Can Psychedelics Solve the Youth Mental Health Crisis?

Can Psychedelics Solve the Youth Mental Health Crisis?

Can Psychedelics Solve the Youth Mental Health Crisis?

Nearly two-thirds of young adults report having either depression or anxiety. In California, Connecticut, Illinois, and other states, lawmakers are considering their options for psychedelics legalization.

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As a high school freshman, Aiden McDonnell began exploring dissociative drugs with the help of well-connected friends: first with DXM, a cough suppressant often found in over-the-counter medicine, and later with magic mushrooms and LSD. His initial experiences with these substances—typically labeled “psychedelic” for their visual or illusory effects—were “not fun” and spawned regrets over losing “the innocence of childhood,” said McDonnell. “That’s probably not the best when you haven’t even started figuring stuff out.”

But now McDonnell, 19, is more careful with psychedelics, which he says have helped him understand himself better. His foray into recreational substances isn’t unique and is increasingly common among his generation. According to federal survey data, 8 percent of young adults reported using psychedelic drugs in 2021, up from 3 percent a decade prior. Growing cultural acceptance along with a nascent field of research with promising implications for treating depression have positioned psychedelics as a potential aid to a youth mental health crisis. Nearly two-thirds of young adults report having either depression or anxiety. In 2019, 9 percent of high school students reported attempting suicide during the previous 12 months, and suicide remains one of the leading causes of death for teenagers.

In California, Connecticut, Illinois, and other states, lawmakers are considering their options for psychedelics legalization. And in cities like Oakland, for example, psychedelics remain illegal by state and federal law but have been effectively decriminalized by placing them as the lowest priority for the city’s police department. Full legalization of psychedelic possession, however, remains scant, as legislators hesitate to open paths for recreational use. On the federal level, at least one substance, MDMA, has passed its first Phase 3 trial, needing only a second successful trial before it may be approved for medical use by the Food and Drug Administration.

But some parents have already turned to psychedelic clinics to alleviate their children’s mental health conditions. When Lori Calabrese, a physician and researcher from Windsor, Conn., began administering ketamine, some of her patients suggested the drug for their teenagers who struggled with depression and anxiety. As Calabrese did more research and conducted her own clinical trials, she realized that adolescents, who are often excluded from research trials or clinical treatments with psychedelics, could benefit tremendously. One 2021 study by researchers at Yale, which used 17 adolescents ages 13 to 17 who had major depressive disorder, found that 76 percent experienced relief within three days of receiving ketamine infusions. Calabrese attributes these improvements to neuroplasticity—the ability of the brain to form new neural pathways and adapt to environmental changes—which occurs at all ages but might be “especially vibrant in a teenager or a young adult.”

For a depressed mind, taking ketamine is like “getting a download of all kinds of perceptions, ideas, thoughts,” said Calabrese. “It’s sort of like you’re a stalled car, and ketamine is giving you some juice and a key in the ignition.” And for many, it can be the difference between suicidal thoughts and a realization that “Oh my gosh, I’m really loved,” according to Calabrese. Her work with teens led her to publish a 2019 study, which included adolescents, that found that ketamine infusions could dramatically decrease the likelihood of ER visits and suicide attempts. 

Rebecca Hendrix, a psychotherapist in New York who administers ketamine-assisted therapy, sees a strong medicinal potential in psychedelics. Her young clients are less receptive to alcohol and hard drugs, such as fentanyl, and seem “more hardwired for taking care of themselves and a healthy lifestyle.” Federal and polling data show that young people, despite increasingly consuming marijuana and psychedelics, are steering away from opiates and, at least compared to older generations, drinking less. What’s more, Hendrix notes, is that many young adults are looking for alternative methods of mental health treatment. “What’s available to them is to take an SSRI every day for maybe the next 10, 20 years or the rest of their life,” said Hendrix. “A lot of times, the medications that are out there address the symptoms, but not the core.”

