Magic mushrooms, once associated mostly with Phish concerts, may lead to better end-of-life care for cancer patients. One dose of the active ingredient, psilocybin, can help terminal cancer patients experience less depression and anxiety even six months later. Two studies from New York University and Johns Hopkins University confirm a recent wave of research suggesting that hallucinogenic drugs are an important mental health tool.
Cancer patients who took pure psilocybin found it easier to cope with their illness, according to two studies published today in the Journal of Psychopharmacology. The researchers hope to conduct a large trial that might pave the way to US Food and Drug Administration approval for treating the terminally ill with the hallucinogens. (Both studies were funded by the Heffter Research Institute, a nonprofit organization that supports research into hallucinogenic drugs.)
Dinah Bazer participated in the NYU study after being diagnosed with ovarian cancer. “I was totally consumed with anxiety for two years,” she says. “It was running my life and ruining my life.” The experience of taking psilocybin was incredibly powerful in helping her feel better, she says. She visualized her fear as a physical mass in her body: “I became volcanically angry and screamed ‘get the fuck out’ and it was gone.”
Many people said this was one of the most meaningful experiences of their lives
Drugs like psilocybin, LSD, and MDMA were once used in therapy — famously, even Cary Grant was treated with LSD. But since the 1970s, these drugs have been designated dangerous and tightly controlled substances, which means there hasn’t been much research on them. These drugs come with cultural baggage, too, and are often associated with the more radical political beliefs of the ‘60s. But in recent years, as the War on Drugs subsides, the government has cautiously become more open to using these substances in research. This has caused renewed interest in the clinical potential of these drugs, and the FDA just approved a large-scale study of ecstasy to treat PTSD.
“I’m struck by the difficulty of the research that was accomplished and barriers that persist in researching controlled substances,” says Daniel Shalev, a resident psychiatrist at Columbia University Medical Center who was not involved in the studies. “There is a scientific necessity of further research for other controlled substances, including MDMA and cannabis, which are very therapeutic in specific controlled settings.”
In the NYU study, researchers assigned 29 patients to receive either a small dose of psilocybin or a placebo that seemed to create a hallucinogenic experience. Both groups received psychotherapy during the sessions, which were about eight hours. These patients had both advanced cancer and what is called “existential distress,” essentially anxiety and depression related to their fear of dying. Existential distress isn’t just psychologically uncomfortable, says study co-author Stephen Ross, a professor of psychiatry at NYU. People with a lot of existential distress are less likely to survive serious illness. Halfway through the trial, the participants taking psilocybin started taking the placebo and vice versa. The trial was double-blind, which means that neither the patients nor the doctors knew who was taking what. Results from double-blind, controlled, and randomized studies like this one are considered very strong.
Some results were immediate. About 80 percent of the patients were less anxious and depressed by the next day, according to Ross. The participants also reported feeling more spiritually fulfilled and fearing their deaths less. There were still signs of improvement more than six months after the dose.
Doctors have long struggled with managing existential distress
The work from Johns Hopkins showed similar results. This time, there were 51 participants with cancer. They had two sessions five weeks apart. Participants met with clinicians in a room that looked like a living room. They laid down on a couch, used an eye mask, listened to music, and were encouraged to think about their inner experience. In one session, they had a normal dose of psilocybin, and during the other they had a control dose that was too low to have any effect. Again, the patients reported feeling less afraid and more optimistic. Eighty percent of the participants were still feeling benefits after six months, and over half reported the experience as one of the top five most meaningful in their lives, according to study co-author Roland Griffiths, a Johns Hopkins psychiatry professor.
These studies have “extremely exciting” implications for end-of-life care, says Craig Blindeman, director of the Adult Palliative Medicine Service at Columbia University Medical Center. (He wasn’t involved in the studies.) Doctors have struggled with managing existential distress, he says, especially because psychotherapy has had mixed results and it can be hard to get treatment due to limitations in mental health coverage. Studies like these could result in psilocybin becoming more widely available, and that could make a big difference for people who are suffering.