It was the sort of headline that I initially assumed was a prank article: “Active ingredient in magic mushrooms reduces anxiety, depression in cancer patients.” Even more so when I couldn’t find the study it was referring to over on PubMed. But this is a real study, and a real finding: the researchers presented at a conference sponsored by the American College of Neuropsychopharmacology, which is a legit organization, and the study is under review at a journal.
The lead researcher, Roland Griffiths, is a professor of Psychiatry and Neuroscience working at Johns Hopkins. He apparently divides his research energy between the most socially acceptable highly addictive drug in the contemporary U.S. (which is to say, caffeine, and he led one of the studies that proved it really is addictive) and hallucinogens, especially psilocybin, the active ingredient in magic mushrooms.
The new study investigated whether a dose of psilocybin “sufficiently high to induce changes in perception and mystical-type experiences” would help relieve anxiety and depression in cancer patients. They found that it did, and that the effect was sufficiently strong that the effect on mood persisted six months later.
The media contact for the study was David Nichols, one of the organizers of the symposium at ACNP, so I e-mailed him with my questions, like how big was this study, and was it double-blind, and if so, how on earth do you do a placebo for a hallucinogen?1
The Johns Hopkins study was a randomized double-blind placebo cross-over design, which means that all the participants got both the placebo (a very low dose of psilocybin) and the treatment (a high dose of psilocybin). There were 51 people who started the study, and 41 who finished it. One of my questions was whether they screened for prior use of hallucinogens. There were no recent users, though some participants had used them decades ago. Nichols added, “Roland is a master at designing double blind studies. They were told that they might receive a variety of different drugs or dosages.”
Depression and anxiety were assessed with a number of standard questionnaire-type tools like the Beck Depression Inventory.
I was also wondering how they supervised the patients while they were under the effects of psilocybin. Nichols was able to answer that question: “Patients took psilocybin in a room that more resembled a comfortable room in someone’s home than in a medical school; it had a sofa, paintings, flowers, etc. Patients received a number of hours of therapy prior to ingestion of psilocybin, and during the session wore eye shades and listened to a program of music so that the entire experience was internalized. There was no significant intervention by the co-therapists during the effect of the psilocybin. Sessions essentially lasted one day.”
This was, in fact, a Phase 2 study on psilocybin in cancer patients. A previous study, done at UCLA with a paper published in 2011, had only about a dozen patients but saw similar results. The UCLA study used a niacin placebo rather than a low dose of psilocybin, which made it easier for patients to figure out that they’d been given a placebo; there were also only about a dozen participants, and the dose of psilocybin was lower than the dose used in the newer study. The UCLA researchers noted that “transcendent states of consciousness are usually associated with higher doses of hallucinogens” but added that they did see some marked effects: “Common themes reported by subjects included examining how their illness had impacted their lives, relationships with family and close friends, and sense of ontological security. In addition, subjects reported powerful empathic cathexis to close friends and family members and examined how they wished to address their limited life expectancy. In monthly follow-up discussions, subjects reflected on insights and new perspectives gained during their psilocybin treatment.” The UCLA study also specifically recruited patients who were dying; nearly all had died by the time the study saw publication.
One of my other questions was how they got permission to do these studies. Psilocybin is a Schedule 1 controlled substance, which means that it’s considered to have no medical purpose and present a high risk for abuse. The whole categorization of drugs into Schedule 1 vs. Schedule 2 is utterly bizarre, frankly. Schedule 2 drugs are supposed to be super dangerous but with medical value, and Schedule 2 includes cocaine, Angel Dust, methamphetamines, and a long list of opiates. Schedule 1 includes heroin, LSD, psilocybin, ecstasy, and pot. POT. (WTF, guys. WTF.) I’m actually in favor of full legalization of pot — I mean, for God’s sake it safer than alcohol and tobacco, and they’re legal — but at the very least, it doesn’t belong on Schedule 1.
But the more I read about studies like this one, the more I wonder if anything belongs on Schedule 1. “No known medical purpose” in a whole lot of cases turns out to mean “because we’re going to stop all research on this so you’ll never find out what it’s good for.”
[Post image via Shutterstock]
Can people talk themselves into full-on hallucinations? I have never experimented with hallucinogens but I once got hallucinations as an unintentional side-effect. I was in labor; they gave me Ambien; the next few hours featured crocodiles, Technicolor plants, and giant tubular noodles descending from the ceiling. I was entirely aware that I was hallucinating but unable to tell what real objects in my hospital room I might need to step over or navigate around. I now list Ambien as a drug allergy. Sadly, I didn’t have any mystical-type experiences, unless you count giving birth to my second daughter. ↩