J. R. Rahn, a techie whose company is helping fund New York’s first psychedelic-medicine center, spent the middle years of the past decade leading a successful startup while his life quietly came apart. “To the outside world, I was doing really well, but inside me I was struggling,” Rahn, a thick-built thirty-three-year-old with a shaved head, a smile-shaped beard, and delicate rimless glasses, said on Zoom the other day. He’d left New York to weather the pandemic in Miami; some palm fronds fluttered behind him. “People would say, ‘Oh, you’re just depressed.’ Well, I’m depressed, but I also can’t fall asleep without drinking a bottle of wine. I can’t have fun at a party without using cocaine.” Also, there was Xanax, for anxiety. Rahn needed help—or did he just need drugs of another kind? “A friend recommended I have a psychedelic experience, to piece together a solution,” he said. He did LSD and mushrooms a few times, and gave up all the other stuff.
Now Rahn is the co-founder of MindMed, a startup that develops psychedelic drugs to treat mental illness and addiction. In theory, such drugs are promising because they could be administered on a limited course (“like antibiotics,” Rahn says), in coördination with talk therapy—a contrast to addiction medications like methadone and Suboxone, and to many mental-health medications, which are often taken indefinitely. In practice, obstacles include the Timothy Leary factor (people still associate psychedelics with Ram Dass and British Invasion sitars) and the challenge of transferring lab successes to the therapeutic couch. “There’s really never been a precedent for using these substances within the psychiatric community,” Rahn said. “So how are you going to train the next generation of psychiatrists to take them seriously?”
One way is to train them at the training point. For years, researchers at N.Y.U. Langone Medical Center had been discussing the idea of a center for psychedelic medicine. MindMed just pledged five million dollars to N.Y.U. Langone, to kick off such an establishment, with the money earmarked for training. As the center-to-be settles the rest of its funding, its director, the psychiatry professor and addiction researcher Michael P. Bogenschutz, is preparing to bring aboard four junior faculty members and two postdocs: a New York team. (The first psychedelic-medicine center in the country, at Johns Hopkins, was created last year.)
“What distinguishes our effort is, you’ve got the practical focus on treatment of hard-to-treat psychiatric disorders front and center,” Bogenschutz said. The center will have no structural relationship with MindMed, but MindMed is looking to return its testing, now run by partners in Australia (tax incentives) and Switzerland (out-there medicine), to the U.S. for late trials.
In assessing drugs for study, Rahn was first drawn to ibogaine, a shrub-root derivative that had shown promise in addiction therapy. Unfortunately, at certain doses, it can lead to sudden death. Then Rahn’s co-founder, Stephen L. Hurst, turned him on to 18-Methoxycoronaridine, or 18-MC, a non-hallucinogenic relative of ibogaine that, in one study, helped rats stop eating cocaine and responding to Pavlovian triggers. The company is also running trials on LSD as a treatment for anxiety.
Rahn says that, for him, psychedelics opened his eyes to the source of his depression, anxiety, and substance abuse: his mother. “I discovered her dead on a vacation in the Dominican Republic as an eight-year-old child,” he said. It had not previously occurred to him that this might relate to his problems. “I think I probably got over the trauma, but what I didn’t get over was the guilt.”
Regarding the potential mental-health benefits of psychedelics, Bogenschutz notes, “What’s interesting is, why do people end up changing in a particular way as a result of a relatively brief experience?” So far, it’s unclear. “Our working model is that, because of an enhanced neuroplasticity, there is a temporary weakening of the established dominant networks that may keep people within a rigid pattern of behavior, such as drinking or ruminative thoughts,” he said. In addiction treatment, the effects sometimes last for years, suggesting a baking-in of new patterns—hence, in Bogenschutz’s view, the value of accompanying therapy.
In recent years, the market for psychedelic medicines, once a punch line, has become serious business. Compass Pathways, a psilocybin-centered company backed by Michael Novogratz and Peter Thiel, had its I.P.O. last month, and is listed on the Nasdaq. MindMed has filed Nasdaq papers, too, after noting clouds over the nation’s mental health. “I came to this realization that technology, A.I., this world I was in was about to displace a whole lot of people from work,” he said. “And, when people are displaced from work, rates of addiction and mental-health issues skyrocket.” The pandemic has darkened those skies further; prescriptions for anti-anxiety drugs leaped by a third in its first month. “Eleven per cent of Americans seriously considered suicide in June,” Rahn observed—a doubling since last year. “We’re not O.K.” ♦
