mdma as a cure for ptsd

 

MDMA-assisted psychotherapy & PTSD: Revising our pasts

MDMA, or ecstasy, is what you take before you go clubbing, right? Or, during your therapy session – which it looks like we may all need after Covid. And by then MDMA-assisted psychotherapy may actually be available.

MDMA isn’t a classic psychedelic like LSD. It doesn’t exactly alter your reality (though it might be able to change your past). The drug, which makes you feel happier, confident, and more empathetic, was synthesized in 1912, but wasn’t used until the 1970s, when it enjoyed a brief therapeutic career. In the 1980s it was sold on the street as a party drug, and was swiftly criminalized in 1985.

On the street, ecstasy is seldom pure MDMA; it’s usually cut with other drugs like amphetamine. It’s true that it’s not as harmless as classic psychedelics like LSD or psilocybin, and overdose or heavy, long-term use can have serious consequences. Its use at raves have earned it a negative reputation in the press, but pure MDMA – when used sparingly – is relatively safe, and less addictive than most illicit drugs.

Anyways, now that psychedelics are becoming more acceptable, the media is changing its mind and shedding light on MDMA’s seemingly magical powers to alleviate – if not cure – PTSD. And these days, there’s more trauma than ever.

The more we talk about PTSD, the more it shows up. One could even say we live in a traumatized society. Around 10% of people in the US are estimated to have PTSD at some point in their lives, and about 3.5% of the population in any given year. But those are the official estimates.

PTSD as a diagnosis was created to describe the symptoms of Vietnam War veterans. However we’re now learning that not only war, but everything from bullying, to living in poverty, to racism, to having Covid can cause PTSD. It’s also common in first responders like paramedics, who have to witness traumatic events on a daily basis. Whether or not we catch the “disease” depends less on the objective event as it does on the person, how they experience it, and the support they receive immediately afterwards.

Oppressed groups such as racial minorities and people in poverty are more likely to experience long-term stress and traumatic events. And those who don’t know they have PTSD are at greater risk of being retraumatized. This can lead to its new, stronger variant, C-PTSD (trauma is also mutating).

The only currently approved treatments for PTSD are SSRIs and psychotherapy, in particular exposure therapy. In exposure therapy, the patient recalls the traumatic event(s) in safe contexts over time. This is supposed to promote “fear extinction”, or an unlearning of the fear response. It turns out patients don’t tend to like remembering their traumas over and over again, and it has high dropout rates. Neither antidepressants nor exposure therapy are very effective in treating PTSD, with only around half of patients responding.

MAPS, an organization founded in 1986 to promote the research of psychedelics, has been at the forefront of MDMA research. MAPS decided early on to focus on MDMA because it’s the drug that best lends itself to therapy, and it had the potential to treat PTSD, which has no strong treatment alternatives. They’ve been trying to conduct research with veterans since 1990, with no luck because of the stigma, despite the huge need; over one million veterans are on disability for PTSD.

“The real motivation, why I’ve kept going for so long, is that humanity as a whole is, I would say, massively mentally ill,” said MAPS founder Rick Doblin in an interview.

 

Towards an understanding of PTSD

More people with anxiety, depression, and even addictions are realizing that these problems are often rooted in trauma. This was the approach of early psychoanalysts, that psychological problems sprang from childhood trauma (though people like Freud created weird theories around it, like “this person is anal retentive because they experienced a trauma during the very scientific phase of potty training”).

Behavioral psychology and medical explanations have dominated since the mid-20th century, because it’s more profitable to treat human beings like lab rats than traumatized subjects. Acknowledging the sources of trauma would also mean addressing the deep inequities in our society. However the popularity of people like the doctor Gabor Maté, who says that all addiction is rooted in trauma, has helped bring trauma theory back.

And now that we now know a lot more about the brain, there’s some biological understanding of how PTSD works (and MDMA, too).

