in asking for a sequel to Psychedelic Medicine: Volumes 1 and 2 . We
would also like to acknowledge the contributions of Arnold E. Ruoho,
Nicholas Cuzzi, and Charles Nichols as reviewers. Thanks also to Cindy
Winkelman for assistance in formatting the manuscript.
D e d i c a t i o n
This book is dedicated to the psychedelic scientist, the psyche-
delic explorer, the secret researcher, the daring therapist, the rebellious
patients, and all of humanity that is willing to open their eyes to evidence-
based science regarding psychedelics, and also to reclaiming a spiritual
and therapeutic heritage of humanity. Psychedelics have languished for
too long under the oppression of inquisitions, the persecution of shamans
and healers, and the postmodern assault of the draconian war on drugs.
We wish to change this situation by seeing psychedelics legally approved
and used as prescribed medicines, while also learning from and preserv-
ing their indigenous use around the world. It is in this spirit that we
dedicate this book to people in all walks of life who wish to lift the veils of
ignorance and see the great therapeutic and spiritual potential of psych-
edelics to change lives and heal the affl icted.
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CHAPTER ONE
Introduction to
Advances
in Psychedelic Medicine:
The Psychedelic Renaissance
Continues
Michael Winkelman and Ben Sessa
Following the groundbreaking success of Psychedelic Medicine: Volumes 1
and 2 (Winkelman & Roberts, 2007), it is with great pleasure that we
bring you Advances in Psychedelic Medicine: State-of-the-Art Therapeutic
Applications .
The words “psychedelic renaissance” have been used with increasing
frequency in recent years—with good reason. When Psychedelic Medicine
was released a decade ago, we were at the beginning of the new profes-
sional wave of interest in psychedelics heralding the “psychedelic renais-
sance” (Sessa, 2012/2017). The opening of research in the fi rst decade of
the 21st century made possible an evaluation of the therapeutic potential
of psychedelics, and we are now in the midst of a new understanding of
the potentials of psychedelics. The sheer volume of published papers on
psychedelics reviewed in the chapters here, and the growing number of
research institutions with active psychedelic research programs, attests to
this ongoing revolution.
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2 Advances in Psychedelic Medicine
Across the globe major neuroscientifi c and medical institutions are
now running psychedelic research programs, including Imperial College
London, Johns Hopkins University, New York University, University Col-
lege London, Oxford University, Harvard, University of California Los
Angeles, Cambridge University, Yale University, the Maudsley Institute,
Cardiff University, Kings College London, University of New Mexico, and
Bristol University, to name but a few. These are not fringe institutions.
Psychedelics are now at the cutting edge of contemporary psychophar-
macology and neuroscience. Not a month goes by without a major, high-
impact peer-reviewed medical or scientifi c journal publishing original
research on psychedelics. From the Lancet , the Journal of Psychopharma-
cology , Nature , Science , the British Journal of Psychiatry , the British Medical
Journal , the Journal of Addiction , Neuropharmacology , Frontiers in Neurosci-
ence , Frontiers in Psychiatry , Psychopharmacology , Archives of General Psy-
chiatry , Neuroscience Letters , Journal of Affective Disorders , the New Scientist ,
Journal of Psychoactive Drugs , PLOS One , Biological Psychiatry , and many
other peer-reviewed publications, we see a plethora of scientifi c articles
establishing the positive effects of psychedelic medicines and an enthusi-
astic outpouring of interest and support for psychedelic drug studies and
treatments and their implications.
Given the worldwide prevalent use of psychedelics today and the rapid
increase in international psychedelic societies for professionals and the
interested public alike, we have begun to eclipse the initial impact of a
comparatively small—but nonetheless hugely infl uential—era during the
1960s when a cultural revolution inspired by psychedelics blossomed
briefl y. Indeed, the advances in research over the last two decades are so
profound that the fame of the “psychedelic sixties” pales in comparison to
the immense biomedical knowledge we now have about psychedelic effects,
safe use, and medicinal applications that we present here in Advances in
Psychedelic Medicine .
Much has transpired since LSD and the other psychedelics were banned
in the late 1960s, resulting in a “dark ages” of psychedelic research through
the 1970s and 1980s. But even those quiet decades were not completely
without psychedelic discovery, as clinical MDMA briefl y emerged, only
to quickly sink again in political response to the party rave scene culture
that accompanied the introduction of MDMA to the public.
