It’s hard to offer a pithy summary of what A World Appears is about, but one can scarcely blame its author Michael Pollan for that. As the science journalist and polymath acknowledges, there is just too much vagueness in how “consciousness” gets used. One split is between those who use it loosely to mean awareness or experience generally, and those who insist the term refers only to subjective aspects in particular. The latter are interested in our capacity to mentally focus on “the windowpane” — Pollan’s metaphor — and not just what can be seen through it.

According to the standard story, conscious experience has an internal perspective built into it, and so implicitly refers to a self — as the sight of a candle flame also indicates your own (distant or near) spatial position to it. Or as philosopher Thomas Nagel wrote in his famous essay “What is it like to be a bat?”: “an organism has conscious mental states if and only if there is something that it is like to be that organism”. And if that doesn’t help, just focus on what it is like to be a reader now, failing to understand Nagel’s deathless prose.

The “subjective” part has made many a philosopher conclude that the inside is less real than the outside. Galileo split the world in two, putting quantifiable, objectively detectable stuff like mass, weight, and number in first place, and relegating private subjective aspects like color and taste to the realm of so-called secondary properties. Other thinkers followed; eventually, as Pollan nicely puts it: “the method morphed into a metaphysics”. We got the idea that the felt reality of consciousness is deceptive, and despaired of it ever being fruitfully studied by science at all.

Yet more mystical types have suggested that it is possible to drop the subjectivity completely — to reach a state of pure “self-less” awareness — and that counts as consciousness too. Thomas Metzinger, a German philosopher, tells Pollan that this idea would be better understood if researchers did more meditation and more drugs. “You have these people who are superambitious and dominating the discussion yet in their own mental lives are … completely impoverished” he complains. 

The temptation to take your own inadequate mind as your only laboratory seems to be a frequent hazard. Pollan relates how some of the loudest voices in the field possess what psychologist Alison Gopnik calls “professor consciousness”, a fact which tends to skew their findings in a different way. Socially clueless, screen-bound boffins discover that the essence of consciousness lies in the capacity to process information, while being physically embodied and having feelings turn out to be of negligible interest. What are the chances?

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Worse: effectively, these theorists are then rewarded for their literal narrow-mindedness. For if you define the thing you are investigating in a relatively circumscribed way to begin with, you’re more likely to derive a sexy-sounding answer to a hot button question like “are computers conscious?” later. If, for instance, consciousness is simply equivalent to information processing, then by definition you won’t need a human brain for it. Abracadabra! — information-processing computers can now be conscious too. 

Alternatively, if you treat consciousness as a kind of sentience, involving positive or negative responses to a changing environment, then it will turn out that plants can be conscious as well. Wordsworth’s “faith that every flower/ Enjoys the air it breathes”, vindicated at last. Again, this is a cool-sounding result; except that by stripping the original phenomenon down to something so minimal, you conveniently changed the subject.

Pollan avoids this mistake, as you might expect from someone who co-founded a center for the science of psychedelics at UC Berkeley. He is interested in the whole shebang: “the sense impressions, feelings, words, images, daydreams, mind-wanderings, ruminations, deliberations, observations, opinions, intuitions, and occasional insights”, not to mention the “the banalities, the trivialities, and all the seemingly arbitrary bits and bobs of mental flotsam”. At one point he takes part in an experiment, wearing an earpiece which beeps randomly throughout the day, so he can then write down everything he is aware of at that moment. Having hoped for mental brilliance or even just a bit of edgy transgression, he is dismayed at “the sheer tedium” of his inner world.

He agrees that there can occasionally be self-less consciousness, recalling a markedly non-tedious mushroom trip where he saw himself dissolve into a puddle of blue paint, yet from “a completely unfamiliar vantage — perfectly disinterested, uninflected, unruffled, and utterly indifferent … a state of consciousness without a subjective perspective or qualities of any kind”. At this point, the skeptic in me sprang briefly to life, as I wondered how you can see anything without at least an implied spatial perspective, indicating the position of a self that is looking. But maybe I just haven’t taken enough drugs yet.

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Casting your net this widely increases the complexity of what is to be analyzed, and makes a complete physical explanation of consciousness look further off. Understandably, a central question of the book is what recently has become known as the hard problem of consciousness: how to explain all that subjective, ephemeral, flickering mental stuff in a way that shoves it firmly back into the brainbox. Or as Pollan puts it, more beautifully: “no scientist or philosopher has charted a plausible path from the intricate gray and white folds of the cortex to the felt experience of an early winter’s day at the end of fall semester.”

In my view, there are better and worse defenses of the ultimate insolubility of the hard problem. The philosopher who coined the phrase, David Chalmers, has argued that materialism — that is, the attempt to tether every aspect of consciousness to a physical cause — must be false, because he personally can imagine the existence of a zombie duplicate, physically identical to a human, who does not have consciousness at all. Quite why we are supposed to take what Chalmers can or cannot imagine as relevant is unclear, though. Imagination, precisely, thrives on an absence of knowledge about the limits of reality; and philosophers’ imaginations especially so, in my experience. 

But there are better reasons to think consciousness can’t smoothly reduce to the physical, as Pollan explores. One is that “the very act of sneaking up on our experience becomes part of the experience”, so that we can’t get a stable hold on what is to be explained. When the beeper goes off and the mind dutifully looks inward to monitor its own stream of thought, does it actually create something new? Is there really a fact of the matter about whether the thoughts I had 10 seconds ago took the form of images or words, before I stopped to inspect them? We are tempted here by a homunculus fallacy, imagining consciousness like a livestream or ticker tape, passively watched by a miniature version of the self. But there is no clean separation between the watcher and the watched. Nor, says Pollan, is there even a sharp distinction between hardware and software; for experience is constantly rewiring the circuitry.

And there’s also the fact that — thanks to Galileo and co — moving from the third-personal, objective idiom of science to the first-personal stance feels like moving beyond the official remit of science altogether. But even if this inference is unfair, it still looks improbable that we could ever get a satisfying translation manual, exhaustively transforming the experience of a memorable meal or a terrible dream into information about neuronal activity, electric pulses, and hormones. 

And nor is the inert language of scientists or philosophers ever likely to properly capture our feelings of awe at the mystery of it all. For this we have poetry — specifically Wordsworth, described by Pollan as the “great poet of the numinous”. His Prelude, for instance, gives us: “Dust as we are/ The immortal spirit grows/Like harmony in music/ There is a dark/ Inscrutable workmanship that reconciles/ Discordant elements, makes them cling together”. It’s a magisterial riposte to the hard problem, and without a stupid zombie in sight.

Not surprisingly, scientists intent on formulating the evolutionary purpose of consciousness tend to play down such issues. They say they don’t require a physical explanation for every fleeting thought, but only a general account of consciousness’s function and origin. According to one approach — championed by figures such as Karl Friston, Antonio Damasio, and Mark Solms — the point of consciousness is to advance the system’s basic goal of homeostasis: maintaining internal equilibrium in response to changing external conditions. Just as hunger prompts us to find food, and feelings of cold to find warmth, more sophisticated conscious feelings — including the capacity to reflect on one’s own perspective, as such — help us to explore, understand, and predict the behavior of complicated fellow humans, again for the purposes of survival. Summing up the depressingly disenchanted thrust, Solms tells Pollan that “the mind’s ultimate goal is to render consciousness superfluous by reducing uncertainty to zero and putting the maintenance of life on autopilot”.

But again here — this time, thankfully — we run into the unbridgeable gulf between the scientist’s bloodless coding of the material world, and what goes on in the private here-and-now. From the inside, as it were, rendering consciousness superfluous is absolutely not on my bucket list. On the contrary: having read Pollan’s illuminating book, I long to dive further in. What count as adaptive goals for a species or an individual, couched baldly in scientific terms — the passing on of genetic material, fuel acquisition, the hoarding of resources, or whatever it is — are scarcely ever recognizable amongst the desires, fancies, whims, and wishes a person is aware of right now. Nobody can stay in the language of science for very long; not even the scientists. It’s too inhuman.

