A day in the life of a consultant psychiatrist and psychedelic drug researcher

Drugs are central to my life. Just like you, I was born to a drugged mother, injected minutes after birth and repeatedly dosed throughout my childhood. Drugs help me get up and go to work, sustain me throughout the day and relax me in the evenings. I am a regular consumer of legal highs. Almost all of us are.

I work with children in a secure custodial setting, most of whom have used drugs before incarceration to have fun. I also work in an adult addictions service with people whose drug use is mistaken for the cause of their problems. It is not. Addiction is not about drugs. Rather, drugs slot neatly into a pre-drug maladaptive profile of failed opportunities and chronic exclusion of hope. My patients are simply self-medicating. And who can blame them? Their medicines (heroin, crack and alcohol) work better than mine (Prozac) at blunting life’s sharp edges. Nevertheless, I give them my drugs and help them off theirs. But in my clinical experience no drugs in isolation will eradicate mental disorder. Most psychiatric prescribing merely ‘papers over the cracks’ of patients’ symptoms with maintenance therapies that do not cure them. The core of their distress (childhood trauma, social exclusion, lack of education and opportunities) is hard and expensive to resolve. Prozac is cheaper and faster.

And I also work for the Family Law courts, assessing parents and children whose prospects are judged by court decisions based on their past or potential future drug use.

And finally, I am part of a thriving university psychopharmacology research department at Imperial College London, exploring the therapeutic potential for psychedelic drug-assisted psychotherapy as an innovative new approach to treating unremitting mental disorders with the compounds LSD, psilocybin, ketamine, DMT and MDMA.

 


 

But drug use and misuse are different. Most people take most drugs, most of the time relatively benignly. Drug misuse and addiction is not the “drugs’ fault”. Simply prohibiting drugs and criminalising users is a grossly simplistic and dangerous folly. Our system for classifying drugs is unscientific, socially irresponsible and morally reprehensible. Our drug laws increase the harms, deaths, associated crime and even the usage of drugs. There is more scientific validity for homeopathy than prohibition. The arbitrary assignment of substances into classes A, B and C has no pharmacological validity, is patronising, dangerous and sends the wrong public health message.

Drugs don’t kill people. Prohibition does.

Yet our drug laws have persisted, unaudited and unaltered for 50 years despite clear evidence of their lack of efficacy. Why? This is a complex question that often leads towards unhelpful conspiracy theories. In wishing to avoid this, I can only assume successive governments sustain the destructive policy with my best interests at heart.

It’s enough to turn one to drugs.