A priest, a minister and a rabbi walk into Johns Hopkins Bayview Medical Center to ingest psilocybin, the active ingredient in hallucinogenic mushrooms. Although this probably sounds like the beginning of a great joke, new advancements in the field of psychedelic medicine are no laughing matter.
After nearly 50 years of prohibition, academic studies and clinical trials have recently begun to examine illegal and psychedelic drugs as treatment tools for a variety of physiological and psychological conditions. Of these, marijuana has been at the forefront, based on growing evidence of its beneficial applications as a treatment for diverse pathologies, including glaucoma, seizures and chronic pain. This has led to an increased acceptance of the plant in the medical pharmacopeia, and indeed, its legalization for medical use has increased from four to 25 states since 2000. Similarly, ketamine, a dissociative anesthetic conventionally used in veterinary medicine, has shown remarkable efficacy in recent trials for treating depression. The psychoactive compound MDMA, or Ecstasy, is being utilized in conjunction with psychotherapy to treat patients with post-traumatic stress disorder, with remarkable results. The success of this combination has been so dramatic that the Food and Drug Administration recently fast-tracked the MDMA-assisted psychotherapy phase III clinical trials that are already underway in hopes of determining an acceptable medical use of the drug by 2021.
This recent resurgence in psychedelic studies is exciting but not necessarily surprising for two researchers at Johns Hopkins Bayview. Roland Griffiths and Matthew Johnson have been examining the powerful effects of psilocybin in a variety of contexts for over a decade, and both are optimistic about its future applications as an accepted pharmaceutical. In collaboration with a small group of researchers from several universities around the world, Griffiths and Johnson have demonstrated that psilocybin-assisted psychotherapy can help induce and maintain behavioral changes, such as quitting nicotine or cocaine, as well as psychological changes, including reduction in depression symptoms and end-of-life anxiety associated with terminal cancers. In both cases, preliminary trials have demonstrated efficacy rates over 80 percent, which were maintained for at least one year.
The first psilocybin study Griffiths completed in 2006 examined the concept of the “mystical experience” in volunteers. The majority of study participants experienced significant feelings of “unity ... an interconnectedness of all things ... sacredness of life,” and over 60 percent reported it as the most meaningful experience of their lives. In further studies, Griffiths showed a consistent correlation between individuals’ self-reporting of this mystical experience and the success of their treatment. Strikingly, those with the most success quitting smoking or resolving symptoms of depression all reported high levels of this mystical aspect. To better understand this phenomena, Griffiths and Johnson are now recruiting religious leaders to engage in a study where they will use psilocybin in a therapeutic setting and report exclusively on its effects to their own deeply held beliefs. Griffiths believes the benefit will be twofold: These participants will be better able to communicate the mystical experience to researchers, and may also enrich their own congregation and vocation in a new and powerful way.
Psychedelic researchers are quick to distinguish that these positive effects in clinical settings do not mean the drugs are suddenly safe to use by anyone, anytime. Instead, they advocate strongly for controlled consumption, with a well-trained clinician guiding the patient through the experience to highlight positive growth and outcomes.
Originally made illegal during the Nixon administration, psychedelics have been placed on the Schedule I list for having “no medicinal value” for nearly 50 years. But as a remarkable body of evidence to the contrary is collected by researchers like Griffiths and Johnson, the country must begin to more seriously discuss how to best incorporate these substances into the medical field so their positive effects may reach the patients who need them.
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