‘Psilocybin service centers’ won’t be drive-through places where mechanics check the enchantment pressure of your psychedelic stash. Come 2023, they will be distribution centers for psilocybin as mandated under Oregon’s Ballot Measure 109, passed by popular vote in November of 2020. They may also be where psilocybin-assisted psychotherapy is given.
Impressed by a body of studies showing a benefit to psilocybin-assisted therapy for a range of addiction and mental health problems, an advocacy group founded by two psychotherapists put on Oregon’s November 2020 ballot a remarkable proposal. Ballot Measure 109 required the state to establish a system through which psilocybin can safely be given to adults as part of supervised, supportive mental health and substance abuse treatment. Four and a half months after the voters approved that measure as well as one decriminalizing the noncommercial, personal possession of any drug, Oregon’s Governor Kate Brown announced the names of the advisory board members who will work with the Oregon Health Authority to develop a network of psilocybin service centers. Governor Brown’s March 16, 2021, announcement put Oregon on its way to taking advantage of a once disgraced psychedelic compound that has been used therapeutically and sacramentally since before recorded history.
Even today psilocybin is popular in America, though its use, like the use of all psychedelics, is largely sub rosa. In 2013, researchers extrapolating from 2010 survey data of nearly 58,000 adults between the ages of 21 and 64 suggested that about 32 million American adults had used a psychedelic at some point in their lives. This number included roughly 17 percent of people aged 21 to 64. As reported in 2018 in the peer-reviewed journal Pharmacology and Therapeutics by researchers at Johns Hopkins University and at the University of Alabama at Birmingham School of Public Health, LSD was at that time the most popular psychedelic in America, with psilocybin and mescaline/peyote ranking behind it.
First came LSD, at least in terms of modern, controlled research for potential medicinal use. In 1938, Sandoz Pharmaceuticals chemist Albert Hofmann synthesized lysergic acid diethylamide (LSD). Hoffman had found the compound in natural form in ergot, which is a parasitic fungus that commonly grows on rye and other grains. Trying to develop legitimate pharmaceutical applications for ergot, Hofmann had expected to discover one or more stimulants. What he’d found, though, were compounds that showed some efficacy against migraines and hemorrhage. (Indeed, in the 16th century, ergot was used by midwives to stem maternal blood loss.)
Five years passed before 1943 when Hoffman accidentally ingested some of the LSD he’d synthesized. On his bike ride home from work, the drug began to take effect, and he experienced dream-like hallucinations. He took LSD many times after that and had great plans for the drug as an aid in creating receptivity to insight and change in people undergoing psychotherapy. Sandoz began marketing lab-synthesized LSD under the trade name Delysid. A catalogue distributed to psychiatrists and mental hospitals for research purposes described it as “used in analytical psychotherapy to elicit release of repressed material and to provide mental relaxation, particularly in anxiety states and obsessional neurosis. Delysid intensifies the reactions of psychotic patients …. By giving Delysid to normal subjects, model psychoses of short duration can be induced. This enables psychiatrists to study certain psychotic phenomena, and gain an insight into the world of ideas and sensations of mental patients.”
Some members of the psychiatric community heartily embraced its use. Timothy Leary and Richard Alpert (Ram Dass), conducting experiments at Harvard on the use of Delysid-assisted psychotherapy, were big fans — evangelists, even — of LSD.
Next came psilocybin. Roughly twelve years after Hofmann’s revelatory bicycle trip home from work, a banker and amateur ethno-mycologist named R. Gordon Watson spent two nights with his wife taking part in veladas, or sacred magic mushroom ceremonies. They were conducted in a rural village in Oaxaca, Mexico by a sabia (“one who knows”) named Maria Sabina. The granddaughter and great-granddaughter of shamans, she may have been the first sabia to allow white people to participate in psilocybin ceremonies.
Sabina spoke only Mazatec, the language of Oaxaca’s indigenous people. Her biographer Álvaro Estrada translated one of her psilocybin trance chants.
Because I can swim in the immense / Because I can swim in all forms / Because I am the launch woman / Because I am the sacred opposum / Because I am the Lord opposum
I am the woman Book that is beneath the water, says / I am the woman of the populous town, says / I am the shepherdess who is beneath the water, says / I am the woman who shepherds the immense, says / I am a shepherdess and I come with my shepherd, says
Because everything has its origin / And I come going from place to place from the origin….