The History of the Renaissance
The path toward a psychedelic renaissance arguably may have begun
with Rick Strassman’s landmark DMT study at the University of New
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Introduction to Advances in Psychedelic Medicine 3
Mexico in the 1990s (Strassman, Qualls, Uhlenhuth, & Kellner, 1994).
While his studies were designed primarily to assess toxicology and dosage,
the phenomenological data of entering alien worlds, shared in his accounts
of the experience in DMT: The Spirit Molecule (Strassman, 2000), kept the
psychedelic community interested and engaged. Federally funded research
by the U.S. National Institute on Drug Abuse (NIDA) at the University of
Miami, School of Medicine on the toxicity of ibogaine (see the chapter
by Alper and Lotsof in Psychedelic Medicine: Vol. 2 ) provided another early
step. It was abortive, however, as NIDA withdrew funding for continued
research. Psychedelic research continued to emerge in the fi rst decade of
the 21st century when a research team at the University of Arizona evalu-
ated the use of psilocybin for treatment of obsessive-compulsive disorder
(OCD) (see Moreno and Delgado’s chapter in Psychedelic Medicine: Vol. 1 ).
Perhaps the new era of psychedelic research fi nally exploded into pub-
lic and professional consciousness with the publication of a study at the
Johns Hopkins University School of Medicine by Roland Griffi ths and col-
leagues. Their double-blind study (fi rst published in the journal Psychop-
harmacology ; also see Psychedelic Medicine: Vol. 2 ) showed that psilocybin
caused mystical types of experiences and lasting personality change, with
implications that have reverberated across anthropology, religious studies,
psychology, psychiatry, and other fi elds. Strassman’s “spirit molecule” was
obviously also a candidate for the genesis of religion, mysticism, shaman-
ism, and other noteworthy human achievements.
From there emerged a growing number of academic institutions inter-
ested in psychedelic research. Now the fi eld of psychedelic research is no
longer the preserve of a few scattered, esoteric institutions and New Age
communities, but has begun to emerge from the shadows of unregulated
and clandestine research to form part of the research programs at the top-
tier research universities mentioned above. This rapid growth of the fi eld
of psychedelic research refl ects multiple threads, including a new genera-
tion of young people—and politicians alike—who don’t even know the
name of Timothy Leary and the storm of media-driven antipsychedelic
backlash that brought down the fi eld of research in the late 1960s. Rather,
newcomers to the subject—both within and outside the psychedelic
community—are regarding these compounds with fresh, open-minded
approaches to their therapeutic potentials. Rather than Leary’s revolution-
ary call for a global chemical utopia to transform society, the emphasis
today is placed on taking an objective, evidence-based, scientifi c, and,
dare we say it, sober view of the potential benefi ts of these medicines for
treating some of the most recalcitrant problems faced by medicine and
society.
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4 Advances in Psychedelic Medicine
An Overview of
Advances in Psychedelic Medicine
It is in the spirit of this objective approach that we present Advances in
Psychedelic Medicine . This book expands on the issues addressed in Psy-
chedelic Medicine: Volumes 1 and 2, but rather than an update to those ear-
lier chapters, it addresses new research, topics, and treatment areas that
have emerged in the past decade.
Psychiatric Applications of Psychedelics
Psychedelic Medicine: Volume 1 presented the evidence for psyche-
delic applications for a range of psychiatric disorders including OCD,
PTSD, depression, and end-of-life issues associated with terminal cancer.
Research on these and other topics has progressed considerably since then,
as documented in the overview in Chapter 2 by Charles Grob and Gary
Bravo on “Psychedelics and Psychiatry: A New Treatment Model for the
21st Century.” This places the resurgence of psychedelic research in his-
torical and clinical context, and shows evidence for successful treatment
of an expanded range of conditions, especially treatment-resistant depres-
sion. Their chapter also addresses some of the challenges that psychedelics
pose to the prevailing psychopharmacological paradigm of psychiatry, and
the importance of the shamanic traditions of using these substances and
the spiritual experiences that they induce.
At the time of presenting Volume s 1 a nd 2 , a treatment that had already
gained international fame was the use of MDMA for post-traumatic stress
disorder (PTSD). Here in Chapter 3 Ben Sessa provides an overview of the
important role of MDMA in addressing trauma in “Therapeutic Applica-
tions of 3,4-methylenedioxymethamphetamine (MDMA).” He looks at the
extended evidence for the effectiveness of MDMA not only for PTSD, but
also for the potential treatment of addictions.
