Spit into a tube and pop it in the mail, and the lab results may lead to a better high—or at least a safer one. That’s the premise of a home saliva testing kit sold for $199 by Endocanna Health Inc., which looks for 57 genetic traits that could influence a customer’s response to marijuana, so they can select the best strain and correct dose. The company also plans to look at similar factors for a range of psychotropic drugs.
“Your DNA is your blueprint,” says Len May, chief executive officer of the Burbank, Calif.-based startup. “It gives you a GPS that can guide you to an experience that is more optimal and helps you avoid sharp corners.”
Endocanna is among a handful of early-stage companies following in the footsteps of precision medicine by trying to help people understand how they’ll react to cannabis or psychedelic drugs, such as psilocybin, MDMA, DMT, and ketamine. Companies researching alternative therapies for depression, addiction, chronic pain, and other afflictions want part of the $27 billion global market for traditional psychiatric drugs. They’re trying to solve the piece of the puzzle that holds many people back from microdosing magic mushrooms or undergoing marijuana therapy: fear of a bad trip—or even lasting psychosis.
Pharmacogenomics, the branch of pharmacology concerned with how genetic factors influence reactions to drugs, has already seen some success in oncology. Although there’s no scientific consensus about whether a person’s response to any kind of psychiatric drug can be predicted with genetics, companies including Endocanna are already wading into research and even direct-to-consumer kits. If they can succeed in preventing extreme reactions to psychedelic drugs, it could smooth a path for the industry more broadly.
The risks are more significant than just bad trips. Marijuana is often recommended to ease anxiety, but it can also provoke it in some people. The National Institute on Drug Abuse says smoking high-potency marijuana could increase the chances of developing psychosis. On the flip side, a 2015 analysis of U.S. patient data found that 19,299 Americans who took classic psychedelics such as LSD, psilocybin, and mescaline weren’t at increased risk for developing problems such as schizophrenia, psychosis, depression, or anxiety, or of committing suicide.
Bad trips are still problematic: A Johns Hopkins University study of 1,993 people who reported bad trips found that 11% said they had put themselves or others in harm’s way during the experience, and 8% had sought treatment for what they believed were enduring psychological symptoms related to the event. “That to me is disquieting, particularly in light of the cultural enthusiasm for legalization and decriminalization,” says Roland Griffiths, director of the Center for Psychedelic & Consciousness Research at the university. “People trying them are not only seeking treatment but may be putting themselves or others at risk—even life-threatening risk.”
The risks aren’t deterring investors. The Canadian Securities Exchange said $277 million has been raised for psychedelics companies since 2020, and $11.25 billion has been raised for cannabis and hemp companies since 2016. Vancouver-based Entheon Biomedical Corp., which sells a mail-order saliva test for people considering psychedelics, priced at $89, is among them. The early-stage company went public last year through a reverse takeover.
Entheon’s psychedelic test looks at five factors: a liver enzyme for ketamine metabolism, serotonin receptor variations to gauge “psychedelics sensitivity,” and three other factors to weigh “mental health risk” by analyzing genes believed to influence responses to THC and CBD—including a test for the AKT1 gene, which the National Institute on Drug Abuse has identified as potentially linked to a higher risk of psychosis in people who use marijuana.
The company grew out of CEO Timothy Ko’s desire to help his opiate-addicted brother, who tried traditional treatments for a variety of mental ailments before dying two years ago. “Some of the difficulty that we faced as a family was that there was a lot of uncertainty as to what he was actual suffering from and what medications might be given to him,” Ko says.
Entheon’s dashboard for customers taking its tests contains links to dozens of scientific studies published in peer-reviewed journals that offer some clues to potential links, but no definitive answers. The company is also conducting research on electroencephalogram brain waves in patients undergoing psychedelic-assisted therapy to further research links between genetic variance and drug response.
Griffiths says it’s too early to know if a psychedelic treatment plan can be personalized to account for someone’s genes. “Right now within precision psychiatry, there aren’t even good genomic predictors of responses to most interventions,” he says. “I’m not aware that there are any within psychedelics, either.”
With regards to marijuana, factors other than genetics help determine someone’s response. “It’s also about what a person has eaten that day, what time of day they take the drug at, and how well hydrated they are,” says Dr. Jan Roberts, a New York-based psychotherapist who specializes in cannabis and mental health. Some foods, like mango, have a reputation for enhancing the effects of cannabis, she says.
Entheon says there is a place for direct-to-consumer tests, though the scientific understanding of how genetics relates to drug sensitivity and mental health is evolving.
Other companies are also pushing ahead despite the uncertainties. Berlin-based Atai Life Sciences NV has more than a dozen entities pursuing various drugs in the psychedelics space. Among them is PsyProtix, a joint venture that’s researching depression, genetics, and metabolomics—or the study of small molecules within cells.
New York-based startup Mind Medicine Inc., known as MindMed, is betting on precision medicine that isn’t limited to genetics. It aims to use information culled from step counters, pulse rate sensors, sleep patterns, and side effects from past medications to help psychiatric patients determine which drugs to take and at what dosage. The results could help as MindMed develops a pipeline of potential products, including treatments based on LSD, MDMA, DMT, and an ibogaine derivative: 18-MC. MindMed CEO Rob Barrow says he doesn’t believe in the hype around home-DNA tests. “Genomic testing can be confusing even for people who know what they’re doing, like physicians,” he says.
There’s a debate about whether it’s even desirable to avoid bad trips altogether. Christian Angermayer, the chairman of Atai, says that while long-term psychosis isn’t desirable, a negative experience for the duration of a psychedelic dose is actually rewarding for some people, who turn to psychedelics to cope with negative experiences like personal trauma and depression. “A bad trip is not a bad outcome,” Angermayer says. “It helps you go through your demons.”
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