This Week in the ASAM Weekly
History Repeats Itself: Psychedelics Are Promoted Today the Way Opioids Were Promoted in the Early 2000s
Anna Lembke, MD, FASAM
Anna Lembke, MD, FASAM is a professor of psychiatry at Stanford University School of Medicine, program director of the Stanford Addiction Medicine Fellowship, and author of Dopamine Nation: Finding Balance in the Age of Indulgence.
After more than two decades as a practicing psychiatrist, I’ll be the first to admit that we need new and innovative treatments to treat depression, anxiety, and other psychiatric disorders. Psychedelics like LSD, psilocybin, and MDMA (Ecstasy) are being researched and promoted as ground-breaking advances for combatting mental illness. Multiple jurisdictions have already relaxed laws or policies related to these substances, often with an eye toward therapeutic use.
But the evidence to support the therapeutic use of psychedelics is not yet robust enough to justify liberalized access, especially for unsupervised use. Even more concerning, I see eerie similarities between the promotion of medicinal psychedelics today and medicinal opioids beginning in the 1990s, based on unsubstantiated claims of high benefit and low risk. Full disclosure, I have been retained as a medical expert witness in opioid litigation against Purdue Pharma and others.
The unsubstantiated claims about opioids are the following: (1) Opioids are the safest and best treatment for chronic pain; (2) opioids are the answer to our epidemic of pain; (3) opioids are ‘rarely’ addictive when prescribed by a doctor for a patient with pain.
In fact, the evidence shows that opioids are no better than Tylenol in the treatment of chronic pain and incur more medication-related adverse events. The increase in opioid prescribing did not decrease the population pain burden and was instead a major contributor to today’s opioid epidemic of addiction and overdose death. Far from being ‘rare,’ getting addicted to opioids through a doctor’s prescription is tragically common.
Read the full editorial here.