PS452 Unit 6 Hallucinogens Paper Example

He Said the Toad Ceremony Fixed His Depression: A PS452 Unit 6 Hallucinogens Paper

[Student Name]

Purdue University Global

PS452: Psychopharmacology of Alcohol and Drugs

Unit 6 Hallucinogens Paper

[Instructor Name]

[Date]

The writer, the unit, the patient and every detail are composite and illustrative; the sources cited are real.

Skyler's Question

Skyler, twenty-four, came to our Albuquerque withdrawal unit after a month of heavy drinking that began when he lost his job. On his second evening, sitting in the day room, he told me that the previous spring he had gone to a ceremony near Santa Fe where participants inhaled vaporized 5-MeO-DMT, a powerful psychedelic found in the secretion of a desert toad and also made synthetically. He said that for about three months afterward, his depression lifted almost completely. "Then it came back, and I started drinking. Can that stuff fix this?"

His question deserved a careful answer. Interest in psychedelics as treatments has grown fast, and patients read headlines. As a technician, I cannot advise him on treatment, but I can understand what the science does and does not say, and I passed his question to the nurse and physician.

How Classic Psychedelics Act

Nichols (2016) reviewed the pharmacology of psychedelics. Classic psychedelics, including psilocybin, LSD, mescaline and DMT, act mainly as agonists at serotonin 5-HT2A receptors, which are dense in the cortex, especially on large pyramidal neurons. Activation of these receptors changes how cortical networks communicate, producing altered perception, thought and sense of self. Nichols noted that classic psychedelics have relatively low physiological toxicity and do not produce the compulsive use patterns typical of drugs that act strongly on dopamine, though they carry psychological risks, especially in unsupervised settings.

5-MeO-DMT is a related tryptamine. It acts at 5-HT2A receptors and also binds strongly to 5-HT1A receptors, and its effects are intense and brief, typically lasting under an hour when inhaled.

Why Compulsive Use Is Uncommon

Skyler had used 5-MeO-DMT once and had no urge to repeat it every weekend, a pattern that fits what is known about classic psychedelics. Meyer and Quenzer (2019) explain that tolerance to these drugs develops very quickly: a second dose taken a day after the first produces much weaker effects, because 5-HT2A receptors are rapidly reduced in number or responsiveness. Tolerance carries across drugs in the class, so someone tolerant to LSD is also tolerant to psilocybin for a few days. No recognized withdrawal syndrome follows stopping. And because these drugs do not act mainly on dopamine reward pathways, they do not tend to produce the cycle of craving and repeated use seen with stimulants, opioids or alcohol. That does not make them safe; it means their risks lie mostly in the experience itself and its aftermath rather than in dependence.

Set and Setting

Researchers have long observed that the effects of psychedelics depend heavily on the user's mindset and the surroundings, often called set and setting. Clinical trials prepare participants in advance, give the drug in a calm room with trained monitors and hold follow-up sessions to help people make sense of the experience. A ceremony may offer some of these elements and lack others, such as medical screening. Skyler said the ceremony leaders asked about his medications but not about his mental health history.

What Davis and Colleagues Found

Davis et al. (2019) surveyed people who had used 5-MeO-DMT in a group ceremonial setting and asked about changes in depression and anxiety. Many respondents with prior depression or anxiety reported improvements after use, and those who described more intense mystical-type experiences tended to report larger improvements. The authors described the findings as unintended effects, since participants had not necessarily sought treatment.

The study's design limits what it can show. It relied on retrospective self-report from people recruited through networks of users, who may be more likely to have had positive experiences and to want to report them. There was no control group and no clinical assessment of depression before or after. People who had bad experiences may not have responded.

A survey of satisfied attendees can suggest a question; it cannot answer whether the drug treats depression.

Risks

Psychedelics are not free of risk. Intense experiences can cause panic, confusion and risky behavior, especially without preparation and supervision. People with personal or family histories of psychotic disorders may be at higher risk of lasting psychiatric effects. Some people report persisting visual disturbances. 5-MeO-DMT carries specific dangers when combined with certain other substances, including monoamine oxidase inhibitors found in some ceremonial brews and medications, which can cause dangerous serotonin toxicity. And substances sold in unregulated settings may not be what they claim.

Research Versus Treatment

Controlled clinical trials of psilocybin and other psychedelics, given with preparation and psychological support, have reported promising results for depression and for alcohol use disorder, but these treatments are still investigational, and the conditions of those trials differ greatly from an unregulated ceremony. Skyler's experience, like the survey results, is consistent with the possibility of benefit; it is not evidence that psychedelics would treat his drinking, and certainly not a reason to seek them outside research.

What Happened

The physician talked with Skyler the next morning. She acknowledged that research into psychedelic treatments is active, explained that they are not approved treatments outside clinical trials, and focused on treatments available now: medication for alcohol use disorder, therapy for depression and a referral to a psychiatrist. Skyler said he appreciated being taken seriously rather than lectured, which had happened to him at a clinic before. He also asked how to find clinical trials, and she pointed him to the federal trial registry, noting that most trials exclude people who are drinking heavily or have just gone through withdrawal, so stabilizing his drinking would come first either way. Skyler said that gave him one more reason to take his discharge plan seriously.

Talking With Patients About New Drugs

Patients often raise drugs that are in the news. The response that seemed to work with Skyler had three parts: take the experience seriously, explain the difference between early research and approved treatment, and offer what is available today. Dismissing his experience would likely have ended the conversation.

Conclusion

Skyler's three months of relief after a 5-MeO-DMT ceremony fits early reports, such as Davis and colleagues' survey, of improvements in depression after psychedelic use. Nichols's review explains how these drugs act at serotonin receptors and why their risks differ from those of other drugs. But self-report without controls cannot establish treatment effects, and psychedelics remain investigational, so his care focused on treatments available now.

References

Davis, A. K., So, S., Lancelotta, R., Barsuglia, J. P., & Griffiths, R. R. (2019). 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) used in a naturalistic group setting is associated with unintended improvements in depression and anxiety. The American Journal of Drug and Alcohol Abuse, 45(2), 161-169. https://doi.org/10.1080/00952990.2018.1545024

Meyer, J. S., & Quenzer, L. F. (2019). Psychopharmacology: Drugs, the brain, and behavior (3rd ed.). Oxford University Press.

Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264-355. https://doi.org/10.1124/pr.115.011478