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Psilocybin Could Open the Door to Legal Hallucinogens

Researchers are hoping the decriminalization vote in Denver could usher in a new era of therapeutic and recreational use

EEarlier this month, the people of Denver narrowly voted to decriminalize magic mushrooms. Initiative 301 does not technically legalize the psilocybin-based hallucinogens but “deprioritizes” them, which means police won’t arrest or prosecute anyone found with them. The result is significant not because it will free up police time — only 90 people in Denver were arrested for possession of magic mushrooms between 2016 and 2018 — but for what it says about progressive attitudes toward therapeutic and recreational use of drugs.

In 2018, activists in Oakland secured a city council sponsor to try to decriminalize a range of psychedelics, including mushrooms, LSD, peyote, and ayahuasca. They came close to placing a resolution on the ballot, and plan to try again in 2020. In Iowa, Republican Representative Jeff Shipley has introduced a series of bills to decriminalize the use of psychedelics for medical uses, such as for the treatment of war veterans scarred by PTSD. And in Canada, a team of medical doctors, registered nurses, and licensed psychotherapists have applied to the national government for permission to use psilocybin for the “end-of-life distress” that accompanies terminal illness.

We’ve been here before with cannabis, which was legalized in Colorado and Washington in 2012 after years of battling for public acceptance, and is now legal in 11 U.S. states. Advocates hope that 2019 could prove to be the bellwether year not just for psilocybin, but for all psychedelics.

“This is an extraordinary development,” says Dr. Charles Grob, professor of psychiatry at the University of California Los Angeles, who has been investigating psilocybin for more than 15 years. “Never before in this country has a Schedule 1 psychedelic been decriminalized across the board in a particular geographical area.”

WWhen I arrived in the U.K. from Canada in 2003, magic mushrooms were, in practice, legal. A ruling from the House of Lords in 1978 stated that fresh mushrooms were acceptable, though frozen or dried ones were not. The authorities consequently turned a blind eye, so mushrooms of all sorts — moist, frozen, dried, imported, ground, cooked — were widely available. Magic “liberty cap” mushrooms grew freely in public parks, and teenagers could pick bags of them every autumn. During my first summer in London, the Camden Mushroom Company had a permanent stall in the city’s punk district.

The new millennium mushroom days didn’t last. Many countries tightened laws against psilocybin in the early 2000s; the U.K. explicitly banned magic mushrooms in 2005, classifying it in the same category as heroin and crack cocaine. Though legal in Brazil and Jamaica, and partly decriminalized in countries including Mexico and Spain, magic mushrooms have been illegal in the U.S. since 1968. Until the Denver vote.

Advocates want to see psilocybin downgraded from a Schedule 1 to Schedule 2 drug, which would then allow it to be prescribed by doctors and support research into therapeutic uses. Stephen Reid, founder of the U.K.-based campaign group, The Psychedelic Society, says this follows the precedent of “medicalization” set by patient advocacy groups during the 1990s and 2000s for medical marijuana: start with legitimizing the use of the substance for people with cancer, multiple sclerosis, chronic pain, and debilitating epilepsy, then work towards legal use for pure pleasure.

“This excellent news from Denver is likely to trigger a cascade of similar ballots in cities and states across the U.S.,” says Reid. “If another substance is going to be legalized next, it will be psilocybin.”

MMushrooms that contain the chemical psilocybin grow widely across the world, on every continent but Antarctica. Humans are known to have ritualistically used the mushrooms for many thousands of years; a 7,000 year old cave painting in Algeria depicts them. It’s hard to get a precise figure on how many people around the globe still partake in the drug, but a 2013 survey of Americans from all walks of life found that 13% of people had taken a psychedelic at some point in their lives, and this month the Global Drug Survey found 14% of respondents had taken magic mushrooms in the past year.

The chemical that puts the “magic” in the mushroom, psilocybin, is one of the “classic” psychedelics that produces the characteristic giggles, euphoria, and hallucinations that make everything appear to glow with significance. And like all classic psychedelics, such as LSD or mescaline, psilocybin does not induce addiction or cravings, despite how fun it is for many people who use it.

Mushroom trips typically last four to six hours, compared to eight to 12 hour LSD trips. Like cannabis, mushrooms are wild organisms found in nature — not artificial man-made chemicals crafted in a lab. In small doses, mushrooms can be far less intense than LSD. Perhaps most importantly, psilocybin carries none of the stigma of other psychedelics.

“There’s less baggage associated with it than LSD, which is still tied to the culture wars of the 1960s,” says Grob. “It’s also gentler, less likely to cause anxiety, panic, or paranoia, and it doesn’t last as long. It’s just easier to work with.” Bad experiences do happen, including disturbing hallucinations, paranoid delusions, and fears that one might never come down, but they are typically less intense and end sooner.