Why, then, do we fear that this consciousness stuff somehow lacks reality, even when we each know our own version so intimately? After all — as idealist philosopher Bernard Kastrup points out to Pollan — “matter is an inference” while “mind [is a] given”. Right now, each of us has already access to a boundless, telescoping universe full of fascinating transformations. All we have to do is go in.

One reason for this is that the dimensions of ourselves that are churned up while under the influence of psychedelics are ones that we often have difficulty squaring with the persons endowed with moral agency that we ordinarily take ourselves to be. It is normal to recoil from some of what we find within ourselves, to seek to disavow it once the trip is over. But the fact that we are able to find hidden dimensions of ourselves that seem to have a life of their own, whether we like what we find or not, while under the influence of certain substances, is itself of interest, or should be, to anyone who wants to understand what it is to live in this world, with a human mind and a sense of wonder.

It raises the question: how is it that we perceive reality the way we do? And what does it say about our perception of reality that it can be so fundamentally altered through an intentional alteration of our internal chemistry? Do psychedelics warp our perception of reality, drawing us further than in our ordinary lucid state from the actual way things are? Or do they rather reveal something to us about the way things are that we ordinarily cannot perceive? It seems that to answer in favor of the view that psychedelics push us further from apprehension of the world as it is presupposes that our mind is, in its default state, naturally and adequately constituted so as to know reality itself. But philosophy has spent the last few millennia coming up with some pretty good reasons why we should be skeptical of the idea that the mind is so constituted.

Something therefore seems a bit off, a bit fishy, when philosophers, along with the surrounding culture, shy away from psychedelics, whether taking them or studying their effects, on the grounds that they distance you from reality. Philosophy is born of the realization that we already are, or seem to be, at some distance from reality even in our default mode of consciousness. Why not, then, explore all the modes of consciousness available to us, considering what each of them might have to tell us about the relationship between mind and world? That is exactly what I did while researching my new book, On Drugs: Psychedelics, Philosophy, and the Nature of Reality.

Not so long ago, I was in a city in the Netherlands for three nights. I had been invited to give a public lecture, and I decided to stay on over the weekend to conduct some research for my book. In that time, I took psychedelics twice.

The evening of the second psilocybin trip, having taken more than before, and far more than is recommended, would turn out to be one of the most intense and transformative experiences of my life. Though I bump up against the limits of language when I try to convey what it was like.

My hotel room had a cheap-looking poster of Marilyn Monroe framed on the wall. One of the first signs that the psilocybin was taking effect arrived when I was walking towards the bathroom, and I saw her there and paused in front of her image and stared at her in absolute wonder. “Do I know Marilyn Monroe?” I asked myself. I never met her, but she has been with me my whole life, just as she has probably been with everyone reading this piece. She is at least as familiar to me as, say, any of my first cousins. And yet, I reflect, I have never so much as greeted her. How strange! So, there in that hotel room, I greeted Marilyn Monroe, and it was heartfelt, and I was certain that whatever just transpired counted as a meaningful interpersonal exchange.

But this was just the beginning, as the particular quality of that encounter with Marilyn would be felt 10 times more strongly when I returned to the bed and pulled up old clips on YouTube of Cass Elliott, more commonly known as Mama Cass. For some inscrutable reason, earlier in that day I had had an earworm from The Mamas and the Papas’ 1967 song “Creeque Alley” going through my head, in particular the line that runs: “And no one’s gettin’ fat except Mama Cass.” This had come to me in my completely unaltered mental state, a reminder that the mind and memory are a marvel, too, without psychedelics. I don’t know what it was doing there. I’m not particularly a fan of Sixties folkpop. But there it was, in my head, and so I pulled it up on the computer, and I ended up spending the next few hours watching clips of Mama Cass on the talk show circuit, all the while feeling not only that I knew her, and had always known her, but that I had always loved her.

To say it like this sounds ridiculous, but the feeling was entirely sincere. Something about Mama Cass seemed to tell the whole story of my own existence. I suddenly recalled a black-and-white picture of my parents, from the summer of 1972. My mother is pregnant with me, and she is unusually heavy. Then I recalled a distant memory from early childhood when that photo was being shown around to guests at our home. I knew I was in it, though still unborn, and I knew I was the reason why my mother had gained so much weight. Then I recalled that someone, I don’t know who, said, when looking at the photo, that my mother looked like Mama Cass. Resemblance, now, seemed to collapse into identity, or rather the distinction between them no longer mattered. Mama Cass suddenly appeared to me as “Mama” in the fullest sense: the fount of my being and the origin of my world.

I am not going to attempt to defend this conviction, which felt so strong at the time. That it is indefensible, that it is ridiculous, is precisely what I am attempting to convey. Why did such thoughts come to me so intensely and unbidden? The mind, it seemed to me as I reviewed the experience on the following day, is just so much more wondrous, so much stranger, than my professional colleagues ordinarily take it to be! We philosophers are typically concerned to understand how a human mind can entertain such propositions as “There is a pain in my foot” or how it can perceive a red dot on a screen. These are fascinating problems, too, but surely we might also gain from considering how the mind can become convinced that a long-dead pop star has become identical with one’s own mother or with something like “cosmic motherhood”.

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I think at least a part of the reason we tend to stick with the pain in the foot or the dot on the screen is that, in order to talk about the stranger divagations of the mind, we generally have to acknowledge that we have experienced them, and that is an acknowledgment that typically entails a measure of shame. Part of my motivation in writing what I have written here is to push beyond that shame, to write about conscious experience in a way that truly faces up to the weirdness of the world.

Was my encounter with Mama Cass so ridiculous in the end? Was I completely out of line in my conviction that I loved her? In the Symposium Plato has Socrates describe the ideal ascension of this emotion, from its lowest to its highest expressions. Early in life, we experience love mixed with sexual desire for the beauty of a particular other person’s body, and then we move from there to love of all beautiful bodies. But if we progress as we might hope to do, towards wisdom, then as we age we will also gradually come to love all beautiful minds, and in turn all beautiful institutions and endeavors, then all beautiful knowledge, and in the end, as wise old philosophers, our love will be focused upon nothing but Love itself.

The truth is that most of us vacillate throughout our lives between the various positions on this imagined hierarchy. But whether we think of the ascension as a one-way journey or not, the key philosophical idea in it is that there is a real entity, Love, that exists independently of any of its instances as we know them from experience. This is what we generally refer to as a “universal”, and the question whether such a thing exists or not — not just loveable creatures and things, but Love itself; not just instances of justice, but Justice itself, and so on — will divide the schools of the philosophers, with their running “footnotes to Plato”, as Alfred North Whitehead described the history of Western philosophy, for millennia to come.

I am certainly not going to make any progress towards solving the problem of universals in my book, nor even stake out a position on either of the familiar sides of the debate. But I will remark, first, that psychedelic experience can itself deliver a strong argument in favor of the realist camp in the debate. Under the influence of psilocybin, I seemed not to love Mama Cass, for example, in her particularity, but rather to love her because this love is a point of entry, so to speak, to the experience of Love itself. When I listen to music while on psilocybin, I love the particular song, but I also feel, much more strongly, that the song is my point of entry to Music, with a capital “M”, to the thing itself that exists eternally behind and before all the songs that have ever been sung.

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We all have this feeling from time to time, to some extent. It’s the feeling, in fact, that music and poetry excel above all at conjuring in us: the feeling that there is another dimension that these works of art are coming from. Ordinarily, in a sober and lucid mind, this feeling mostly gets expressed in the form of longing. Songs we love have a particular power to make us feel as though there is a world that we know, somehow, but from which we are cut off. Songs seem to emanate from that world but generally do not seem fully to open that world up to us. Yet under the influence of psilocybin, one of my most vivid thoughts goes something like this: “So that other world is real after all, and it is now open to me! I wasn’t only imagining it!”

Do I still think that other world is real, now, when my brain chemistry is back to its default setting? The answer is complicated, but I believe philosophy can help us face up to the challenge somewhat.

