The last time singer, songwriter and activist Melissa Etheridge heard her son’s voice, he said, “I’m sick. Mom, it’s fentanyl.”
According to the CDC’s National Center for Health Statistics, there were an estimated 70,029 overdose deaths involving opioids in 2020. On May 13, 2020, her son Beckett Cypheridge became one of the statistics: He died from causes related to opioid addiction.
He was just 21 years old.
Etheridge says she remembers asking herself: What do I do with the pain?
For most of her life what she did — and continues to do — is make music. While I wait for her to continue speaking during a recent Zoom interview, I can’t help but hear the lyrics of “Precious Pain” in my head, her throaty voice wailing about clinging to the feeling of hurt as an identity, how sorrow can keep someone from moving on.
In real time, it is obvious she has done a lot of healing, not only since releasing her debut album in 1998, but since those first gut-wrenching moments without Beckett.
When she finally exhales a gust of breath to go on, she says, “As I have now lived for 63 years, I have experienced all the different types of pain, physical, emotional … and the more I have worked on my own understanding of what I call spirit or the source of this life force that I have, I have realized that pain is just a symptom, a sign to pay attention. Something needs to change.”
Singer Melissa Etheridge speaks during the opening keynote at the California Cannabis Business Conference in Anaheim, CA on Tuesday, October 23, 2018. (Photo by Paul Bersebach, Orange County Register/SCNG)
In her opinion, what needs to change is our approach to — and treatment for — addiction.
Part of that change for her was founding the Etheridge Foundation, a nonprofit that advocates for and supports scientific research into plant medicine and psychedelic treatments for opioid use disorder (OUD). Why? She believes this kind of therapy has the potential to shift both physical and emotional responses to pain, enhancing the sufferer’s ability to confront and move past it.
“We feel like people deserve the opportunity to access these medicines in an equitable, affordable, legal and safe way” like any other treatment, says foundation executive director Anna Symonds.
Pharmakon
In his latest book, “This is Your Mind on Plants,” Michael Pollan writes that the ancient Greeks understood the two-faced nature of drugs, reflected in their term for them: pharmakon. A pharmakon is a medicine, poison or scapegoat — depending on the dose, intention and public opinion.
“Everything can be medicine,” agrees Valerie (Vimalasara) Mason-John, co-author and co-founder of “Eight Step Recovery: Using The Buddha’s Teaching to Overcome Addiction” and the co-creator of Mindfulness Based Addiction Recovery (MBAR). “Alcohol is medicine, food is medicine. It’s just when we get out of control with it that it becomes poison.”
An obstacle to using psychedelics as therapy is that they are still illegal in many places, including California. Although promising research was being conducted into the therapeutic uses of these substances in the 1950s and 1960s — LSD research paved the way for the development of SSRIs, a class of medications commonly prescribed to treat depression and anxiety disorders today — the counterculture movement and widespread recreational use raised concerns about public health and safety, prompting strict regulations.
President Richard Nixon signed the Controlled Substances Act (CSA) in 1970, not only prohibiting many psychedelics in the United States, but classifying LSD, psilocybin and even cannabis as Schedule I — dangerous, addictive and harmful substances with no recognized or accepted medicinal use.
That means decades of restricted research have limited our understanding of their potential benefits. Social stigma and fears about misuse or psychological distress continue to influence public perception and policy, while proponents of their use point to the hundreds of thousands of people who have lost their lives in the opioid crisis, which was spawned by legally prescribed narcotics first misrepresented as nonaddictive by pharmaceutical companies in the 1990s.
In a bid to move the needle on reforming the legal status of psychedelics, the Etheridge Foundation has awarded several research grants since it was founded in 2020. These include an $85,000 award to the University of British Columbia to study psilocybin-assisted psychotherapy aimed at tapering opioid medication in chronic pain patients, and $15,000 to the Psychae Institute in Melbourne, Australia, for the study of botanical ayahuasca as a treatment for opioid use disorder (OUD). (Ayahuasca is a powerful plant medicine that has been used for centuries by indigenous communities in the Amazon as a tool for healing, growth and connection to the natural and spirit worlds.)
Personal experience
“We love our people,” Etheridge says. “But we can’t save them.”
Still, she wishes she could have shared the power of psychedelics with Beckett. “My belief,” says Etheridge, “is that if I could have taken him somewhere with psilocybin-assisted therapy, I think it would have given him more of a working chance.”