PTSD changes our brain structure. As we revisit the memory or it’s cued in our environment by a “trigger”, our bodies secrete stress hormones like adrenaline and cortisol to respond to the threat, and our bodies reactivate the fight, flight, freeze, or fawn response. Our hippocampus measures and regulates cortisol, but too much wears it down, and so it shrinks. Meanwhile, cortisol continues to signal the fear center of the brain, the amygdala, which grows as we maintain a state of hypervigilance. The pre-frontal cortex, which is responsible for thinking and can rationally tell your amygdala to calm down, also shrinks as the amygdala grows. So people with PTSD have a smaller pre-frontal cortex and hippocampus, which translates to deficits in thinking, learning, and memory, and a larger amygdala, making them more sensitive to fear. 

Of course this hypervigilant state was meant to respond to real threats in our environment, but PTSD is usually maladaptive, playing traumatic memories or their reminders and fear responses on loop.

It’s worth noting that memories aren’t only visual. As a study of traumatic experience notes:

“Episodic memory can present itself in parts… [it] might appear as an inner vision, a sound, or just a hint – a brief sensation in the belly or a strong pain in the chest.”

 

MDMA-assisted therapy offers hope

“We know from brain scans of PTSD patients that PTSD changes people’s brains, and MDMA can change it back in almost the exact same way,” said Doblin. 

“So, where PTSD increases activity in the amygdala (the fear processing part of the brain), MDMA decreases activity in the amygdala. PTSD decreases activity in the prefrontal cortex (where we think logically), MDMA increases activity in the prefrontal cortex. PTSD makes people feel isolated, alone, mistrustful, but MDMA builds trust and connection.”

MDMA increases the availability of the neurotransmitters serotonin, norepinephrine, and dopamine, while releasing hormones including oxytocin, cortisol, prolactin, and vasopressin.

This neurobiological cocktail puts subjects in an ideal therapeutic state. It provokes a sense of peace and safety, makes them more introspective and open, and more trusting in their relationship with their therapists.

And in combination with psychotherapy, it appears that MDMA heals trauma in about two-thirds of cases.

It wasn’t with veterans, but MAPS was finally able to conduct their first study in 2008. It was such a success that the FDA granted MDMA-assisted psychotherapy Breakthrough Therapy Designation in 2017, fast-tracking the research. 

In 2020, MAPS aggregated the follow-up data for six phase 2 trials of MDMA-assisted psychotherapy. All of the trials were conducted similarly, with participants undergoing eight psychotherapy sessions, two of which lasted eight hours and involved MDMA. 

At treatment exit, 56% of participants no longer met the criteria for PTSD. However in the one year follow-up this number had increased, and 67% of participants no longer met the criteria, while over 90% had a clinically significant reduction in symptoms. These are magical numbers. A follow up of an older study is even more promising, suggesting that the benefits of MDMA treatment for PTSD canlast at least 3.5 years.

MDMA-assisted psychotherapy for PTSD is now in phase 3 trials, which are expected to be completed in 2022, and the therapy could be approved by the FDA as soon as 2023.

In case the government wasn’t sold on the benefits, MAPS produced a separate study estimating that making MDMA-assisted psychotherapy available to just 1,000 patients with PTSD would reduce general and mental health care costs by $103.2 million over 30 years. So for a million veterans, it would save $103.2 billion.

 

Positively changing our memories

MDMA & PTSD

MDMA-assisted psychotherapy is thought to treat PTSD through memory reconsolidation. It increases the connectivity between the hippocampus and amygdala, which may indicate a heightened capacity to emotionally process fear-related memories.

It turns out that when we recall memories, they become malleable. There’s a small window in which they “reconsolidate”, and we can modify and update them. The events themselves may not change, but the way we remember them, and especially the feelings we have associated with them, do.

We do this all the time. For example if you once looked back on a fun experience with a partner fondly, but then found out that partner cheated on you, you might remember that same experience differently – perhaps with sadness, anger, or a sense of betrayal.

When we recall trauma memories and our adrenal receptors in the amygdala are activated, those memories are reinforced from a place of fear. Continually recalling the same memories with the same emotions may be what underlies the long-term nature of PTSD.

MDMA therapy is like the opposite of that. The key is reconsolidating memories in a positive state. First you enter a safe, happy state of mind, and only then do you recall memories with your therapist, process them, and reconsolidate them.