The trouble is that Western philosophy has long valorized the sober, lucid mind above the drugged, drunk, or dreaming one. For at least the past two millennia, Western philosophy has defined itself in contrast to other related endeavors, such as mysticism, theology, poetry, and myth, even as nonspecialists often run these endeavors together. The key difference between philosophy and mysticism in particular, and indeed a key point of pride among the philosophers, is that unlike the mystics — who often rely on techniques to bring themselves into altered states of consciousness, which might include drugs, but also include meditative practices, or attention to one’s own dreams, or the hallucinations induced by descending into the dark depths of a cave — we philosophers are expected to rely entirely on the cognitive faculties available to us in our lucid, waking, and sober state. Our aim is to produce natural-language propositions that can be shared with other philosophers, discussed, argued about, and nitpicked.

Philosophy is almost always held to be concerned, by definition, with meanings and arguments, not with what lies beyond these. But there has also always been a dissenting camp, which says that philosophy should occupy itself with whatever human beings experience, whether easily rendered into propositional form or not. It may be that it is ultimately for the good of philosophy if some of its practitioners willingly run the risk of being seen as having gone off the deep end.

***

This is an excerpt from On Drugs: Psychedelics, Philosophy, and the Nature of Reality. Copyright (c) 2025 by Justin Smith-Ruiu. Used with permission of the publisher, Liveright Publishing Corporation, division of W. W. Norton & Company, Inc. All rights reserved.

It blew my head off. But not in the way I thought it might. There were no hallucinations, there was no Day-Glo assortment of colors. It was something much more profound. Basically, it was paradise, and it was paradise all the more so for being so adjacent to everyday reality.

The first time I did LSD I was in a family house — a house I’d been to thousands of times before. But suddenly, everything about the place was imbued with new layers of meaning. Touching the chairs that my grandparents and great-grandparents had sat in, I discovered a new understanding of these figures who had always been somewhat remote to me.

My thoughts were still recognizably my own, but rather than having, say, three or four at once, I now seemed to have 11 — each occupying its own dimension, as if in some kind of stereo effect. I would be thinking about different phases of my childhood and the music I was listening to and the room I was in and the dynamics I had with each person around me. At the same time, I felt a calm self-assurance. Having spent my twenties (in retrospect) in the grip of different anxieties, I could now, with the aid of the LSD, see myself far more fully, far more richly. I could see that there were worlds and worlds inside myself — as there are for everyone.

Inevitably, I suppose, that started a journey. The lab-created psychedelics such as LSD and MDMA showed the immense resources latent within a person, and the drop of acid, like a scientist putting a bit of fluid onto a slide, illuminated what was already there. The plant medicines, such as ayahuasca, were where it really got trippy, since these were entirely natural compounds. They seemed to be part of an intelligence that existed throughout the natural world. If I took kambo — a frog venom — I found myself seeing the world like a frog; if peyote, like a cactus. Each one seemed to have their own personality, to have a message directed at a particular psychological tangle in my own life.

Towards the peak of my psychedelic exuberance, in 2017, I realized that I was only a small part of a bigger movement, “a breath, sweeping through the cognoscenti”, as I wrote at the time. So many people I was coming across in this space — perfectly sane, balanced people — had psychedelic experiences that changed their lives. And, for a while, it felt like a dizzying scavenger hunt.

After my LSD experience I began to hear about ayahuasca — which, at the time, still seemed like an urban legend. Soon, I would find myself at a beach cafe near a group actually preparing for an ayahuasca ceremony, complete with Amazonian shamans in full regalia. And then when I was exchanging Facebook friendships with these ayahuascans, I discovered that the one friend we had in common was the most interesting guy I knew in college who turned out to be running a group, based in New York, for taking an African plant, iboga. Inevitably, not long after, iboga would blow my head off.

“All these people I meet all seem to be on the same page — with a united outlook, which is very different from how any of us were raised,” I wrote, trying to understand what was going on. “We believe in self-work, a kind of unremitting self-awareness and self-improvement. We are people of faith, which isn’t religious. It’s more that we believe everything anybody has ever said.” We were part of what became known as the “psychedelic renaissance” — a wave of young people, largely millennials, discovering that psychedelics had been seriously misrepresented in the aftermath of the Sixties culture wars and enthusiastically embracing them as a means for self-knowledge and self-growth.

Within the psychedelic community there were a few widespread, entrenched beliefs. One was that, throughout history, psychedelics had been a core part of the spiritual life of many societies. That is, the use of psychedelics was the norm, and our abstinent society was the exception. This was certainly true in indigenous societies all over the world. The classics professor Carl Ruck had very convincingly argued that the Eleusinian Mysteries in Ancient Greece partook of psychedelic ergot, a fungus that is also in LSD, while a few years ago Brian Muraresku was at least intriguing in claiming that early Christian rites, the Eucharist included, involved psychedelics. In the Fifties, the banker R. Gordon Wasson had been startled to come across a thriving mushroom sect in Mexico, and I experienced a mature, coherent religion in Gabon that centered on plant medicines.

Another belief was that the culture wars had basically gone the wrong way. After its lab discovery in 1943, LSD had been practiced in clinical settings throughout the Fifties and had been the therapeutic wonder drug of the era (you can see some of the videos of its use on YouTube). The belief was that the genie had escaped the bottle a bit too fast — above all, through the showmanship of Timothy Leary — and that resulted in a severe backlash. In 1970, the Nixon Administration gave LSD a Schedule I status, right alongside heroin, and then for good measure threw in plant medicines like peyote and ibogaine. Baby Boomers spoke wistfully of their LSD trips — a surprisingly large number of Americans claim to have dropped acid at one point or another in their lives — but, basically, the War on Drugs had stamped out both the clinical use of psychedelics as well as a great deal of psychonautic exploration. The belief in the millennial community was that this had vastly set the culture back. So much of the great art of the Sixties, the music above all, had been psychedelically inflected: the Beatles, for instance, dropped acid innumerable times during that period, with Paul McCartney saying “it started to find its way into everything we did, really”. Stories abounded that the Prague Spring had been a psychedelic event, that Kennedy had been turned on to LSD in 1963 and that it had driven his pursuit of peace in the Cold War, and that Silicon Valley was largely created on the back of psychedelic experiences.

I had a similar experience. Even early in my journey, the psychedelics helped me immensely. Writing had always seemed like a massive anxiety attack — it took me months to agonize over a play. But after trying LSD, I found it came easily, I sounded like myself, and writing became a pleasure. I haven’t had writers’ block since (although the anxiety never entirely goes away). My fear had been that psychedelics would cause me to “drop out”, to become some kind of a hippie, but, actually, they gave me a new relationship to work — I could understand much better that a job needn’t be all of my identity. Meanwhile, there were no deleterious effects from the psychedelics. To this day, I’ve never had a bad experience with any one of them.

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The most influential book to make the case for the mainstreaming of psychedelics was Michael Pollan’s How To Change Your Mind (2018). Pollan told the story of the clinical use of psychedelics in the mid-20th century, and the “restart”, which was a series of studies starting in the 2000s by Johns Hopkins University that found that psychedelics could produce mystical experiences, reduce anxiety in terminally ill cancer patients, all with next-to-no-negative impacts. What seemed to have disappeared completely was the bad science of the War on Drugs — for instance, the myth that MDMA created a dopamine deficiency, which was based on a bottle mix-up during a study. Enough people were doing psychedelics, both in clinical settings and on their own, without going crazy or suffering flashbacks. So many of the arguments against the psychedelics just didn’t hold up. And then the clinical benefits did seem very real and were borne out in study after study.

I suppose the peak of my psychedelic journey occurred when I was stone-cold sober. I was working on a documentary about ibogaine — a derivative of iboga — and accompanied a heroin addict from San Francisco to a clinic in Mexico. The place was called “Clear Sky” because, apparently, an addict right after his treatment looked up outside and said “oh a clear sky” — it was the first thought, really, that he had had of the outside world after years of being in the grip of his addiction. My experience was very similar. I had seen how the addict I was accompanying was living — unable to sit through a meal without going to the bathroom to smoke heroin off tinfoil, driving to the airport with a car that would shut down completely if it ever came to a complete stop. And then I saw him a few days later, after the ibogaine trip. He had cut his hair for the first time in a decade. His voice had a different timbre and his eyes had a different light. He had no cravings for heroin at all — it was, in the language of the clinic, an interruption that could allow him to reset his life.