The first major study in this century to explore psilocybin’s potential in addiction treatment was led by Dr. Matthew Johnson at Johns Hopkins University in 2014. The results provided new insights into how psychedelics can rewire the brain, promote emotional breakthroughs and foster long-term behavioral change. This allowed Johnson to secure the first federal funding for psychedelic research in more than 50 years, from the National Institute on Drug Abuse (NIDA).
It was an accidentally heroic dose of cannabis (a very large quantity of a hallucinogenic substance) in a homemade cookie that catapulted Etheridge onto her path of spiritual awakening and personal transformation — an experience she details in her latest memoir, “Talking to My Angels.” She dedicated herself to understanding what had happened to her by reading books about neuroscience, psychology, philosophy, physics, religion and ancient Indigenous cultures (which would later lead her to participate in an ayahuasca ceremony).
When I ask her about sharing this knowledge with Beckett, she says, “I was just at the beginning of my psychedelic experiences,” and still learning about their scientific and spiritual benefits “when Beckett was starting his own hard decline into addiction.”
She adds that her acrimonious relationship with her ex-partner and co-parent Julie Cypher was another restriction. “We shared custody, and I didn’t want to give his other mother a reason to take him away, like, ‘she’s giving him drugs.’”
The best she could do, Ethridge says, was be an example, something she speaks about in the present tense, because she is a mother of four.
“It can only be learned, right? I can only show them how happy I am, how delighted and surprised I am with reality every day. And hopefully, they’ll move toward that light.” Still, she says, smiling ruefully, “What is that saying? ‘A prophet is not welcome in his own town?’ My kids were like, here she comes with that woo woo stuff.”
Ethridge says Beckett was only 17 when he took his first prescribed painkiller. He was training to be a professional snowboarder when he had an epic fall and broke his ankle in two places. The ER doctor sent him home in a stabilizing boot with a prescription for Vicodin — a drug that’s a combination analgesic, containing acetaminophen and hydrocodone with a high risk for addiction and dependence. When Ethridge saw him again, he’d lost weight, his face was ashen and there was a faraway look in his eyes.
It was clear to her that her son was hooked on painkillers.
Years of therapy and treatment followed, but Beckett couldn’t manage to stay clean. He didn’t resonate with the 12-step programming and complete abstinence from all substances that most residential treatment programs still require.
“He would say, ‘Why can’t I just get off the [opioids] and then have cannabis so I can get up and go from there?’,” she recalls, “but there was nothing like that.” She notes that the cannabis plant has been cultivated to treat pain, nausea and inflammation for thousands of years, but yet it wasn’t considered as a legitimate option.
Which is why another one of the Etheridge Foundation’s awards was for $25,000 to Dr. Staci Gruber’s Marijuana Investigations for Neuroscientific Discovery (MIND) Program at McLean Hospital in Boston, to research the impact a proprietary CBD product has on pain, related symptoms and the conventional use of pain medication — particularly opioids.
So, what exactly is OUD?
A 2022 report from the Substance Abuse and Mental Health Services Administration (SAMHSA) defined opioid use disorder (OUD) as a chronic disease. It affects 6.1 million people in America, like Beckett.
Contrary to what may have been believed in the past, opioid addiction is now understood not a moral failing or a simple lack of willpower. While we can’t say definitively why some people are more susceptible to OUD than others, what we do know is that addiction results when the brain’s reward system goes haywire, flooding our systems with dopamine, a primary “feel good” neurotransmitter that, from an evolutionary perspective, keeps us engaging in food and sex so that our species stays alive.
Opioids increase dopamine by binding to opioid receptors, which leads to reduced inhibition of dopamine release in the brain’s reward areas. The longer someone uses opioids, the more the brain’s structure and chemistry change, leading to increased tolerance, craving and compulsive drug-seeking behavior.
A critical component of this disease is that while it can be managed, it cannot be cured. This means that no matter how well someone becomes, the potential for relapse will follow that person forever.
Full disclosure: I have been in recovery from my own substance misuse disorder for more than a decade, and I work in recovery facilities, teaching movement and breathwork meditation (facilitating a practice similar to the one developed by psychedelic research pioneer Stanislav Grof). As a result, I’ve sat in thousands of 12-step meetings, residential rehabs, outpatient programs, hospitals, coffee shops and living rooms with many opioid addicts.