MDMA allows us to visit the ghosts from our pasts from a place of empathy or compassion. Without fear, we can see through them and give them new meanings. We can make peace with them, and lay them to rest.

Can you use MDMA to treat yourself? You can try, but I wouldn’t recommend it. You’ll need the psychotherapy help you to integrate your experience and process your trauma, but to pick up the pieces of your life that trauma has left in its wake.

Doblin says the end goal of the MAPS project is “mass mental health”. If phase 3 trials are successful and MDMA-assisted psychotherapy is approved by the FDA, MAPS will focus on researching group therapy for PTSD, as well as other indications for MDMA.

Because MDMA is thought to stimulate prosocial behavior, MAPS is also studying MDMA-assisted psychotherapy as a treatment for social anxiety in autistic adults. It’s also being investigated for couples therapy and addiction.

 

Before Dawn by Bisbiswas

 

The ketamine craze: Ketamine infusion therapy for depression & PTSD

Ketamine clinics for depression and PTSD are popping up like wildflowers, but is it a poison or a cure?

 

ketamine for depression, PTSD, anxiety

 

Ketamine’s first recorded synthesis was back in 1956. It was approved for use in the US on humans and animals in 1970, and it became the most commonly administered battlefield anaesthetic during the Vietnam War. However during the 1980s it emerged on the street and became popular within the rave party and gay scene as a drug to get high on.

Though not widely used recreationally in the US, over the past decade ketamine has become UK teenagers’ “drug of choice”. Maybe they’re self-medicating… but the consequences of ketamine addiction can be serious. We’ll get to the recreational, or dark side, of ketamine later.

2020 saw ketamine hit the headlines once more as a successful treatment within clinics for patients suffering from treatment resistant depression. As with classic psychedelics like psilocybin, ketamine infusion therapy has shown promise as a treatment for depression, PTSD, OCD, anxiety, and even addiction.

 

Ketamine poison or remedyMoonlight Circus by BisBiswas

 

Despite its risk of abuse, because of its anaesthetic and pain-relieving applications, ketamine is a Schedule 3 substance in the US, as opposed to Schedule 1 like magic mushrooms, LSD, or MDMA. That makes it a lot easier to conduct research on ketamine and use it in clinical trials, and means that doctors can use it off label.

It’s because ketamine has approved medical applications that ketamine clinics are now able to proliferate across the US (and now also the UK), and news of it as a panacea is lighting up the marquees. The irony, of course, is that ketamine is much more dangerous than psilocybin, and probably less effective – or at least, its effects are shorter lived.

Ketamine clinics, like the company MindBloom, offer ketamine injections or infusion therapy, sometimes in conjunction with psychotherapy, Since the treatment is experimental and not approved by the FDA, it’s not covered by insurance – though some clinics are making ketamine infusion therapy as affordable as a visit to the psychiatrist.

 

How does ketamine work?

Ketamine is an NMDA receptor antagonist. NMDA receptors are activated by glutamate, the main excitatory neurotransmitter in the brain.

Overactivation or “excitability” of NMDA receptors is implicated in chronic stress and anxiety, and eventually leads to neural atrophy, a loss of neural plasticity, and depression.

As an NMDA antagonist, ketamine temporarily blocks glutamate from binding with NMDA receptors, preventing activation of downstream neurons (which we might experience as negative thoughts if we’re depressed). Glutamate is the most abundant neurotransmitter in the brain, and it’s especially involved in learning and memory and the formation of long-term neural pathways (known as long-term potentiation, or LTP).

The prevailing theory is that a series of chemical processes are then set off that increase levels of brain-derived neurotrophic factor (BDNF), a key protein for the growth of neurons, which is stunted when NMDA receptors are overactivated.

Blocking NMDA receptors also causes glutamate to activate more AMPA receptors, the other main glutamatergic receptor. In situations of chronic stress, AMPA receptors are underactive and there are fewer of them at synapses. However AMPA receptors are key to synaptic plasticity; they stimulate short-term and long-term potentiation, or the creation of new neural pathways.

ketamine and depression
A healthy synapse versus one under chronic stress, as in when NMDA receptors are overactivated

Neuroscientists believe ketamine’s antidepressant effect to be achieved by increasing the number of AMPA receptors and by stimulating BDNF in the brain, fostering the growth of new neurons and dendrites, and strengthening synapses. All of this increases neuroplasticity, or how healthy and flexible our brains are, which is thought to play a key role in the antidepressant effects of all psychedelics. 