One of the medical practitioners I met during the making of the documentary, a former ER doctor, described the first time he saw an ibogaine treatment as “a miracle”. I felt the same way. There weren’t very good numbers on how well the ibogaine cure had worked but the clinic estimated that the recovery rate was about 40% after a year compared to around 5% in the mainstream recovery industry. If there weren’t good numbers to go by, I was at least somewhat persuaded by what I read in the clinic guestbook. “Take this moment, breathe the air, hug the staff, feel the tears coursing down your cheek. You have waited so long for this.” “I woke up from treatment if reborn, alive with senses I hadn’t felt in years,” wrote another. A third simply wrote: “Ibogaine saved my life.”

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The psychedelic renaissance has since lost some of its momentum. There were a number of decriminalization initiatives in different states, and a number of companies attempting to put psychedelics through clinical trials. A ketamine spray for the treatment of depression was approved by the FDA in 2019 and ketamine treatments have become widespread among therapists. Psilocybin (magic mushrooms) continues to perform well in clinical trials, above all in alleviating depression. Microdosing has become widespread, most famously in Silicon Valley. But California’s governor vetoed a decriminalization bill and, more significantly, the FDA asked the company Lykos Therapeutics to redo their phase 3 trial for MDMA. Lykos’ offense had more to do with the fact that one of the therapists had had a sexual relationship with a patient six months after that phase of the study concluded — but it was enough for The New York Times to more or less declare the drug renaissance dead: “How Psychedelic Research Got High On Its Own Supply,” one recent article was titled. But even avowed practitioners have had to recognize setbacks. “The media pendulum is swinging,” Pollan said in an interview. “The wind has definitely gone out of its sails,” said researcher Rick Strassman.

Psychedelics disappeared from my life as well — and, as it happens, really around the time that the psychedelic renaissance was cresting. I can almost remember the moment when I knew that I wouldn’t have much to do with psychedelics again. It was during the pandemic, and it felt like a tide was going out. I had never had a directly negative experience with a psychedelic, but there were some adverse effects. Through my epiphanic period, I had probably developed a false optimism which turned out to be unsustainable. I had also come across some of the darker sides of the psychedelic renaissance — self-appointed “gurus” and “shamans” who allowed their transcendent psychedelic experiences to inflate their own egos and then enjoyed manipulative control over people who participated in their ceremonies. Looking back — and I think about this every day — it is very hard for me to say whether psychedelics have made my life better or worse.

But if I had a choice I would do it all again the same way. The psychedelics represented a journey into the unknown and the more complicated aspects of the self. They showed me that there was far more to the world than I ever would have suspected. And that seemed to be more or less the same place that the culture-at-large had got to. The sense with the Sixties was that it had been too much too soon — that society wasn’t able to handle the insights of psychedelics. We may have already started to feel the same way about the “psychedelic renaissance”, that psychedelics are so powerful that they can’t be casually disseminated on a mass scale.

That is not necessarily an indictment of psychedelics. They really are, as Aldous Huxley put it, “the doors of perception”. If psychedelics are too much for us (and they often are), that may say more about our own limitations than it does about the psychedelics themselves.

So far, Dr Vladislav Matrenitsky, a pioneer of psychedelic-assisted psychotherapy based in Kyiv, has treated around 300 patients suffering from depression, PTSD, or anxiety with ketamine therapy. A growing number of them have been soldiers, including a military psychologist, Ihor Kholodilo, who was left unable to speak after his jeep was hit by a Russian tank shell. After six sessions of ketamine therapy, his stammer was cured. Since then, he claims to have referred an elite Ukrainian special-forces unit for the treatment.

Though using ketamine to treat mental illness has been legal in Ukraine since 2017, MDMA and psilocybin — the active molecule in magic mushrooms — are still banned. But Kseniya Vozsnityna, director of Forest Glade, a government military-rehabilitation centre, believes that a pilot project using MDMA and psilocybin could be approved within six months. If so, Ukraine would be in good company. Australian clinicians became the first to treat patients with MDMA and psilocybin at the start of this year, while MDMA-assisted therapy could become a treatment for PTSD in the US this year, with the Food and Drug Administration in the final stages of approval.

As a researcher in the field, and having run legal psilocybin retreats, I’ve seen first-hand how careful use of psychedelics can help people with life-long depression or crippling PTSD. And when I spoke to psychiatrist and psychedelic researcher Simon Ruffell, he said that his ongoing study giving combat veterans Ayahuasca in Shipibo ceremonies in Peru is showing promising results: of the 28 participants with PTSD, none met the study’s criteria for PTSD after treatment.

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Yet psychedelic therapy is a complicated process. An experience with psilocybin or MDMA might last eight hours, often with two therapists present for a single participant. During the trip, participants might come face to face with memories, feelings or thoughts from which they had disconnected and work through them; or they might have a powerful “mystical-type experience”. After the trip, they are encouraged to make sense of the profound insights and realisations they’ve had and integrate them into their life in a meaningful way.

In a war zone, however, drug therapy raises complex ethical questions. For instance, should ketamine or MDMA be used to improve performance in battle? Kholodilo argues that not only would psychedelics stop depression spreading through the trenches, but it could also help frontline soldiers overcome their paralysing fear of death. The appeal of this isn’t hard to glean. As Oleh Orlov, chair of the Ukrainian Psychedelic Research Association, told me: “We are in the middle of a huge war, so we kind of need people recovered. We don’t have the luxury to just go home and recover.”

It wouldn’t be the first time that psychedelics have been considered for use in warfare. In the paranoid climate of the Cold War, the CIA grew obsessed with the idea that LSD could help with espionage and psychological warfare. Between 1953 and 1973, it carried out operation MK-Ultra, a secret and illicit human experimentation programme aimed at discovering new methods of mind control and interrogation. The full scope of this shameful operation was laid bare in 1974, when it emerged that the CIA had drugged unwitting citizens with LSD to see if it could be used to force confessions. The truth is, psychedelics are far too complex and unpredictable for these purposes, but that discovery came at the cost of broken minds and shattered lives.

That said, there is no evidence that Ukraine is planning to use psychedelics or ketamine for any other purpose than mental-health treatment. And Orlov hasn’t heard of anyone in the government or the clinical community promoting psychedelics for use in battle. His NGO is focused entirely on the spiralling veteran mental-health crisis — although he does view the introduction of psychedelic therapy for veterans as a matter of national security. Ruffell, meanwhile, is sceptical that drug therapy could be used to fortify Ukrainian warriors, telling me that most of the veterans he’s treated come out of their Ayahuasca experience looking for more peace in their lives, not a return to the front line.

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But such treatments are still a long way off for most Ukrainians. And in desperation, many are starting to self-medicate. Dr Jack Allocca, a neuroscientist and pharmacologist at the University of Melbourne, went to Ukraine last summer to interview soldiers, clinicians, and Ukrainian civilians about medical and recreational drug use. He described a hedonistic and chaotic scene in Kyiv and Odessa, with Ukrainians “using partying as group therapy” and taking a wide variety of drugs. The black market has been flooded with the usual recreational drugs you’d find in most cities, as well as obscure psychedelic research chemicals. These include drugs in the DOx family, which are chemically related to MDMA but highly potent and more psychedelic, with a trip lasting for 48 hours. Allocca was surprised to see such drugs on the streets, and described it as a live experiment by drug cartels on a traumatised population.

The result of all this self-medication, Allocca says, is “very messy”. One person he interviewed was overcome with guilt and grief during his trip because he feared he was going to be drafted. Another who had managed to dodge the draft got stuck in a guilt-ridden thought-loop. This is hardly a healing experience. And it’s worth emphasising that, in order to be effective, psychedelics and ketamine have to be combined with a therapeutic practice. The psychedelic experience is highly contextual, and indigenous cultures that have used them constructively have always done so in combination with meaningful rituals that give the trip a wider purpose. It is important that we do this as well.

