Psychedelic medicine, how did I get here?
By Jo Neill
This is the story of how someone absolutely committed to conducting original research, developing new and better medicines for psychiatry, and enhancing our understanding of the brain — for over 35 years — has given all this work up (including running a University based CRO) to work to enable patients to access psychedelic medicine.
For this story, I thought I’d start at the beginning. I grew up in Troubles-era Belfast, during the 1970s, and, in retrospect, this instilled a certain determination – both to leave, and to succeed. I left Belfast in September 1982, having had a happy childhood – Head Girl and hockey player at my small, protestant all-girls school, and surrounded by friends I’m fortunate to still have today. My Dad dropped me at the overnight ferry — Belfast to Liverpool (all these less than glamorous boat trips are why I’ll never willingly go on a cruise!) — and from here I made the long journey to Bath University by train. No one in my family had a science background, and there was little career help at school — I wasn’t deemed clever enough to study medicine or dentistry, and I was rejected by Queen’s University to study pharmacy — so I fell into pharmacology rather by chance. As kids, we’d had lots of pets in the family: Bertie (who later turned out to be Bertina following a surprise litter of rabbits), Willie (the notorious guinea pig once stopped from crossing the now-defunct Irish border), and Jamie (the miniature wire-haired Dachshund), among others. I loved animals and studying their behaviour. Looking back, I was bound to end up working in psychopharmacology, examining the effect of drugs on the brain and behaviour.
As for most people, I guess, I got there by a circuitous route. The Bath pharmacology course was disappointingly dull for me. I discovered that I wasn’t particularly interested in how drugs affected the lungs, heart and kidneys. Organic chemistry was baffling to me, and many of us failed this exam in the first year, meaning I was forced to spend my first summer at university cooped up in the library, studying for re-sits. For me, the best thing about the course was the placement year. I went to Strasbourg and did my first stint in the pharmaceutical industry, working for Merrell Dow. I worked on behavioural pharmacology for Mark Tricklebank, and absolutely loved it. Finally, a subject I could really engage with. I ended up at Merrell Dow by chance, as has been the case with many of my career decisions. The person to be interviewed for that position was poorly, and the chap conducting the interview had travelled from Strasbourg specially, so they asked me to fill in, and I got the position! Mark was a wonderful mentor, and if there’s one thing I learned during that year, it’s that we all need a good mentor — something I now try to be for others. Members of the in vivo drug discovery team, led by the infamous John Fozard, were all wonderful, and they taught me a great deal, as well as looking after me in a way no one had before. This was my first experience of drug discovery in psychiatry. They were looking for better drugs for anxiety disorders, and the pharmacological target was the serotonin-5-HT1A receptor. Back in those days, there were only about five 5-HT receptors known in the brain (now there are seven families of 5-HT receptor and fourteen subtypes), and the tools available for characterising behavioural responses to a particular mechanism or receptor were rather blunt. One thing I love about working in pharma is the lack of hierarchy among the scientists, unlike in academia. I returned to Bath speaking much better French, with a full appreciation of French cuisine, and knowing that I wanted a career in behavioural pharmacology*.
After I graduated, I worked with Mark again in the summer of 1986 at Merck Sharpe & Dohme (MSD) in Terlings Park, Harlow, run by the Iversens — world renowned pharmacologists. Then to Birmingham Psychology to do a PhD with Steve Cooper on serotonin and feeding behaviour in rats. Almost as a follow up to the project in Strasbourg, I spent the 3 years studying the pharmacology of serotonin’s control of ingestive behaviour, again learning a great deal from Steve, another wonderful mentor. I started to play squash there (a lifelong passion), and football (not a game I excelled at). From there, I did a stint at Mario Negi Istituto di Richerche in Milan, and worked for Rosario Samanin, whom I never argued with! Mario Negi is a private research institute established by wealthy jeweller, Silvio Garattini, which has produced some wonderful scientific achievements. Next, on to Leeds University, Psychology, to work with Colin Hendrie — an eccentric ethopharmacologist. Colin and I became very good friends, and he taught me how to study animal behaviour properly, paying particular attention to the instincts and natural behaviour patterns of the species being studied — David Attenborough style, but in the laboratory. He had some brilliant ideas including a model of depression that split up gerbils that had pair bonded. The male became very sad, stopped eating and grooming and this behaviour could be rescued by anti-depressant treatment. Very smart, I thought!
In Leeds, I met Keith, my husband, and moved to Bradford University (the funding for the Leeds job was from MSD — back to pharma again — and was short-term as most post-doctoral positions are, unfortunately). We lived in Bradford for 22 years, brought our 2 daughters up there, and ate a lot of fantastic curry. I worked at Bradford University for 21 years, starting as a post-doc again, this time funded by GSK, working on addiction — trying to establish a rat model of alcohol misuse, then as a lecturer, and finally made Professor in 2008.