Time and again, I’ve seen how shut down this disease and its prognosis can make people, especially in early recovery. What I know is that clinging to the belief that nothing will work closes a door at a time when what people most need is to stay open to what is possible.
Stuck in a cycle
While cannabis is still considered a Schedule I narcotic, the FDA has approved three medications for opioid use disorder (MOUD), which are standard protocols for treatment: Methadone is a synthetic opioid that reduces cravings and withdrawal symptoms by activating opioid receptors in the brain; buprenorphine is a partial opioid that has similar actions; and naltrexone is an opioid blocker that is used to prevent relapse.
Marijuana plants growing in one of three grow rooms at OutCo, a legal medical cannabis business that operates Outliers Collective. (Howard Lipin / U-T file)
People in recovery can remain on MOUD for months, years, or even a lifetime, stuck treating the physical symptoms of the disorder, but potentially avoiding the real work of living a recovered life.
Joe Schock, who owned and operated Casa Vista Sober Living in Venice Beach for 17 years, knows this firsthand. “The idea is to wean people off (MOUD) once they build sober support. Many times, that doesn’t happen.”
Josh Lazie, co-founder of the Bend Recovery Collective in Bend, Oregon, agrees. “Suboxone maintenance has become the gold standard for treatment,” he says (this is a combination of buprenorphine and naloxone). “There may be the best intentions behind it,” he adds, “but can you really heal?”
Plant medicine and healing from OUD
True healing is hard work. Staying off of opioids is only the first step. There is a lot of potential pain in recovery that can lead to relapse. People with OUD have to learn how to “human” again.
This means facing social stigma, debt, legal problems, chronic health issues, employment gaps, parenting, isolation, emotional upset, boredom and stress. Internalized shame, doubt and a lack of self-esteem can challenge a person’s ability to decide who they are, what they want and how they show up. Life can lack meaning and color. Many people realize they have co-occurring mental health conditions like depression or anxiety, and it’s not unusual for repressed trauma to resurface.
“Everything was a trigger when I got sober,” says Schock, who was diagnosed with OUD and depression.
Psychedelic therapy shows promise in treating addiction by addressing both the psychological and neurological aspects of OUD. Classic psychedelics — LSD, psilocybin, mescaline and DMT — promote neuroplasticity, helping the brain form new connections that can disrupt rigid patterns of addictive behavior.
Psilocybin mushroom of AJNA BioSciencesxe2x80x99 cultivation facility in Littleton, Colorado on Wednesday, December 13, 2023. (Photo by Hyoung Chang/The Denver Post)
These substances also reduce the activity of the Default Mode Network (DMN), which is responsible for our perceived identity. This can lead to a state where individuals experience a loss of their usual sense of self, which can shift perspectives and foster a sense of profound interconnectedness. This change can help people confront the underlying emotional or psychological issues driving their addiction, such as trauma or anxiety. What’s more, psychedelics can promote emotional insights and personal breakthroughs, creating an opportunity to reframe negative thoughts and build healthier habits.
In an interview for the 2023 Global Mental Health Summit, Johnson, now a senior researcher for the Center of Excellence for Psilocybin Research and Treatment at Sheppard Pratt’s Institute for Advanced Diagnostics and Therapeutics, said that in the psilocybin-assisted therapy he conducted, there were “high rates of mystical experiences (reported), amazement at life, and experiences of unity that provided a reframing of personal narrative.”
About one of her experiences, Etheridge wrote in “Talking to My Angels”:
“I became suffused with love, giving in to the space around my body and merging into an infinite horizon. By whom was I loved? And who was generating this love? Was it possible to imagine being loved? And in that imagining, make it real?
As these questions arose in a burst of spontaneous and tangible insight, I began to realize that it was me doing the loving. That for the first time ever, I felt a profound self-love. … The universe was trying to tell me that I did not have to be afraid. That I did not have to worry. That I did not have to fight so hard for what I wanted. That the love moving through me, the love that runs through all of us and connects us to one another, to the sky and trees, the animals and plants — the all of it — that the love is within us and all around us.”
While transformative results like this are possible with psychedelic therapy, this is not an easy fix. These therapies aren’t about avoiding pain, they’re about opening a doorway to walk through it in a potentially profound way, allowing people to see new possibilities for themselves and their lives.
