If you haven’t thought much about psychedelics since Woodstock, you’ve missed a lot: Namely, their subtle return to the zeitgeist after former U.S. president Richard Nixon declared drug abuse “public enemy No. 1” to a (mostly) legal and legitimate medical miracle drug.
That said, modern psychedelic therapy isn’t anything like dropping acid on route to a concert. In Canada, anyone dabbling in psychedelics for mental health can experiment with psilocybin (mushrooms), MDMA (ecstasy), LSD (acid), DMT (fantasia) and ketamine (which goes by many street names, like Special K and Kit Kat) to treat everything from PTSD to depression to eating disorders to addiction. With the help of a trained professional to guide you through a safe trip, of course.
Arguably, the most controversial is ketamine, which is either hailed as a promising cure for addiction that should be explored further or a poor choice, since it means treating addiction with an even more addictive substance. The grey area in between interests Vancouver-based Daniel Kalla, an emergency-room doctor and bestselling author whose new thriller High Society explores these contradictions in glamorous, high-stakes California.
There, and only there, could Dr. Holly Danvers’ addiction support group of seven include a rock star, rich heiress, CEO and fashion designer with a dependency on everything from booze to sex to Xanax. Just like her (mysteriously deceased) father and (alive and well) grandfather, Danvers believes in the possibilities of psychedelics as medicine. She even partakes herself on the sly: So pop that sketchy behaviour into the grey area, too. Once her patients start dying – one-at-a-time, Agatha Christie-style – Danvers must figure out who on the inside has turned murderous, and why.
Like most of his books, Kalla’s High Society (respectfully, legally, etc.) borrows inspiration from his day job to explore controversial medical issues – in this case, whether psychedelics are good for therapy. Like most things in life and science, the answer is “it depends”; what works like a dream for one patient could be a nightmare for another. That’s this reader’s takeaway, but what is Kalla’s? And did the doctor partake in the name of “research”? You know I’m just nosy enough to ask.
Rosemary Counter: Hello and good morning in Vancouver! How are you?
Daniel Kalla: Good, though the last few days have been a bit hectic. I’m fighting a cold and worked a night shift last night. I’m glad this interview isn’t live.
RC: I had to take some migraine meds and feel a little bit off. It’s thematic though, so I don’t think you’ll mind. Were you a writer first or a doctor?
DK: Certainly by heritage I’m a doctor first. Third generation. You can’t swing a dead cat around my family without hitting a doctor. As a kid, and throughout high school, I loved creative writing, but I let it go for a long time to focus on science and medicine. I always had the itch to get back to it, so as soon as I finished my residency, I picked up writing again.
RC: I don’t think it’s fair to be good at both medicine and writing. You should stay in your lane!
DK: Hah! I work in emergency medicine, so it’s not full time and it’s shift work. A lot of us in the emergency department have some pretty interesting side gigs: I meet a lot of aspiring musicians and real estate developers in there. I don’t think I’d have been an emerg doc for 30 years if I didn’t have the writing, and vice versa. I’m so lucky to have two careers that inspire each other.
RC: Is it tempting to write about your patients?
DK: I see and hear incredible things as an emergency doctor – so much of it far wackier than fiction – but I learned early on that basing my stories on anything real and specific didn’t work for me: especially the characters, which just became caricatures, so I stopped doing that.
I never base my writing on anyone, but I do use the flavour. My last five or six [books] have been written around some kind of hot-button theme: pandemics, vaccines, psychedelics.
RC: When and how did you start getting interested in psychedelics?
DK: Just in the last few years, my friends started talking about psychedelic therapy. Microdosing became a thing. Growing up, I never thought about LSD or mushrooms in that way, but the more my friends and colleagues talked about it, the more I started to read about it, and I was just fascinated. Then you find out they have this absolutely incredible history. Psychedelics are the most politicized drugs in the history of mankind. In the 1960s, LSD was the most studied psychedelic drug, full of promise and potential, but by the ’70s, it was suddenly equated to cocaine and heroin. Research just stopped for 50 years.
RC: You must have done a tonne of research for this book. What were your takeaways?
DK: I don’t think we understand them yet, but I do think there’s something incredible about this class of drugs. They activate a part of the brain that is not usually activated by anything – you can see it on an MRI. That in itself is amazing, powerful stuff.
RC: You know I want to ask you if you took them, so badly…
DK: I don’t mind if you ask and I don’t mind admitting to dabbling. I tried microdosing with psilocybin and LSD, a little half-dose and never a full hallucinatory dose. It was OK, even good, though I didn’t find it as intense as I thought it might be. Maybe I should have known, as my job – I work downtown at an opioid crisis centre – has me seeing high people having panic attacks, psychosis, delusions, cardiac stuff related to cocaine, vomiting associated with marijuana. But you know what we almost never see? Patients coming in after taking psychedelics. Everyone’s so terrified of that terrible trip, but it’s so much more benign than that. Relative to other substances, it’s so low-risk.
RC: What did you learn about therapeutic psychedelics?
DK: There’s some amazing research coming out. Harvard is studying using psilocybin for cancer patients to take away their fear of death. There’s never been a better substance to take for alcoholism than LSD. The founder of Alcoholics Anonymous used LSD. There’s all kinds of evidence, to some degree or another, that psychedelics can help with PTSD, depression and suicidality.
RC: So your crew of seven could have been all depressed or all suffering from PTSD. Why addiction?
DK: I chose addiction because it so often has elements of all of those. Addiction’s associated with trauma and depression and any number of other complicated issues, and since I wanted characters that were very, very flawed, addiction seemed a commonality that gave me a lot of space to work with. At the same time, I didn’t want them to be stereotypes of people with addiction, down and out and homeless. I wanted high-functioning people with successful lives that have somehow accommodated their drug use. In lots of cases, that just means money and resources. I set the group in Orange County because Los Angeles felt like the only place that a rock star and an heiress might find themselves sitting in the same office.
RC: I love that even your protagonist, a doctor, is as sketchy as the rest.
DK: I love a flawed protagonist. In retrospect, she’s almost too flawed, because she’s someone who suffered trauma herself and now she’s fanatical about psychedelics. She makes some unethical and borderline illegal choices along the way, but only because she has this passionate belief about psychedelics that makes her keep going when she shouldn’t. She’s a great vehicle to tell the story, because as much as I’m a proponent of psychedelics, they’re not perfect. Nothing in life or medicine is. I like the idea that over the course of the story, she has to learn to question what she’s doing and when she’s crossed the line.
RC: Like getting high in her office? C’mon! What are you working on next?
DK: I’m already hard at work on another [book], actually. This one combines two issues: MAID [medical assistance in dying] and AI. I’m looking at the ethical bounds of MAID through the lens of a tech executive in Seattle who’s diagnosed with a terminal condition. He started looking into MAID, but, um, none of it is what it seems. I could talk all day about it, but I shouldn’t say more. I like to keep people guessing.
This interview has been edited and condensed for length and clarity.
