One medicinal use of LSD that touches on fundamental ethical questions is its administration to the dying. This practice arose from observations in American clinics that especially severe painful conditions of cancer patients, which no longer respond to conventional pain-relieving medication, could be alleviated or completely abolished by LSD. Of course, this does not involve an analgesic effect in the true sense. The diminution of pain sensitivity may rather occur because patients under the influence of LSD are psychologically so dissociated from their bodies that physical pain no longer penetrates their consciousness. In order for LSD to be effective in such cases, it is especially crucial that patients be prepared and instructed about the kind of experiences and transformations that await them. In many cases it has proved beneficial for either a member of the clergy or a psychotherapist to guide the patient's thoughts in a religious direction. Numerous case histories tell of patients who gained meaningful insights about life and death on their deathbeds as, freed from pain in LSD ecstasy and reconciled to their fate, they faced their earthly demise fearlessly and in peace.

The hitherto existing knowledge about the administration of LSD to the terminally ill has been summarized and published by S. Grof and J. Halifax in their book The Human Encounter with Death (E. P. Dutton, New York, 1977). The authors, together with E.

Kast, S. Cohen, and W. A. Pahnke, are among the pioneers of this application of LSD.

The most recent comprehensive publication on the use of LSD in psychiatry, Realms of the Human Unconscious: Observations from LSD Research (The Viking Press, New York, 1975), likewise comes from S. Grof, the Czech psychiatrist who has emigrated to the United States. This book offers a critical evaluation of the LSD experience from the viewpoint of Freud and Jung, as well as of existential analysis.

5. From Remedy to Inebriant

During the first years after its discovery, LSD brought me the same happiness and gratification that any pharmaceutical chemist would feel on learning that a substance he or she produced might possibly develop into a valuable medicament. For the creation of new remedies is the goal of a pharmaceutical chemist's research activity; therein lies the meaning of his or her work.

Nonmedical Use of LSD

This joy at having fathered LSD was tarnished after more than ten years of uninterrupted scientific research and medicinal use when LSD was swept up in the huge wave of an inebriant mania that began to spread over the Western world, above all the United States, at the end of the 1950s. It was strange how rapidly LSD adopted its new role as inebriant and, for a time, became the number-one inebriating drug, at least as far as publicity was concerned. The more its use as an inebriant was disseminated, bringing an upsurge in the number of untoward incidents caused by careless, medically unsupervised use, the more LSD became a problem child for me and for the Sandoz firm.

It was obvious that a substance with such fantastic effects on mental perception and on the experience of the outer and inner world would also arouse interest outside medical science, but I had not expected that LSD, with its unfathomably uncanny, profound effects, so unlike the character of a recreational drug, would ever find worldwide use as an inebriant. I had expected curiosity and interest on the part of artists outside of medicine—performers, painters, and writers—but not among people in general. After the scientific publications around the turn of the century on mescaline—which, as already mentioned, evokes psychic effects quite like those of LSD—the use of this compound remained confined to medicine and to experiments within artistic and literary circles. I had expected the same fate for LSD. And indeed, the first non-medicinal self-experiments with LSD were carried out by writers, painters, musicians, and other intellectuals.

LSD sessions had reportedly provoked extraordinary aesthetic experiences and granted new insights into the essence of the creative process. Artists were influenced in their creative work in unconventional ways. A particular type of art developed that has become known as psychedelic art. It comprises creations produced under the influenced of LSD

and other psychedelic drugs, whereby the drugs acted as stimulus and source of inspiration. The standard publication in this field is the book by Robert E. L. Masters and Jean Houston, Psychedelic Art (Balance House, 1968). Works of psychedelic art are not created while the drug is in effect, but only afterward, the artist being inspired by these experiences. As long as the inebriated condition lasts, creative activity is impeded, if not completely halted. The influx of images is too great and is increasing too rapidly to be portrayed and fashioned. An overwhelming vision paralyzes activity. Artistic productions arising directly from LSD inebriation, therefore, are mostly rudimentary in character and deserve consideration not because of their artistic merit, but because they are a type of psychoprogram, which offers insight into the deepest mental structures of the artist, activated and made conscious by LSD. This was demonstrated later in a large-scale experiment by the Munich psychiatrist Richard P. Hartmann, in which thirty famous painters took part. He published the results in his book Malerei aus Bereichen des Unbewussten: Kunstler Experimentieren unter LSD [Painting from spheres of the unconscious: artists experiment with LSD], Verlag M. Du Mont Schauberg, Cologne, 1974).

LSD experiments also gave new impetus to exploration into the essence of religious and mystical experience. Religious scholars and philosophers discussed the question whether the religious and mystical experiences often discovered in LSD sessions were genuine, that is, comparable to spontaneous mysticoreligious enlightenment.

This nonmedicinal yet earnest phase of LSD research, at times in parallel with medicinal research, at times following it, was increasingly overshadowed at the beginning of the 1960s, as LSD use spread with epidemic-like speed through all social classes, as a sensational inebriating drug, in the course of the inebriant mania in the United States. The rapid rise of drug use, which had its beginning in this country about twenty years ago, was not, however, a consequence of the discovery of LSD, as superficial observers often declared. Rather it had deep-seated sociological causes: materialism, alienation from nature through industrialization and increasing urbanization, lack of satisfaction in professional employment in a mechanized, lifeless working world, ennui and purposelessness in a wealthy, saturated society, and lack of a religious, nurturing, and meaningful philosophical foundation of life.

The existence of LSD was even regarded by the drug enthusiasts as a predestined coincidence—it had to be discovered precisely at this time in order to bring help to people suffering under the modern conditions. It is not surprising that LSD first came into circulation as an inebriating drug in the United States, the country in which industrialization, urbanization, and mechanization, even of agriculture, are most broadly advanced. These are the same factors that have led to the origin and growth of the hippie movement that developed simultaneously with the LSD wave. The two cannot be dissociated. It would be worth investigating to what extent the consumption of psychedelic drugs furthered the hippie movement and conversely.

The spread of LSD from medicine and psychiatry into the drug scene was introduced and expedited by publications on sensational LSD experiments that, although they were carried out in psychiatric clinics and universities, were not then reported in scientific journals, but rather in magazines and daily papers, greatly elaborated. Reporters made themselves available as guinea pigs. Sidney Katz, for example, participated in an LSD