After a thoroughly “wowed” Watson returned to the United States, he wrote an article about his experience with Sabina. Life Magazine published it in 1957, and the general public was intrigued.
In 1958 Sandoz’s Hoffman synthesized the active organic compound in psilocybin. By 1960 Sandoz was distributing the drug under the trade name Indocybin to researchers looking for a medicine to assist therapies for mental illness and addiction. Those pink pills quickly became a darling of the Harvard researchers. Conservative middle Americans were by and large not fans of the Harvard labs’ output, and held Leary especially in contempt for one-liners like “You’re only as young as the last time you changed your mind,” “Women who seek to be equal with men lack ambition,” and “If Aristotle were alive today he’d have a talk show.” Most famous was “Turn on, tune in, drop out.” Because of the average taxpayer’s antagonism towards the Harvard team and its joyful flouting of science protocols, and because of the general, LBJ-era antipathy for the entire counterculture community, recreational use of all psychedelic drugs was eventually banned — not only in the United States, but by the 1971 UN Convention on Psychotropic Substances.
With the market potential of psychotropics yanked out from under them and with the force of the law imperiling researchers who might otherwise have continued investigating medical and therapeutic uses, pharmaceutical companies pulled the drugs off the market and ended research into their potential.
After a long break, a few researchers leading very small studies looking at psilocybin-assisted therapy waded back into the breach.
In 2006 investigators at Johns Hopkins University in Baltimore and at the Council on Spirit Practices in San Francisco published in the peer-reviewed journal Psychopharmacology an article titled “Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance.” Really and truly, the title said it all. The study showed that, for thirty volunteers who were not depressed and who received the drug under supportive, supervised conditions, one 25 mg dose produced positive mood changes that were still in effect two months later.
A flurry of studies followed, documenting a significant potential for psilocybin and other psychedelics in the treatment of drug-resistant depression, major depression, alcoholism, tobacco dependence, and anxiety and depression in patients being treated for life-threatening cancer. Researchers at the NYU Grossman School of Medicine even found that, for people combatting cancer, the anti-anxiety and -depression benefits of a single dose of psilocybin could extend for five years.
In all of these studies, however, the number of patients tested was small. The results of “small n” studies like this often fall under suspicion because results can be unusual just by chance. Because of this, the need for larger studies became increasingly apparent. Meanwhile, the fact that each study showed a positive and safe effect for psilocybin was undeniably impressive.
One inexpensive and safe way to do larger studies is to re-assess a big data set gathered for other purposes. In 2015 the Journal of Psychopharmacology published the results of an investigation of the relationship between the use of classic psychedelics and the occurrence in a survey population of psychological distress and suicidal thoughts. In structuring the study, a team led by University of Alabama at Birmingham School of Public Health clinical and research psychologist Peter S. Hendricks used data collected in the National Survey on Drug Use and Health (NSDUH). About 190,000 survey participants had answered questions asking whether, at some point in their lives, they had used drugs recreationally. They’d also specified what type of drug they’d used, and they’d answered questions about past-year psychological distress and suicidal thoughts. The researchers found that lifetime use of classic psychedelics was associated with significantly reduced odds of suicidal thinking and planning. Lifetime use of other drugs like cocaine, amphetamines, and heroin, however, was associated with increased odds of such distress. (The term “classic psychedelics” generally refers to psychedelics that are grown and therefore have a long history. They can include, for example, LSD, mescaline/peyote, psilocybin, and ayahuasca.)
Then, in 2017, Hendricks was part of a team investigating relationships between drug use and criminal behavior. This study, too, relied on a large set of NSDUH data — lifetime drug use pooled from survey participants during the three-year period 2012 – 2014. The research team found that the lifetime use of psychedelics, and specifically of psylocibin, was associated with reduced odds of criminal behavior, where the lifetime use of other drugs was associated with increased odds.
