Is there a future for psychedelic treatment in Saudi Arabia?

RIYADH: Psychedelic researcher Stanislov Grof once wrote that “psychedelics, used responsibly and with proper caution, would be for psychiatry what the microscope is for biology and medicine or the telescope is for astronomy.”

To many, this may sound like an outlandish claim, but now more than ever, it is proving to be true and may very well become a frontier in practicing medicine.

Saudi Arabia was enduring a mental health epidemic and the psychological strains of the pandemic exacerbated that. People are finding themselves desperate for ways to cope. One of the most recent psychotherapy methods in the region, albeit stigmatized, is psychedelic-assisted psychotherapy. A recent study published by Neuropsychopharmacology showed that the substances were proven to achieve positive long-term mental health effects and their efficiency, safety and tolerability in treating major depression, post-traumatic stress disorder, obsessive-compulsive disorder and certain addictions.

I get more people contacting me asking me how they can receive this treatment, and it’s really heartbreaking to tell them, I’m sorry, but you’re gonna have to wait. It’s not available yet.

Haya Al-Hejailan, Saudi well-being practitioner and psychedelic integration specialist

It is also associated with enhancing creativity and problem-solving, according to an article published by the Journal of Psychoactive Drugs in 2019.

While the stigma around mind-altering substances, both in the region and globally, is unavoidable, researchers and scientists argue that if these drugs are regulated and used purely for medicinal reasons, what is the harm?

The term “psychedelics,” a class of hallucinogens, comes from the Greek words “psyche,” meaning the mind, and “delia,” meaning manifesting. The psychoactive substances are meant to alter the mind and create an alternative cognitive perception.

Psychedelics are classified into classical, which includes lysergic acid diethylamide (LSD), psilocybin (commonly known as magic mushrooms), mescaline and others, and non-classical, such as methylenedioxymethamphetamine (MDMA or ecstasy) and ketamine.

“(They’re) really great tools for us being able to understand the brain and the study of consciousness better,” Saudi well-being practitioner and psychedelic integration specialist Haya Al-Hejailan told Arab News. Her work centers on psychedelic research and the treatment of borderline personality disorder.

This point may seem counterintuitive: How can addiction be treated with a substance that may cause another addiction? But psychedelics are, in fact, anti-addictive in nature.

“They have anti-addictive properties, meaning they don’t constitute physiological addiction, but one can become psychologically addicted to anything,” said Al-Hejailan, refererring to non-substance addictions such as coffee or mobile devices.

However, the use of psychedelics can pose certain dangers, making it crucial to undergo treatment strictly under professional medical supervision, which can only be accessible through clinics. Psychedelic therapists are trained to create a controlled environment for patients undergoing psychedelic therapy, with sessions prior to administering the treatment dose to identify any red flags or possible risks that would otherwise create a larger margin of error. Patients who self-dose could potentially be subject to health risks, retraumatization, depersonalization and dissociation.

“I get more people contacting me asking me how they can receive this treatment, and it’s really heartbreaking to tell them, ‘I’m sorry, but you’re gonna have to wait. It’s not available yet,’” Al-Hejailan said. “But I’m optimistic with highlighting the word ‘yet.’”

An article published by The Lancet showed that most antidepressants are ineffective and can be harmful to adolescents and children.

In an attempt to fulfill that medical need, several research efforts and trials have been unertaken to evaluate alternative routes, such as psychedelic-assisted therapy.

A study published by the National Library of Medicine found that small IV doses of ketamine can have positive, long-lasting antidepressant effects in patients. Although the scientific research regarding psychotherapeutic psychedelic use in the region is insufficient, Saudi Arabia has been easing its way into their use use for other purposes. Last year, the Saudi Journal of Emergency Medicine published a paper describing a successful case of refractory status epilepsy, a life-threatening condition, in a child treated with a single dose of ketamine.

Despite its growing popularity in mainstream media, psychedelic science is one of the cutting-edge neurosciences, yielding insufficient research compared to other sciences. The 1950s saw the first English-language report published on LSD, and research continued into Richard Nixon’s US presidential term, ending in the 70s. However, research efforts were quickly banned under the justification of the war on drugs as a public enemy declared by the US president. However, it was supported by other factors, such as the lack of funding for psychedelic research and failed medical trials, according to an article published by the Cambridge University Press.

That area of medicine was considered niche until recently. In 2017, MDMA was given “breakthrough therapy” designation by the Food and Drug Administration, meaning it was granted an expedited review process. In 2018, the FDA granted a group of psychiatrists researching psilocybin-assisted therapy for treatment-resistant depression the same status.

In the same year, Michael Pollan’s book “How to Change Your Mind” created a public space for people to think differently about psychedelics and the consciousness expansion of the mind. Ketamine was granted the same status a year later. Arguably, that is when psychedelics hit the mainstream, although its resurgence into clinical research and trials resumed in the 1990s.

“(Before that) I was met with a lot of skepticism. People literally thought I was talking about something that’s crazy,” Al-Hejailan said in reference to discussing psychedelic-assisted psychotherapy before 2018.

“There’s a lot of interest, enthusiasm and curiosity that I’m met with now when I talk about my work.”

With a master’s in applied positive psychology and coaching psychology from the University of East London, Al-Hejailan’s work also includes positive psychology integration and psychedelic education, providing training in psychedelic therapy and ketamine-assisted psychotherapy. She also co-directed and co-produced a documentary titled “Psychedelic Renaissance,” centered on the reemergence of the psychedelic movement globally and its cultural significance.

Al-Hejailan said that raising awareness about psychedelic studies was the first step in creating a regional environment that allows for alternative psychotherapy methods.

“I think we need to, in general, focus more of our energy and attention on psychoeducation, educating the public about mental health and well-being. The more we do that, the more people are likely to continue becoming accepting and interested,” she said.

Future steps to normalize the use of psychoactive drugs include active training for clinicians and therapists on their uses and benefits and eventually establishing specialized clinics and research centers.

“My goal is to have presentations specifically on psychotherapy and to meet with therapists, psychologists, psychiatrists and other physicians, and policymakers at some point. To show them what’s happening abroad, what the science shows and to discuss how we can replicate this here in a safe way that respects our culture and that respects our specific or unique needs,” Al-Hejailan said.

“I really want to open a clinic and research center here. Me and my colleagues would very much love to see Saudi pioneer in psychedelic research in the region, and maybe globally.”