There is, however, a good chance that Ukraine will become a hub for psychedelic research in the coming years. According to Orlov, Ukraine’s drug enforcement agency isn’t averse to rescheduling psilocybin and MDMA in a medical context, though the Minister of Health has requested more clinical data. A local pharmaceutical company has offered to make MDMA for $10 per dose, far less than it costs in the US or UK, so that small Ukrainian trials may begin.

But in the fog of war, no one can be sure what the future will hold. After all, in a nation torn by violence, psychedelic therapy can both offer profound healing and, when used unchecked, lead to disorder. Humphry Osmond, who coined the phrase “psychedelic”, may have put it best when he wrote to Aldous Huxley in the Fifties: “To Fathom Hell or Soar Angelic, just take a pinch of psychedelic.”

This week, Prof Nutt visited the UnHerd Club to discuss his latest research, the resistance he’s faced from the academic community and the transformative power of psychedelics. Below is an edited transcript of his conversation with Flo Read:

Florence Read: Instead of turning on parts of the brain, psychedelics can do something quite unusual, which is actually turn some parts off. Could you just explain a little bit more about that?

David Nutt: Obviously, Timothy Leary was wrong, these drugs don’t turn on the brain, they actually turn off the brain. Imaging work has shown that there’s a circuit in the brain called the “default mode network”, which controls how you think. Our research showed that network was being switched off.

You’ve probably heard of Aldous Huxley’s book The Doors of Perception. That book was written after a mescaline trip, but the phrase “the doors of perception” is taken from William Blake. And Blake said that: “If the doors of perception were cleansed every thing would appear to man as it is, Infinite. For man has closed himself up, till he sees all things thro’ narrow chinks of his cavern.” He was referring to people who aren’t artists, who see things in a very restricted way. Huxley used that quote, but he realised that what mescaline had done was open his mind, and then worked out that something must be closing his mind. What’s closing his mind? He said: the brain.

The brain is an instrument for focusing the mind. Psychedelics switch off the parts of the brain that control your mind. There was a group at Yale doing work in depression. They showed that the default mode network — the part of the brain that was turned off by psychedelics — is overactive in depression. If you scan the brains of depressed people, a greater amount of their brain is engaged in this internal, reflective, self-referential thinking. We thought: “Let’s see if we can turn it off in depressed people, and will they be non-depressed?” And lo and behold, they were.

We gave a single dose of psilocybin to people who had failed on other treatments. (They’d all failed on two antidepressants — somebody had failed on more than 10; they’d all failed on CBT.) They all got better. It’s the strongest effective treatment for resistant depression there’s ever been. Some of them are still well now, 10 years later. For the majority, the depression has crept back, and that tells us something else about the nature of how deeply embedded depressive thinking can be. But the fact that you could switch off the depression circuit, and lift people’s mood — that was a discovery.

FR: Among that cohort of treatment-resistant depressives, was there a common thread between them, in terms of their experience on the psilocybin? Or is it quite individualised?

DN: The content of a psychedelic trip is completely unpredictable. After that first trial, we set up a second trial, where we wanted to see if we could prolong the antidepressant effect of psilocybin by giving two trips, three weeks apart. And there was absolutely no relationship between the first trip and the second trip. Some people had a terrifying trip the first time, then a good one, and vice-versa.

What we try to do in therapy is get people to use the experience to deal with the thinking that is underpinning their depression. We asked them to try to engage with problems, to go back to issues in their childhood that might be relevant to their depression. Most of them don’t want to do that. One of the theories of depression — one of the theories about why your mind is so preoccupied in depression — is that you’re trying to resist re-engaging with those traumas. But we encouraged them to do that. It’s challenging, it’s difficult, they find it distressing — but they often get fundamental insights.

One of our patients on the first trial said: “I saw my father abusing me and I realised that was why I was depressed.” He realised: “I was blaming myself for the abuse. And in the trip, I was able to say to him, ‘That’s it.’” He got closure. He came out of the trip and he’s been well ever since. So people’s trips often focus on an individual trauma in their lives which they struggled to deal with. They have that in common.

FR: So given this level of success, why are these drugs not available for depressives in the UK?

DN: There are so many hurdles. Where to begin? The first is really weird. That initial study that we did was actually funded by the Medical Research Council. They put out a call for new treatments for depression and we got the grant. Getting the grant was the easiest bit. It took three iterations of the Ethics Committee to get permission to do this study. The ethics committee said: “It’s too dangerous; you can’t give depressed people psychedelics.” Why not? “Well, they might die.” That’s pretty unlikely — no one’s ever died on psilocybin before — but why do you think depressed people might die? “Well, they’re depressed.”

The third time we were going to this committee, I realised if we didn’t agree to do what they said, we would never get the study done. So in the end, they said: “You cannot do a controlled trial; you can do a safety study. Give 12 people it, see how they go. If none of them are dead in six months then you can come back and do a controlled trial.” So we said yes — in fact, the original trial was to see if people survived, which they all did. And the secondary outcome was whether their mood had changed. They could have got worse. They all got better.

So it took us a year to pass ethics. It took us another year to get hold of the medicine — the drug — because there’s only one place in the world that could make it. Then we had to get import licences and export licences. It took 30 months to get hold of the drug, and two more months to get permission from the Home Office to actually use it. That’s 32 months out of a 36-month grant — all because these drugs have been vilified for the last 50 years. The bureaucracy is so intense.

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FR: Is this a bureaucracy problem or is it a moral failing?

DN: It’s more than moral; it’s political. The reason psychedelics were banned in 1967 in the US and in 1970 in the UK was simply because psychedelics were allowing people to think differently about how they wanted to run international relations. The war in Vietnam was being protested. There’s this amazing photograph I have, of someone holding a placard that says: “Drop acid, not bombs.” They couldn’t ban the anti-war protests so they banned the drugs instead, thinking that would dissipate the protests. Of course it didn’t, and eventually, the protesters won.

The Vietnam War ended but by that time, the drugs had been banned. And one of the worst things about drug laws is that it’s almost impossible to remedy them. For example, in America, two-thirds of states have medicalised cannabis, and half of states have recreational cannabis, but it’s still illegal under the federal law. In fact, there’s only two countries in the world that have actually pulled cannabis out of the UN conventions, and that’s Canada and Uruguay. Every other country in the world, even America, still complies with the UN regulations, which still say that cannabis is an illegal drug. And no country has pulled psychedelics out of the UN conventions.

So everything we do, we do in the face of this enormous barrier. They’ve created this myth that these are very dangerous. Almost everything you’ve heard about psychedelics has actually been a deliberate misrepresentation to perpetuate this political decision that people shouldn’t use them.

FR: Would the power dynamic between a doctor and a patient change if this kind of drug became legalised?

DN: The medical profession isn’t really that progressive. And I can say that: I’m a doctor. I have become more and more disappointed by the inability of medicine — particularly in fields like psychiatry — to move with the times. I personally think that psychedelics will re-energise psychiatry. A lot of psychiatrists are very disillusioned. We haven’t had any real innovation in psychiatric medicine or psychiatric psychotherapy for 50 years.

FR: One thing under threat at the moment is the idea of holistic health — the idea that your mind and body have some sort of co-dependent relationship.

DN: We are quite top-down, paternalistic and autocratic in healthcare. There is very little scope to do anything that we’re not told to do from above — and, of course, that’s why I was sacked. Because even if you challenge — even if you just raise an intellectual question about the policy — they don’t like it.

It probably doesn’t come as a surprise to you that I’m quite a fan of Huxley. But my favourite book is not Brave New World or Doors of Perception. It’s actually Island, his last book. It is a roadmap to a society where you use psychology — you use dance, you use movement, you use exercise — and you use psychedelics to maximise quality of life. That’s what we should be doing. I was on the Good Read programme about six years ago, and Island was my Good Read. And two weeks later, I was in Parliament, at a group on drugs and drug addiction, and I was viciously attacked by a drug service provider for daring to talk on the radio about the use of illegal drugs to help people have a better life. That exemplifies our silos of thinking, which have become entrenched over decades. I don’t even think psychedelics could open their minds. 