Clinical depression represents a growing burden for societies and is often
diffi cult to treat with traditional psychiatric approaches. British psychia-
trist James Rucker reviews the mechanisms, rationale, and latest clinical
advances in psilocybin-assisted advances in Chapter 4, “Psilocybin Ther-
apy for Major Depressive Disorder.” Rucker reviews the clinical trials for
psilocybin treatment of depression underway and randomized controlled
trials in preparation for Phase 3 evaluations. This evidence, combined with
neuroimaging work, is revealing the neurological dynamics underlying the
subjective dynamics of psychedelic experience and how these understand-
ings may contribute to an appreciation of the therapeutic mechanism that
may address the emotional and existential predicament presented by the
syndrome of depression.
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Introduction to Advances in Psychedelic Medicine 5
Since the publication of Psychedelic Medicine: Volumes 1 and 2 we have
seen a global expansion of the off-license use of ketamine, as well as
clinical studies of its use for addressing treatment-resistant depression.
Here studies assessing clinical effi cacy and mechanisms of actions are
described in Chapter 5 by L. Alison McInnes and Marc Ettensohn in
“Ketamine Therapy for Treatment-Resistant Depression.”
This potential of psychedelics to provide effective treatment of depres-
sion is also attested to in Chapter 6 by Dráulio Barros de Araújo, who reviews
“Evidence for the Therapeutic Effects of Ayahuasca.” De Araújo points
to a phenomenon virtually unheard of in pharmaceutical treatments—
signifi cant and persistent effects from a single dosage.
Psychedelic Treatment of Addictions
The psychedelic treatment of addictions is closely connected with the
very beginnings of psychedelic therapies from the 1950s onward. This
topic was explored extensively in Psychedelic Medicine: Volume 2 , where
six chapters addressed programs and research on the treatment of addic-
tions using peyote, LSD, ketamine, ayahuasca, and ibogaine. Since then
new research has evaluated the effi cacy of psychedelics in the treatment
of addictions. Chapter 7, “Psilocybin for the Treatment of Substance Use
Disorders” by Ishani Rao and Greg Lydall, reviews research on the effi -
cacy of psilocybin in treating nicotine and alcohol disorders, as well as
reviewing best practices and probable mechanisms of effi cacy.
Chapter 8 by José Carlos Bouso, Rafael G. dos Santos, and Jaime Hal-
lak reviews research addressing “Potential Applications of Cannabis and
Cannabinoids in the Treatment of Substance Use Disorder and in Harm
Reduction.” Studies show the potential of this popular and broadly useful
drug in reducing various aspects of addiction to more serious and debili-
tating substances.
The broader application of psychedelics in the treatment of addictions
is addressed by Peter Eischens and William Leigh Atherton in Chapter
9 on “Psychedelic Therapy as a Complementary Treatment Approach for
Alcohol Use Disorders.” Their chapter concentrates specifi cally on alco-
hol addiction, providing a review of the mechanisms generally involved
in psychedelic resolution of substance abuse, and a range of ways that
psychedelics may help reduce the burden of addictions.
Medical Hypotheses
The applications of psychedelics for physical medicine were suggested
in Psychedelic Medicine: Volume 1 where Andrew Sewell and John Halpern
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6 Advances in Psychedelic Medicine
presented evidence regarding the effectiveness of psychedelics in the treat-
ment of the notoriously treatment-resistant cluster headaches. Advances in
Psychedelic Medicine presents additional evidence of psychedelic treatment
of physical problems in Chapter 10 where Attila Szabo reviews “Effects
of Psychedelics on Infl ammation and Immunity.” Szabo suggests novel
therapeutic possibilities for various pathologies from chronic infl amma-
tion and autoimmunity to infectious diseases and cancer.
Evidence for “The Protective Role of Dimethyltryptamine against
Ischemia-Reperfusion Injury” is addressed in Chapter 11 by Ede Frecska,
Attila Kovacs, and Attila Szabo. This extends previous insights (Frecska,
Szabo, Winkelman, Luna, & McKenna, 2013) that the evolutionary sig-
nifi cance of DMT (and by extension other psychedelics) is not that they
produce hallucinations, but rather that they are involved in basic meta-
bolic processes. The apparent release of DMT in response to trauma (i.e.,
near-death experiences, shamanic visions) may refl ect its effects in mini-
mizing the effects of both trauma and the physiological trauma responses
on the body and cells.
