The war on cures

At the start of the year I wrote a series of five articles predicting what might happen throughout the course of 2019.

I made predictions in the following five areas:

Cars

Communication

Big Tech

Crypto

Medicine

Today, I’d like to take a look at what’s been going on in the world of medicine, and how it relates to my predictions. As you’ll see, it’s all coming together.

Here was the crux of my article:

A strange thing happened in medicine over the course of the 20th century. Although it progressed massively in many areas, in many more it was held hostage by political beliefs.

You may think that science is the driving force of medicine. But that is simply not the case. Politics comes above science when it comes to medicine. When it comes to most things, in fact.

The 20th century’s “war on drugs” meant many promising compounds were kept out of the reach of medical researchers.

The Controlled Substances Act (CSA) was drawn up in 1970. It divides drugs into four categories.

On this scale, schedule one drugs are the worst you can get. They are defied as having “no currently accepted medical use and a high potential for abuse.”

And this is where the trouble starts.

In this category there is:

  • Diamorphine (heroin)
  • LSD
  • Cannabis
  • MDMA (ecstasy)
  • Psilocybin (magic mushrooms).

If a drug is in this category, it is incredibly hard to conduct medical trials with.

Remember, officially, all schedule one drugs have no medical use. If one did, it would no longer be schedule one. It would have to be re-classified.

At least that’s what would happen if politics followed logic. Unfortunately, it does not. Politics is based on ideologies, not science or logic. And so the CSA is also based on ideologies and not science or logic.

For example, diamorphine is regularly prescribed for pain relief and cancer care in the UK. It clearly has medical uses.

A lot is already known about diamorphine because it is an opioid. Most prescription painkillers are. And as such, they all work in a similar way. Other than diamorphine, the most well-known opioids are probably morphine and codeine.

Yes, that’s right. Codeine is an opioid. That’s why you can only buy it over the counter when it’s missed with paracetamol and called co-codamol. They mix it with paracetamol to stop people abusing it recreationally.

You might remember that the US is currently in the grip of an “opioid crisis”. Prescription painkillers – both opioid and synthetic opioid – have become such a problem that they have actually reduced the average life expectancy in the US.

According to the CDC, 2017 was the third year in a row in which US life expectancy fell. That hasn’t happened since the dual decimation of the First World War and Spanish flu in 1915-1918.

And here was the most important part:

Not only are our current painkillers flawed – in that they are killing vast swaths of the population – but current antidepressants only work in around 60% of cases.

If only scientists were free to use all the tools at their disposal to tackle the problem. Perhaps they would come up with some new “innovative” treatments instead of pushing out stronger and stronger opioid variations, and lacklustre antidepressants.

Well, it seems that enough people have been dying for policymakers to start thinking more rationally about the problem.

Over the last few years, we’ve seen a number of studies come out that showed the vast potential of many schedule one substances (which you’ll remember, have “no currently recognised medical uses”).

The interesting thing about these findings is that these illegal drugs are proving to be viable treatments for conditions that traditional treatments are failing at.

Cannabis legalises cannabis and researchers discover it is 30 times more powerful at reducing inflammation than aspirin

Since cannabis was legalised in Canada, research into its medical uses has skyrocketed. And that research is starting to pay dividends.

From the University of Guelph in Canada – where cannabis is legal:

University of Guelph researchers are the first to uncover how the cannabis plant creates important pain-relieving molecules that are 30 times more powerful at reducing inflammation than Aspirin.

The discovery unlocks the potential to create a naturally derived pain treatment that would offer potent relief without the risk of addiction of other painkillers.

“There’s clearly a need to develop alternatives for relief of acute and chronic pain that go beyond opioids,” said Prof. Tariq Akhtar, Department of Molecular and Cellular Biology, who worked on the study with MCB professor Steven Rothstein. “These molecules are non-psychoactive and they target the inflammation at the source, making them ideal painkillers.”

The interesting thing about this discovery is that it’s not a new one at all. It’s been known about for over 30 years, but researchers weren’t allowed to work on it because of cannabis’ schedule 1 classification.

This much-needed medical use was first researched and documented more than 30 years ago

The irony here is simply astounding. For more than 30 years, science has known that cannabis possesses these pain-reliving properties – the definition of a medical use. Yet it has remained illegal because it officially has “no currently accepted medical use”.

From the University of Guelph:

Known as “flavonoids,” cannflavins A and B were first identified in 1985, when research verified they provide anti-inflammatory benefits that were nearly 30 times more effective gram-for-gram than acetylsalicylic acid (sold as Aspirin).

However, further investigation into the molecules stalled for decades in part because research on cannabis was highly regulated. With cannabis now legal in Canada and genomics research greatly advanced, Akhtar and Rothstein decided to analyze cannabis to understand how Cannabis sativa biosynthesizes cannflavins.

“Our objective was to better understand how these molecules are made, which is a relatively straightforward exercise these days,” said Akhtar. “There are many sequenced genomes that are publicly available, including the genome of Cannabis sativa, which can be mined for information. If you know what you’re looking for, one can bring genes to life, so to speak, and piece together how molecules like cannflavins A and B are assembled.”