Burke Ramirez knows personally that taking anti-anxiety medication “was not really a pleasant experience.” Having taken meds throughout high school, Ramirez says he’s still dealing with the side effects. Though he’s had mixed experiences with psychedelics, he believes that they have led to “a lot of self-reflection” and that they should be widely available to those who may benefit from them. “To me, it’s just expanding the doctor’s toolbox.… if one chemical advantage can be extremely effective, it’d be such a shame to not let that be utilized for people.”

But whether these potential benefits warrant immediate legislative action—especially for already vulnerable groups—is less clear. Though their long-term effects are not yet fully understood, psychedelics are generally considered nontoxic and carry little risk of a fatal overdose, unlike harder drugs like heroin or crystal meth. Kimberly Juroviesky, president of the insurance advocacy group Ketamine Taskforce, knew a patient who developed major bladder issues after four years of receiving two normal doses of ketamine every week. “Now we’re realizing it’s not just about the dose, even if it’s much smaller. When you keep hammering the bladder with ketamine, it still can cause the same side effects,” Juroviesky says. But if “used appropriately” and with sufficient time in between doses, the drug “can be very safe.”

In New York, legal possession of psychedelics—whether for medical or recreational use—might soon be a reality. Assembly member Linda Rosenthal filed a bill in December that would legalize possession of natural psychedelics, including magic mushrooms, for adults ages 21 and over. Though it excludes synthetic psychedelics like MDMA, which Rosenthal says is a tactical move to increase support for the bill, and does not legalize the sale of psychedelics, it would help existing therapeutic communities and practitioners to safely conduct psychedelic-assisted mental health treatment. “A bill like this is hard enough,” Rosenthal told The Nation. But whether Republicans help make psychedelics a bipartisan effort is something “we’ll have to see.” Most recently, Arizona Republicans joined Democrats to propose a bill to fund magic-mushroom trials for PTSD research. And if New York “passes something and has a great impact, other states consider it.”

Another New York Assembly member, Pat Burke, also filed a separate bill this winter that would establish medical facilities for psilocybin mushrooms to be grown and administered to patients. According to Avery Stempel, who has met with state legislators alongside the New York Psilocybin Action Committee, Burke’s bill likely stands a higher chance of passage thanks to its primarily medical approach. “We want the Linda Rosenthal bill,” Stempel says, “but unfortunately, New York will not open the floodgates to pure decriminalization without first working it through a medicinal mode.”

Some researchers, however, still urge caution. Professor of psychiatry and behavioral sciences at Stanford University Robert Malenka worries that governments may be rushing to conclusions prematurely without sufficient scientific consensus. If more states and cities decriminalize or fully legalize psychedelics, opening the path for broad recreational use across the country, Malenka said, “there is no doubt that their use will increase and that will increase the numbers of individuals who have bad or even dangerous experiences.”

Others see a more complicated picture. Executive Director for Students for Sensible Drug Policy Jason Ortiz believes that criminalizing psychedelics is wrong from a moral and practical standpoint. He points to broad policy reports suggesting that drug penalization fails to prevent addiction and, in some cases, only further undermines public health by prioritizing carceral solutions. “We should not be making policy based on fear,” said Ortiz. “All the negative side effects of drugs can be approached from a place of compassion, and reduced.… But none of that requires prohibition or law enforcement to deny anyone the ability to try it.” Given millennials’ broad support for progressive rehabilitative policies, youth support for psychedelic decriminalization may be substantial. “I think a lot of young people wouldn’t necessarily consider themselves anti-drug,” says Aaron Genuth, a legislative coordinator with the New York Psilocybin Action Committee. “People have become a lot more aware of the degree to which the drug war hasn’t worked, and has been rooted in racism, classism, falsehoods, and violence.”

But even if states like New York legalize psychedelics, it might not be enough. Particularly for young people, accessibility may prove to be the biggest challenge; costs for full psychedelic treatment can exceed $4,800, and some psychedelic companies are pursuing patents to ensure their future profits. Passing the first wave of laws, though, is the first step for activists. “The research going back a bunch of years has been pretty exclusively positive,” said Genuth. “That’s why I say it’s a matter of when, not if.”

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