This is a general overview; the exact mechanism by which ketamine relieves depression is still being investigated.

A recent study found that the antidepressant effects of ketamine may be through one of its metabolites, hydroxynorketamine.

Serotonin may also play a role. A 2020 study found that ketamine treatment increased binding with serotonin 1B receptors in the hippocampus of depressed patients.

 

What is ketamine like?

The ketamine high isn’t exactly like that of classic psychedelics such as LSD or psilocybin. It’s dissociative, so it can make you feel disconnected from your body as well as your regular thoughts and emotions. Users report feeling like they’re floating, with changes in perception and dreamlike states.

Mentally it’s not for the faint hearted; it’s a powerful tranquilizer and the trip is intense, introspective and psychedelic. As a street drug, ketamine can be quite moreish on a low dose so it’s very easy to go over on the second line… and then you may end up in a “K-hole”, coming around a few hours later with no memory of what happened.

The comedown is spacy and empty, leaving you feeling a bit down.

 

Ketamine infusion therapy for depression

We’ve known for at least 20 years that ketamine relieves depression. Since then, several studies have found ketamine infusion therapy to reduce depressive symptoms in patients with treatment resistant depression, meaning, those who have failed to respond to traditional antidepressants. 

Ketamine is fast acting, known to relieve depression almost instantaneously. It’s also promising for those at risk of suicide; ketamine has been found to significantly lower suicide ideation.

Most patients experience near total relief of their depressive symptoms within one to 24 hours of their treatment. On the down side, the antidepressant effects of ketamine typically wear off within one month, so it’s not a cure.

It seems that as a long-term treatment, patients need to receive injections weekly or monthly, though by combining ketamine infusions with psychotherapy their effects may last longer.

 

Ketamine infusion therapy for PTSD

People who have been through a traumatic event, or repeated or chronic events, can develop PTSD or chronic C-PTSD. Common symptoms include depression, flashbacks, anxiety or panic, and nightmares. However PTSD can also manifest in difficulty concentrating, cognitive impairments, loss of interest and detachment, emotional dysregulation, and reckless behavior. 

Since these symptoms are also common in those suffering from neural lesions or traumatic brain injury, a group of researchers theorized that PTSD may also be caused by a lack of synaptic connectivity.

They write:

“It is well established that chronic stress causes neural atrophy and decreases the number of synapses within cortical and limbic circuits implicated in the regulation of mood, cognition, and behavior. Glutamate synapses are the dominant form of synaptic connectivity in these circuits.”

So they hypothesized that ketamine could treat PTSD based on how it is thought to treat depression – building the strength of synapses by increasing BDNF, the number of AMPA receptors, and the number and strength of dendrites, the branches at the receiving ends of neurons.

Now that theory is being tested. A study just published in the American Journal of Psychiatry found that a two-week course of six ketamine infusions significantly improved symptoms of PTSD, and the effects lasted for nearly a month. Research on humans is still limited, but at least one other study has found similar results. More research has been done on rats, suggesting that ketamine can help us forget bad memories.

 

Ketamine and OCD

Since glutamate is thought to play a central role in the obsessive thought patterns which plague OCD, ketamine has been investigated as a possible treatment. A 2013 study found that treatment with ketamine had rapid and stable results, reducing symptoms of OCD in half of participants for at least one week.

 

Ketamine and addiction

Ketamine can itself be addictive, so it seems an unlikely candidate to cure addiction. However one study in 2019 found that one ketamine treatment plus five weeks of mindfulness-based therapy resolved cocaine addiction in 44% of participants for at least six months, while all of those who only received the therapy (the control group) continued using.

 

Ketamine & esketamine for anxiety

Though the effects aren’t as pronounced as they are for depression, a few studies have also found ketamine to be somewhat effective in treating anxiety. In one study, ketamine was found to reduce social anxiety but not generalized anxiety compared to placebo.

