Interview with Dr. Ben Sessa - Psychedelics: more than a renaissance.
Growing up in a liberal family, rooted in arts and literature, Ben became interested in the social and cultural aspects of psychedelics from a young age. None of his family are scientists or doctors. They are all artists, musicians, and teachers.
When he went to medical school he was surprised to see that the historical influence of medical psychedelics in the 50s and 60s was completely absent from the curriculum. He wanted to change this, so wrote the first medical psychedelic editorial paper (since the sixties) in the UK medical press (2004, BJPsych).
In 2005, he set up a small meeting at the Royal College of Psychiatrists to speak about the topic. At Albert Hoffman’s 100th birthday party in Basel (2006), he met similar others in the field, but no other doctors in the UK were involved at this point.
He quickly found himself at the centre of UK research… of which there was none at the time..
In 2006, he met Robin Carhart-Harris (who was completing his PhD at Bristol), and joined David Nutt's psychopharmacology department. This led to his involvement in the first psilocybin study, making him the first person to legally receive a psychedelic (since the sixties) when Nutt injected him in 2009 as part of Robin's first study.
Thereafter, his interests grew as he saw the lack of safety and efficacy of traditional psychiatric treatments and became determined to bring this new field into mainstream medicine.
Q: What is the last record you bought? What was the first?
A: Last: Drella, Reed and Cale (last week). First: Adam and the Ants (aged 11).
I'm a vinyl DJ, having been 18 years old at the peak of rave culture emerging in 1990. I still DJ!
Q: Although we are hearing this phrase used more than ever, you first published your book ‘The Psychedelic Renaissance’ back in 2012. What are your views on the ‘renaissance’ today and should we still be using this term?
A: It’s more than a renaissance. It’s a revolution. People talk about 'the psychedelic sixties', but truth is, there is a far greater cultural and research use of psychedelics today than there ever was in the 60s. Now is the psychedelic time. Today there are so many clubs, groups, and societies connected by the internet. So many festivals conferences and institutions carrying out research. And a far greater influence on medicine than ever before.
Psychedelics are no longer some weird fringe thing carried out only by bearded people in California. Every major neuroscience research institute in the world is now carrying out psychedelic research projects. It’s not fringe. Its cutting-edge neuroscience and healthcare research. It’s where psychiatry is heading. We should be calling it The Psychiatric Renaissance. Get involved!
Q: How does the therapeutic use of MDMA differ from ‘pinging at a rave’?
A: So many ways. Dose. Drug purity. Context. Support (preparation/integration). Monitoring. Screening of patients. Collecting data. Combination with psychotherapy. Targeting mental illness. Aiming for lasting lifestyle change. Focusing on childhood trauma. So many ways it is different. But raves and festivals are still fun and they ain't going away any time soon!
Q: Your recent (fantastic) paper demonstrating the safety and tolerability of MDMA has received a lot of attention. What can these findings teach us about the nature of ‘comedowns’?
A: Most people take ecstasy at night. They miss sleep, they exercise heavily (throwing shapes on the dance floor), they drink, use cocaine, amphet, cannabis etc. Street ecstasy is never pure (we use only 99.98% pure MDMA - by far the greatest adulterant in our clinical MDMA is the gelatine capsule). Of course they feel like sh*t on Monday - it’s a hangover from a weekend of caning it!
When we use the medicine clinically, the patient takes the drug at 9am. The drug wears off by 5pm. They feel great, having done a hard days work of important psychotherapy in a containing and facilitated environment with therapists they trust. No come down. And no 'Black Monday/Blue Tuesday’ (whatever). They are left with a week-long afterglow effect. The post-ecstasy affect drops associated with recreational ecstasy use are not about MDMA. They are due to multiple confounding factors. Missing sleep is probably the greatest cause of comedowns and 3-day delayed affect drops. Not the MDMA.
Q: How does your medical cannabis prescribing clinic in Bristol work?
A: I no longer do my medical cannabis clinic; had to give that up to make way in my diary for AWAKN. I did med canna prescribing for 12-months, wrote over 500+ scripts.
I did 2-days/week, mainly online (since covid struck). Prescribing a range of mainly oils with varying amounts of THC and CBD for a wide range of psychiatric indications including depression, anxiety, PTSD. It was valuable experience. I'll probably return to it at some point later in my career.
