Synonymous in pop culture for their recreational use and ability to induce mind-bending hallucinations, magic mushrooms and more importantly their active compound Psilocybin, have been a victim of their own press through their hallmark involvement in the 1960’s counter-culture movement. For a substance once marginalized by mainstream science their has been an explosion of interest and research conducted by elite institutions including Johns Hopkins, New York University and Monash University exploring the clinical value of these fungi in treating a variety of mental illnesses.
The West Discovers Psilocybin
Magic mushrooms are among the oldest recreational drugs that human beings have ever used, with ritualistic usage tracing back to 9000 B.C. in North African indigenous cultures, based on representations in rock paintings. The Native American cultures like the Mayas and Aztecs had symbols, statues and paintings which indicate that they consumedpsilocybin mushrooms, especially during religious rituals, as a way to communicate with deities. They often refereed to them as “ teonanácat,” or “flesh of the gods” due to their ability to induce mystical experiences which they believed to be a form of divine communion.
In 1957 Albert Hofmann isolated psilcobin from the Central American mushroom Psilocybe mexicana. This would act as a catalyst for later studies performed at Harvard University by counter-culture poster child Timothy Leary and his peers Ralph Metzer and Richard Alpert (Who later changed his name to Ram Dass).
Promising studies arose from this bout of psychedelic interest at Harvard University including the Concord Prison Experiment, which explored the efficacy of psilocybin assisted psychotherapy in reducing recidivism rates among prisoners with impressive results.
A Fear of the Unknown
Approximately 1000 clinical papers involving over 40,000 patients were published on classical psychedelics (sucha as LSD and Psilocybin) from 1950's to the mid 1960’s, however the promise of legitimate study and research was short lived when in 1968 Leary and his Harvard Psilocybin Project were fired from Harvard when the safety of their studies were brought into question.
In the summer of 1968 Psilocybin, among other psychedelics such as LSD were swept into the obscurity of a Schedule 1 drug classification (That with no medical value and strictly prohibited) by the FDA as a knee-jerk reaction to the rampant recreational use of psychedelic drugs among the nascent counter-culture.
A Rebirth of Mainstream Interest
For many decades after it’s classification in 1968 Psilocybin was obscured by legislation and association with the “hippie culture”, those scientists and doctors who sought further research into these psychedelic substances were faced with abrupt professional marginalization. Perhaps in recent years, with the backlash of the 1960’s psychedelic over-enthusiasm reaching a safe and comfortable distance we have been able to more moderately revisit the possibility that such an ancient molecule could truly hold unprecedented potential for psychiatric treatment.
Near-Death Anxiety and Palliative Care
The most recognized re-ignition of psychedelic research has come from medical heavy-weight Johns Hopkins University in Baltimore who launched their very own dedicated psychedelic research unit, since their launch in 2004 they have now published over 15 laboratory studies and 50 scientific manuscripts exploring the efficacy of psychedelic compounds for medical use. One of the most widely cited being their 2016 study which explored with wild success the efficacy of psilocybin in relieving near-death anxiety in terminally ill cancer patients.
A large portion of cancer or other palliative care patients encounter high-levels of psychological distress when faced with their imminent mortality with up to 40% of cancer patients meeting the requirements for a clinically diagnosed mood disorder including depression, anxiety and/or severe impairment to quality of life.
Currently treatment for near-death anxiety relies upon two primary classes of pharmaceutical drugs known benzodiazepines and opiates which include recognizable brand names such as Xanax, Valium, Morphine and Methodone. These pharmaceuticals are implemented as a short term treatment as protracted use often results in additional complications including dependence, withdrawal and a general decline in efficacy. Personal accounts of palliative care patients point to the ineffectiveness these drugs have on relieving the deep rooted psychological distress those facing imminent mortality encounter.
In Johns Hopkins 2016 study 51 cancer patients with terminal diagnosis were administered a single dose of psilocybin under randomized double-blind conditions with the guidance of trained psychiatrists. Over the course of the study the mood, attitude and behavior of these patients were rated by peers, staff and community observers. Moderate to high doses of psilocybin produced significant decreases of both self- and clinician-rated depression and near-death anxiety in patients by a staggering degree, with the vast majority of patients also reporting an increase in life meaning, optimism and other positive psychology attributes.
Attracting even greater attention and awe to this research has been the profound results of a follow up study conducted no less than 6 months after patients initially experienced their psilocybin treatment. Over 6 months later more than 80% of patients attested that the positive improvements to their perspective and attitude towards death and their remaining time alive had been sustained long after they first experienced them. The clinical significance of this lasting positive effect was captured by Professor of Psychiatry, Roland Griffiths, remark that the results were “unprecedented within the field of psychiatry”.
Mechanism of Action
Psilocybins mechanism of action for relieving anxiety and depression is still up for debate, however the current consensus has us believing that it is directly connected the molecules ability to temporarily switch off or quieten our Default Mode Network (DNM). The DNM is a network of areas in the brain which seem to be responsible for a select handful of activities such as daydreaming, revisiting memories or planning our future. The one common thread running throughout these thought activities is their tendency to draw us “out of the moment”.
The importance of living in the present moment has been echoed through the halls of time by transcended masters and spiritual Guru’s for eons. Is it then possible that Psilocybins ability to produce such profoundly transformative effects on the depressed or anxiety-ridden is simply through the molecules power to force individuals into the present moment? Into a state where we are no longer in fear of future nor ruminating on past, a state where fresh new perspectives may be patterned into our brains?
The Future of Psilocybin Treatment
With such optimistic research at the forefront of science the vanguard championing for Psilocybin reclassification has only grown exponentially in recent years. With organizations such as MAPS (Multidisciplinary Association for Psychedelic Studies), John Hopkins Psychedelic Research Unit and PRISM (Psychedelic Research in Science and Medicine)campaigning for reclassification and medical use many believe we may see Psilocybin ushered in as a legitimate psychiatric treatment within the next five years.
“We want to initiate the conversation now as to how to classify psilocybin to facilitate its path to the clinic and minimize logistical hurdles in the future,” says Matthew W. Johnson, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “We expect these final clearance trials to take place in the next five years or so.”