Promotion criteria in academia are very simple; bring in research money, teach well, and publish research papers, which is exactly what I did. I wanted to work on addiction, but couldn’t get funding, so I switched to schizophrenia, as cognitive dysfunction in schizophrenia was (and still is) an unmet medical need that pharma were working very hard to develop blockbuster medicines for.
I established a CRO (Contract Research Organisation) called B-neuro with a research technician, and now good friend, Ben Grayson who continues to run the company, while I focus on psychedelic medicine. We never spun it out from the University but with a good steady turnover over the past 20 years we have funded a vibrant and successful team of technicians, PhD & MSc students. Ben is a horse (and rodent) whisperer, and ran all the experiments initially. He’s a wonderful behavioural scientist; I supervised his PhD, and many others. We established an animal model of cognitive and social behaviour deficits of relevance to psychiatric disorders, with a focus on schizophrenia, and a battery of ethologically relevant behavioural tests. Over the years we have worked with many major pharma companies, small biotechs, and academic groups.
I travelled the world giving talks at conferences, both for these companies (presenting the data with their compounds in our model) and on more basic research. I also have a very long-standing love of the BAP (British Association for Psychopharmacology), and have been a member since 1986 (thanks to Steve Cooper enlisting me as a PhD student), later becoming President in 2016. I was on Council from 2005 until 2020, and learned an enormous amount about the practice of psychiatry, as BAP is where science meets clinical practice. I also made some really good friends through BAP, and that is how I came to know the legendary David Nutt.
Bradford is a very small University and not cash rich, and, in 2012, I left to join the much larger and better funded school of pharmacy at Manchester University. I tell people that it’s like I used to play for Accrington Stanley, and now I play for Manchester United — the two Institutions being leagues apart. At Manchester, due to the wealth of scientific expertise, I was able to establish another animal model, this time a model of maternal immune activation in rats for neurodevelopmental disorders, in collaboration with Eric Prinssen at Roche.
I loved Manchester, but became increasingly frustrated with the lack of grassroots impact my work has had on patients and their carers. Sadly, no drug I have ever worked on has made a large difference to patients, yet! One of my favourite projects is with Autifony — a company established after GSK pulled out of psychiatry drug discovery, as most big Pharma did about 15 years ago. Their novel molecule has the potential to make a positive impact on patients’ quality of life, but is unlikely to do so for another 5-10 years — far too slow!
I’ve worked in drug discovery for psychiatry my entire career (ever since that amazing year in Strasbourg in 1984), and still the pharmacological treatments for psychiatric illness are based on molecules that were discovered by serendipity in the 1950s. Understanding of the causes of illnesses such as schizophrenia, depression, OCD, PTSD, and their underlying psychopathology, has advanced, as has the impact of psychological treatments. But for drug treatments, we haven’t really achieved what I expected to see in my lifetime. We still only manage patients’ symptoms. We don’t cure or heal people with current medicines.
There are many reasons for this lack of innovation and advancement, compared with other disciplines. Diagnosis is subjective, relying upon an interview with a health care professional, drugs must get into the brain, crossing the tight network of junctions and transporters making up the blood-brain-barrier (the brain’s sophisticated safeguard), a lack of proper research funding and patient stratification, and lack of investment in the animal models, among other issues. It seems totally unreasonable to expect all patients with depression or psychosis to have the same psychopathology and respond to the same treatments. We don’t do this in any other branch of medicine, and we shouldn’t here either.
That’s when I started to understand that psychedelics, which mostly come from plants, can heal people, which is essentially what I wanted to achieve through involvement in drug discovery for psychiatry but had not yet achieved. My perspective started to shift gradually of course, but a rather random event prompted a lightbulb moment! Driving home from work one Friday evening in October 2016, I heard Eddie Mair interview former undercover drugs police officer Neil Woods**. I was mesmerised. Neil talked about his 14 years’ experience gathering evidence to prosecute Organised Crime Groups (OCGs), the dangers he faced, and the guilt and PTSD he suffered from ‘betraying’ drug users he had befriended over the years — people often highly marginalised by society. These vulnerable people also received custodial sentences because of our current drugs policy in the UK. He mentioned the book he had written about his experiences: “Good Cop Bad War” and the worldwide organisation he was then Chair of in the UK, LEAP (Law Enforcement Action Partnership). His work aims to raise awareness, and he campaigns for total reform of the current drug laws.
