At Auckland University, neuropsychopharmacologist Dr Suresh Muthukumaraswamy is working to finish off approval for a historic LSD microdosing experiment - here in New Zealand.
His research could change lives, science, and how we treat psychedelics. Dr Muthukumaraswamy sat down with Newshub to discuss his work.
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Psychedelic research flourished in the 1950s and 1960s, before concerns about LSD's recreational usage - and the overenthusiasm of some researchers - led to a legal crackdown.
But now the field is flourishing again as part of a psychedelic renaissance, with researchers exploring how psychedelics and empathogens could help treat mental health issues such as PTSD, addiction and clinical depression.
LSD works by binding to serotonin receptors in the brain, changing the electrical signalling and resulting in the hallucinogenic effects. While it is a Class A drug - the same as cocaine, heroin and methamphetamine - it has one of the lowest rates of harm for a drug and isn't considered to be addictive.
What is microdosing?
Microdosing involves giving people very small amounts of psychedelics, not enough to experience a perceptual difference but enough to cause a slight elevation in mood.
"Back in the 60s and onwards the focus was always a really large transformative doses where you take this one big dose… and have this profound psychological experience," Dr Muthukumaraswamy told Newshub.
"Then this microdosing phenomena kind of emerged with the publication of Jim Fadiman's book in 2011. What was happening in this kind of underground culture was people were starting to take very small doses of LSD or psilocybin, about a tenth of what you would have to have a tripping effect.
"They were taking it every second or third day, and they claimed that they can experience many of the positive effects, even some of the more long-term positive effects from taking these drugs, but actually only in very small doses."
These claims of positive effects include claims of improved focus, wellbeing, and an improvement in mood and anxiety issues - important benefits as rates of mental disorders rise and the discovery of new antidepressants slows.
"We have these growing kind of mental health problems," Dr Muthukumaraswamy told Newshub. "Depression is now the leading cause of disability worldwide so we've got this massive mental health problem."
The microdosing trial
Dr Muthukumaraswamy is planning a randomised, controlled trial to see how effective microdosing actually is. Some of the volunteers will be given LSD, while others will be given a placebo.
"At the moment there's not a lot of rigorous scientific study of this, in fact, is really no rigorous scientific studies," he told Newshub.
"So what we want to do is a kind of controlled study where we look at these sub-perceptual doses to see whether they really have these kind of effects."
About 40 male subjects will be needed. Although Dr Muthukumaraswamy says there won't be any risk to those involved, because the LSD will be tested on people, there are stringent ethics and safety requirements. This costs a lot of money.
"Setting up a trial like that, first you have to get enough money to do it because these things are expensive to do," he says.
"You need to get the team of experts that you need to do it, various types of doctors and pharmacists, you need the facilities in place to do the study.
"Then you need to put together a study plan, and then you need to apply for ethics to do the study. You need regulatory approval of various layers, so in New Zealand, that's from MedSafe."
Even getting hold of the quantity of LSD he needs is difficult - and expensive.
"A really tricky thing is actually trying to get the drug in a pure pharmaceutical-grade form that you can afford it because drugs are normally produced in massive, massive amounts," he says.
"They might be producing 100,000 doses on a factory line whereas our little study only needs 500 doses. So that can actually be very expensive to produce just a very small amount of drugs."
Dr Muthukumaraswamy says getting the trial started is a "big process that might take a year's work".
"We're about halfway there," he adds.
Newshub.