A couple of studies found that esketamine significantly reduces both depression and anxiety in chronically ill patients.

Generally ketamine is a sedative, however another study found that experiencing anxiety during ketamine infusions for depression was associated with poor outcomes. So the first word of advice to those seeking ketamine treatment for depression might be: just relax.

A second word of advice? If you’re having ketamine treatment, take magnesium supplements along with it. Ketamine and magnesium are thought to work in similar ways to treat depression, and a recent study found that supplementation with magnesium enhances ketamine’s antidepressant effects.

 

A look at recreational ketamine use across the pond (or, the case against ketamine)

 

ketamine craze: cure or poison?

 

In England, where ketamine is widely used as a party drug, people are seeing the dark side of ketamine, as young men in their 20s are starting to have bladder problems. This is because ketamine breaks down the wall of your bladder over time.

If you develop a habit and regularly take a lot of street ketamine, you will fairly soon start running into some serious problems, as tolerance grows rapidly. In the beginning it’s fairly cheap, selling at around 20 pound a gram in the UK — that’s enough to get you well and truly munted for up to five hours. And if you start using at the levels given to sedate animals like elephants and horses, your problems will deepen as your usage goes up and tolerance builds.

The obvious drawbacks are the onset of adverse physical effects after heavy or long-term use of ketamine. These are worse than most other street drugs; primarily the rapid destruction of your bladder and urinary function. It’s sad to see teenagers that have been caning k for a few years simply pissing their pants and having seriously painful stomach cramps.

People’s experiences are individual and specific, so whilst Jill who had a little dabble here and there for a few years managed to walk away unscathed and actually benefited from her experiences, Jack spent way too much money and is having a tough time trying to stay off it whilst suffering psychosis, kidney, and bladder problems. You can never know another person’s capacity to say no or have an understanding of how other drugs, medications, and personal traumas are affecting another person’s ability to make positive decisions.

Other associated problems may include scenarios such as where a person on ketamine walks into a busy road oblivious to their surroundings. Unfortunately it is also used by rapists, gay and heterosexual. Finally, it is illegal in most jurisdictions, so you could do hard time if caught dealing or importing–situations many addicts fall into whatever drug they are on to either fund usage or settle mounting drug debts.

An alcoholic who drinks hard liquor morning noon and night could develop cirrhosis of the liver, slurred speech, and a switchy personality, and whilst some may quietly destroy themselves others may be easily manipulated into violence and vicious cycles of low self-esteem, prison, and toxic relationships.

The recent studies have found that ketamine infusion therapy can immediately alleviate a person’s suffering who is suicidal, however the studies also show that after a period of two weeks the person is likely to be back in the same state of depression, so there is no long term gain.

Popular street drugs are popular because they give you a rush or cause an intoxicating effect, and a good experience will give you confidence to try it again. I suppose what I’m hinting at is that making a career out of ketamine will end up doing you serious harm physically and emotionally. While a short course may have benefits, it comes with no recommendations from my end.

 

Es/ketamine: don’t try this at home

There you have it, folks. While some psychedelic drugs may be safe to experiment with yourself for therapeutic purposes, ketamine is not one of them. Ketamine infusion therapy as an occasional treatment in a clinic may be safe, but it’s definitely one of those “Don’t try this at home” drugs.

And as for esketamine: since ketamine itself can’t be patented, pharmaceutical companies had to slightly change it in order to profit from ketamine therapy. Thus, esketamine is basically just a patented version of ketamine, though it’s said to be a bit weaker. And since most studies of ketamine have been by infusion, and since it’s slightly different chemically, it may be less effective in treating depression. And did we mention that ketamine’s addictive? Yeah, don’t get prescription ketamine.

 

Magic mushrooms are healthy

The benefits of magic mushrooms

 

By Katalina Lourdes

 

“If the doors of perception were cleansed everything would appear to man as it is: infinite. For man has closed himself up, till he sees all things thro’ narrow chinks of his cavern.”

