Psilocybin: A Journey Beyond the Fear of Death

    Roland Griffiths, a clinical pharmacologist at Johns Hopkins University, talks about a great new study that suggests the power of psychedelic drugs as therapies

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    In one of the largest and most rigorous clinical investigations of psychedelic drugs to date, researchers at Johns Hopkins University and New York University have found that a single dose of psilocybin—the psychoactive compound in “magic” mushrooms—decreases substantially depression and anxiety in patients with advanced cancer.

    Psychedelics were the subject of a flurry of medical research in the 1960s, when many scientists believed that some of the mental compounds were tremendously therapeutic for treating a range of conditions, including severe mental health problems and alcohol addiction. But flamboyant Harvard psychology professor Timothy Leary, one of the leading scientists involved, began aggressively promoting LSD as a consciousness-expanding tool for the masses, and the youth counterculture movement answered the call of a great way. Leary lost his job and eventually became an international fugitive. Virtually all legal research on psychedelics shook when federal drug policies tightened in the 1970s.

    The decades-long research blackout ended in 1999 when Roland Griffiths of Johns Hopkins was one of the first to initiate a new series of studies on psilocybin. Griffiths has been called the grandfather of today’s research renaissance, and is a 21st century pioneer in the field – but the soft-spoken researcher is no Leary-esque activist or shaman/showman. He is a scientifically cautious clinical pharmacologist and the author of over 300 studies on mood-altering substances ranging from coffee to ketamine.

    Much of Griffiths’s fascination with psychedelics stems from his own practice of mindfulness meditation, a practice that he says sparked his interest in altered states of consciousness. When he began administering psilocybin to volunteers for his research, he was surprised that more than two-thirds of the participants rated their psychedelic trip as one of the most important experiences of their lives.

    Griffiths believes that psychedelics are not just tools for exploring the far reaches of the human mind. He says they show remarkable potential for treating conditions ranging from drug and alcohol dependence to depression and post-traumatic stress disorder.

    They can also help ease one of humanity’s cruelest agonies: the anguish that comes from facing the inevitability of death. Griffiths and Stephen Ross, clinical director of the NYU Langone Addiction Center of Excellence, conducted research in which 80 patients were given laboratory-synthesized psilocybin—and in a carefully monitored setting, accompanied by limited psychological counseling—, from Baltimore and New York, with advanced cancer. The result was that more than three quarters reported significant relief from depression and anxiety. These improvements continued to be reflected in a follow-up survey, conducted six months after taking the compound, according to the double-blind study published Dec. 1 in The Journal of Psychopharmacology.

    “For a single dose of a drug to produce these kinds of dramatic and long-lasting results is simply unprecedented in psychiatry,” Ross says. He and Griffiths acknowledge that psychedelics will never be available on the pharmacy shelf. a promising future for these substances during controlled clinical use.In a wide-ranging interview with Scientific American, Griffiths discussed his cancer study and his other work with psychedelics, a field he says could help ensure our survival as a species.

    Interview with Dr. Griffiths:

    What were your concerns when doing the cancer study?
    Volunteers often came to us very stressed and demoralized by their illness and the often exhausting medical treatment. I was very cautious at first, wondering if this might reopen the wounds of people dealing with painful questions about dying and death. How do we know that this kind of experience with this disorienting compound wouldn’t exacerbate that? Turns out he doesn’t. does exactly what contrary. The experience seems to be deeply, spiritually and personally meaningful, and very healing in people’s understanding of the context of their illness and how to deal with what comes.

    Could you describe your procedure?

    We spend at least eight hours talking to people about their cancer, their anxiety, their concerns, and so on, to develop a good relationship with them before the trial. During the sessions there was no specific psychological intervention: we simply invited people to lie down on the sofa and explore their own inner experience.

    What did the volunteers tell you about that experience?
    There is something at the core of this experience that opens people to the great mystery of what we do not know. Not that everyone comes out of it and says, “Oh, now I believe in life after death.” That need not be the case. But the psilocybin experience allows for a deeper sense of meaning and the understanding that in the bigger picture all is well and there is nothing to fear. There is a very significant optimism that comes out of that. Seeing people who are so battered by this disease, providing reassurance to the people who love them most, telling them that “everything is fine and there is no need to worry” – when a dying person can provide that kind of clarity to their caregivers, even we researchers are left with a sense of awe.

    Was this positive result universal?