Psychedelic Medicine: Volume 2 reprinted the groundbreaking paper in
Psychopharmacology by Roland Griffi ths and colleagues that presented
evidence suggesting that psilocybin had the potential to induce spirit-
ual experiences and lasting personality change. Here Petr Winkler and
Rita Ko cˇ árová review further evidence for psychedelics’ ability to create
personality change in Chapter 12, “Psychedelic Treatment of Disruptive
Personality Patterns.” They further propose that psychedelics can help
people in general improve their overall mental health and behavior.
Therapeutic Guidelines and Training
Therapeutic guidelines for the safe and effective application of psych-
edelics were previously addressed in Psychedelic Medicine: Volume 1. In one
chapter, Torsten Passie provided an overview of contemporary psycholytic
therapy, while in another, Ede Frecska surveyed the therapeutic guidelines
and contraindications for psychedelic therapy. And in Psychedelic Medi-
cine: Volume 2 further guidelines—including those strategies learned from
non-Western, shamanic traditions—were explored in chapters on “The
Ten L essons of Psyche del ic Ps ychotherap y” (Ne al Gold smith), “Sham anic
Guidelines for Psychedelic Medicine” (Michael Winkelman), “Common
Processes in Psychedelic-Induced Psychospiritual Change” (Sean House),
and “A Psychoanalytic Approach to Psychedelic Therapy” (Dan Merkur).
Here in Chapter 13, “Guidelines in Applying Psychedelic Therapies,”
Friederike Meckel provides the wisdom of her personal experience
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Introduction to Advances in Psychedelic Medicine 7
derived from her years of work as an underground psychedelic therapist.
Friederike provides an expansion and deepening of understanding of
the conditions required for the most effective therapy with psychedelics,
informed by her years of work in psychedelic group therapy.
In light of the hopefully imminent licensing of MDMA and psilocybin,
we are going to need thousands of newly trained psychedelic therapists
to deliver the new treatments when they become legally available. There
is therefore a growing need to develop a standardized and state-of-the-art
educational program to provide a regulated population of psychedelic cli-
nicians for the future. This will be especially important in coming years
as the eyes of the regulatory authorities that control the formal licens-
ing of psychedelics will be fi rmly—and appropriately—fi xed on the fi eld.
The contents and processes of the training developments are explored in
Chapter 14 by Janis Phelps, “Training Psychedelic Therapists.”
The Social Context of Psychedelic Therapy and Research
While the scientifi c applications of psychedelics as medicines have
largely remained stymied in the political apparatus of governmental regu-
latory agencies, the engagement of the populace with diverse psychedelics
and for diverse reasons has continued. This popular use of psychedelics
in the nonclinical population has grown, typifi ed in concerts, raves, and
festivals around the world. It is important to address the risks of this
unregulated and unsupervised use of psychedelics, given that crises
may emerge from numerous factors—including the drug-induced emer-
gence of unrecognized trauma, disorientation, overdose, and fraudulent
misrepresentation of substances. These risks have been in addressed
in worldwide efforts to reduce harms, particularly through the develop-
ment of crisis intervention services in public venues and the promotion
of harm-reduction approaches. Here these social engagements designed
to mitigate risks in psychedelic self-treatment are explored by Maria
Carmo Carvalho and her co-authors through a review of the guide-
lines for such programmatic development in Chapter 15, ”Community-
Based Full-Spectrum Harm Reduction Approaches When Caring for
Psychoactive- and Psychedelic-Related Problems in a Transformational
Festival.”
Advances in Psychedelic Medicine presents the continuation of the citi-
zen scientist, exemplifi ed in the psychedelic treatment of cluster head-
aches that was discovered not by medical researchers, but by a suffering
patient population. The role of the citizen scientist in expanding the
knowledge and application of psychedelics is illustrated here in the realm
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8 Advances in Psychedelic Medicine
of microdosing, which is covered in Chapter 16 by James Fadiman and
Sophia Korb, who discuss “Microdosing Psychedelics.”
