Neuropsychedelia. Nicolas Langlitz
for psilocybin, which the SFOPH needed in order to assess applications like the one submitted by the Swiss Medical Association for Psycholytic Therapy.
It did not take long for Dietschy to realize how vital questions of drug safety were in this area. In 1990, one of the patients treated by SAPT president Peter Baumann died during a therapy session. After a number of prior irregularities, Baumann had taken the woman to a remote, ill-equipped lodge in France (not Switzerland), far away from an emergency room, where he gave her ibogaine, a powerful plant hallucinogen used for ritual purposes in the West African spiritual tradition of Bwiti. Ibogaine was not among the substances approved of by the SFOPH. Dietschy also claimed that, after this fatal incident, other patients came forward reporting that, while in the clinical trial, they had come to suffer from severe depression. “Probably their serotonin supplies had been depleted,” Dietschy said. “Exactly the opposite of what one had aimed for had happened. They were not, as they told us, taken care of. The doctor just pushed them aside because it didn’t fit into his preconceptions.” Soon charges of medical misconduct were filed against a second member of the SAPT.
By this time, Dietschy had grown deeply mistrustful of the organization: “We became very reserved. We felt that there was a lack of scientific seriousness. They were freaks who thought, ‘Here we get a chance to make our mark.’ My impression was, they don’t want to stick to the rules.” Because of the experiences and data provided by Brenneisen, however, Dietschy continued to believe that psychedelic drugs might have a great potential to treat severe mental disorders. Therefore, he told the SAPT that he was not opposed to hallucinogen research in principle but that, in the future, he would only support applications that had a clear study design and were approved by an ethics commission.
At this point, Franz Vollenweider entered the scene proposing to test psilocybin on humans. Dietschy was impressed:
The application was scientifically perfectly neat and correct. I have rarely seen such a solid documentation. The SFOPH waved it through relatively quickly and, to a certain extent, we also supported his research because it was an important part of the puzzle for us to be able to decide later on whether to test these drugs in humans again. This is how Vollenweider got involved and I have to say that I have always only seen top-quality work from him. Few researchers—Brenneisen and Vollenweider among them—never had any problems with us regarding approvals. The SFOPH also supported them financially. Today, Swissmedic doesn’t have research funds anymore. Back then we had budgets for international projects and for research. When you saw a new problem, you could decide relatively spontaneously. Those were the days.
And Brenneisen seconded: “It was an enormous privilege to have authorities that massively supported research. I admit, for me this was the chance of my academic career. Without the politics and the research support of the SFOPH, financially and ideationally, this would not have been possible.”
Paul Dietschy (PJD) and Rudolf Brenneisen (RB) brought their account of hallucinogen research to a close by relating two more reminiscences explaining how Vollenweider’s lab managed to leave behind its local rivals and move to the forefront of the global resurgence of psychedelic science.
| PJD: | Reminiscence 1: I left SFOPH in 2001 and gave up these responsibilities. Until then, the SAPT did not get another approval. Within ten years they did not manage to turn in a dossier complying with the usual standards of good clinical practice. The second point is a funny reminiscence: At the beginning of the 1990s, we got some psilocybin back for disposal, as we were the authorities in charge of this. It was really ancient material. | |
| NL: | Who gave it to you? | |
| PJD: | We got it from someone who had used it for experiments, syntheses, for various things. The laboratory assistant called and said, “Mr. Dietschy, I got some psilocybin. How shall I dispose of it?” I took a look, called Brenneisen, and said, “I would like to know whether the substance still meets any quality standards.” The answer came a few days later: “It meets all standards!” Suddenly we had 100 g of pure psilocybin. Nobody else in the world had such an amount. And the production was very expensive. To give you an example: When I went to an international conference of the US Drug Enforcement Administration, I mentioned this in an aside to people from DEA labs. They said, “What? You really got that? We need this for our kits.” I asked, “How much do you need? I’ll bring it to you to the next conference in Washington.” Today, this would be inconceivable. These were really easygoing times. | |
| RB: | That’s the cue: the link to the US. Of course, they were following what was going on here, also on the level of psychiatric research. “What can Switzerland do? Why can’t we do this as well? Aren’t we allowed to do that too?” There was Rick Strassman in Albuquerque. They got DMT and other materials with FDA approval. But unfortunately his project failed and Strassman left the US for personal reasons. Then David Nichols took over that role. | |
| PJD: | I don’t know whether Vollenweider would ever have been able to start his work if we had not had that psilocybin. If he had had to synthesize it, he would probably not have been able to pay for it. Hence, a number of lucky coincidences came together and made this possible. (Figure 2 pictures some of this Swiss psilocybin freshly encapsulated.) |
THE MANIFOLD MATRIX OF SWISS DRUG POLICY
After a short coffee break, Dietschy and Brenneisen recounted in equal detail the no less venturesome development of the heroin program and Swiss cannabis research and policy in the 1990s. Their accounts were captivating and comprehensive. But when, three hours later, we went for lunch, I still could not see how these different plots added up to a distinctive policy approach. Dietschy had already told me in his first response to my query that, “from the end of the ’80s to the mid-’90s of the last century, there was no continuously planned and stringently designed research policy concerning hallucinogens at SFOPH” and that, “in the first half of the 1990s, important decisions were rather made on an ad hoc basis.”
Swiss drug policy was an assemblage of heterogeneous governmental strategies. In the language of policy makers, this was called the Fourfold Approach (Vier-Säulen-Modell), comprising four strategic trajectories or “pillars”: repression (law enforcement), prevention (keeping citizens from using drugs in the first place), therapy (treatment and reintegration of former drug users), and harm reduction (survival support). In an alternative jargon, borrowed from Michel Foucault (2007), one could also speak of an assortment of elements from three different apparatuses: law, discipline, and security. The law constitutes a purely negative form of normativity, which prohibits particular acts within a confined territory, for example, the manufacture, sale, and consumption of drugs like heroin and LSD in Switzerland. Discipline ideally aims at a continuous panoptic observation of individuals responding even to minute deviations from a norm by disciplinary measures. Close monitoring of all people having to do with illicit substances can serve as an example. Drug scenes were infiltrated by undercover narcotics officers; dealers and consumers were prosecuted; scientists studying controlled substances needed special permits and their laboratories could be subject to inspections. At the same time, addicts willing to undergo therapy were registered (“Nobody could enter into a heroin trial without the permission of the SFOPH,” Dietschy told me); they were tested for the additional use of street drugs (based on a method developed by Brenneisen) and had to inject the heroin provided by the Swiss state under supervision in special outpatient clinics. The heroin-assisted treatment programs served to enmesh addicts in the safety net of the otherwise not overly developed Swiss welfare state. These measures were highly effective. In the course of the 1990s, many patients enrolled in these programs managed to return to a well-ordered life, and the number of addicts declined significantly—in part because the heroin programs destroyed the image of the junkie as countercultural hero defying society by making him into a welfare case dependent on the state (Aarburg and Stauffacher 2004).
However, total control of society has remained a totalitarian utopia. As neither proscriptions nor treatment or continuous monitoring of individuals could guarantee the desired outcomes, a third strategy was developed: security. The emergence of security as a form of government can be interpreted as a response to the limits of legal and disciplinary instruments. Here, the aim of total control is replaced by the modulation of a preexisting milieu in order to regulate a population at large. While discipline is based on sustained interventions, security adopts, at least to a certain extent, a laissez-faire