FR: When people are having these transcendent experiences on psychedelics, are they finding something that we have all lost? Barely 3% of the country goes to church anymore; we’ve lost so much of our connection to the spiritual. Do you think they are recovering some of that?

DN: Yes, I have no doubt. Psychedelics increase connectedness — with the self, with other people and with nature. There’s a very interesting relationship between psychedelics and religion, because pretty much all religions emerged from groups of people using psychedelics. Hinduism came from a combination of mushrooms and Ephedra. South American beliefs came from ayahuasca and DMT and also from mushrooms. There’s a wonderful study going on in the States using psilocybin on priests who’ve lost their faith, and it’s working — it’s working for some faiths: I don’t think it’s quite as good for Islam as it is for Christianity — but there are priests coming out saying they have begun to find their faith again.

And of course, there was this remarkable experiment called the Marsh Chapel Experiment at Harvard in the Sixties. They took trainee priests on Good Friday — when they’re going to be in chapel praying and contemplating for the whole day — and they split them and gave 10 of them psilocybin in the same doses. And of the 10 given psilocybin, eight of them have this powerful mystical experience where they saw God.

So that does help make sense of the way in which religion or religious beliefs can be facilitated by changing the way your mind works. Of course, historically, people have done that in very different ways. In the old days, you used to starve yourself for days and nights, or kneel and pray for hours and hours, to get those kinds of mystical changes. And they would have been produced by alterations in biochemistry — due to stress — which are not necessarily very different from those that psychedelics produce. But psychedelics are just easier and probably more effective.

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FR: If these drugs did become widely available, how would we preserve this connection to spiritual well-being?

DN: There’s a really interesting experiment going on in the US now. Oregon has made magic mushrooms effectively a legal medicine. But more than that, they are authorising wellness centres, all around the state, to provide mushroom therapy, or mushrooms as part of wellbeing therapy. Now, that’s an amazing decision. It’s the first time anywhere in America that there’s kind of socialised medicine — using what it is now, and will be even when the therapy centres are open, an illegal drug. The purpose is to improve wellbeing in communities, and I think it’s going to work. 

FR: You’re a good advocate for psychedelics, but have you faced judgement from your academic peers? Do you find that you are in any way isolated in that community?

DN: About five years ago, I gave a talk to the Royal College of Psychiatrists and about psychedelics as the future of psychiatry. And after the talk, the room divided into three separate groups. There were about seven or eight men in the room older than me, who said: “Fantastic. I was there in the Sixties, we were using it. It was working fine. Thank goodness you’re bringing it back.” And the majority of the room were people from 35 to 60 who said: “This is rubbish. There’s no RCTs. They’re dangerous drugs.” And then there were about 50 trainees who said: “Fantastic — at last. Psychiatry has got something to offer me!” So credibility is very age-related.

Academically, I’ve been generally pleasantly surprised by the positivity. I think there are a lot of academics out there who realise that this is the way forward. They just don’t have the courage to stand up and do it because they don’t want to be vilified, they don’t want the Daily Mail writing about them. But they are on-side. There’s very little criticism within the scientific community about what we’re doing, because it’s good science. It’s published in the top journals. It’s very hard to argue with that.

FR: Let’s take some questions from the audience.

You spoke about shutting down the “default mode network” as a one-off event. Have you found that there’s a need to link therapy, psychotherapy, and a deep understanding of people’s trauma with the psychedelic experience, versus treating it like a neuroscientific event?

DN: What I find amazing is that both are true and that’s why it’s unusual. In fact, it’s kind of unique in psychiatry — to be able to do a brain imaging of someone who’s had a treatment, and see why it’s worked. What we see in people who’ve been depressed, who’ve had a psychedelic trip, is their brains are more flexible. And that accords extremely well with the cognitive experience of actually being able to think differently and not be locked into negative thought loops.

But I absolutely agree with you that the experience itself is what people want to talk about — and the value of that, in terms of helping them change their lives and move forward is, for the patient, absolutely central. Critics say: “Prove to me that what the patient thinks matters.” In fact, there are people who’ve said to me: “I’m not going to believe that psychedelics work until you give it to people under anesthetic, because it could all be placebo.” It’s surreal, because we don’t do any other kind of therapy under anaesthesia. People want to talk about why the experience is valuable to them. They want to get other people to engage with it. 

FR: Placebo is a concept that’s totally vilified in the mainstream scientific arena. Do you think that there’s room for a good placebo effect?

DN: Half of everything any doctor does to you is placebo. It’s you wanting to get better. If you don’t want to get better, you won’t get better. If you want to get better, you can get better, and psychedelics allow you to get better — whether that’s a placebo, or whether it’s a drug effect. I think it’s a drug effect, but proving it’s a drug effect is kind of pointless, and probably impossible, and I’m not going to bother.

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I was a government minister in the Department of Health in 2018, when we rescheduled THC for therapeutic use. And probably the most important thing was having a cause célèbre. There was Billy Caldwell, and a number of children with horrendous, untreatable epilepsy — suffering dozens of fits a day — who were treated by these medicines. And the compassionate power, forced on people in positions of power, was irresistible. That is actually what led to change. So applying that to psychedelics — who will be the cause célèbre?

DN: Australia decided in February that, from the first of July, psilocybin for treatment-resistant depression, and MDMA for treatment-resistant PTSD, will be approved medicines. And that was driven by an example: a woman who was actually a friend of the Prime Minister’s husband became severely depressed, begged for psychedelic therapy, couldn’t get it, and killed himself. And she made videos and she campaigned and she became the cause célèbre because of her dead husband.

We haven’t got that patient in Britain. But the sad thing is, we do have a lot of veterans who are medicating themselves. Some of them have been part of our studies. We’ve been working with them for eight years. They have been campaigning for this law change. And it’s not happening. These veterans are going to South America to get treatment — many of them can’t afford it; we’ve got senior members of the military arguing for this. But it’s falling on deaf ears. And I don’t know what the problem is. It may be because it’s not a child. The other thing about Billy Caldwell is that he was dying in St. Thomas’s, which is just across the river from politics. Parliamentarians could not avoid the fact that he could be dead within a few hours. So they had to do something. We don’t have quite the same immediacy.

I feel that cannabis has got stuck. It’s got stuck at this stage where unlicenced cannabis medicines are massively on the rise, but the NHS is not prescribing the licenced medicine. And it’s very hard to change. Even if tomorrow, the Home Office looked to reschedule psilocybin, we’ll end up in a similar place — where psilocybin therapy is only accessible privately because the NHS won’t endorse it. What’s your view on how we push past that?

DN: You’re quite right: for four and a half years cannabis has been a medicine, and there have been four prescriptions on the NHS. That’s almost as big of a scandal as having made it illegal in the first place in 1971. The NHS is not flexible and the mistake made was to insist that cannabis could only be prescribed by a specialist. And most specialists are old white men like me who spent their lives working on treatments which aren’t cannabis, and they don’t want to have to get out of their rut and learn about cannabis. The people that need to prescribe medical cannabis are the GPs and they’re not allowed to.

The other problem with the NHS is their budgets are controlled by pharmacists.You’d think pharmacists would be interested in pharmacology, but actually they’re not — they’re interested in money, and they’re really resistant to bringing in new treatments. So even with patients where it’s incontrovertible — the consultant says: “Medical cannabis has helped this person, please can we prescribe on the NHS” — the pharmacist says: “No because NICE hasn’t approved it.” And that’s why I left the NHS. That’s why now my work with ketamine is outside the NHS. Because it’s the only way we can actually use a psychedelic drug on patients. The same will be true with psilocybin or MDMA when they become available.

What we’re doing in the clinics that I’m working with — the awakened clinics here — is collecting data. At some point in the not-too-distant future, we will be able to go to the NHS and say: “100 patients with depression treated with ketamine therapy. Make NICE approve it.” We’re all campaigning to get NICE to accept that this real-world data for ketamine could be used — in the same way that real-world data for cannabis was collected.

