On Tuesday, October 22, 2024, the Association of Cannabinoid Specialists welcomed Eugene Vortsman, DO to present on Psychedelic Medicine: A Clinical Perspective.
While this is a slight departure from our regular programming, ACS feels that with psychedelics on the ballot in states such as Massachusetts this year, as well as the increase in research and interest, it is important to provide educational opportunities on such topics.
Dr. Vortsman gave an thought-provoking and fast-paced lectured on several types of psychedelics, how they each work in the body, side effects, studies, what medical benefits we hope to gain from these substances in the future based on the research we are seeing now, and the limitations of that research.
Psilocybin: this molecule comes from mushrooms in the genus psilocybe, and works on serotonin receptors. It can cause euphoria, peacefulness, derealization, depersonalization, visual alteration and distortion, muscle weakness, hallucinations, and more. Effects last 4-7 hours.
There are currently psilocybin trials for major depressive disorder, fibromyalgia, substance use disorder, alcohol use disorder, headache prevention, anorexia nervosa, PTSD, phantom limb pain, and more.
Ketamine: this was originally synthesized in 1965 and is a non-serotonergic psychedelic. It has hallucinogenic properties and also has profound anti-depressant effects almost felt immediately. It is already approved for treatment resistant depression in the FDA approved Esketamine (Spravato). There are ketamine studies on fibromyalgia, major depressive disorder, and chronic regional pain syndrome (CRPS).
3,4-Methylenedioxymethamphetamine (MDMA) and Lysergic Acid Diethylamide (LSD): both have similar methods of action but different modalities. Both increase serotonin and dopamine, influencing mood, including feelings of love, trust, sexual arousal, and empathy.
LSD was discovered in 1938, was used for treating mental health disorders starting in 1948, and was banned in 1967 after becoming a recreational drug.
MDMA was originally patented as an appetite suppressant in 1912, was used for some time in the 1970s and 80s by psychotherapists, and by 1985 was made illegal due to its illegal use as a designer drug. It has been shown to allow access to painful emotions, and in many studies has been shown to significantly reduce PTSD symptoms in patients.
Ibogaine: this is a drug that comes from the bark of a plant in Gabon, Africa. It has a similar structure to serotonin and is a NDMA antagonist as well as a serotonin and dopamine uptake inhibitor. It provides a unique two-part experience: an acute phase, lasting 4-8 hours, with hallucinations, ataxia, tremors, and more; and a reflective phase, with calmer acute symptoms over time to reflect on what had been seen during the acute phase, generally lasting 8-20 hours.
Ibogaine has been used for a variety of treatments, including use disorders, PTSD, depression, anxiety, and more. However, there are safety concerns such as sudden death reports, arrhythmias, long QT syndrome, bradycardia, hypotension, and more.
Dr. Vortsman’s excellent presentation gives us an broad overview of psychedelics as a whole, and more information on these under-discussed potential treatments.
To watch the full presentation, check out our Symposia page.