Once home, I emailed David Nutt, asking if he knew Neil. David’s typically concise and pertinent reply was, “he’s a great guy”. I have now found this out for myself! I really have Neil (and David) to thank for a great deal of my current work and trajectory. I decided that I needed to meet Neil, and that as many people as possible must hear him communicate the importance of reforming the UK’s drug policy, which has destroyed so many lives. I organised a symposium in Manchester, in March 2017, “Street Drugs in the Northern Powerhouse”, at which Neil and David both spoke.***
I am proud to say I have been involved with several events since then at which both Neil and David have spoken, and have met many other wonderful people involved in drug law reform. One person in particular is James Morgan, a criminologist from London Metropolitan University. James came to the Manchester Street Drugs event, and I asked him afterwards for some feedback. We got chatting, and I suggested that he host the next one (I was fairly determined to keep these events going across the UK, to reach as many people as possible). To my surprise, James said yes, and organised a brilliant event in London in 2018, “Street Drugs in the Big Smoke”, to which James invited Nuno Capaz from Portugal (where all drugs were decriminalised in 2001, significantly reducing drug related deaths and harms) and Marcos Baudean from Uruguay (where cannabis was legalised in 2013). We were all invited to Parliament to present these two models of drug policy to the APPG on drug law reform, co-chaired by Crispin Blunt MP and Jeff Smith MP, a first for both of us, and hugely exciting. James and I became good friends, and due to the pandemic, we have organised a series of online events with Chris Chandler, also of London Metropolitan University. Street Drugs Discussions was born! We have now held 8 of these, and are still going strong. We have hosted discussions on broad topics, from drug policy, policing and politics, vaping, chemsex, alcohol, and, of course, psychedelic medicine.
Another very significant meeting for me has been with the parents involved in Anyone’s Child, a campaign of Transform (established by Jane Slater), to support the families who have lost someone to drugs. They march on parliament every summer and are a powerful force, campaigning for regulation of all street drugs to keep our families safe. At an event in Manchester, I met Ray, from the Isle of Man, who lost both his sons to the same batch of ecstasy (MDMA) on the same night. Of course, if Ecstasy was regulated, and they had known the strength of what they were buying, this awful tragedy would never have happened. It is not possible to hear of these tragedies without wanting to get involved in drug law reform.
Due to my increasing awareness of the medicinal benefit of psychedelics, Craig Whittall (from Manchester University’s Policy unit) and I decided to work towards re-scheduling psilocybin to enable research. I joined David Nutt’s organisation, Drug Science, in March 2019, and he asked me to be the Chair of the Drug Science Medical Psychedelics Working Group later on that year (to my delight!). I took a sabbatical in 2019 to learn more about psychedelic medicine.
In August 2019, I spent 2 hours talking to a former soldier from the parachute regiment who treated his own PTSD with psilocybin — the active component of so-called Magic Mushrooms. He had to go to Amsterdam to do this, due to the illegal status of psilocybin in the UK and our outdated drug laws — a shameful situation for someone who has served his country.
I learned that drugs that are currently illegal (and indeed are Class A and Schedule 1, according to our laws) such as Psilocybin and MDMA, have enormous medicinal potential, and they can provide a long-term solution for many people. They are safe, have almost no side effects, and can be effective as a once-only treatment, although some patients may need more than one dose, for example every six months or so.
The combat veteran I spoke to took 2 doses of psilocybin in January 2019 and is still well. It has been a life-changing experience for him. In his own words: “I believe psilocybin has massive medicinal potential and that its prohibition means many veterans who struggle with PTSD are being denied a safe and effective treatment option.” Hearing his story strengthened my resolve to change my career to work on psychedelic medicine.
It is very important to state that these drugs should be used in combination with extensive psychotherapy, and that set (mind set) and setting (physical and social environment) are extremely important for their beneficial effects. Also, the experience, while life changing for patients, can be very frightening. This meeting, combined with everything I learned about psychedelics and their healing potential for people, decided my future career; that I would focus on research into psychedelics with the ultimate goal of access for patients on the NHS and through retreats. So I am now doing this through my work with Heroic Hearts UK (as you are reading this on their website I assume you know all about this fantastic organisation for combat veterans and first responders), the Conservative Drug Law Reform Group, Drug Science, and a very new venture for me, the Psychedelic Experience.
Since working in the field of psychedelic medicine, I have met the most wonderful, dedicated and talented people, and I have enormous hope that, in the not-too-distant future, many people’s lives will be transformed as a result of their work.
* When academics receive the title of Professor there is a choice regarding area of expertise, e.g. Professor of cardiology, endocrinology etc. I chose psychopharmacology because, through all my interactions with the BAP, I have a much better appreciation of the practice of psychiatry and I have always worked towards developing drugs for psychiatric disorders. Psychopharmacology seemed a much more appropriate title than behavioural pharmacology (which really only applies to the mechanisms of animal behaviour).
** http://www.bbc.co.uk/programmes/p04bb7c5
*** https://www.bap.org.uk/articles/street-drugs-in-the-northern-powerhouse-perspective-and-policy/