Entheogens and the psychedelic renaissance

Two Johns Hopkins studies put mystical experience back into the laboratory — and the same compounds are being sold as therapy years ahead of the evidence.

What it is

Entheogen — from Greek roots meaning roughly "generating the divine within" — was coined in 1979 by a group of scholars including Carl Ruck and R. Gordon Wasson, who wanted a term for the ritual and religious use of psychoactive plants that did not carry the recreational associations of "psychedelic" or the pathological framing of "hallucinogen".

The principal compounds:

Psilocybin, from Psilocybe mushrooms, used ritually in Mesoamerica
Mescaline, from peyote and San Pedro cactus
DMT, chiefly encountered in the Amazonian brew described under ayahuasca
LSD, synthesised by Albert Hofmann at Sandoz in 1938 and its effects discovered in 1943
Iboga, from West Central African Bwiti practice

This article is about the interaction between these substances and religious experience. It gives no dosages, no protocols and no guidance on obtaining or using anything.

Where it came from

Ritual use is ancient and documented archaeologically — peyote from Texas rock shelters dated to roughly 5,700 years ago, and Anadenanthera snuff paraphernalia older still in the Andes.

The modern Western encounter has three phases.

The first wave (1950s–60s). Wasson published his account of a Mazatec mushroom ceremony in Life magazine in 1957, with consequences for the Mazatec community that nobody had asked them about. Psychiatric research on LSD ran to over a thousand papers. Aldous Huxley's The Doors of Perception (1954) argued for the "reducing valve" model — that the brain filters a wider consciousness and these compounds open the aperture.

The Good Friday Experiment (1962). Walter Pahnke, supervised by Timothy Leary at Harvard, gave psilocybin or an active placebo to divinity students before a Good Friday service. Almost all who received psilocybin reported experiences they rated as genuinely mystical; almost none of the controls did. It is the founding study of the field, and Rick Doblin's 1991 follow-up found the effects had lasted — while also reporting that Pahnke had omitted several adverse reactions, including one participant who required antipsychotic medication.

The collapse and the return. Research stopped almost entirely after the 1970 US Controlled Substances Act. It resumed in 2006, when Roland Griffiths and colleagues at Johns Hopkins published a rigorous double-blind study showing that psilocybin reliably produced experiences that participants rated, fourteen months later, among the most personally meaningful of their lives — comparable to the birth of a child.

How it is used

Ritually, in the traditions that hold them; therapeutically, in trials; and increasingly commercially, which is where the trouble is.

What we can and cannot say

We can say the mystical-experience finding is robust. Griffiths's 2006 result has replicated. The experiences score highly on standard mysticism scales, the ratings persist at long follow-up, and the intensity of the mystical experience predicts the size of any clinical benefit — which is a strange finding for a pharmacological model and a suggestive one for everyone else.

We can say the clinical evidence is real, early and narrower than the coverage suggests. Psilocybin for treatment-resistant depression, for depression and anxiety in life-threatening illness, and for alcohol and tobacco dependence has produced striking results in small trials. Larger and longer studies are running. Effect sizes tend to shrink as trials grow, blinding is close to impossible when participants know what they have taken, and expectancy effects in this field are enormous.

We can say the risks are serious and specific. Psychosis in people with a personal or family history of schizophrenia or bipolar disorder; hallucinogen persisting perception disorder; cardiac risk from some compounds; dangerous interactions — ayahuasca's MAO inhibition with serotonergic medication in particular; and prolonged psychological difficulty after a bad experience, which the survey literature indicates is not rare. Ibogaine has caused deaths from cardiac arrhythmia. This is not medical advice, these substances are illegal in most jurisdictions including Australia outside authorised settings, and anyone considering them for a mental health condition should be talking to a clinician.

We can say the therapeutic settings have produced documented abuse. A MAPS-sponsored MDMA trial in Canada produced a well-documented case of therapist sexual misconduct with a participant under the drug's influence, recorded on the trial's own video. Suggestibility under these compounds is extreme, and the ordinary safeguards around a teacher or practitioner matter more here, not less.

We can say the cultural questions are live and are being handled badly. Peyote is a sacrament of the Native American Church, it is slow-growing, and demand from the wellness market is depleting wild populations — NAC representatives have asked outsiders directly to leave it alone. Ayahuasca tourism has reshaped Amazonian practice, and the tradition-holders were not consulted about that either. Wasson's own trip ended a Mazatec practitioner's standing in her community.

And we can say the philosophical question is genuinely open. If a compound reliably produces an experience indistinguishable from those the mystics describe, two readings are available: the brain generates mystical experience and the chemistry proves it; or the compound removes an obstacle to something that was there anyway. The data do not choose between them, and both W.T. Stace and R.C. Zaehner argued the point vigorously in the 1960s without resolving it. It is the same argument set out under perennialism and constructivism, with better laboratory access.