Thoughts on LSD Treatment for Alcoholism

I ran across a press release ( href="http://www.eurekalert.org/pub_releases/2006-10/uoa-ltf100606.php">1
href="http://www.brightsurf.com/news/headlines/26739/LSD_treatment_for_alcoholism_gets_new_look.html">2)
pertaining to a journal article (‘Hitting Highs at
Rock Bottom’: LSD Treatment for Alcoholism,
1950–1970)
on the use of LSD for treatment of alcoholism.  When I saw it,
I
thought I'd blog about it.  As it happens, several people beat
me
to it.



Anyway, the topic is sufficiently compelling that I am going to post it
anyway, and try to add a little to what has already been said.

Sparkgrass Community, a bunch of med student
bloggers, along with a few other intellectual types, wrote about it href="http://garrettsparks.blogspot.com/2006/10/medicine-lsd-treatment-for-alcoholism.html">here.
 There's a little more discussion at href="http://sciencebanter.blogspot.com/2006/10/power-of-lsd.html">Science
Banter, a blog by a science writer.   href="http://neurophilosophy.wordpress.com/2006/10/09/1077/">The
Neurophilosopher's Weblog reviews the article, adds
a few links, and has a nice illustration, to boot. There is a bit of
historical perspective at href="http://www.strangeattractor.co.uk/further/archives/2006/10/lsd_aids_alcoho.html">Further:
Strange Attractor and beyond.  Scienceblog
(not to be confused with THE ScienceBlogs) picked up on the story href="http://www.scienceblog.com/cms/lsd-treatment-for-alcoholism-gets-new-look-11680.html">here.
 Interestingly, there is a blog called Addiction and
Recovery News, written by a worker at Dawn Farm, that href="http://www.dawnfarm.org/2006/10/lsd-treatment-for-alcoholism-gets-new.html">made
note of the article.   href="http://www.dawnfarm.org/">Dawn Farm is a
long-term substance abuse recovery facility near Ann Arbor.
 The href="http://theszaszblog.blogspot.com/2006/10/lsd-treatment-for-alcoholism-gets-new.html">Szasz
Blog picked it up, too.  I've never been a
fan of Thomas Szasz, but I was interested to note that his followers
maintain a web presence. 
Another site to note the article was href="http://www.sushituesday.com/news-medicine/2006/10/9/october-9-2006.html">Sushi
Tuesday, which appears to be a site devoted mainly to medical
and science news, but has a lot of other stuff.   href="http://edwardwillett.blogspot.com/2006/10/pioneering-weyburn-lsd-research.html">Hassenpfeffer,
a blog written by a resident of Saskatchewan, noticed it and wrote
about it, primarily because the author grew up in the town where the
experiments were performed.  Perhaps most strangely, it was
also
noted on the href="http://rncnyc2004.blogspot.com/2006/10/lsd-treatment-for-alcoholism.html">Repbulican
National Convention Blog, and href="http://www.friendsofliberty.com/modules.php?name=News&file=article&sid=3006">Old
Right, "the voice of the right."



There were href="http://www.blogpulse.com/search?query=LSD+Alcoholism&image22.x=0&image22.y=0">numerous
other mentions
on various Livejournal sites, among others.  In fact, I was
surprised at the number of bloggers who expressed an interest in the
topic.  Apparently, a wide variety of people have an interest,
for
a variety of reasons.  



I am interested in this for the same reason I was interested when there
was a news article about the href="http://trots.blogspot.com/2005/01/headline-that-startles-reader.html">use
of ibogaine for alcoholism.  But the article about
LSD was more interesting.  For one, it was published in the
journal, Social
History of Medicine.
 Two, the journal article provides a fascinating perspective
on
the medical history that puts the study in context.  Third,
the
article got me to thinking a lot.  Which is why I read those
kinds
of things.  



Unfortunately, much of the interesting material requires a
subscription, or academic access of some sort.  The abstract
is
openly available href="http://shm.oxfordjournals.org/cgi/content/abstract/19/2/313">here;
the full text is href="http://shm.oxfordjournals.org/cgi/content/full/19/2/313">here
(if you have access.)



The crux of the story is here:

In 1962, psychiatrist Sven Jensen, working in
Weyburn, Saskatchewan, accepted this challenge and published the first
controlled trial on LSD treatment for alcoholism.



Jensen relied on three pools of subjects for treatment: one group of
alcoholics took LSD at the end of a hospital stay (usually lasting a
few weeks); the second received group therapy; and Jensen’s
colleagues at Weyburn treated the third group with their own standard
approaches, excluding psychedelic therapy. In his two-year study,
involving follow-up periods of 6 to 18 months, The results of the study
demonstrated that 38 of the 58 patients given LSD remained abstinent
throughout the follow-up period. These numbers conveyed greater
significance when compared with the second group. Among those patients
receiving nothing other than group therapy, only 7 of the 38 involved
in the trial remained abstinent. Even those figures, however, showed
greater promise than the results from the group treated by
Jensen’s colleagues by other means; in this group only 4 out
of 35 patients stopped drinking.



The ARF countered with its own trials. Researchers Reginald Smart,
Thomas Storm, William Baker and Lionel Solursh designed an experimental
environment that isolated the effects of the drug before analysing its
efficacy. They administered LSD to subjects and subsequently
blindfolded them and/or employed physical restraints to restrict
movement.



They instructed observers not to interact with the subject, creating a
research design aimed to minimise the influence of all factors except
the drug itself. This approach sought more adequately to ascertain
whether the drug offered genuine benefits, or whether the perceived
advantages merely inspired clinical enthusiasm that corrupted the real
outcome. Subjects used in the ARF study showed some improvement, but,
overall, the results from this study demonstrated that LSD did not
produce results analogous to those claimed by the Saskatchewan group.
Conclusions from the ARF trial indicated the ineffectiveness of LSD
when measured under controlled circumstances. Given the authority
vested in this form of methodology, the ARF study represented damaging
criticism.

The problem was that the more conservative, mainstream medical group
insisted on a particular kind of controlled study.  That is,
they wanted to get rid of the effect of the relationship between the
doctors and the patients.  



Hmmm.



I generally support the notion of strict controls.  But I also
support the notion of doing studies under conditions that mimic actual
clinical practice.  If a drug works in the lab, but not in the
office, what good is it?  Likewise, if something is marginally
effective in the lab, but is remarkably effective in the hands of a
skilled practitioner, who care about the results in the lab?
 Does it really make sense to deny patients an effective
treatment, just because of a technicality?  



In point of fact, every decent psychiatrist on the planet will tell you
that the relationship with the patient plays a very important role in
the effectiveness of the treatment.  So, it is interesting to
see what happens when the relationship is factored out, but it does not
tell you anything that is directly useful.  



Note that I am not advocating this treatment.  The studies
never went far enough to come close to satisfying modern requirements
for FDA approval.  Plus, it obviously is counterintuitive to
think that you could treat an addiction by introducing the patient to
an abusable drug.  Probably most AA adherents would find the
idea repulsive.



One of the core ideas in substance abuse treatment is that the person
in recovery needs to swear off all methods of getting high.
 Absolutely.  



Now, I don't consider this post finished, but it is getting a little
too long for my tastes...