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Inside the mushroom bubble

- Beth Amato

Psychedelics: Are they the magic bullet some claim for the treatment of conditions such as depression and post-traumatic stress disorder?

The colourful, spiralling land where people can supposedly hear colours, taste shapes and confront the traumas of their past seems to have captured the world's imagination. Psychedelic drug acolytes have been known to spend their life savings travelling to these Dali-esque cure-all mindscapes from the earthly comfort of their luxury accommodation in the Amazon jungle. In fairness, the quest to slay hungry psychic ghosts and finally get to grips with the human condition is understandable and, perhaps, necessary.

Psychedelics and mushrooms | Curiosity 16: #Drugs ©

Psychedelics, which alter the state of consciousness bringing purported mental and emotional benefits, include ayahuasca, psilocybin (magic mushrooms), San Pedro (mescaline), toad venom, MDMA (Ecstasy), peyote, and ketamine and indeed are part of post-capitalism's lexicon. Now, you too can get rich off psychedelic stocks because hallucinogenic start-ups are (ahem), mushrooming.

Before hallucinogens hit the mainstream, making appearances in swanky sweat lodges from Sao Paolo to Swellendam, they had been used for thousands of years for ritual, medicinal, cultural and trade purposes in indigenous societies. This raises many concerns, chief among which include the economic exploitation of indigenous knowledge and resources, and of course, the overall safety and oversight of the psychedelic industry.

So promising are psychedelics’ treatment of complex post-traumatic stress disorder and intractable depression, that Australia became the first country to allow doctors to prescribe MDMA and psilocybin to patients. Many developed countries have embraced the zeitgeist, with several US states such as Colorado and Oregon making psychedelic use legal. 

Whatever happened to the war on drugs?

Ironically, it is these countries that were staunch proponents of the so-called "war on drugs" that pushed psychedelic and traditional healing medicines to the margins. But the Global North is very good at spotting and exploiting monetary opportunities. Cue health entrepreneurs with immense wealth to set the wheels of production in motion. Eventually, pharmaceutical companies will be able to sell their psychedelics (heavily marketed as the ultimate medical magic bullet) back to the people who have been custodians of these products and systems for generations.

In South Africa, mind-altering substances and rituals were regulated by draconian colonial laws.

Cannabis, which can have psychoactive components, has a long history of indigenous use in South Africa. The practice of using cannabis to induce a trance-like state in 'rituals of rapture' has been embedded in Khoisan culture for over 600 years. Notably, cannabis performed a critical role in the pre-colonial exchange economy until the British sought to outlaw it. They believed that cannabis caused mental instability, insanity, crime and delinquent behaviour. The government under Jan Smuts officially prohibited cannabis in 1922.

Professor Catherine Burns, a medical and health historian, and the Educational Developer at the Wits Health Sciences Teaching and Learning Office, says that historically, people have always used the fruits of the land, particularly in the northern parts of the country. "People have used plants to aid in childbirth, to connect with ancestors, to suppress hunger, assist with aches and pains, and alleviate nausea," she says.

Burns notes that many South Africans continue to use a variety of healing modalities, despite the dominance of the western medical model in hospitals and clinics, and the fact that so-called alternative medicines have been marginalised. Nevertheless, she still laments the split between ethno-pharmacology and chemical pharmacology. The latter is deemed robust and has a strong tradition in South Africa with its range of clinical trials and its leadership at the height of the HIV/AIDS pandemic.

Dr Sinethemba Makanya, a Lecturer of Medical Humanities in the Department of Family Medicine and Primary Care at Wits University, explains that while there is no specific name for psychedelics in African traditional medicine, substances are used to bring one closer to spiritual guides. Makanya, who is also an inyanga, calls it dream medicine. "We ingest it so we open ourselves up to receive messages. We want our ancestors to show us the path," she explains.

These plant medicines hold a central place in many cultures in which people and plants are mostly seen to have a reciprocal relationship rather than one of extraction, expedience, and exploitation of the one by the other.

Bio-piracy and cultural appropriation

Hoodia, a well-known appetite suppressant cultivated initially by the Khoisan, was the subject of a landmark "bio-piracy" case. When the Council for Scientific and Industrial Research (CSIR) patented 'P57', derived from the Hoodia cactus, and granted development rights to UK pharmaceutical firm Phytopharm, the San community was not informed but ultimately won the legal case and is now part of a 'benefit-sharing' agreement with the CSIR.

This case highlights issues of cultural appropriation relevant to the use of indigenous hallucinogens, and the brazen profiting from ancient healing practices.

"It's tricky territory," says Makanya. "What does compensation mean? And what makes it meaningful?" She believes that we need to consider using others' practices as tools to incorporate into one's repertoire. "It is the energy you approach it with. We can't have a purist notion of healing … It's about incorporating different therapies into the canon of your work."

Makanya is concerned with issues of access and the continuation of systemic injustice in the healthcare system. "I came to San Pedro and psilocybin through well-connected people and with access to technology. It was from a privileged place. If these medicines are indeed important for healing, then we need to make them available to everyone," she says.    

Safety first

Makanya explains that there are strict guidelines for taking traditional African dream medicines. Clients must perform cleansing rituals to prepare the body mentally and physically. "I think this kind of oversight is really important, because we are talking about people's psychological wellbeing." 

In Australia, they have experienced some pushback due to the psychedelic hype outpacing safety and ethical considerations.

Psychedelics are still illegal in South Africa and are classified as Schedule 7 drugs, along with heroin. Meanwhile, adults are allowed to possess, use and grow cannabis for their own personal consumption. This was a landmark Constitutional Court ruling, and while beset with flaws in its application, it has inspired South African advocates to push for legalising psychedelics.

The burden of mental illness means wider treatment options should be available.

Burns says that we must guard against believing psilocybin, for example, is a silver bullet to treat mental health issues. This reductionist view doesn't account for the range of ways and combinations of modalities often required in a treatment plan.

Nevertheless, the available treatment options for mental illness could be expanded. A paper by the South African Medical Research Council Developmental Pathways for Health Research Unit shows that more than a quarter of South Africans suffer from probable depression and anxiety. This is significantly higher than in other countries. Sadly, only a quarter of those with mental illness seek treatment.

“With our high burden of disease, the time is now to consider broadening treatment modalities”, says Burns.

  • Beth Amato is a freelance writer.
  • This article first appeared in Curiosity, a research magazine produced byWits Communications and the Research Office
  • Read more in the 16th issue, themed: #Drugs, where we highlight the diversity, scope, and multi-dimensional nature of drug-related research at Wits University.