– William Blake

 

While sitting in the stairwell of my friend’s basement, I watched a photon come alive in a beam of light. When I closed my eyes, I saw God in the form of a pulsating star. This was my first experience on magic mushrooms.

As a teenager I refused to take my antidepressants on principle. I believed that my depression was trying to tell me something. I think this is often the case, that it signals a problem in your environment, though rejecting treatment risks prolonging depressive episodes, which is also bad for your brain. In retrospect I believe that my experiences with magic mushrooms resolved my depression.

A recent study compared the efficacy of psilocybin (the active ingredient in magic mushrooms) versus Lexapro, a typical SSRI, in treating depression. After six weeks of treatment, 57% of the patients who had taken psilocybin no longer met the criteria for depression, versus just 28% for the Lexapro group.

This suggests that magic mushrooms may be twice as effective as traditional anti-depressants in treating depression.

My teenage brain had been onto something. I wasn’t taking them for depression, though. It was the mystical experiences I was after. The insights gave my life more meaning and I became fascinated with psychedelics themselves.

Back then the only place to read about psychedelics was Erowid, and books that spoke of times before they were criminalized.

 

Psychedelic lit review

 

Aldous Huxley claimed that tripping opens up, or “cleanses”, the doors of perception.  In his eponymous essay, Huxley describes his first experience with mescaline in 1953:

 

“I was looking at my furniture, not as the utilitarian who has to sit on chairs, to write at desks and tables, and not as the cameraman or scientific recorder, but as the pure aesthete whose concern is only with forms and their relationships within the field of vision or the picture space. But as I looked, this purely aesthetic, Cubist’s-eye view gave place to what I can only describe as the sacramental vision of reality. I was… back where I had be in a world where everything shone with the Inner Light, and was infinite in its significance.”

 

Magic mushrooms and mescaline aren’t quite the same experience, but Huxley and I both saw the sacred in the mundane and the infinite in light. Psilocybin, the active ingredient in magic mushrooms, hadn’t been synthesized yet, and Huxley didn’t take it until 1960 as a part of the Harvard Psychedelic Research Project with Timothy Leary. His notes on the trip read:

 

“#11 sat in contemplative calm throughout; occasionally produced relevant epigrams; reported experience as an edifying philosophic experience”

 

Within two years of this trip, Huxley wrote Island, a novel about a utopian society in which magic mushrooms are a cornerstone and a rite of passage. The novel is the counterpoint to Huxley’s dystopian Brave New World, in which people are numbed by the drug soma. In Island, moksha instead awakens the characters. 

In the book, magic mushrooms are referred to as “the moksha-medicine, the reality revealer, the truth-and-beauty pill”. They’re central to happiness, spirituality, as well as harmonious social relations on Pala, the island utopia.

 

“The moksha-medicine prepares one for the reception of gratuitous graces—premystical visions or the full-blown mystical experiences. Meditation is one of the ways in which one co-operates with those gratuitous graces,” explains one of the main characters to a skeptical foreigner.

 

The book reads a little like a how-to guide for both building a society and using sacred plants. Huxley emphasizes meditation to tell us that psychedelics aren’t necessarily a panacea in themselves, and should be accompanied by spiritual practice.

As he concludes in The Doors of Perception:

 

“…the man who comes back through the Door in the Wall will never be quite the same as the man who went out.

“He will be wiser but less cocksure, happier but less self-satisfied, humbler in acknowledging his ignorance… yet better equipped to understand the relationship of words to things, of systematic reasoning to the unfathomable Mystery which it tries, forever vainly, to comprehend.”

 

However Island ends on a tragic, or perhaps cautionary note; the peaceful society is destroyed by a neighboring country after its oil.

In the neurobiological sense, most psychedelics work by activating serotonin receptors, promoting the neuroplasticity of existing brain cells, and possibly by stimulating neurogenesis–the growth of new brain cells. With these changes, our brains become more flexible, more open to new perspectives, able to think in new ways, solve old problems, and form new habits.

It isn’t simply a cognitive process, however. It’s through mystical experiences that we’re transformed, and may find meaning and empathy that will help us in our daily lives.

