Educate, Empower, and Heal Part 3

The brain after psilocybin assisted therapy

Educate, Empower, and Heal Part 3

Psilocybin has been actively researched for nearly 70 years to discover its potential benefits and positive effects. We are discovering much about how effective it is as treatment for certain common mental health conditions, especially anxiety, major depression, and addiction, but also OCD, trauma, and eating disorders, among others. Psilocybin is recommended for ongoing, detailed study in all of these areas.

The Psilocybin Assisted Therapy Association was created with a focus not on all psychedelics but on psilocybin, mainly due to its unique properties and ability to promote healing. While Parts 1 and 2 of this series expanded on PATA’s pillars to educate and empower, in Part 3 we’ll briefly look at why psilocybin-assisted therapy (also referred to as psilocybin therapy and mushroom therapy) is thought to help people heal. After briefly reviewing the origin of psilocybin in healing, we’ll cover the likely mechanisms of healing, why psilocybin in particular may be most appropriate for use, and the primary mental health diagnoses treated.

Psilocybin meets West. Maria Sabina, the indigenous medicine woman who for better or worse introduced psilocybin to Western culture, referred to mushrooms as her niños santos (“holy children”). She had only used it in her culture’s velada ceremony, during which she would also consume a powerful dose in order to speak with what she knew of as divine power or “God” to heal the sick. She was featured in a Life magazine article and subsequently was discovered by white/Western culture. As more and more people flooded to her village to explore their own use of psilocybin, she faced confusion and ostracism from her own people while wondering what, if not healing, all of these outside visitors wanted from her sacred mushrooms.

Ryan Marino, emergency medicine physician and medical toxicologist in Ohio summed it up well enough: “Although more research is needed to determine what’s happening at the chemical level, psilocybin appears to increase the brain’s capacity to change, to become more adaptive, and to break out of habits and negative thought patterns” (University Hospitals 2022). Numerous psychedelic medicine specialists like doctors Rosalind Watts and Roland Griffiths, and pharmacologist David Nichols, who has been researching the benefits of psychedelics for over 50 years, know and agree that psilocybin has great potential for healing.

So it has healing potential, but how does it work? Psilocybin, like other hallucinogenic psychedelics (LSD, mescaline/peyote, salvia, DMT/ayahuasca) produce effects like hallucinations, feelings of oneness or spiritual connection, and sudden insights in an experiential way that is often difficult to describe. Of course, this is not the whole story. Dr. Robin Carhart-Harris, psilocybin researcher with the Imperial College of London, has proposed the “entropic brain theory,” based on his work exploring the real-time effects of psychedelics on brain function. He states psychedelics like psilocybin seem to work on low-entropy cognitive patterns, where an excess of order and rigidity is the problem (ex. OCD), in a way that increases flexibility and promotes new learning.

Psilocybin is thought to do this by lowering activity in the brain’s default mode network (DMN). Carhart-Harris described the DMN as the brain’s “orchestra conductor,” “corporate executive,” or “capital city.” Albert Hofmann, the scientist who first synthesized psilocybin, proposed that psilocybin may “attack the spiritual center of the personality, the self.” Michael Pollan, journalist and author of How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, has described the DMN as the ego’s “address” in the brain. When the DMN’s activity is inhibited, people experience anything from “ego death” to enhanced ability to learn and make new connections. This function of increased neuroplasticity, even after one non-micro dose of psilocybin, has been shown to last for weeks, months, or even a year (Hopkins Medicine 2022).

Psilocybin is indeed only one of several psychedelics that can promote increased neuroplasticity, insight, and other mystical, healing, and life-changing experiences; however, we find psilocybin to have the most potential out of all of them for mainstream use. LSD, while very similar to psilocybin, is not a natural substance and cannot be harvested, foraged, or grown by individuals. Peyote and DMT-containing substances may technically be available, but their collection may have problems such as growing or being found mostly on indigenous lands. Psilocybin is also the one true psychedelic in the U.S. on track for more widespread use, including its legalization in PATA’s home state of Oregon for supported adult use in the newly created Oregon Psilocybin Services (OPS) program.

Psilocybin Therapy

The Science: The following is a review of the main literature to be found on using psilocybin for healing, but does come close to representing an exhaustive list. In addition, about a hundred projects studying psilocybin are currently underway or in the planning stages, so stay tuned to our website and other reputable sources for more discoveries on the promise of healing using psilocybin.

Depression: Psilocybin has been designated by the FDA as a “breakthrough therapy” for long-term depression, meaning there is a nationally recognized benefit and encouragement for further study. Johns-Hopkins University has shown substantial long-term effects, noting that the effects of PAT can last for up to one year (Gukasyan et al 2022). Suicidality: In addition, a large multi-year survey on drug use and health has found a lower occurrence of suicidality in people who have used psilocybin (Daniel and Haberman 2018).

Anxiety: one of the first and most promising studies on PAT noted reduction of existential or health anxiety for those with terminal illness (Daniel and Haberman 2018). Research on generalized anxiety continues and shows that people with anxiety report significant reduction in symptoms after one dose of psilocybin, with increased hopefulness and well-being (Raison et al 2022).

