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Taking Mushrooms Seriously

On a Friday morning in June, a crowd of mostly Boomer-aged men in tie-dye and Hawaiian shirts milled about the ballroom of the UCLA student union, where colorful, swirling posters hung from the walls. It was the first-ever Los Angeles Psychedelic Symposium, a two-day conference featuring presentations by prominent hallucinogen researchers, interspersed with New Age activities like a breathwork panel and an afternoon sound bath.

While the symposium was held in the name of modern science, its vibe recalled the freewheeling ’60s: Everything was running about an hour behind schedule. Neither of the two people I had arranged to meet showed up or responded to my many text messages. Just past a booth advertising an ayahuasca retreat, I overheard a kaleidoscopic art vendor telling a customer to go off her antidepressants. And someone was playing a sitar.

Even so, if emerging research is any indication, psychedelics including psilocybin, LSD and MDMA (Ecstasy) are due for a PR overhaul. The recent resurgence of these drugs in scientific research has yielded promising results. Psilocybin, the psychoactive compound in so-called magic mushrooms, has been shown to relieve depression and anxiety in terminal cancer patients, help smokers kick their habit and even treat addiction. At the American Psychological Association’s annual conference in August, researchers presented work suggesting that MDMA, psilocybin and ayahuasca, coupled with psychotherapy, could effectively treat PTSD, depression and anxiety.

“These drugs have the potential to make a real impact on people with substance-use disorders and mood disorders,” said Frederick Barrett, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University and a leading hallucinogen researcher. “There are not many successful treatments for either of these things. This could revolutionize psychiatry.”

Barrett and his colleagues have been leading studies at Johns Hopkins for more than a decade, and similar hallucinogen research has started up at other universities around the world.

Many who’ve studied psilocybin tout its potential as an apparent wonder drug — one that can eliminate pain, add meaning to a person’s life and ease anxiety around mortality. Two studies published in the Journal of Psychopharmacology in December 2016 showed that a single dose of psilocybin, combined with counseling, significantly alleviated depression and anxiety in people with an advanced cancer diagnosis.

“It may be that psilocybin, LSD and other psychedelics work best for people who are most open to the experience.”

Researchers at Imperial College in London found that some subjects with treatment-resistant depression described the effect of psilocybin as a “reboot,” alleviating their symptoms and improving their moods overall. The prospect of a drug with a lasting impact after just one or two doses has potential to dramatically alter the way doctors treat conditions like depression. “It really breaks the medical model of pharmacotherapy,” Barrett said.  

The current treatment model for many mood disorders involves taking drugs indefinitely. Once the pills stop, the disorder returns. Potentially, with psilocybin, Barrett explained, “you take the drug one or two times, and with the proper setting and proper care and aftercare, this will basically change the course of the disease. That’s exactly the impetus to study these drugs further.”

Psilocybin research involving healthy subjects, Barrett pointed out, shows the lasting impact of the drugs as well. “I still find it fascinating that people can say, ‘It’s one of the top meaningful experiences or the most meaningful experience of my life,’” in the same category as the birth of a child or other milestone.

Up to this point, many of these studies have only been performed on small groups of people. The task for researchers now is to replicate the results of previous studies on a larger scale. “We have to begin to test that these drugs will work on a broader range of people,” said Barrett. “We need to know if it’s just a certain segment of the population for whom this will work. It may be that psilocybin, LSD and [other] psychedelics work best for people who are most open to the experience.”

A lot of psychedelic studies follow a similar protocol: Participants lie down on a couch with eye masks on, tucked under blankets and listening to music through headphones. The setup is “almost like a cocoon,” Barrett says. Participants take the drug in capsule form with water. A guide, often a licensed therapist, monitors participants for their whole therapeutic trip, which can last six to eight hours.

Some current psilocybin research is focused on what Barrett calls “nerdy” questions about how the drug works on a molecular level, which brain receptors it binds to and how it affects brain chemistry on a long-term basis. (Many published psilocybin studies look at the acute, or short-term, effects of the drug.)

“It’s still preliminary because the final data are not published yet,” he said. “But psilocybin seems to be affecting brain regions involved in the cognitive control of emotion, so that we don’t have to exert as much mental effort to regulate negative emotion.”

“I’m almost right-wing about high doses. You need a guide and people who know what they’re doing, or you can get in trouble.”

Scientists studied psychedelics extensively in the 1950s and ‘60s, until the Controlled Substances Act of 1970 classified the drugs as illegal. Psilocybin, LSD and MDMA all remain Schedule I drugs today, in the same category as cannabis and heroin. Beliefs about the drugs, like their tendency to “fry your brain” or that LSD gets trapped in your spinal fluid, simply aren’t true, says Barrett. But they are persistent.

Activist groups in three states — California, Colorado and Oregon — have tried to make legalization of psychedelics a ballot initiative, but haven’t yet succeeded. Barrett doesn’t think hallucinogens should or will follow that same path to legalization, even for medical use, as marijuana has in many states.

“Hallucinogens are far different from cannabis,” he said. “The acute drug effects can be much stronger and lead to much riskier behaviors if you’re not in a safe environment. That’s not to say that they can’t be safely used in controlled situations — quite the opposite. Under the right circumstances, they can be safely administered, but it might be irresponsible to take them in the same direction cannabis has gone.”

Psychologist James Fadiman, who has studied and experimented with psychedelics for decades, is looking at the effects of microdosing. The term has become something of a buzzword; it means taking extremely small amounts of a hallucinogen — 5 to 10 micrograms, about one-twentieth to one-tenth the size of a recreational dose. He calls his microdosing endeavors “search” instead of “research.” Search, as Fadiman describes it, is less formal and more geared towards discovery.

On his website, Fadiman enlists people who microdose to keep records of their experiences and submit data, and he says thousands have participated. While this crowdsourcing project is far from a controlled study, Fadiman sees it as a way to map out new research territory.

“You discover things you wouldn’t discover otherwise,” he said. “Nobody in the world would say, ‘Take a psychedelic if you’re having a bad period.’ But for a number of women in our exploration with difficult periods, it turns it around. It’s amazing.”

In his search, Fadiman is less concerned with accepted benchmarks like statistical significance. He looks for trends, like psychedelics soothing severe period pain, and passes them along to other researchers, so they can test his observations in formal studies. For Fadiman, having witnessed the criminalization of the drugs after decades of working with them, current university research represents an exciting shift. “Let’s just say I know the way Moses felt when, after 40 years in the desert, they said, ‘Oh look, you can settle here.’”

Like Barrett, he emphasizes the importance of exercising caution when it comes to consuming larger doses. “I’m almost right-wing about high doses,” Fadiman told me. “You need a guide and people who know what they’re doing, or you can get in trouble. But with microdoses, for instance, either you or I could have taken a microdose this morning and we’re both perfectly effective at our jobs.”

“There are certainly people who think that we’re nuts and this shouldn’t be happening,” said Barrett, “but I think there are an equal if not far greater number of people who are willing to look at data and ask, ‘Could this be an effective therapy?’ And that’s where we are — trying to answer that question.”’

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