A Talk With Johns Hopkins’ Illegal Drug Doc

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Dr. Matt Johnson is one of those Johns Hopkins doctor who does all those studies on psychedelic mushrooms; he’s also done research on the effects of meth, nicotine, caffeine, alcohol, and cocaine. Not your typical medical researcher, in other ways. He just did an AMA (“ask me anything”) session over at Reddit, and the questions–and answers!–were illuminating. Some highlights below:

Q: Do you have any personal experience with psychedelics or other psychotropic drugs?

A: Answering that question is a no win situation. If I said I had not, half the folks would say I am unqualified to do the research. If I said I had, the other half would say I am too biased to do the research. It’s the research that matters. I do understand that some folks think one needs empathy for folks undergoing these experiences, but just taking a substance does not necessarily generate that empathy (plenty of folks have taken psychedelics that would be lousy therapists). For those with this concern, I can assure you that we have deep concern for our volunteers and do our very best to understand them and empathize with them at a human level.

Q: In your opinion, which recreational drugs are most dangerous? And which are least dangerous?
A: In terms of fatality, there is no question, tobacco is the deadliest drug and among the most difficult to stop. It kills more than all other drugs combined by a long shot. Alcohol is a distant second in terms of fatalities, but it’s ability to destroy the quality of life is the greatest. Among illicit drugs, heroin is associated with the greatest risk of fatal overdose. At the other end of the spectrum are drugs like cannabis, caffeine, and psychedelics. While they have their dangers (and cannabis and caffeine can be addictive) they are associated with much less damage than most other drugs.

Q: What is the most mind blowing observation about the use and or affects of psychedelics that you have seen evidence for in your profession?

A: The most mind blowing observation is for people in their 60s who have never taking a psychedelic before say that it has dramatically changed the way they interact with the world. To have 70 year old man tell you that for the first time he knows what it means to stop and smell the flowers, that he can’t walk down the street and watch a tree without being brought to tears by the unfolding miracle of existence. Or to have a lifetime nail biter say he has gone a year without biting his nails after a session – the tendency just disappeared. Or to have a decades long smoker say he didn’t even experience withdrawal when he quit smoking (as I was recently told by a participant 6 months after quitting). How in the world does a 6 hour experience on a substance have the ability to change somebody in such dramatic ways? We know very little about what is really happening cognitively. Much to learn!

Q: Would you say we’re on the edge of a change in the government’s attitude towards the therapeutic uses of psychedelics? In your estimation how long will it be before we see psychedelics used in mainstream treatment of drug and alcohol addiction?

A: Yes I’d say we are on the edge of some change. Might be over the next decade or two rather than immediate, but it is slowly happening right now. More and more solid, mainstream scientists are becoming intrigued by the therapeutic potential of these substances. The landscape is very different than when I started in psychedelic research almost 10 years ago. Now, most psychopharmacologists I know are not surprised at all about this therapeutic potential. Every drug class has it’s unique harms and potential benefits when controlled. Virtually every other class of abused drugs also have accepted therapeutic uses (opioids, sedatives, cocaine, amphetamine, even THC is an FDA approved drug which is not controversial at all compared to whole plant cannabis), it’s just a matter of understanding and minimizing potential for clinical harm. It is really not surprising that some dimension of benefit can be realized through cautious application of these agents. And that does not mean that the same drug can have greater dangers when used haphazardly in an illicit context.

Q: How difficult has this research been in the legal sense?
A: It has gotten a bit easier over the years. But that doesn’t mean it is easy. There has been some trust building. I think the FDA, IRB, and other folks have seen that we and others have done responsible, well conducted research over the years, so things start to look a little more boring and less sensationalistic, like most research.

Q: What is your opinion on recreational use of psychoactive substances and the stigma against them, both in schools and society?
A: I think we should do our best to minimize the problems that come from recreational drug use, but do it in a way that does not actually create more harms.

[questions/answers edited from full text, found here.]

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