Psychedelics’ Exciting Potential to Benefit Autistic People

    [This article is published in collaboration with Narcotica, a podcast about drugs and the people who use them, hosted by journalists Troy Farah, Zachary Siegel and Christopher Moraff. To learn more about the experiences of autistic people who have benefitted from psychedelics, you can listen here.]

     

    Psychedelic drugs are closer than ever to becoming mainstream, FDA-approved medications. MDMA, also known as Molly or ecstasy, shows remarkable efficacy for treating severe post-traumatic stress disorder. Most recently, the results of a phase 3 clinical trial published in Nature found that 67 percent of participants who took MDMA no longer met the diagnostic criteria for PTSD, which is a big deal for this hard-to-treat condition. Meanwhile, psilocybin, the drug in “magic” mushrooms, has been shown to be as effective as a common antidepressant, according to new research in The New England Journal of Medicine.

    Both drugs have been deemed “breakthrough therapies” by the Food and Drug Administration and appear poised for approval, if no sooner than 2023.

    Many scientists are now engaged in searching for other ways in which psychedelics may help people. And among them, a growing number of researchers are turning their attention to relieving symptoms of autism spectrum disorder (ASD).

    “After the study … All these things that really required a lot of social interaction, they were completely fine.”

    This month, Nova Mentis Life Science Corp announced the launch of an observational study on the microbiome and genetics of patients with ASD and Fragile X syndrome. Part of the research is focused on serotonin signaling, the chemical in the brain most associated with psychedelic effects. That’s because the Vancouver-based psychedelics company plans to test psilocybin to illuminate “the neural underpinnings of social dysfunctions” in ASD, the company said in a press release.

    MAPS, the Multidisciplinary Association for Psychedelic Studies, has been especially interested in this question, and has explored using MDMA to treat social anxiety in autistic adults. So far, the nonprofit has been the only organization to complete such a clinical trial in the 21st century. It was a small trial with just 12 participants (four receiving placebo) but it “demonstrated rapid and durable improvement in social anxiety symptoms,” according to results published in Psychopharmacology in 2018.

    “The results had a large effect size, which means that it’s a strong signal that we might be able to alleviate the social anxiety symptoms that they were suffering from,” Berra Yazar-Klosinski, one of the study authors, told Filter. “We had a six-month follow up and many of the participants had completely transformed lives after the study. These were folks that never left their parents’ home. And after the study, they moved out, and they started school, and they joined a soccer team. All these things that really required a lot of social interaction, they were completely fine.”

    For Yazar-Klosinski, the interest in studying this was personal. Her brother is autistic, and she wondered if such a treatment could someday help him with his social challenges. “He’s in his 40s, and he still lives at home with my parents. And so I was always really motivated to try to find a way to help him.”

    It could be a while before another study with a larger sample size is conducted and MDMA for autism symptoms is granted FDA-approval. Although the University of Chicago is currently recruiting for such a study, it’s the only active autism-and-psychedelics trial currently registered through the National Institutes of Health.

    “I found that it was really helpful in making me feel connected to people.”

    Regardless, a small, growing group of people with ASD aren’t waiting for the science to catch up. They’re trying these drugs now—and creating social networks based around these promising therapeutics—sometimes with life-changing results.

    For author and journalist Maia Szalavitz, who identifies as autistic, psychedelics like LSD and mushrooms are what helped her connect to her peers at a time when she attended “about 100” Grateful Dead shows in her youth.

    “I really was just socially clueless and couldn’t figure out how to fit in with people until I discovered drugs,” she told Filter. “I found that it was really helpful in making me feel connected to people, and in having me understand that being overwhelmed and intense is not that horrible.”

     

    Autism and a Checkered Research History

    According to Johns Hopkins Bloomberg School of Public Health, the prevalence of ASD has nearly tripled since 2000, from 0.67 percent of 8-year-olds to 1.85 percent. Some experts believe this is due to better reporting and screening standards; in other words, that we’re finding more instances of autism because we’re looking harder and better.

    Autism remains an often misunderstood and stigmatized condition, and its definition is not always easy to pin down. Its traits exist along a spectrum, and it manifests differently in different people. It’s not always debilitating—in fact, many people are delighted by the way their brain works and resent any notion of being “cured.” As Anya Ustaszewski put it in the Guardian, “people on the autistic spectrum are disabled more by society than by their autism.”

    “As long as they can find a good fit for how their brain functions and find work that’s rewarding, it’s often possible for them to have completely fulfilling lives,” Yazar-Klosinski said. “Actually, I don’t think that being autistic is a mental health condition. It’s more of a way of being.”

    That doesn’t mean having autism is always easy. Some people can struggle with social interaction, especially with making eye contact or interpreting nonverbal communication. Hypersensitivity to sound, light or other stimuli is also commonly reported.

    “Autistic people are often very used to dealing with sensory overload and I think it’s very interesting that LSD in particular acts on the serotonin system, which is involved with sensory gating,” Szalavitz said.

    Psychedelics seem to be able to address the more uncomfortable symptoms of ASD by helping people adjust better to their environment, Yazar-Klosinski said. “The part we can treat is the social anxiety and the trauma that comes with being autistic.”

    Psychedelics are not being promoted as a “cure” for autism. However, research hasn’t always been so considerate.

    “When the participants were under the influence, they didn’t actually feel like anything was different sometimes, which was interesting,” she continued. “They’re already living their lives in a pretty altered state. So having the psychedelic on top didn’t seem all that different.”

    It’s important to note that psychedelics are not being promoted as a “cure” for autism in modern research. However, research hasn’t always been so considerate.