Life-threatening illness and existential anxiety: One of the very first ways that psilocybin was studied in research settings, going back to the 1950s-60s, was for managing life-threatening illness, which is often understandably accompanied by depression, anxiety, or both. Experienced researchers such as Charles Grob, psychiatry professor at Psychiatry at Harbor–UCLA Medical Center, recognize the uniqueness of this kind of research, describing psychedelic therapy as a form of “applied mysticism.” While research in this area came to a halt with the 1970’s “war on drugs,” it resumed in 2004 with a small study at UCLA, followed by Johns Hopkins and New York University. Psilocybin was chosen, in part, for its use dating back thousands of years, as well as being considered extremely safe with minimal negative side effects. Results from past research at Johns Hopkins showed 83% and 79% of the participants had significantly reduced anxiety and depression after six months, NYU study participants reported 58% and 83% of the participants were free from anxiety and depression, respectively at six months, and the most recent NYU study found a reduction in anxiety and distress in over 80% of participants after six months (Ross, Guss, and Bossis, Dec 2022).

Trauma/PTSD: This diagnosis seems to generate the widest popular interest these days and is being studied for treatment with psychedelics, most notably MDMA. While there are no completed and published studies yet, research with psilocybin in particular is currently underway. A few politicians have introduced legislation to remove barriers to research due to its Schedule 1 drug classification, a false designation that labels psilocybin as a substance with no therapeutic merit, when in fact it has shown great merit and even has the official “breakthrough treatment” designation from the FDA for some circumstances.

OCD: A small study noted “marked decreases in OCD symptoms of variable degrees were observed in all subjects” (Moreno et al 2006), again possibly due to the ability of psilocybin to reduce rigidity of thinking, which plays a major role in OCD.

Alcohol dependence: LSD and psilocybin have long been studied, with a notable small study that found “significant increase in abstinence after subjects had received psilocybin” (Bogenschutz, et al 2014) and more recent findings of “robust decreases in percentage of heavy drinking days” (Bogenschutz 2022). A long-term review has also concluded that psychedelic use is associated with recovery from alcohol and other drug dependence (Hendricks, et al., 2014). There has also been at least one study with more underway about the significant effect of psilocybin on smoking.

Eating Disorders: Because rigidity of thinking also plays a role in disordered eating, psilocybin is a focus of current research for this, such as at the ongoing pilot study to explore PAT at the Imperial College of London, as well as a Johns Hopkins study in recruitment as of late 2022. Both are starting with the condition of Anorexia Nervosa (AN), in which very strict mental and emotional rules may be created about food and eating. AN is also the only known mental health disorder that produces life-threatening physical symptoms and is therefore in critical need of more and better treatment options for lasting recovery.

Where we go from here. The work of PATA has grown as Oregon spent the past year rolling out OPS and now is the first state in the nation to have legal supported adult use of psilocybin. Unfortunately, many still refer to OPS as Oregon Psilocybin Therapy implying the program is providing therapy when it specifically excludes any clinical component. PATA may continue to grow over time as more states adopt their own psilocybin-assisted therapy programs, but our guiding pillars to educate, empower, and heal will remain.

References:

Bogenschutz, M. et al. “Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study,” 2015. (abstract): https://doi.org/10.1177/0269881114565144

Calder, A.E., Hasler, G. “Towards an understanding of psychedelic-induced neuroplasticity.” Neuropsychopharmacol. 2022. https://rdcu.be/cWcZQ

Daniel, J. and Haberman, M. “Clinical potential of psilocybin as a treatment for mental health conditions,” Mental Health Clinician, 2018. www.ncbi.nlm.nih.gov/pmc/articles/PMC6007659/

Horgan, J. “Doubts about psilocybin from Albert Hoffman, LSD’s discoverer,” Scientific American, 2010. https://blogs.scientificamerican.com/cross-check/doubts-about-psychedelics-from-albert-hofmann-lsds-discoverer

Johns Hopkins Medicine. (2022, Feb 15). Psilocybin Treatment for Major Depression Effective for Up to a Year for Most Patients, Study Shows. Hopkins Medicine. www.hopkinsmedicine.org/news/newsroom/news-releases/psilocybin-treatment-for-major-depression-effective-for-up-to-a-year-for-most-patients-study-show

Kabil, A. “This Mexican medicine woman hipped America to magic mushrooms, with the help of a bank executive,” Timeline, 2017. https://timeline.com/with-the-help-of-a-bank-executive-this-mexican-medicine-woman-hipped-america-to-magic-mushrooms-c41f866bbf37

Moreno, et al. “Safety, Tolerability, and Efficacy of Psilocybin in 9 Patients With Obsessive-Compulsive Disorder,” Journal of Clinical Psychiatry. 2006. https://www.psychiatrist.com/jcp/ocd/safety-tolerability-efficacy-psilocybin-patients-obsessive/

Nichols. D. “Psychedelics.” Pharmacological Reviews, 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813425/

Pollan, M. (2018). How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence [Kindle iOS version].

Raison, et al. “Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States,” Frontiers in Psychiatry, 2022. https://www.frontiersin.org/articles/10.3389/fpsyt.2022.831092/full#B12

Ross S, Bossis A, Guss J, et al. “Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial.” Journal of Psychopharmacology. 2016;30(12):1165-1180. https://doi.org/10.1177/0269881116675512

Rucker, J., et al. “The effects of psilocybin on cognitive and emotional functions in healthy participants: Results from a phase 1, randomized, placebo-controlled trial involving simultaneous psilocybin administration and preparation,” 2022. https://journals.sagepub.com/doi/10.1177/02698811211064720

Spriggs, et al. “Psilocybin as treatment for Anorexia Nervosa,” Frontiers in Psychiatry 2021. https://doi.org/10.3389/fpsyt.2021.735523

University Hospitals. (2022, May 15). “Magic Mushrooms,” Psilocybin and Mental Health. The Science of Healing. www.uhhospitals.org/blog/articles/2022/05/magic-mushrooms-psilocybin-and-mental-health