1 Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK.
2 Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena, Roma, Italy.
J Psychopharmacol. 2018 Jul;32(7):725-731. doi: 10.1177/0269881118754710. Epub 2018 Feb 15.
Psychedelic drugs are making waves as modern trials support their therapeutic potential and various media continue to pique public interest. In this opinion piece, we draw attention to a long-recognised component of the psychedelic treatment model, namely ‘set’ and ‘setting’ – subsumed here under the umbrella term ‘context’. We highlight: (a) the pharmacological mechanisms of classic psychedelics (5-HT2A receptor agonism and associated plasticity) that we believe render their effects exceptionally sensitive to context, (b) a study design for testing assumptions regarding positive interactions between psychedelics and context, and (c) new findings from our group regarding contextual determinants of the quality of a psychedelic experience and how acute experience predicts subsequent long-term mental health outcomes. We hope that this article can: (a) inform on good practice in psychedelic research, (b) provide a roadmap for optimising treatment models, and (c) help tackle unhelpful stigma still surrounding these compounds, while developing an evidence base for long-held assumptions about the critical importance of context in relation to psychedelic use that can help minimise harms and maximise potential benefits.
致幻剂正掀起波澜，因为现代试验支持其治疗潜力，各种媒体继续引起公众兴趣。在这篇观点文章中，我们提请注意迷幻治疗模式中一个长期被认可的组成部分，即“设定”和“环境”——这里包含在“背景”这一术语下。我们强调：(a) 我们认为经典迷幻剂（5-HT2A 受体激动剂和相关的可塑性）的药理学机制使其效果对背景极为敏感，(b) 一种用于测试迷幻剂和背景之间积极相互作用假设的研究设计，以及(c) 我们小组关于影响迷幻体验质量的背景决定因素以及急性体验如何预测随后的长期心理健康结果的新发现。我们希望本文能够：(a) 为迷幻研究提供良好实践的信息，(b) 为优化治疗模型提供路线图，以及(c) 有助于解决仍然围绕这些化合物的无益污名，同时为长期以来关于迷幻使用中背景至关重要的假设提供证据基础，从而帮助最小化危害并最大化潜在益处。