Q: AWAKN could be the most exciting thing the UK has ever seen, ever. What can we expect from AWAKN over the next decade?
A: Ketamine is the only licensed psychedelic drug to date, so we are starting with ketamine-assisted psychedelic psychotherapy for now. But we are not simply an infusion clinic like all the others. We will use ketamine like we use MDMA and psilocybin, as a tool to assist psychedelic therapy. The Bristol clinic is open now. London and Manchester clinics opening later in 2021. Then Birmingham, Brighton, London 2, Edinburgh. We are aiming for 15-20 clinics in UK and Europe in the next 4 years. We are the high street presence.
It is a medical clinic. We are not a retreat. We are not a wellness centre. We are not providing ceremonies or experiences for hippies. We are treating severe, unremitting serious mental health problems using evidence-based medicine delivered by a full multidisciplinary team of doctors, psychologists, therapists and nurses.
We are also carrying out research with MDMA, developing this as an approved medicine for treating alcohol use disorder. Currently submitting phase 2b and phase 3 research protocols to MHRA and ethics. Also doing the same for ketamine; aiming to see MDMA and ketamine approved by FDA, MHRA and EMA in the next 3 years. And we are starting novel molecule development plans.
Plus, we are setting up a training program for UK clinicians to become psychedelic therapists.
Q: Why do you think media attention disproportionately demonising psychedelics in comparison to drugs like alcohol or tobacco?
A: Because the Misuse of Drugs Act 1971 is completely unscientific, unpoliceable, immoral, unethical and dangerous. It funds the mafia, criminalises innocent users, creates ghettos, kills kids, separates families, fills the prisons, and does nothing to reduce the deaths, harms, usage or crime associated with drug use. Prohibition harms everyone - not just drug users. Banning drugs is a 'head in the sand' mentality. It doesn't eradicate drug use or protect individuals or society. It simply hands the franchise to criminals and kills people. Prohibition is the greatest socio-political folly of the last 60 years. Write to your MP and ask them to review and audit the terrible UK drugs policy.
But - in answer to your question - the reason appallingly bad drug policy persists is because the War On Drugs has been incredibly successful at one thing: poisoning the minds of otherwise intelligent and erudite people to believe the lies successive governments have spun them that any drugs (other than fags and booze, which don't count because they are not drugs - sigh) that are used recreationally are dangerous and addictive and couldn't possibly have any benefits. It’s a lie. Truth is, most people take most drugs most of the time perfectly benignly. Drug abuse / misuse is a health / psychology issue - usually rooted in social failures and childhood abuse. Drug use is not drug abuse. Don't get me started!
Q: What is the biggest challenge in your field of work?
A: Undoing the last 50 years of negative stigma and finding funding to carry out the important work we need to do to provide a platform for safe and effective medical treatments for my worthy patients who could benefit. And getting the NHS to pay for it. Psychedelic therapies should be free for widespread public benefit.
Q: Do you think there’s any role for the medical use of psychedelics for prevention as well as treatment of mental health problems?
A: Totes. Safe and supported psychedelic drug use need not only be restricted to clinical populations. Healthy people can benefit from the personal growth and development of these medicines. Psychedelics - when used properly - engender and foster a healthy lifestyle.
Q: Do you think it’s important for psychedelic researchers to disclose their own psychedelic use?
A: It’s up to them. Given my involvement in research - administering and receiving psychedelics in research protocols of the last 15 years - I am one of the only people in the world who can openly speak about my legal use of MDMA, psilocybin, LSD, DMT and ketamine. I appreciate that for other people they might fear reputational risk in doing so. No one should feel obliged to disclose anything if they are not comfortable about doing so.
Q: Is the unsupervised use of psychedelics to improve people’s well-being something that we should be worried about?
A: Well, it’s been going on for at least 5000 years and rates of morbidity and mortality associated with non-clinical recreational and ceremonial use of psychedelics have remained consistently low. So, no. But when combined with psychotherapy in a formal clinical setting it’s even safer and the results are staggeringly good.
Q: What is the most important lesson you’ve learned in the past 10 years?
A: Collaboration and connection are essential. Let’s not compete. Let’s affiliate and share our knowledge. I have made so many great friends and connections in the last 20 years through psychedelics. There is a terrific network of wonderful people out there. We are stronger together.