There is already a substantial body of research into the therapeutic benefits of psilocybin. Grob was one of the first researchers to bring psilocybin into medical research in the early 2000s.

In a study from 2004 to 2008, Grob gave psilocybin to twelve people with terminal stage cancer. Publishing his results in the Journal of the American Medical Association, Grob reported that “psilocybin produces mood-elevating effects that persist after the acute effects of the drug.” Other studies have shown the same benefit — 80% of people with terminal illnesses given a single dose of psilocybin, combined with talking therapy, still felt less anxious and depressed six months after a single treatment.

His study built on earlier research in the 1950s, which had studied the use of LSD during psychotherapeutic sessions for several thousand late-stage cancer patients, helping them accept their diagnosis and enhance their ability to appreciate the time they had left.

A Canadian advocacy group called TheraPsil wants to enable legal provision of psilocybin to treat “end-of-life distress” and says it is a “humanitarian right.” TheraPsil has gone directly to the Canadian government, arguing that the prohibition of psilocybin contravenes the Canadian Charter of Rights and Freedoms because it “limits the liberty of medical users by foreclosing reasonable medical choices through the threat of criminal prosecution.” It has worked before: In 2015, the Canadian Supreme Court ruled the absolute prohibition of cannabis was unconstitutional for the same reason.

“Health Canada will have an insurmountable task finding experts who could overrule our experts,” says TheraPsil founder and psychotherapist Bruce Tobin, PhD. “The research on end-of-life anxiety is more robust than for any other clinical issue. Right now, we are only asking for palliative treatment for people who are going to die anyway, but we then want to move from there to include patients with HIV, depression, and more.”

Over the past ten years, researchers have studied how psilocybin could help with post-traumatic stress disorder, obsessive compulsive disorder, and addiction to alcohol, nicotine, cocaine, and even opiates. The Heffter Research Institute, a nonprofit specializing in psilocybin research, is broadening the scope, planning to study its efficacy in treating anorexia and even Alzheimer’s.

One of the most promising applications of all could be for treatment-resistant depression. As many as one third of people with clinical depression do not respond to traditional antidepressants, and of those, one in six will go on to commit suicide. It’s estimated that worldwide, 800,000 people with clinical depression take their own lives every year. With no significant treatment breakthroughs in the past decade, the FDA recently granted “breakthrough status” to startup COMPASS Pathways to accelerate its work on treating depression with psilocybin.

In 2015, Professor David Nutt of Imperial College London led the first modern clinical trial examining how psilocybin could treat depression with a small pilot study involving just twelve participants, all of whom had tried a raft of behavioral and pharmaceutical therapies without success.

Nine of the subjects experienced relief from their depressive symptoms within just one hour of taking the drug. Six months after the dosing, most subjects still felt relief from their depression — despite having only taken the drug once.

Conventional drugs, on the other hand, are designed to be taken daily for years. Antidepressants take weeks to kick in (if they work at all). Although much more work needs to be done to establish its efficacy, psychedelic therapy has been described as “ten years of conventional therapy in a day.”

Psilocybin seemed to work on the root causes of the study subjects’ depression rather than just repressing their symptoms, says Rosalind Watts, PhD, a clinical psychologist on the Imperial team. “Psilocybin helps you find a way out of your suffering rather than padding the cage.”

During prior brain imaging studies, the Imperial researchers administered psilocybin to healthy, normal subjects, and found that psilocybin increased the “functional connectivity” between brain regions. Neuroscientists believe this “state of unconstrained cognition” allows patients to make new connections in their minds, join the dots, and gain new insights into their past, their traumas, their habits, their beliefs, and their behaviors. Traditional antidepressants can only stabilize or numb — none provide illumination or rejuvenation. But taking a psychedelic can be like taking off in a plane, broadening the landscape of your mind for a short time and giving you a broader perspective on your entire life.

Nutt thinks that of all the psychedelics, psilocybin has the best chance of being accepted into mainstream medicine. The vote in Denver is one positive step, he says, but researchers will need to ensure they don’t repeat the mistakes of LSD enthusiasts in the 1960s. Exaggerated claims and a failure to exercise caution led to more than a few “acid casualties,” a violent public backlash, and the silencing of the science. The result was that psychedelics were kept out of the hands of the people who needed them most: those suffering from addiction, depression, terminal illnesses, and other serious medical conditions.

“Whatever it takes, we need to get psychedelics back into mainstream medicine,” says Nutt. “Once we get psilocybin for depression approved, then all other doors are open.”

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