Psilocybin: Beyond Magic Mushrooms and into Psychiatry
In 1955, Dr. Valentina Wasson (a pediatrician and refugee of the Bolshevik Revolution) and her husband Gordon traveled to a small village in Oaxaca, Mexico. The Wassons were mycologists (mushroom scientists), lured by tales of a mysterious variety of mushrooms supposedly being used in religious ceremonies by the indigenous peoples of Mexico. For centuries, tales of these ceremonies had leaked out of the area, but as yet no Westerners had participated in the ceremonies. When the Spanish Conquistadors arrived centuries ago in Mexico—accompanied by Catholic priests who viewed mysticism as a direct threat to the church—indigenous ceremonies had been driven underground. The villagers participating in the ceremonies were naturally reluctant to practice openly, for fear of criminal and religious persecution.
The Wassons were curious as to why the villagers would continue an illegal practice in the face of severe punishment. What about the experience could be so powerful, so transformative, that they would be willing to risk imprisonment?
During that 1955 trip, the Wassons experienced first-hand the powerful force that motivated the locals. They became the first known westerners to participate in a mushroom ceremony, led by local curandera Maria Sabina. The experience was the pinnacle of wonder and transcendence, a transformative change to their lives which they recounted in a 1957 article in Life magazine. After the publication of the article, Valentina became one of the first physicians to suggest that the particular mushroom, Psilocybe, could be useful in the treatment of psychiatric disorders.
The next year, in 1958, Albert Hoffman—the Swiss chemist who first synthesized LSD—identified the active compounds in the mushrooms: psilocybin and psilocin. Thus began a rush of medical inquiry into the therapeutic benefits of psilocybin. Physicians began using psilocybin to treat depression, PTSD, and addiction. As more clinicians gained proficiency with the medication, the transcendent experience of psilocybin became an integral component of psilocybin-assisted psychotherapy.
Unfortunately, psilocybin was listed as a controlled substance in 1971 after the moral panic of the late 1960s. Funding for research evaporated, and like the villagers of Oaxaca, psilocybin use was driven underground yet again. Then came the War on Drugs, D.A.R.E., and a lost generation of psilocybin research.
Drawn by the transcendent experience of psilocybin and its therapeutic efficacy, physicians, scientists, and psychologists continued exploration of the medicine. In the early 2000s a few researchers, chief among them Dr. Roland Griffiths at Johns Hopkins University, began to work through the legal process and performed above-ground studies involving psilocybin. Dr. Griffiths and his colleagues confirmed the findings of the 1960s—psilocybin could be an effective treatment for depression, anxiety, and other mood disorders. They also showed that the mystical experience occasioned by psilocybin tended to be one of the top 5 most meaningful experiences of study participants’ lives.
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Psilocybin is non-addictive and has a safe therapeutic index. That means that the therapeutic dose is far less than the toxic dose. Overdoses are rare. That doesn’t mean that the medicine is completely safe. Most studies are performed in carefully controlled environments, where study participants are monitored throughout the process. This ensures an ethical environment of psilocybin use, where the psychological safety is at the forefront of treatment protocols.
When used in conjunction with psychotherapy, psilocybin relaxes the ego’s defense mechanisms. Patients are able to process traumatic experiences in a manner that doesn’t trigger their fight-or-flight mechanism. Patients also gain a birds-eye view of their minds. The insights gained are meaningful and, through a process called integration, the insights are applied into their daily lives. After even one session with psilocybin, patients have reported relief of depression lasting 6 months or more.
Dr. Paul Thielking, associate professor of psychiatry at the University of Utah, is one of the clinicians watching these developments closely. Dr. Thielking instituted a program for outpatient ketamine services for cancer patients, modeling an ethical framework similar to the Johns’ Hopkins teams.
“Good clinics have a container for helping people process the psychedelic experience,” Dr. Thielking said. “This usually takes the form of integration after the treatment.” Dr. Thielking also advocates closely monitored sessions as opposed to large groups receiving psychedelics without appropriate oversight.
Today, several companies are involved with the development of psilocybin for approval by the Food and Drug Administration. The FDA has designated psilocybin as a ‘breakthrough’ drug and has put it on the fast track for approval. In 2020, Oregon became the first state to legalize psilocybin use in a therapeutic setting, setting the stage for a responsible roll-out of psilocybin treatment centers.
Full FDA approval of psilocybin is expected to happen in 5 years. In the meantime, underground practitioners are continuing its use for therapeutic and spiritual reasons. Future articles in the Utah Bee will explore the current state of psychedelic practice in Utah, and how current, human-oriented practitioners are grappling with the emergence of for-profit corporations entering the psychedelic market. What emerges in the next several years will be a far cry from Woodstock, but will potentially reach a far wider audience.
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