    The response was found to be dose dependent. The higher dose created a much larger response than the lower dose. We also found that the occurrence of mystical-type experiences is positively correlated with positive outcomes: those who experienced them were more likely to have large, lasting changes in depression and anxiety.

    Have any of your volunteers experienced difficulties?
    There are potential risks associated with these compounds. We can protect them against many of those risks, it seems, by screening and preparing our medical environment. About 30 percent of our people reported some fear or discomfort during some part of the experience. If individuals are anxious, then we might say a few words to them, or hold their hand. It’s just about reminding them of consensual reality, reminding them that they’ve taken psilocybin, that everything is going to be okay. Very often these short-lived, psychologically challenging experiences can be cathartic and serve as a gateway to personal transcendence and meaning, but not always.

    Where does it goes after this?

    The Heffter Research Institute, which funded our study, has just opened a dialogue with the Food and Drug Administration (FDA) about starting phase 3 research. A phase 3 clinical trial is the gold standard for determining if something is clinically effective and meets the standards that are necessary to be released as a pharmaceutical product. Approval would be under very narrow and restrictive conditions initially. The drug could be controlled by a central pharmacy, which sends it to clinics that are licensed to administer psilocybin in this therapeutic setting. So this is not writing a recipe and taking it home. The analogy would be more like an anesthetic dispensed and administered by an anesthesiologist.
    He is also currently conducting research on psilocybin and smoking
    We’re using psilocybin in conjunction with cognitive behavioral therapy with cigarette smokers to see if these deeply meaningful experiences that can happen with psilocybin can be linked to intention and commitment to quit, among people who have repeatedly failed in doing it. We previously ran an uncontrolled pilot study on this in 50 volunteers, where we had 80 percent abstinence rates at six months. We are now doing a controlled clinical trial in that population.

    How do you explain your remarkable initial results?

    People who have taken psilocybin seem to be more confident in their ability to change their own behavior and control their addictions. Before this experience, very often the individual feels that they have no freedom in relation to their addiction, that they are hooked and do not have the ability to change. But after such an experience – which is like backing up and seeing the bigger picture – they begin to wonder, ‘Why would I think I couldn’t quit smoking cigarettes? Why do I think this desire is so compelling that I have to give in to it?’ When psilocybin is combined with cognitive behavioral therapy, which gives smokers tools and a framework to work through this, it appears to be very helpful.

    You are also working with people who meditate. Are you having similar experiences?
    We have done an unprecedented study with beginning meditators. We found that psilocybin enhances your commitment to your spiritual practice and appears to increase disposition characteristics, such as gratitude, compassion, altruism, sensitivity to others, and forgiveness. We were interested in whether psilocybin used in conjunction with meditation could create sustained changes in people that were of social value. And that seems to be the case.

    So it’s actually like changing personality?

    Yes. That’s really interesting because personality is considered a fixed characteristic; It is generally believed that it locks up in individuals in their early twenties. And yet here we’re seeing significant increases in your “openness” and other pro-social dimensions of personality, which are also correlated with creativity, so this is really surprising.

    Do we know what is really happening in the brain?

    We are doing neuroimaging studies. Dr Robin Carhart-Harris’s group at Imperial College London is also carrying out neuroimaging studies. So it’s a very active area of ​​research. The effects are perhaps explained, at least initially, as changes in something [in the brain] called the “default mode network,” which is involved in self-referential processing [and maintaining our sense of ego]. It turns out that this network is overactive in depression. Interestingly, in meditation it is inactivated, the same thing happens with psilocybin. This can be correlated to the clarity experience of entering the present moment.

    Maybe it’s an explanation of the acute effects, but the lasting effects are much less clear, and I don’t think we have a handle on that at the moment. It is certainly going to be much more complex than just the network by default, due to the vast interconnectedness of brain function.

    What are the practical implications of this kind of neurological and therapeutic knowledge about psychedelics?
    Ultimately, it’s not really about psychedelics. Science will go beyond psychedelics as we begin to understand the underlying brain mechanisms and start harnessing them for the benefit of humanity.
    The mystical experience is one of the interrelationships between all people and things, the awareness that we are all in this together. It is precisely the lack of this sense of mutual care that puts our species at risk right now, with climate change and the development of weapons that can destroy life on the planet. So the answer is not that everyone needs to take psychedelics. It is understanding what mechanisms maximize this type of experience and learning how to take advantage of them so that we do not end up annihilating ourselves.

    Resonance Costa Rica

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