Hallucinogenic drugs like psilocybin-containing magic mushrooms are closely linked in the public imagination with hippies and pleasure-seeking. While there's nothing inherently wrong with pleasure-seeking (we'll see about hippies), growing evidence suggests that, properly used, these drugs may be just as effective for healing minds as they are at blowing them. A recently published study reports that, among other uses, psilocybin is a very effective treatment for depression.
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Positive Results, Minimal Side Effects
"In a randomized, placebo-controlled, 6-week trial in 104 adults, a 25-mg dose of psilocybin administered with psychological support was associated with a rapid and sustained antidepressant effect, measured as change in depressive symptom scores, compared with active placebo," according to the authors, led by Dr. Charles L. Raison of Wisconsin's Usona Institute, of "Single-Dose Psilocybin Treatment for Major Depressive Disorder: A Randomized Clinical Trial," published in August in the Journal of the American Medical Association. "No serious treatment-emergent adverse events occurred."
The trial, conducted at different locations between December 2019 and June 2022, included participants between ages 21 and 65 who had been diagnosed with major depressive disorder of at least 60 days' duration. Half of the participants were given a 25-mg dose of psilocybin and the other half were given niacin as a placebo, administered in identical capsules. The patients were assessed at eight days (the original end point of the study) and then at 43 days (the extended time frame).
Over the course of the study, "a single 25-mg dose of psilocybin administered with psychosocial support was associated with clinically and statistically significant reductions in depressive symptoms and improvement in measures of functional disability compared with a 100-mg dose of niacin placebo administered under an identical protocol." The researchers also found a higher rate of sustained remission from depression symptoms among those who received psilocybin, "but the difference was not statistically significant."
Adverse events potentially related to psilocybin consumption included one reported migraine, a headache, and one participant experiencing panic attack and paranoia. Nothing similar was found among the placebo group. As side effects go, that's pretty mild and comparable to those linked to commonly used antidepressant drugs. Hence the finding that the study resulted in "no serious treatment-emergent adverse events."
More Potential Benefits
By no means is this the first study to explore potential benefits from psychedelic drugs. Johns Hopkins Medicine is looking at psilocybin mushrooms for treating tobacco addiction. A University of British Columbia study of psilocybin and LSD use published in November 2021 "identified lower levels of anxiety and depression among microdosers relative to controls." "MDMA-assisted therapy is highly efficacious in individuals with severe" post-traumatic stress disorder (PTSD), according to research published in 2021 in Nature Medicine.
But while the powers-that-be have budged a little from their anti-drug mania—MDMA won designation from the Food and Drug Administration as a "breakthrough therapy" for PTSD, allowing for clinical trials—users and researchers face serious obstacles despite the drugs' promise and the right of individuals to make their own choices.
"Currently, most psychedelic compounds are illegal under federal law," notes a Journal of the American Medical Assocation editorial comment published with the psilocybin study. "They were placed on the most restrictive class of drugs, Schedule I, in the 1970s as part of the 'war on drugs,' meaning that they were considered to have high potential for abuse with no accepted medical use. However, the ever-growing global mental health crisis, coupled with the shortage of effective therapeutic strategies, has given rise to a reconsideration of the therapeutic potential of these compounds in recent years."
"The study by Raison et al provides an excellent example of the promise of this new approach using psilocybin therapy for patients with major depressive disorder," the journal editorial comment adds on the way to calling for greater study and exploration of such treatments.
But legally studying these drugs, let alone using them as a treatment for mental woes or just for fun without running some handcuff-adjacent risks, is severely hampered so long as it's subject to draconian government restrictions.
Uphill Fight for Reform
"Psilocybin is a Schedule I substance under the Controlled Substances Act, meaning that it has a high potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use under medical supervision," according to the Drug Enforcement Administration. The DEA listing for MDMA uses the same language, as does that for LSD, and for Marijuana.
None of the DEA claims, aside from the drugs' legal status, are entirely true. Acknowledging that "psychedelic drugs show initial promise as potential treatments for mood, anxiety and substance use disorders," the FDA published new draft guidance in June for clinical trials.
California is poised to follow Colorado and Oregon in legalizing (somewhat, subject to onerous regulations) psilocybin. Reps. Dan Crenshaw (R–Texas) and Alexandria Ocasio-Cortez (D–N.Y.) and Sens. Cory Booker (D–N.J.) and Sen. Rand Paul (R–Ky.) have worked in a rare example of constructive (instead of more-common destructive) cross-aisle amity to make it slightly easier to study the medical benefits of psychedelics. They haven't had much success.
"And yet, for all this agreement, it has so far proved difficult to pass any bills related to psychedelics. This is not — according to both Crenshaw's and Ocasio-Cortez's offices — because of some organized anti-psychedelics lobbying or big money lining up in opposition," The Washington Post's Ben Terris reported in July. "The psychedelics coalition is up against an even more common impediment to change: Washington's fear of something new. Some politicians can't help but tune out when it comes to drugs that have long been considered illicit in American law and culture."
Medical researchers, patients, and their advocates in government see promise from psychedelic drugs, including psilocybin, in treating stubborn mental illnesses, and many Americans enjoy their use for the insights they offer or just the pleasure they give. But drug cops can still pretend these substances have "no currently accepted medical use in treatment" and lock people up for consuming them.
It's a depressing situation. If only there was a safe treatment that offered "clinically and statistically significant reductions in depressive symptoms" we might get a bit of relief.
If you're interested, here's a how-to guide for taking magic mushrooms.