I work at the Centre for Social Justice and we work with around 800 small grassroots charities, many of which are working in the addiction sector. And I have yet to meet a single one of those organisations that thinks legalisation is the answer. In fact, they actually think the opposite. We recently held a roundtable with a load of drug dealers, and we asked them what they thought about legalisation, and they said they were absolutely desperate for it, because it was going to significantly increase the number of people who will be buying drugs. And their response to that, they said, would be to undercut the legal drugs by making them cheaper, and then they can make them stronger or weaker, depending on what the clients want. And I wondered what you thought of that?

DN: Free markets are a problem, aren’t they? So my argument would be that we should decriminalise personal possession of all drugs. Criminalising people who use drugs is both immoral and ineffective. It would be economically sensible to have regulated markets for all drugs which are less harmful to the user than alcohol. Because reducing the use of alcohol would have a net beneficial effect on society. We’re beginning to see that now, in countries or states where medical cannabis has become legal: people are drinking less, and also using less opiates.

In our medical cannabis initiative — the Drug Science 2021 initiative, which you can access online — we had 3,500 people on medical cannabis, over 1000 of them for chronic pain. And they almost halve their use of opiates without even being asked to stop opiate painkillers. They’re just stopping because medical cannabis is better for pain.

In terms of treatment providers, the reason cannabis is a problem in Britain is because we tried to get rid of cannabis, in the same way that heroin is a problem in America because they tried to get rid of heroin. They tried to stop people using relatively mild forms of cannabis and what did the market do? The market just shifted to make stronger forms of cannabis. When we tried to clamp down on cannabis in prisons, what happened? We started making spice, and spice kills people; cannabis doesn’t. So our hostility to cannabis has driven the problem for cannabis. When we tried to stop the use of opium in 1910 by Chinese people in the East End of London, what happened? They stopped smoking opium; they started injecting morphine.

Almost every drug we’ve tried to control through prohibition has resulted in the use of stronger, more toxic alternatives, and lead to greater problems with addiction. I was in a huge conference in Orlando, speaking to 2,500 addiction service providers, last year. I started talking about using psychedelics to treat addiction and they were horrified. But it’s their business. The addiction business is a big business. A lot of people get their employment out of it, but they need addicts to keep the business going. And if we can get rid of addicts, they will be out of business, so they don’t want change either.

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When the default mode network is switched off, how does it come back? And if it comes back, how does it not cause the depression again?

DN: It comes back different, it comes back more flexible, it comes back less entrenched. Now why that is? We don’t know. One analogy is, if you keep thinking something, it’s like a cartwheel going along in a muddy field. It digs deeper and deeper and deeper. But then if you have a rainstorm or a flood, you can wash the ruts away and you can start again. But how that actually translates into neurochemical changes, or neurological changes in neurons, is still a mystery, and it is actually to my mind the big target at present. I would really like to understand how we get rid of it. Some people use the analogy of a snow field: once you’ve skied for a long time, you get stuck in a rut. Then the snow comes and you can see normally again. But eventually, for many people who’ve been chronically depressed, particularly from childhood, there’s a pressure to rut again. And what is that? I don’t know. And that’s one of the areas I’m really trying to get my head around intellectually, because then we might be able to design some experiments to test it.

FR: This comes back to this idea of neuroplasticity, which you have when you’re young and then you lose as you get older — do you think people have a fear of the general public becoming more neuroplastic?

DN: Yes and no. No one minds people with Alzheimer’s getting more neuroplastic. But young people thinking differently — that frightens society, or the establishment. But neuroplasticity — this is an ancient concept. Every time you do anything, you’ve grown a few synapses in your brain, you’ve consolidated some synapses, you’ve made them more efficient. Now, that process is very powerfully stimulated by psychedelics. It’s also stimulated by ketamine and MDMA. And from the insights you get during a trip, people often see things very differently, come up with new solutions to old problems. But they can consolidate those new solutions by neuroplasticity. 

The US Department of Defence has invested something like $27 million in trying to develop drugs which will produce plasticity, without being psychedelic, because they’re terrified of psychedelics. If you’re a vet in America, and you use an illegal drug to get better, you lose your pension, and you lose your access to healthcare. So rather than change the law, they’re trying to find drugs which will actually heal the brain through plasticity. I don’t know if that’s going to work. I think it might be useful. It might augment psychotherapy. But I think it’s going to be something you take every day. I don’t think you’re going to have a single dose of a neuroplastic agent and suddenly you’re going to wake up the next morning feeling un-depressed. But the research is going on, and we’ll find out.

What is monkey dust?

DN: Monkey dust is a new cathinone. Here’s a story. Just before the 2010 election, along comes mephedrone (“meow meow” or MCAT), a relatively weak cathinone that’s legal. It becomes very popular. But an election’s coming up, and Gordon Brown doesn’t want to be seen as soft on drugs. So mephedrone gets banned. And then, after a couple of years, we start to look at the data. And what we saw with mephedrone between 2008 and 2010 was as use went up, cocaine deaths fell, amphetamine deaths fell. Why? Because people were switching from an illegal, dangerous, harmful drug, to a legal, less harmful drug. So there were two or three deaths from mephedrone, and it reduced cocaine deaths by about 50%. It’s the biggest impact on cocaine death ever.

When mephedrone is illegal, and the dose and supply runs out, people switch back to cocaine because it’s a better drug. If everything’s illegal, why not use a better drug. Cocaine deaths have now gone up and up and they’ve now reached an all-time high. So for those two years, we saw that the drug market does have a lot of rationality. People want a drug that is fun but less harmful than the ones they’re using. So having banned mephedrone people said: “Mephedrone is pretty weedy. Why don’t we make a stronger mephedrone which we can sell in smaller amounts?” That’s monkey dust. Monkey dust is to mephedrone what fentanyl is to heroin. It’s just the product of having banned mephedrone.

Are there any studies on microdosing?

DN: Yes there are and we’ve done the best one. It’s very difficult to do because the problem with microdosing is: it’s illegal. And when we set up a microdosing study at Imperial, six years ago, we wanted to give a microdose — one microgram of LSD — to people twice a week for six weeks and see what happened. And the ethics committee said yes, but every single microdose had to be given in hospital, and they had to stay in hospital for 12 hours. We’ve never done the study because we couldn’t afford to do it.

So we did a citizen science study. We basically worked out a way of getting people to randomise their own microdoses, and that study was published last year. It shows that microdosing works — if you think you’re microdosing. So if you’re taking placebo, and you think it’s a microdose, it works. That’s the best study we have so far. It’s what you want it to be, in a way. So at present, we don’t know if microdosing works, but it doesn’t seem to harm you.

With antidepressants, you don’t know what it’s doing, but you feel better after it’s built up. With psilocybin, we can see the effect on the brain scan: it’s essentially an experience that changes the person. Are there any other drugs that are like that? 

DN: It’s like surgery. It’s like a cure. Are there any other drugs like that? I suppose with some anti-cancer drugs, you might get a relatively rapid cure. But not in terms of mental health. But the idea of a sudden cure is not novel in psychiatry. When I was on the Isle of Skye 30 years ago, there was a wonderful tale there about how they used to treat depression. They used to take depressed people to the blacksmith and put their head down on the anvil and the blacksmith would take out his massive hammer and bring it down right next to their head, but not hit them. And they would get better. That seems implausible, but it’s not completely implausible, because that is a massive stress.

Pavarotti suffered from depression. And he was talking about how he overcame his depression, and he was on a plane that crashed. He said: “That near-death experience lifted my depression.” And in fact quite a lot of people who have near-death experiences say not only that their depression goes, but that they feel more spiritual. Interestingly, the brain scans of people who have near-death experiences and those after psychedelics are very similar. So the final answer to your question is that it is a psychological experience, but fundamentally it’s a biological experience, changing your psyche, and that’s why it’s so powerful. Huxley was right: your brain controls your mind. If your brain gets it wrong, as it sometimes does, change your brain. Then your mind can be free.

