Film Review by Harry Karlinsky, MD, MSc, FRCPC
Canada, 2002. Director: Connie Littlefield
The hallucinogen lysergic acid diethylamide (LSD) was accidentally discovered in 1943 by Swiss chemist Albert Hofmann. Surprisingly, a significant amount of the early research that explored LSD’s potential role in psychiatry was undertaken at the now closed Saskatchewan Hospital, a tertiary psychiatric facility located in Weyburn, Saskatchewan. The key early investigators were Humphrey Osmond and Abram Hoffer. Osmond was a psychiatrist who arrived in 1950 from England with an established research interest in mescaline. Hoffer, born in Saskatchewan and trained both as a biochemist and psychiatrist, began working with Osmond one year later. By 1952, the “creative” Osmond and the “tenacious” Hoffer had obtained samples of LSD for investigative purposes.
Joined by other investigators, such as the psychologist Duncan Blewett, Osmond’s and Hoffer’s research team aggressively studied the effects of LSD at the Saskatchewan Hospital throughout the rest of the 1950s and early 1960s – both in terms of its possible therapeutic effects for disorders such as alcoholism as well as an agent that might helpfully mimic illnesses such as schizophrenia. It was Osmond who originated the term psychedelic and penned the prophetic lines, “To fathom hell or soar angelic, just take a pinch of psychedelic.”
These pioneering years in Saskatchewan, as well as the subsequent controversial reception that LSD received by the establishment – medical and otherwise – are engagingly captured in the documentary titled Hofmann’s Potion: The Early Years of LSD.
Directed by Halifax-based filmmaker Connie Littlefield, Hofmann’s Potion is a fascinating and sympathetic portrait of not only LSD’s role in the world of psychiatric research, but its even more controversial role as a putative tool for mental exploration and selfunderstanding. Proponents of the latter included such well-known figures as Aldous Huxley, Ralph Metzner, Myron Stolaroff, Ram Dass (then known as Richard Alpert) and, of course, the infamous Timothy Leary – and all have fascinating cameos within the film courtesy of historical footage and, in some instances, contemporary interviews.
It is clear from events depicted in Hofmann’s Potion that the scientific interest in LSD was soon overtaken by its non-medical and recreational use by members of the general public. The most enthusiastic participants appear to have been young adults involved in counterculture activities such as opposition to the war in Vietnam.
One of the early health care professionals to express reservations about the non-research use of LSD was Dr. James Tyhurst, professor and chairman of the University of British Columbia’s Department of Psychiatry. In a review “prepared at the request of the British Columbia College of Physicians and Surgeons and a number of practicing physicians in the community,” Tyhurst concluded in 1959 that, “It is fair to say that the consensus among responsible investigators at the present time in regard to therapy is that while the intoxicants offer considerable opportunity for research into various aspects of abnormal psychology, there is no adequate rationale for the use of these drugs in treatment.”1
Interestingly, an unstated impetus for Dr. Tyhurst’s report was likely the unusual activities occurring at a Vancouver area psychiatric facility aptly named Hollywood Hospital. An LSD clinic had been opened in the hospital in 1957, largely due to the enthusiasm of Captain Alfred M. Hubbard, an ex-CIA agent and oneof- a-kind character whose mission in life seems to have been to distribute LSD as widely as possible – the socalled “Johnny Appleseed of LSD.” Viewers of Hofmann’s Potion are briefly introduced to Hubbard as well as satisfied Hollywood Hospital clientele. For those interested, a 1965 academic paper provides a review of almost 500 patients who received over 600 treatments at the Hollywood Hospital.2 A more entertaining account in the popular media has recently been published and includes this following description: “The Hollywood Hospital was a stately mansion that had served for years as a detox centre for Vancouver’s more affluent drunks. It remained so, but Hubbard and MacLean also turned it into a walk-in LSD boutique. Anyone with $500 was welcome. Patients would check in, get a physical examination, fill out an MMPI psychological profile, and disclose in writing their personal histories, complete with “hang-ups.” After taking LSD, they retired to the “therapy suite,” where plush sofas, a high-end sound system, and fanciful artwork encouraged a positive experience.”3 The Hollywood Hospital closed in 1975.
Unfortunately not all experiences with LSD were positive – particularly the so-called ‘bad trip’. Hofmann’s Potion chronicles the escalating recreational use of LSD in the 1960s as well as the increasing and alarming media and scientific reports about LSD’s appar- “Turn on and tune in” ent dangers, ranging from LSD-fueled suicide and homicide to pathogenic effects such as mutagenesis and neurotoxicity. By the end of the 1960s, the possession of LSD had been made illegal by most governments, and even LSD for legitimate investigational purposes became virtually impossible to obtain. Ironically, “research ceased while illicit use remained.”4
In retrospect, there were obvious methodological laws in the early research related to LSD, including that conducted by the (well-meaning!) Canadian pioneers. Limitations included observer bias, uncontrolled studies, small sample sizes, inconsistent protocols and, in some cases, the interesting challenge of having both the subject AND investigator on LSD during the research interaction. There were also legitimate concerns about the safety of LSD, particularly those revolving around its potential neurotoxicity. The question, however, is whether such medical concerns should have led to the widespread regulation of LSD within even the medical research community. As Hoffer implies in Hofmann’s Potion, it seems more than unfair to attribute the same adverse effects associated with the recreational use of “blackmarket” LSD (of uncertain purity and dosage and often consumed in combination with other recreational drugs and/or alcohol in a wide range of environmental circumstances) to those that might occur with the use of LSD in controlled clinical studies.
Ultimately, events depicted within Hofmann’s Potion challenge us to rethink whether, to paraphrase the title of Ben Sessa’s thought-provoking article, psychedelics can play a role in psychiatry once again.4 Hofmann’s Potion makes abundantly clear that the injunctions against LSD research had as much to do with massive social and political changes as with issues concerning neurobiological safety and risk-benefit ratios. Sessa concludes his article by stating, “Perhaps a more dispassionate criticism based upon scientific reasoning and not influenced by social or political pressures is called for if we are truly to investigate whether these substances can have a useful role in psychiatry today.”
The renewed interest in exploring whether the hallucinogen MDMA (methylenedioxymethamphetamine), also known as Ecstasy, can assist the psychotherapeutic process, including an about to begin Canadian investigation of ‘MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder’,5 suggests “the times they are a changing.”
References
- Tyhurst JS. The Therapeutic Use of d-Lysergic Acid Diethylamide (LSD-25). Report prepared for the British Columbia College of Physicians and Surgeons. December, 1959.
- MacLean JR, Macdonald DC, Ogden F, Wilby E. LSD-25 and mescaline as therapeutic adjuvants. In: Abramson H, ed. The use of LSD in psychotherapy and alcoholism. New York: Bobbs-Merrill; 1967.
- MacDonald J. Peaking on the Prairies. Walrus. June 2007. Available from: http://www.walrusmagazine.com/articles/2007.06-society-peaking-on-the-prairies/.
- Sessa B. Can psychedelics have a role in psychiatry once again? British Journal of Psychiatry. 2005;86:457-458.
- MDMA Research Information. Available from: http://www.maps.org/research/mdma/.