The US medical community is slowly embracing marijuana.
Will magic mushrooms be next?
Two studies published Thursday in the Journal of Psychopharmacology could open a path to transforming this taboo drug into a routine psychiatric treatment. The studies — one conducted at Johns Hopkins University and the other at New York University — found that a single dose of psilocybin, the psychoactive ingredient found in hallucinogenic mushrooms, can produce immediate, lasting, and positive effects for cancer patients with anxiety and depression.
Six months after a high-dose psilocybin session overseen by researchers and mental health professionals, about 80 percent of the participants in the Johns Hopkins group reported significant decreases in depression and anxiety. And in the NYU group, between 60 percent and 80 percent of participants reported similar results.
The two trials, combined, included roughly 80 participants.
“These were dramatic clinical changes,” said Dr. Stephen Ross, who led the NYU study and directs the substance abuse services program at NYU Langone Medical Center.
Normally, Ross said, these patients would be treated with medications like Prozac or Celexa, which belongs in a class of medications known as a selective serotonin reuptake inhibitors, or SSRIs. But he said that for cancer patients, such medications don’t work better than placebo, which both work around 40 percent of the time.
These medications also take longer to work, he said, and sometimes come with significant side effects.
Ross unveiled the results with a heavy measure of caution. “If someone goes out and does this themselves, they could have enormous anxiety and paranoia, and can feel much worse,” Ross said. “Though I’m sympathetic, I’d strongly recommend people not do that.”
Even research participants who raved about the experience talked about how their psilocybin treatment could have turned tragic, if not for the fact that they were treated in a tightly controlled environment.
Kerry Pappas, who contracted lung cancer in 2013, said she suffered from depression and anxiety around her diagnosis. She heard about the Johns Hopkins study through her son, and traveled from Houston in December of that year.
In the first session, she received the high-dose capsule of psilocybin. When it became clear the drug was taking effect, she put on eyeshades and headphones that played a mix of classical and new age music.
Very quickly, she said, she was overcome with a feeling of “total, absolute, undeniable despair in the worst way. It almost makes me cry thinking about it.”
The scene in her mind, Pappas said, was of “massive boulders of very bland, earthy colors. Huge, massive rocks with very muscular men with pickaxes, just chipping away at these boulders. In my mind’s eye, it was, like, ‘This is what it really is: This is life. There’s nothing to it. It has no meaning.’ It went on and on and on.”
“I often thought after that experience that if I was at a party, let’s say, or in a group of people and said, ‘Oh, let’s do this,’ I cannot tell you I wouldn’t have jumped out of a window because of the despair. So it’s very important to me that it be done the way it was done.”
Pappas paused the session and told the facilitators that she was having second thoughts. The facilitator urged her to lie back down and helped Pappas relax. It wasn’t until the final hour of her session that the experience shifted for the better.
“They’re chipping away, chipping away. And there’s — it was a jewel. A single jewel sparkling amongst all this despair,” said Pappas, 58. “It was almost like an ancient scene. In my mind I’m like, ‘Look at this beautiful stone coming forward. And I realized that’s what I represent and loud and clear like you wouldn’t believe were the words, ‘Right here, right now. Right here, right now.’ It was totally audible. It was a voice. I don’t know whose voice. It was a man’s voice.
“And it was like, ‘You need to listen to this. Identify with the beautiful stone.’ It was joyful,” she said. “And it has changed my life.”
Since her session, Pappas said her cancer has reappeared twice, in her brain, but she remains mostly unfazed. “‘Right here, right now’ is integrated in my being. It’s not just words. And just my joy to live is new, for me.
“I hold no delusions that this isn’t going to get me in the end, because statistically it will. But I can live with that,” she said. “Fully. It is amazing.”
This was a so-called Phase 2 study, meant to demonstrate a treatment’s effectiveness and further gauge its safety, and it followed a pilot study based mostly at the University of California, Los Angeles, showing similar effects on 12 patients.
Ross, the NYU researcher, and Roland R. Griffiths, a professor of psychiatry and neurosciences at the Johns Hopkins medical school who led the study there, each said they would pursue a Phase 3 study enrolling a larger group of patients at multiple sites nationally. That effort would take between $20 million and $40 million, and with government funding for a psychedelic research study unlikely, at least in the short term, that money would have to come from foundations and private donors.
Funding for the Phase 2 studies was led by the Heffter Research Institute and the RiverStyx Foundation, both of which are nonprofit organizations. Such studies have been largely dormant since the Controlled Substances Act of 1970, which effectively ended most medical research on psychedelics.
That, of course, came amid the fallout from widespread abuse of LSD, which had its roots partly in medical experiments that were led by the Harvard psychologist Timothy Leary.
The NYU and Johns Hopkins research teams roughly mirrored each other’s research designs. Volunteers were screened for disqualifying factors like active suicidal ideation or psychosis, for instance, and were split into two groups — one that would receive a high dose of synthesized psilocybin and a control group.
At NYU, the control group received a dose of niacin, which can produce a psychological effect, and the Johns Hopkins patients received a small dose of psilocybin. The purpose: give volunteers a sense that they may have received the high dose of psilocybin, to guard against biasing their results.
Volunteers were accompanied during all sessions by trained facilitators, and their vital signs were checked at set intervals during the sessions. Afterward, both groups were debriefed, with the NYU study volunteers undergoing something more closely resembling psychotherapy.
For the second session, volunteers in the control group received high psilocybin doses, while the group that had previously done so was given control group doses.
Researchers recorded a handful of deaths, all but one related to cancer. In the Johns Hopkins study, one participant who previously had suicidal thoughts was dropped from the study after his first session, in which he received the low dose of psilocybin.
The participant said he was bored, according to Griffiths, and opted not to submit to researchers’ questions after his session, despite being told that it would disqualify him from a second psilocybin session. Roughly two weeks later, the man committed suicide — an event which, Griffiths said, was reported to the FDA and the Johns Hopkins review board. He said they agreed with the conclusion that the man’s suicide was not related to the research procedures or to psilocybin.
The studies were published with mostly supportive comments from dozens of psychiatric specialists, including two past presidents of the American Psychiatric Association — Dr. Jeffrey Lieberman of Columbia University and Dr. Paul Summergrad of Tufts University — and a former president of the European College of Neuropsychopharmacology, Guy M. Goodwin.
Goodwin’s critique was at times pointed. He noted that the researchers tried to measure the extent to which participants reached a “mystical” experience. “Perhaps a scale really can measure a relevant kind of experience, but it raises the caution that the investigation of hallucinogens as treatments may be endangered by grandiose descriptions of their effects and unquestioning acceptance of their value,” he wrote.
“Timothy Leary was a research psychologist before he decided the whole world should, ‘Turn on, tune in, and drop out,’” Goodwin noted. “It is best if some steps are not retraced.”