    From the late ‘50s through the ‘70s, experiments were conducted that gave drugs like LSD to autistic people without controls or rigorous study designs. In addition, the studies often lacked participants’ informed consent.

    In 2007, a group of researchers reviewed this research in Developmental Neurorehabilitation and concluded, “the vast majority of these initial Autism/LSD studies were so flawed that the resulting data are little better than anecdote.”

    We have a much better understanding today of how psychedelics can help. These drugs are best known for the powerful hallucinations they can produce: time dilation, enhanced sound or color, visual trails, warping textures and a diminishing sense of self or the ego. But psychedelics also promote what’s known as “plasticity” in the brainallowing this ball of fat and electricity inside our skulls to “rewire” itself and even grow new neural connections.

    While psychedelics have been shown to have some benefit on a biological level, it’s not the drug alone doing the work when it comes to our minds. According to experts, pairing psychedelics with therapy is key to their efficacy.

    “It’s not enough to just open the door, you have to walk through the door, then go and make some new connections after that,” Yazar-Klosinski said. “Any psychedelic that creates that kind of an altered state, that is capable of rewiring the brain, would create such an opening … it’s really that integration [and] psychotherapy that I think is where it’s really important to have both the preparation and integration.”

     

    Autistic People Trying Psychedelics for Themselves

    Aaron Orsini was diagnosed with ASD at 23 and tried LSD at 27. “For myself, it was coming into this awareness that I was missing this sort of energetic signature of other beings in my proximity,” he explained, noting that he was often stuck in “mental rumination mode.”

    “Psychedelics showed me that there was something other than the voice inside my head to navigate the world,” Orsini told Filter. “I had the conventional psychedelic experience that many people would report, as far as connecting to nature, to myself and a sense of oneness or wonder. But the thing that stood out was a deep kind of [experience] that’s referred to as interoceptive processing. And this sort of heightening of my ability to detect inner feeling states.”

    Orsini wrote about his experiences in the book Autism on Acid: How LSD Helped Me Understand, Navigate, Alter & Appreciate My Autistic Perceptions and started a website, AutismOnAcid.com. Soon, other autistic people with an interest in psychedelics began to contact him, including Justine Lee, a graduate student in pharmacology at University of California.

    “Before psychedelics, when I heard a dog barking outside, or a loud car, or a door slam, or someone dropping a plate, I was getting very angry.”

    Together, they began hosting weekly Zoom meetings throughout the pandemic, simply to meet and talk with folks with similar interests. The two co-founded the Autistic Psychedelic Community and later compiled a book, Autistic Psychedelic, which contains a series of testimonials from neurodivergent people who have tried these drugs.

    One testimony, for example, comes from someone named Thomas, who wrote: “Before psychedelics, when I heard a dog barking outside, or a loud car, or a door slam, or someone dropping a plate, I was getting very angry, almost raging, especially if I tried to concentrate. And this is 100% gone today. When there’s a loud noise anywhere, it doesn’t hurt anymore. I’m totally calm.”

    “It’s been kind of an amazing journey,” Lee told Filter. “I can’t express enough gratitude for all the community members who have shared their stories and who just like allowed me to be present and listen to them.”

    “What we’re really trying to do is just build this conversation and just create a space for it,” Orsini said. “And one of these questions ongoing is like, are these changes happening only during the exposure to these substances, are these changes carried forward?”

     

    Cautions and Optimism

    Despite the uplifting nature of these testimonies, it’s also important to note grounds for caution. “With most of these off-label, anecdotal reports that we’re getting about MDMA or LSD being used, the important part is actually that they need to be done in the context of psychotherapy,” Yazar-Klosinski said.

    Szalavitz also doesn’t recommend anyone take psychedelics outside of a clinical trial, but she understands why some may be attracted to these drugs and offers some harm reduction advice.

    “The main thing is just the same advice you’d give to somebody that didn’t have autism, which is you must be in a safe place. You want to have control over the music, over the people, over the environment that you are, in case it goes bad,” she said, emphasizing that you need to trust the source of any unregulated chemicals and prepare to take a few days off before, during and after the experience. “I really do think that a day to prepare, a day to experience and a day to like, chill out afterwards, is important.”

    “I can’t emphasize enough that there’s avenues other than psychedelic substances to get there. It’s just that those were teaching tools for me.”

    And Orsini himself acknowledges a kind of potential confirmation bias: People with positive experiences are more likely to contact the Autistic Psychedelic Community, whereas someone who had a “bad trip,” or experienced no change, may be less motivated to join such a group.

    “We’re aware of that. We do also hear of challenging experiences. We’ve done our best to include those as well in this anthology,” he said. “We’re trying to encourage harm reduction and safety at every turn. Yes, this is exciting, but we don’t want harms to befall anyone out there at all.”

    Orsini added that he now tries to tap into the psychedelic space using meditation and breathwork, rather than drugs. “I can’t emphasize enough that there’s avenues other than psychedelic substances to get there,” he said. “It’s just that those were teaching tools for me at that time that showed me that this was possible at all.”

    Another thing to make clear is that the people choosing to take psychedelics to treat less comfortable aspects of autism are adults, not children. But while a psychedelic experience can be quite intense, the drugs are generally well-tolerated, including by autistic people.

    With the right research and implementation, psychedelics show immense possibility for improving life for many autistic people in a way that prohibition has long denied them.

     


    Photograph via FreeIMG

    • Troy Farah

      Troy is an independent journalist whose reporting on drug policy and science has appeared in Wired, the Guardian, Undark, Discover Magazine, Vice and more. He co-hosts the drug policy podcast Narcotica. He lives in Southwest California.

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