Psychedelic trips have played a part in mystical traditions for millennia, but their revival comes at a time when our old religions are endangered. The march of Reason and Evidence has left a gaping void; we are surrounded by a bubbling sea of Unreality. Television, billboards and newspapers first threatened the dam between dreams and waking consciousness; Twitter, Netflix and the smartphone, always there and nudging away, have blasted it asunder.

In place of structural changes, or indeed religious ones, the system defaults to plaster solutions, offering mere jolts of aliveness. The “altered states economy”, now generating as much as $4 trillion worldwide, offers a range of techniques to tap into the Real, or at least muffle the Unreal. There’s alcohol and disposable vape pens, video gaming and high-intensity sports, breathwork, meditation apps — and now, the legal psychedelic drug, perhaps the most significant launchpad to sacred states yet.

Medical authorities in Oregon are set to roll out psychedelic therapy this year, while many cities and states in the US have, to various extents, decriminalised the drugs. Meanwhile, Mexico is tapping into the market for psychedelic experiences still illegal in the US: the Guardian reported yesterday on clinics set up just over the border that offer courses of the powerful psychedelic ibogaine as treatment for trauma.

The faith we once put in transcendent states has been swiftly industrialised. A scan of the current psychedelic market reveals a strange mix of Big Pharma and young start-ups, such as ATAI, a Peter Thiel-funded firm. Its founder, Christian Angermayer, has been accused of manoeuvring to dominate the psychedelic market through zealous patenting strategies. He envisions his trials as perpetuations of mystical traditions from Ancient Greece. More than 2,000 years later, though, “profane illumination” is now under the microscope, dissected, refashioned as a tool. Only when validated in scientific, psychiatric discourse is it taken seriously. The industrial boom has happened in tandem with an enormous amount of research, much of it funded (with likely biasing effects) by profit-driven entities.

Whereas psychedelic culture used to be defined by its naive subjectivism — you have to take it to know what it’s like, man! — a kind of naive objectivism has taken its place. On a scale of one-to-five, the Mystical Experience Questionnaire asks trial participants, how would you “sense that [your psychedelic] experience cannot be described adequately in words”?

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Our grasping search for the Real is heading for more disturbing developments still. As documented by the scholars Maxim Tvorun-Dunn and Tehseen Noorani, efforts are underway to render “psychedelic medicine” continuous with growing suites of “digital therapeutics”. Some firms plan to substitute post-trip in-person therapy for an app. Other companies intend to track and harvest data from clients’ voyages, via wearable devices that “personalise” and “facilitate” the “clinical experience”.

The ketamine market in the United States offers a terrifying glimpse at this future of runaway capital. In some so-called “McKetamine” clinics, users are shuttled through a pricey yet cost-minimised production line of “profane illuminations”, with little after-support — despite serious risks of addiction, psychosis, and permanent visual disturbances. One such company, Peak, thankfully shut down its operations amid a backlash to its flagrant promotional strategy, which included online consultations lasting two minutes and promises to “cure depression forever”.

Such absurdly utopian rhetoric abounds among the proponents of psychedelics, who include many powerful people in the tech world. Certain transhumanist thinkers in Silicon Valley have called for more research into drugs that produce permanent bliss states without side effects; theirs is an “abolitionist” ideology that seeks to eliminate all conscious suffering from the universe. Meanwhile Elon Musk, who hints strongly at a taste for psychedelics like the aforementioned DMT, has expressed hopes of “extend[ing] the light of consciousness to the stars”, in tandem with technology: his Neuralink brain-machine interface is set to commence human trials in 2023.

This language goes beyond aspiration, or even idealism: it’s a simulated religion. Inconveniently, there are dangers in viewing our search for God as a technical problem — one that can be solved through human ingenuity. The current psychedelic landscape is greatly influenced by Carl Jung, whose acolyte Stanislav Grof administered LSD in more than 5,000 sessions in communist Czechoslovakia. Yet Jung was famously suspicious of what he called “the pure gifts of the Gods”, described and promoted by early “psychonauts” such as Osmond and Huxley. More than anything, Jung suggests, we ought to engage with the psyche on its own terms, as a mysterious and subterranean layer of reality that can’t necessarily be gauged in the terms of Reason that govern our everyday lives.

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Similarly, indigenous and mystical traditions have warned the West against conquistador exploration of ecstatic states for centuries. The Eastern Orthodox tradition, for instance, has a rich literature of prelest, a spiritual malaise in which the seeker of private mystical experiences becomes possessed, obsessed, deluded, or corrupted by egotism. It’s hard not to see a grain of truth in the old Christian warning against demons: a warning levied by various Iberian conquerors against peyote and ayahuasca centuries ago, and now being revived by religious communities alerted to the psychedelic trend.

Despite these warnings, there are growing communities of self-declared “psychonauts” heading deep into DMT space for hours before sharing their experiences on online messageboards. And people do often return from that space with entirely different metaphysical paradigms, with users convinced that the entities they saw were very Real. Yet in an era when the idea of evil has lost much of its cultural currency, it is curious that many report encountering entities that are exceptionally malicious — or, indeed, demonic. So wedded are we to the idea of Reason, we might laugh and pat the heads of these omens, or reduce them solely to psychic projections. But here we fall for a transhuman fallacy: that humans are in control of what’s real. No wonder: it’s easy to fall for that fallacy when you’re in an transcendent state, if it’s a state provoked by a drug humans made (and patented).

Part of the problem is the decline in “ecstatic literacy”: we just don’t know how to discuss or understand — or draw non-delusional conclusions — from “profane illumination”. While the proliferation of psychedelic products has changed the game by normalising such extraordinary experiences, we lack the language, the elders, the tradition that helps us make meaning of them.

Indeed, the ancient roots of psychedelic use, which might have guided their explosion, are in grave danger. In Peru, fully onboarded to the ayahuasca tourism trend, the influx of gringos has fuelled a rise in “pseudo-shamans” who adulterate their brews for extra kicks. Peyote and the bufo alvarius frog, whose venom contains the powerful compound 5-MeO-DMT, are now endangered, and the sustainability of ayahuasca reserves is now a “legitimate concern”. The price of ayahuasca has spiked as much as ten-fold. Where once its sale was fiercely guarded, it’s now touted in Coke bottles by impoverished rickshaw drivers who need extra cash.

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The emergence of the psychedelic industrial complex only accelerated the up-rooting that globalisation has been enabling for decades. Filament Health, a firm whose USP is to use “natural psychedelics”, made headlines recently for its creation of “ayahuasca in a pill”: an absurd peak for an industry long-trained in extracting, stripping and distilling the fruits of the natural world. Anthropologists observe that the whole “healing” paradigm predominant in ayahuasca tourism in Peru is an exotic distortion, with “shaman” itself described as a “made-up, Western category”.

“Start your own religion,” Timothy Leary told his followers in the Sixties. Many tried, although their operations would swiftly descend into power-sustained cults. There recently came allegations of a similar cultishness emerging in a corner of Silicon Valley, at the Centre for Applied Rationality and the Machine Intelligence Research Institute; one of the problems cited was frequent drug-enhanced “debugging” rituals. This is further evidence that attempts to wrench the numinous from its roots, then commodify it, are archetypally foolish — or, in the unfashionable language of religion, sacriligeous. While attempts are being made to draw psychedelics into existing traditions like Judaism and Christianity, it’s not clear how these religions can guide us through the epistemic and personal challenges of still relatively little-researched drugs that spur such swift ascents.

Little in life is really reducible to Damascene moments, but a trip at its best can unlodge something: cause us to remember something we forgot. Yet rather than set us free, the release offered by the psychedelic state — in the absence of any real programme or tradition, or “container” in the current language — seems to dissipate without leaving a meaningful trace. Even those who do experience relief from depression through psychedelics, for instance, reliably relapse after a few months.

Perhaps it is worth heeding what acclaimed psychonaut Aldous Huxley said, while lying on his deathbed in November 1963. He requested a dose of 125 micrograms of LSD to ease his passage to the afterlife, and while it’s said that his passage was uniquely peaceful, his final words are telling: “It is never enough. Never enough. Never enough of beauty. Never enough of love. Never enough of life.”