A number of research labs around the world are experimenting with an interesting medication: hallucinogenic psilocybin mushrooms.
Scientists studied psychedelic drugs and their therapeutic potential back in the 1950s and 60s, but in the 1970s, restrictive federal policies put an end to most research. It's only in the last decade or so that scientific research into the possible benefits of hallucinogens has made a comeback.
"There's now research involving all sorts of hallucinogens — psilocybin, LSD, Ayahuasca, MDMA, and ketamine — and their therapeutic benefits in many different places, both in the US and abroad," says Dr. Albert Garcia-Romeu, who studies psilocybin at Johns Hopkins University School of Medicine.
In controlled trials of psilocybin, his colleagues Roland Griffiths and Matthew Johnson have found that the drug can be administered safely to humans — and that it routinely elicits spiritually profound experiences that, months and even years later, participants rate as some of the most significant experiences of their lives.
More surprisingly, the researchers have found that psilocybin can lead to permanent personality changes, making people more open to new experiences, and that when combined with talk therapy, a dose or two can even help people quit smoking at rates far higher than current treatments.
I recently spoke to Dr. Garcia-Romeu to learn a bit more about his work.
How a psilocybin trial actually works
"We usually spend a total of about eight hours — four weekly two-hour meetings over the course of a month — preparing participants before administering the drug," Garcia-Romeu says. "We talk about their lives, their worldview, and in the smoking study, their motivations for quitting. This is done by two co-therapists, usually a male and a female."
"Then we have our session, during which participants are mostly lying on a couch in a comfortable, living-room like setting, with eye shades covering their eyes, and headphones playing classical music. For most of the day we generally encourage participants to 'go inward,' and to 'trust, let go, and be open' to the experience. So we actually try to limit interaction, and ask participants to focus on their inner experience instead."
"Of course, this doesn't always go as planned. When people are just very chatty and want to talk about all that they are experiencing, we try to tell them that it's like a movie, and that they should focus on the experience itself and that we can discuss the details afterwards, rather than talking through the movie and potentially missing an important part. When there is a challenging experience, we often sit and hold hands with the participant, as well as instructing them to breathe through it, and to face any challenging content rather than avoiding it."
"Afterward, individuals will usually spend several weeks or more reflecting on and working through the content with the same session monitors who were present during the drug session."
How psilocybin may affect spirituality and treat anxiety
"In studies with healthy volunteers, our team has found that psilocybin administration in healthy people can lead to really profound, mystical experiences," Garcia-Romeu explains. "In a 2006 study, 67 percent of the participants rated their experience with psilocybin to be either the single most meaningful experience of their life or one of the top five. And then in a 2011 paper, 61 percent considered it to be the single most spiritually significant of their lives, and 83 percent put it in the top five."
"We've also found that these experiences can have long-term benefits, in terms of people's well-being, attitudes, behavior, and mood. In another study, my colleagues have found that high doses of psilocybin actually changed people's personalities — by increasing openness — which is pretty groundbreaking, since personality is generally considered to be fairly stable after age 30, and no one has previously reported a laboratory manipulation to be able to change personality, to my knowledge."
"We and other research teams have also been studying how psilocybin may help people with life-threatening illnesses — usually cancer patients — come to terms with their condition, and overcome their anxiety. UCLA researchers found that cancer patients with end-of-life anxiety showed significantly decreased anxiety and depression after psilocybin treatment. There are now similar studies going on at NYU and Johns Hopkins, and you can watch interviews with some of the participants online."
How psilocybin helped people quit smoking
"In our smoking research, which was initiated by Matt Johnson, we administered two to three doses of psilocybin as part of a broader cognitive behavioral therapy treatment for smoking cessation. In previous studies, the same therapy program without psilocybin showed success rates of about 17 percent at a six-month follow-up," says Garcia-Romeu.
"But we found that 80 percent of individuals receiving our combination treatment of psilocybin and therapy had successfully quit smoking at a six-month follow-up. This is way more than even the most successful treatments — drugs like Chantix or behavioral therapy alone usually have less than 35 percent success rates."
"The closest I've actually seen was a 71 percent success rate in people quitting smoking just after they've had a heart attack. And I think that's very telling, because it speaks to the inherent impact of these psychedelic experiences for them to be on par with something like a heart attack in terms of motivating a change in behavior."
"There are some limitations in our study, though, which bear mentioning. First, our trial had no control group, and was performed "open-label" — so we didn't have any participants who did not receive psilocybin to compare our results to, and no one was blinded to the drug treatment conditions. So in theory, people could have simply quit smoking because they believed the treatment would be effective. That's the placebo effect."
"Whether or not this is actually the case remains to be seen. We're currently beginning a randomized controlled trial with 80 subjects — half will get psilocybin, and half will get the patch, with everyone receiving the same therapy. That should address some of those methodological issues from the first study, and will also allow us to see whether there are any observable neural correlates of this treatment using fMRI."
How psilocybin might trigger these big changes
"From a neurological standpoint, we don't fully know," Garcia-Romeu says. "But there are a few different potential mechanisms. Both psilocybin and LSD activate a particular serotonin receptor, and this in turn affects other neurotransmitter systems, like glutamate and dopamine, that appear to mediate the efficacy of these drugs in treating addiction or depression, or bringing about long-term changes in personality or behavior. Our team and other researchers are looking at mechanisms of these drugs, so I suspect we'll be learning a lot more in the next decade or so."
"From a more psychological standpoint, one of the common themes that we continue to see is that people have highly salient, meaningful experiences under the influence of psychedelics that are sometimes mystical or spiritual in nature. These experiences might help them to make big changes in their lives if they are so inclined, and if they have access to a supportive therapist and environment."