Two new studies suggest the psychedelic drug psilocybin, a.k.a. magic mushrooms, can provide dramatic and long-lasting relief from depression and anxiety in cancer patients, paving the way for a potential revolution in psychiatry.
Of course, that will only happen if legal and cultural barriers that have long barred medical use of these drugs can be breached. To succeed, proponents will have to walk a fine line between raising hope and creating unrealistic hype, a balancing act that gets all the more precarious when Donald Trump takes office in January.
The data are increasingly impressive, even if the new studies are small: two independent teams at Johns Hopkins and at New York University considered a total of 80 patients with anxiety or depression associated with life-threatening cancer.
Following a single dose of psilocybin, 60 to 80 percent had life-altering reductions in symptoms, which led to improved quality of life for six months or more. In the Hopkins study, which included the majority of the patients, 60 percent had "complete remission," according to lead author Roland Griffiths, professor of psychiatry and neuroscience at Hopkins Medical School.
The studies were double-blind, with NYU participants getting either a placebo or the real drug in one session and the substance they didn't get first in another session weeks later. In the Hopkins trial, a similar cross-over design was used, but instead of placebo, patients got a psilocybin dose too low to be effective. In both studies, everyone ultimately got one therapeutic-level dose.
The data was published Thursday in the Journal of Psychopharmacology, which deemed the results so important that an entire issue was devoted to the two studies, along with supportive commentary from mental health leaders. Those voices include two past presidents of the American Psychiatric Association and the former deputy "drug czar" under George H.W. Bush, Herb Kleber.
There have been similar findings of positive emotional growth after shroom use in small, recent trials in healthy people—and there are also now at least a half-dozen promising modern trials of psilocybin for conditions ranging from smoking cessation to depression.
Before panic over recreational use of psychedelics led to prohibition and halted almost all related research in the 1970s, over 1,000 studies including 40,000 research participants had been published, according to the lead author of the NYU study, Stephen Ross. He serves as the director of addiction treatment at the school's School of Medicine.
At a dial-in press conference announcing the results, Dinah Bazer, a Brooklyn patient who'd had ovarian cancer, said unequivocally, "This drug saved my life and changed my life." Though her cancer was successfully treated with surgery, she remained anxious about recurrence, describing herself as "consumed with fear, which was running my life and ruining my life."
During her trip, Bazer says she visualised her fear as a mass in her body and screamed at it to "Get the fuck out," and then felt it vanish. Afterwards, she says, she just felt "bathed in God's love... for hours." The sense of connection enabled her to re-engage with life— making new friendships and renewing old ones. And her fear never returned, Bazer says.
Both studies found that having a mystical experience—like Bazer's feeling of communion— was highly associated with a positive therapeutic response. "In science, there's a bit of an aversion to even using the term mystical experience," says Griffiths. "But it is definable."
One key factor in having such an experience, Griffiths adds, is a sense that the world is benevolent and that all people are interconnected. "That's accompanied by a deep sense of reverence or respect or even sacredness, something that is humbling," he says. Another important element is a "component of authority: it's more real and more true than everyday waking consciousness and this stamps this experience in as one that informs people's lives going forward."
But you don't need to have a full-on mystical experience to benefit, according to Griffiths. Wesley Weidemann, 74, an agricultural economist, had become depressed after prostate cancer treatment left him with severe side effects. He describes his psilocybin experience as marked by enhanced perception and a sense of "hyper-awareness," which made him feel as though he could hear each instrument in a symphony he listened to, both by itself, and as part of the whole orchestra. And when he was given a rose, he describes it as being unlike any he'd ever seen.
"Just the artful shape of it, the blending of colour, the magnificence of the fragrance," he says. "I was seeing and experiencing that rose in way I never experienced a rose before."
Weidemann had stopped taking antidepressants in order to participate in the trial—and has not returned to them since. "It was a very rich sensory experience and very memorable, but I didn't come to any conclusions about my place in universe or god or anything like that," he says.
Although some participants did have bad trips, these experiences of panic, distress and despair tended to be short-lived and some even resulted in the most meaningful sense of change later, according to Griffiths. Researchers attribute the general lack of harm mainly to the fact that participants were well-screened in advance and prepared psychologically with as many as eight hours of counselling and meetings before taking the drug. While tripping, at least in the Hopkins study, they were in a familiar room, guided by soothing music and supportive counsellors. And afterwards, they met again to process what had happened.
Check out Hamilton's visit to a clandestine shroom lab on VICELAND.
The research raises fascinating questions. For one, is it the sense of meaning, purpose and spiritual renewal that causes therapeutic change—or is this just a side effect of how the drug acts within the brain? And could those effects occur in a drug that doesn't make you trip at all, but does affect the same receptors?
Second, why is American drug policy so out of line with the potential benefits and low risks of these medicines? Classic hallucinogens like psilocybin and LSD are not linked with addiction. In fact, their action on one specific serotonin receptor has been hypothesised to account both for why they aren't addictive and why they may actually be useful in fighting addiction to other drugs.
Moreover, a large population study now suggests that even recreational users do not have higher risks of lasting psychiatric problems. That being said, psychedelics can certainly cause significant distress if used inappropriately, particularly to those who have serious mental illness.
Psychiatrist Allen Frances, who chaired the task force that produced the fourth revision of Diagnostic and Statistical Manual (DSM-IV), urges caution, not blind optimism, for the moment.
"The benefits of new treatments are always exaggerated at the start," he says. "Psilocybin may be very useful in helping some cancer patients deal with their psychological and spiritual challenges; it may be very harmful to others... Widespread premature introduction into general clinical practice would be unwise."
That is certainly true. It's also true that, as psychiatrist and former American Psychiatric Association President Jeffrey Lieberman and his co-author Daniel Shalev put it in one commentary accompanying the research, "The degree of restriction for illegal drugs does not correlate with their risk of harm, and there is no formalised process for reviewing these determinations at the national or international level."
That must change. It is simply insane that drugs that may treat major psychiatric disorders in a single dose can't be easily tested and approved if shown to be effective—all because America can't seem to get over a lingering hatred for hippies.
And our next president represents a new wild card in this ongoing national saga.
"Historically, Republicans have been better at funding research and development and Democrats have been better at funding services," says Lieberman, the former APA president. "But with Trump all bets are off. I hope he will see the importance of funding biomedical research, and he did have a brother who suffered from alcoholism."
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