And fi nally, as we appear to be on the verge of a new era in which,
within the next few years, psychedelics could become licensed as legal
prescription medicines, we fi nish with Chapter 17 by Anne Wagner,
Michael Mithoefer and Rick Doblin on “Bringing Psychedelics and Entac-
togens into Mainstream Pharmaceuticals: A Focus on MDMA. There is
currently an emerging debate from some fringe elements of the psyche-
delic community proposing that formal recognition of psychedelics as
licensed medicines will lead to a “corporatized” exclusivity of their use.
However, the reality is that by gaining formal acceptance by regulatory
authorities, accessibility to these medicines will be increased, not reduced,
to the many millions who could benefi t from them. The complex process
of formal drug development and regulation necessarily involves working
with incumbent regulatory organizations and frameworks. In this chap-
ter Wagner, Mithoefer, and Doblin describe the legal and administrative
challenges faced in seeking approval for psychedelic drugs research and
the impediments faced in transforming the drugs’ status as maligned and
demonized public enemies into sanctioned, safe, and effective medicines
for the future.
Diversity and Equality Going Forward
The contributors to this volume include many of the leading fi gures in
the fi eld, clinicians and scientists who approach their work with diligent
study and a dispassionate eye for scientifi c rigor. The readers of Advances in
Psychedelic Medicine —whether they are researchers, therapists, students, or
the general public—will receive a thorough appraisal of recent advances in
the treatments with psychedelics. Refl ecting the perspectives of clinicians,
researchers, and program administrators in the fi eld, the book presents
the latest advances in establishing the research base to take psychedelic
compounds into the mainstream of medicine and addresses issues such as
clinical effi cacy, safety, state-of-the-art therapeutic approaches, and mech-
anisms of action.
There is also a broader role that psychedelics have to play in today’s
hugely secular, diverse, and expanded global culture. No matter how much
science studies psychedelics, the spiritual element of the psychedelic expe-
rience remains. There are few subjects that so dramatically and effectively
span the disparate worlds of art, science, religion, and culture better than
psychedelics. And appropriately, the social sciences (as well as popular cul-
ture) have responded with an outpouring of literature that examines the
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Introduction to Advances in Psychedelic Medicine 9
implications of psychedelics for understanding the origins of religion and
spirituality, cultures and civilizations, healing, personal development, art
and inspiration. Psychedelics involve a complex merging of postmodern
medicine and a revitalization of the central premodern medicines of the
planet that have recently reentered global consciousness. This reemergence
has stimulated the examination of the clinical applications of ayahuasca,
ibogaine, and psilocybin as today’s clinicians explore the continued rele-
vance of millennial-old medicines for contemporary healing. These natural
psychedelics are being used as tools to augment psychotherapy for a wide
range of conditions, including biological disorders.
The renaissance of psychedelic medicines continues to reverberate
within society. Advances in Psychedelic Medicine supports the general pub-
lic’s interest in the therapeutic applications for psychedelic compounds by
providing concise summaries of the evidence that these medicines repre-
sent an innovative and much needed new approach to treat resistant men-
tal disorders. The medical applications of these substances have always
had an important hidden public arena, an area of substantial research,
exploration, and application that has not waited for the medical sciences,
and especially the regulatory agencies, to catch up. The citizen scientist
functions in these informal medical communities that use these currently
illegal treatments to address a variety of signifi cant physiological, psycho-
logical, and social problems.
And fi nally, there are, of course, many other areas in respect to psyche-
delics that we have not had the time or space to cover in Advances in Psyche-
delic Medicine that nevertheless require urgent academic and sociocultural
attention, especially the profound lack of gender and ethnic diversity
within the psychedelic research community; the growing concerns about
unregulated, underground psychedelic therapists; the dark side of sexual
predation; the damage to indigenous communities through unsolicited
drug tourism; and the ongoing topic of tackling restrictive drug prohibi-
tion laws that hamper research and impede efforts to address the global
problem of drug misuse. Topics for another day, perhaps, but certainly
worthy of ongoing scrutiny. In the meantime, we sincerely hope you enjoy
learning from this book as much as we have in putting it together.
References
Frecska, E., Szabo, A., Winkelman, M., Luna, L., & McKenna, D. (2013). A pos-
sibly sigma-1 receptor mediated role of dimethyltryptamine in tissue
protection, regeneration, and immunity. Journal of Neural Transmission ,
120 (9),1295–1303.
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10 Advances in Psychedelic Medicine
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