Hendricks more recently collaborated on population-based studies examining the effects of classic psychedelics on overall health. He did this work with researchers at Oxford University and the Imperial College London Birmingham. Their papers were published online in March of 2021 in the Journal of Pharmacology. For the first study, data were pooled from the responses of 171,766 people who had taken the NSDUH survey in the years 2015-2018. Respondents who had taken a classic psychedelic at least once reported better overall health and less obesity than respondents who’d used non-psychedelic drugs. They also reported having had fewer cancers or heart conditions in the previous twelve months. The second study showed significantly lower odds of developing hypertension in the previous year.
And the Beat Goes On
Magic mushrooms are non-addictive. Health and mental health benefits both seem well demonstrated. By tradition, a solid step towards drug approval might be to synthesize a standard formulation and do double-blind studies to assess both safety and efficacy.
Therein lies a problem, perhaps.
In double-blind studies, one group gets an inactive placebo, and neither the medical personnel nor the patients know which patients got placebo and which patients got the active drug. Psilocybin, though is heavily psychoactive. Wouldn’t a patient know if he or she had gotten a Big Nothing Pill?
And, that question aside, there is one about cost-effectiveness. Psilocybin has a half-life of 1-3 hours; a “trip” may last 6 hours, or even longer. Is preparing a patient for a session, having a trained professional sit with a patient for the whole session, and doing follow-up a cost-effective way to treat the mental health problems that psilocybin seems to address?
Hendricks thinks it might be. In an email exchange, he wrote, “Looking ahead, if the safety and efficacy of psychedelics are confirmed in larger trials, there is of course a potential concern for real-world scalability in the expense of a guided psychedelic session, which could last between 4-6 hours in the case of psilocybin or 10-12 hours for LSD. There may, however, be a significant cost-benefit advantage. Consider, for example, tobacco dependence treatment. With the best contemporary interventions available, about 30 of the 100 people we treat will stop smoking. If psychedelics can significantly increase these abstinence rates, thousands of lives and billions of dollars could be saved. Alcohol misuse is another example. It’s extraordinarily costly to society — strongly linked to interpersonal violence, liver and heart disease, cancer, motor vehicle accidents, and so on. If we can help reduce alcohol misuse with psychedelic-assisted psychotherapy, the alleviation of suffering would be enormous.”
Hendricks likes to draw a similarity between the life-changing realizations that people can have on supportively supervised psychedelic trips and the makeover that Charles Dickens’ character Ebenezer Scrooge experienced in A Christmas Carol when visited by the Ghosts of Christmas Past, Present, and To Come. “Clinicians are in search of something that can help make a difference. Quantum change —sudden, dramatic, and enduring change — just may be the holy grail. I’m fond of the Scrooge analogy because it captures this notion of quantum change well. And quantum change need not be limited to addiction. It could also apply to treatment-resistant depression, PTSD, end-of-life distress, and other conditions. The hypothesis is that psychedelics could be transformative under the proper conditions.”
Meanwhile, in 2020 a study by South African researchers was published in the peer-reviewed journal Nature. It focused on general health — not mental health — benefits for psilocybin use, and found immune-modulating and anti-inflammatory effects associated with drug use.
The corporate world seems to be listening closely to the results of research like this. If psilocybin passes any FDA-mandated series of carefully constructed efficacy and safety tests there may be money to be made.
Just this month:
- According to Canadian news publisher Baystreet.ca, NeonMind Biosciences, which purveys a line of mushroom-coffee blends, is developing two psilocybin-based drug candidates for controlling the compulsive eating habits that can underlie obesity.
- NBC Los Angeles reports that The Pacific Neuroscience Institute, part of St. John’s Medical Center in Santa Monica, California, is testing the use of a nature video to prime the mystical experience aspect of psilocybin-assisted treatment for alcohol addiction.
- Having acquired Psilocin Pharma Corp. in February of 2020, Revive Therapeutics studied the efficacy of psilocybin in the treatment of traumatic brain injury in rodents. The study was conducted at Taiwan’s National Research Health Institute. On March 19 the company announced positive results.
Meanwhile, many people continue to hold the memory of Sandoz Pharmaceuticals chemist Albert Hofmann dear. April 19, 1943, was the day he accidentally ingested LSD and enjoyed an outstanding bike ride home from work. In gratitude for his explorations and synthesizing of LSD and psilocybin, Bicycle Day is celebrated annually on April 19 by psychedelic aficionados around the world.
April is here. Bikes out?