Research and anecdotal evidence suggest that productive treatment includes many factors. Like any kind of therapy, integrity, trust and ethics play a vital role in making it effective. Set and setting are also key. Set refers to the individual’s mindset and includes expectation, mood and mental state while setting pertains to the physical and social environment of the situation. And integrative activities — meditation, talk, trauma and art therapy, journaling and discussion groups — are essential for helping individuals make sense of their experiences in a lasting and meaningful way.
Imagine we could offer more than survival to millions of sufferers. What if we could help them flourish?
A long and winding road
Schock himself tried everything to manage his depression, from daily meditation to talk therapy and medication. “I did it all,” he says. “And still it seemed like the better my life got, the more suicidal I got. The only thing that kept me going was my kids.”
To see if a change of scenery might help, Schock sold his sober living house and moved to Tennessee. “I built a chicken coop,” he admits, “so I would have a place to hang myself.”
Relapsing wasn’t an option for him, he says, “I just wanted to die.”
After a lot of contemplation, he turned to psychedelic therapy. A process with precarious results, considering the lack of resources available to him: Schock had a few horrible experiences, partly because he couldn’t share any of this work with his sober men’s group.
“I was terrified of losing my support system,” he says, which he believes contributed to his distress during treatment. Finally, he found a therapist he could trust and she introduced him to micro-dosing psilocybin — a process of taking sub-perceptual doses for short periods of time — combined with therapy. It’s the same treatment Etheridge believes would have helped her son.
Doing this work with a therapist allowed Schock, he says, to peel back the layers of the onion and “get” his depression. He discovered that he was a survivor of childhood sexual abuse.
“I know you hear stories like this and you think people are making it up,” he says. “But I remember having one of those aha moments, like, yeah, that really happened to me.”
He goes on to credit his therapist for walking him through those difficult memories and the emotions they brought to the surface. “I’ve done a lot of healing,” he adds.
Not only does he still go to his AA meetings and continue to count his sober days, Schock now offers micro-dosing as part of his coaching and mentoring service. “It’s all about integrity,” he says. “I’m not trying to hide how this therapy has helped me. We need to be able to have these conversations.”
Right in front of us
Turns out, we could have been having conversations about plant medicine and psychedelics the entire time. Rarely discussed is that the spiritual aspect of a Higher Power in AA was ignited by founder Bill Wilson’s treatment with a hallucinogen in the 1930s.
According to “Pass It On: The Story of Bill Wilson and How the AA Message Reached the World,” when Wilson worried about alcoholics not being able to stay sober because they lacked the ability to have a true spiritual experience, he made the decision to try LSD in the 1950s after researching the work of Dr. Humphry Osmond and his mind-manifesting medicines.
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“Anything that helps the alcoholic is good and shouldn’t be dismissed out of hand,” says a passage in “Pass It On.” Wilson went on to receive several treatments to great success, but stepped away when it became clear that most members of AA were “violently opposed to his experimenting with a mind-altering substance.”
So, what makes one medicine good and another bad? How do we determine treatment and healing?
Symonds says that should be up to the individual to decide. “For some people, maybe the pharmaceutical opioids (MOUD) will be enough. But for many people, they’re unsatisfied with where that’s brought them. Where plant medicines and psychedelic therapies are so helpful,” she adds, “is that they also work on the mental, emotional and spiritual aspects of addiction.”
For Schock, it’s all about integrity and intention. When we’re dealing with people who have substance misuse disorders, everything has the potential for abuse.
“A good friend of mine is out there doing journeys (with plant medicine) every week. That’s not what this is about. Psychedelics aren’t for everybody,” he says. “But when it works, it’s like a slow cracking open of your heart. It makes you feel … something. A deep appreciation, not only for mother nature but for humanity and for people.”
As he talks, a smile takes over his face. “The level of compassion I have for myself now,” he shakes his head as if he can hardly believe it, “is uncanny. I dig my life. Is it always hunky-dory? No. There are issues with money and my health, my relationship,” he laughs. “But I love every day. Does my depression show up? Yeah, but I’m not powerless over it anymore. I have some say in it.”
He asks me how I feel about the possibility of relapsing in my own sobriety. When I tell him the idea makes me feel sick to my stomach, he says, “that’s how I feel about suicidality now. Thinking about how close I came so many times, it makes my stomach hurt. I would have missed out on this conversation and my morning meditation with the guys this morning. I would not have run into my friend Steve at the gym and given him a hug. I would have missed all of these beautiful things that we’re talking about. I call it God’s grace, and it’s not lost on me anymore.”