Q). What is psilocybin and why am I hearing about is so much in the news these days?
A) Psilocybin is the main psychoactive component of “magic mushrooms”, which were first mentioned in the 1500’s in reference to Mexico’s Aztec civilization and have been used ever since then by various cultures for religious, spiritual & recreational purposes.
It is beginning to be more and more evident that this chemical likely has significant medicinal value as evidence by positive results from a number of scientific studies as well as from numerous anecdotal reports. This is both a blessing and a curse.
A blessing because some of the disorders for which it looks most promising are ones that western medicine has really struggled to find adequate solutions for thus far. However, psychedelics like magic mushrooms are still illegal in Canada and many other countries for a reason. While there is little evidence to suggest that one can become addicted to this chemical, their use can still lead to unfortunate consequences such as:
- A bad “trip” (usually only at high doses although what constitutes a high dose can be difficult to tell since their potency in the wild can vary radically) may occur leaving the individual feeling paranoid and with a distorted sense of self possibly leading to risk-taking behaviours, possible injuries, social setbacks or even deat
- Flashbacks where users relive extremely traumatic events
- They can elevate blood pressure and heart rate which can be serious in those with pre-existing cardiac conditions (which are often not diagnosed until many years later when people start going for physicals in their 30’s and 40’s)
- When combined with other substances such as cannabis, amphetamines, alcohol… the risk of serious side effects is elevated substantially
- Possible side effects include: muscle weakness, dry mouth, nausea/ vomiting, exaggerated reflexes, convulsions, change in body temperature, loss of urinary control
All this being said, the evidence is fairly clear that compared to other psychedelics such as LSD or other drugs of abuse the safety profile of psilocybin is much better and it is generally well tolerated when the dose is controlled.
In a study that pooled the results of eight previous studies on 110 individuals (which is a smaller sample size than would be ideal), there was no indication that treatment with psilocybin lead to increased drug use, persistent problems with perception, prolonged psychosis or other long-term deficits in functioning. Also, there is growing scientific evidence that psilocybin which possesses serotinergic type properties (serotonin is the primary neurotransmitter/ brain chemical that most of our antidepressants such as Prozac act upon) may be beneficial in a number of different conditions. These include:
- Treatment for addiction/ dependence from a number of substances including alcohol, tobacco, cannabis, cocaine and opioids
- Anxiety disorders such as generalized anxiety disorder, adjustment disorder with anxiety or anxiety related to the diagnosis of life altering diseases
- Post traumatic stress disorder (PTSD)
- Major depressive disorder and many other depression subtypes
- Cluster headaches
- Chronic pain
It is for this reason that, a few weeks ago, about 80 health care practitioners from across Canada, practising in a variety of fields (physicians, psychologists, social workers…), petitioned Health Canada to allow them access to psilocybin after having been previously rebuffed in their attempts to use it on their patients. They fear that many of these patients are now getting their psilocybin from the black market and treating themselves, thereby greatly increasing the risks involved in this type of therapy. People with conditions such as PTSD or addiction are often desperate for help and if the traditional medical community cannot provide it, they are often more than willing to roll the dice feeling they have little to lose.
Recent studies have been particularly promising such as one conducted at John Hopkins in the U.S. on 27 patients with long-term histories of a major depressive disorder. Almost all had used traditional antidepressants at various times of their lives and the majority were currently taking one but failing to respond. These patients were administered two doses of psilocybin two weeks apart and then followed up periodically for a year. Most of the patients had a positive response (75%) fairly quickly and 58% remained in remission 12 months after the psilocybin intervention. Depression symptom scores went from an average of 22.8 to 7.7 twelve months later (for some perspective, a score over 24 is severe, 23-17 moderate depression and less than 7 indicates there is no depression).
The doctors believed that the psilocybin produces perceptual changes which alter a person’s awareness of their surroundings as well as their thoughts and feelings. Other small, but promising studies include another one at John Hopkins where 15 smokers who had attempted to quit on average six previous times were administered a dose of psilocybin as part of a 15 week smoking cessation treatment. The participants, who had been smoking an average of 19 cigarettes a day for 31 years responded incredibly well with 12 of the 15 no longer smoking at the six-month follow-up. A similar positive and sustained result was seen in patients with alcohol dependence in a study conducted at the University of New Mexico.
It is results such as these that have excited psychotherapists and have led to speculation that the FDA in the U.S. will grant approval in the next few years to psychoactive drugs such as psilocybin and MDMA (the active ingredient in the drugs Ecstasy/ Molly which itself had a study published in the prestigious New England Journal of Medicine detailing the relief it brought to patients with PTSD).
It appears that after decades of demonization, psychedelic drugs may well soon have their day in the sun as Canada and other nations desperately search for answers to our opioid and mental health epidemics. For more information about this or any other health related questions, contact your pharmacist.