The Trials of Psychedelic Therapy

The rise—and fall—of research into the therapeutic potential of LSD.

After LSD arrived in the United States in 1949, the drug's therapeutic promise quickly captured the interests of psychiatrists. In the decade that followed, modern psychopharmacology was born and research into the drug's perceptual and psychological effects boomed. By the early 1960s, psychiatrists focused on a particularly promising treatment known as psychedelic therapy: a single, carefully guided, high-dose LSD session coupled with brief but intensive psychotherapy. Researchers reported an astounding 50 percent success rate in treating chronic alcoholism, as well as substantial improvement in patients suffering from a range of other disorders. Yet despite this success, LSD officially remained an experimental drug only. Research into its effects, psychological and otherwise, dwindled before coming to a close in the 1970s.

In The Trials of Psychedelic Therapy, Matthew Oram traces the early promise and eventual demise of LSD psychotherapy in the United States. While the common perception is that LSD's prohibition terminated legitimate research, Oram draws on files from the Food and Drug Administration and the personal papers of LSD researchers to reveal that the most significant issue was not the drug's illegality, but the persistent question of its efficacy. The landmark Kefauver-Harris Drug Amendments of 1962 installed strict standards for efficacy evaluation, which LSD researchers struggled to meet due to the unorthodox nature of their treatment.

Exploring the complex interactions between clinical science, regulation, and therapeutics in American medicine, The Trials of Psychedelic Therapy explains how an age of empirical research and limited government oversight gave way to sophisticated controlled clinical trials and complex federal regulations. Analyzing the debates around how to understand and evaluate treatment efficacy, this book will appeal to anyone with an interest in LSD and psychedelics, as well as mental health professionals, regulators, and scholars of the history of psychiatry, psychotherapy, drug regulation, and pharmaceutical research and development.

“"This book is highly recommended reading not just for aficionados of hallucinogenic drugs but for anyone interested in the history of drug development and regulation."”

I found this book useful from a clinical point of view, as well as clarifying from a psychedelic therapy point of view. I certainly recommend this book.
—Pedro Ruiz, MD, Baylor College of Medicine, Journal of Nervous and Mental Disease
A deeply researched, significant and very specific intervention into the historiography of LSD, drug research, research design and drug use in the context of psychiatry. Oram's study benefits a close and extended reading, and he should be congratulated on writing such a fascinating history.
—James Pugh, University of Birmingham, Social History of Medicine
People interested in drug development, ethics boards, approvals committees and the consequence of research-governance directives will enjoy this book. The Trials of Psychedelic Therapy shines a fascinating light on a discipline that is neither pure pharmacotherapy nor pure psychotherapy. Oram shows how LSD's unique position between these seemingly disparate fields has been, and still is, its potential undoing when it comes to obtaining formal licensed approval.
—Ben Sessa, Imperial College, British Journal of Psychiatry
[The Trials of Psychedelic Therapy] introduces many key figures in LSD research and provides convincing new analysis of studies that are fascinating in themselves. Now that psychedelic therapy is again drawing interest, it is worth fully exploring why research faltered the first time around.
—Sarah Brady Siff, Miami University, Medical History
Oram's accessible writing style should appeal to a range of audiences, from historians and psychiatrists to graduate students and popular science readers. His major argument is consistent and coherent, and his analysis raises interesting questions . . . Prohibition might not have killed the field, but many 'first wave' and contemporary psychedelic researchers strongly believe that it impedes their work. Perhaps Oram's book will offer new stories to tell in the emerging 'psychedelic renaissance'.
—Danielle Giffort, St. Louis College of Pharmacy, History of Psychiatry
Carefully researched and insightful . . . [Oram] tackles how serious medical investigators handled LSD.
—W. J. Rorabaugh, University of Washington, Journal of American History
This book is highly recommended reading not just for aficionados of hallucinogenic drugs but for anyone interested in the history of drug development and regulation.
—Nicolas Rasmussen, University of New South Wales, Bulletin of the History of Medicine

Matthew Oram is a historian in Christchurch, New Zealand. He earned his PhD in history from the University of Sydney.

After LSD arrived in the United States in 1949, the drug's therapeutic promise quickly captured the interests of psychiatrists. In the decade that followed, modern psychopharmacology was born and research into the drug's perceptual and psychological effects boomed. By the early 1960s, psychiatrists focused on a particularly promising treatment known as psychedelic therapy: a single, carefully guided, high-dose LSD session coupled with brief but intensive psychotherapy. Researchers reported an astounding 50% success rate in treating chronic alcoholism, as well as substantial improvement in patients suffering from a range of other disorders. Yet despite this success, LSD officially remained an experimental drug only. Research into its effects, psychological and otherwise, dwindled before coming to a close in the 1970s. In The Trials of Psychedelic Therapy, Matthew Oram traces the early promise and eventual demise of LSD psychotherapy in the United States. While the common perception is that LSD's prohibition terminated legitimate research, Oram draws on FDA files and the personal papers of LSD researchers to reveal that the most significant issue was not the drug's illegality, but the persistent question of its efficacy. The landmark Kefauver-Harris Drug Amendments of 1962 installed strict standards for efficacy evaluation, which LSD researchers struggled to meet due to the unorthodox nature of their treatment. Exploring the complex interactions between clinical science, regulation, and therapeutics in American medicine, The Trials of Psychedelic Therapy explains how an age of empirical research and limited government oversight gave way to one of sophisticated controlled clinical trials and complex federal regulations. Analyzing the debates around how to understand and evaluate treatment efficacy, this book will appeal to anyone with an interest in LSD and psychedelics, as well as mental health professionals, regulators, and scholars of the history of psychiatry, psychotherapy, drug regulation, and pharmaceutical research and development.

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