With the genomic information at hand, they applied classical biochemistry techniques to verify which cannabis genes were required to create cannflavins A and B. Their full findings were recently published in the journal  Phytochemistry. The Toronto Star  also recently wrote about the research.

These findings provide the opportunity to create natural health products containing these important molecules.

“Being able to offer a new pain relief option is exciting, and we are proud that our work has the potential to become a new tool in the pain relief arsenal,” said Rothstein.

Magic mushrooms could replace antidepressants within five years – The Independent

Back in June this article, and a number of others like it popped up in the UK press.

From The Independent:

Hallucination-inducing drugs like magic mushrooms could be about to break big pharma’s stranglehold on the hugely lucrative market for antidepressants, according to the head of the world’s first centre for psychedelic research.

Antidepressant prescriptions have doubled in England in a decade with around seven million adults taking the drugs, and the global market is predicted to be worth $15.9bn (£12.5bn) by 2023.

At Imperial College London, Dr Robin Carhart-Harris is leading one of the first trials to test how therapy using psilocybin mushrooms, which are currently banned in the UK, compares to leading antidepressants.

While he won’t prejudge the results of the study, he says participants describe a cathartic emotional “release” with psilocybin therapy – the polar opposite of antidepressants, which patients complain leave their emotions, whether positive or negative, “blunted”.

It is the first of many studies planned under the banner of the new Centre for Psychedelic Research at London’s Imperial College.

If you go back to the start of today’s article, you can see that psilocybin (magic mushrooms) is on the list of schedule 1 drugs, which have “no currently accepted medical use”.

The key thing here is that psilocybin works differently to traditional antidepressants. From the same article:

“If you ask people who are taking SSRIs chronically, they often say ‘I feel blunted’,” Dr Carhart-Harris told The Independent, meaning both negative and positive emotions are suppressed.

“With psilocybin therapy they say the opposite, they talk about an emotional release, a reconnection, and this key emotional centre being more responsive.”

Basically, psilocybin lets you confront your demons and deal with them (which can be a “nightmarish” experience), while traditional anti-depressants make you not care about your demons. At least, that’s what the researchers seem to say. Again, from The Independent:

During the therapy sessions, patients are encouraged to follow the stream of the psychedelic experience which can be extremely vivid and may require them to confront past traumas or experiences.

 “We don’t call it a ‘bad trip’,” Dr Carhart-Harris says. “We call it a ‘challenging psychological experience’ and we’re honest with people that it can be hellish.

“It can be nightmarish, but we’re prepared for this and this treatment model requires you literally face your demons.”

The research is very promising, but it may still ultimately have a big mountain to climb:

“I would imagine if you had some bookmakers doing the odds, there would be strong odds on that [psychedelic therapy] will be licensed sometime in the next five to 10 years – maybe sooner,” Dr Carhart-Harris says.

That could put it on a collision course with powerful interests of the pharmaceutical industry, particularly if trials show psilocybin therapy to be superior to SSRIs

“The implications of that are actually frightening to me, thinking of the power and influence of big pharma,” Carhart-Harris says. “What are they going to do with that if there’s this big public demand for the ‘mushroom therapy’, and not the Prozac?”

Well, it seems big pharma – and “the war on drugs” – may have a fight on its hands.

As I predicted at the beginning of the year, given the promising research into psilocybin as an anti-depressant, the powers that be are slowly being forced to change their tune… just as they have done with cannabis in Canada.

From The Guardian:

There are already signs that authorities may be beginning to shift. In October, US regulators gave Compass’s [the company running the trials mentioned above] treatment breakthrough therapy status, a designation given to new medicines that might improve treatments for serious conditions, which means authorities will expedite their review of evidence. That decision was followed this May with Denver’s vote to in effect decriminalise magic mushrooms, making it the first US city to do so, followed last week by a similar measure for several psychedelic plants in Oakland, California. Activists are pushing for a state-wide vote in Oregon next year on whether to legalise psilocybin for medical use. Meanwhile, Compass hopes to request marketing authorisation for the drug within three years, if its trials are successful. It is proceeding slowly, though, having treated around six people since trials began in January, and Malievskaia says the process could take a decade until approval. She aims to accelerate progress, with new treatment sites recently opened at Columbia University, as well as in New Orleans and the Netherlands, among others.

So it seems my predictions may have been right. The medical world really is waking up to the possibilities of new and effective treatments derived from “recreational” drugs.

And as you can see, these treatment have the possibility to change many lives for the better. Not least those at risk of becoming addicted to opioids, or those for whom traditional anti-depressants do not work.

However, what I’ve covered today is just one small part of what we can expect to see from the medical world in the coming year.

There are big developments going on in gene editing, biohacking and AI-enhanced treatments. My publisher Nick O’Connor explores these areas in-depth in his book: The Exponentialist.

If you want to see what the future of medicine will look like, I highly recommend you take a look at this book. You can get your hands on your own copy here.

Until next time,

Harry Hamburg
Editor, Exponential Investor

Category: Technology

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