Therapy or spiritual practices like meditation, and even journaling can reinforce the insights and transformational effects of psychedelics, integrating our experience. Exercise and nutrition also play a role in the overall health, plasticity, and mental resiliency of our brain. With time, however, new neural pathways often turn into old habits, and we tend to lose plasticity.

Of course, you can take them again to renew their effects. In Island, characters take moksha periodically throughout their lives, and the message is that so should we. One character uses it to deal with their grief after losing her spouse. As he himself was dying, Huxley asked his wife, Laura, to inject him with LSD.

 

The history of magic mushrooms

 

There’s some evidence that humans have been using magic mushrooms for at least 6,000 years. In the book Food of the Gods the psychonaut philosopher Terence McKenna speculates that they even played a role in human evolution, particularly our development of language. Based on what we’re now learning about how it works in the brain, he may have been right.

Artwork as well as records kept by Spanish monks indicate that magic mushrooms were used extensively by the Aztecs. Their word for the plant, teōnanācatl, means “divine mushroom”. They were also used in Mayan civilization and throughout Central America going back at least 3,500 years, and are still used by some indigenous groups in the region. Of the over 200 mushroom species that contain psilocybin, 54 can be found in Mexico. 

Magic mushrooms were introduced to the West by the mycologist and banker R. Gordon Wasson, who travelled to Mexico in search of them in 1956. The trip was funded by the CIA; Wasson was an unwitting participant in their MK-Ultra program. A Mazatec sage named Maria Sabina included Wasson and his wife in a velada, or traditional magic mushroom ritual. Wasson wrote an article about his experience for Life magazine, and went on to write a book which revealed Sabina’s name and location. Soon after, hippies began flooding her Oaxaca village. The impacts on her community eventually led her to be ostracized from it; her house burned down.

So far the history of magic mushrooms is one of the destruction of civilizations that held them sacred.

Albert Hoffman, the chemist who discovered LSD in 1943, isolated and synthesized psilocybin in 1958.

Research was carried out throughout the 1950s and 60s into the therapeutic uses of both psilocybin and LSD, which showed promise for resolving psychological problems, notably alcoholism. Psilocybin was even marketed by Hofmann’s employer, Sandoz Laboratories, and sold in pharmacies under the brand name Indocybin for a decade until psychedelics were outlawed in the US in 1970.

Along with marijuana, psychedelics were designated as Schedule 1 substances, with “high addictive potential” and “no medical use”. Investigation into their therapeutic uses ceased, and the drug war ensued.

As Nixon’s domestic policy chief, John Ehrlichman, admitted , the drug war was never really about the drugs:

 

“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders. raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”

 

Now, after 50 years of prohibition, we’re in a “psychedelic renaissance”. Psychologists, psychiatrists, and the market are finally acknowledging the positive role that psilocybin and other psychedelics can play in our mental health. In the past decade, clinical research has demonstrated incredible rates of success in relieving symptoms of a range of disorders including depression, anxiety, OCD, PTSD, and addiction, which I briefly review below.

The existing body of research is small but growing rapidly. There’s talk of decriminalization in more cities and states, and descheduling at the federal level that would open the doors to mainstream therapeutic use.

Yet there are figures like Wasson seeking to personally profit from the use of these substances, at the expense of accesibility to those who need them most. Before even emerging from Schedule 1 status, corporations are trying to control the magic mushroom experience. With therapeutic use likely to be approved by the FDA within the next couple of years – and one company trying to dominate the market – we have yet to see how the use of psilocybin for therapeutic purposes will play out.

 

 

Research on the benefits of magic mushrooms

 

The first study to establish the value of magic mushrooms after limited research was reauthorized by the FDA in 1992 was carried out by Dr. Roland Griffiths at Johns Hopkins University in 2000. The results, published in 2006, paved the way for further psychedelic research.

The experiment was meant to assess the ability of psilocybin to induce mystical experiences, and a high dose was administered to a small sample of healthy adults who regularly engaged in religious or spiritual practices. Two-thirds of the volunteers rated the experience among the top five meaningful experiences of their lives. 

These findings were replicated in a 2011 follow up study, in which participants who took four doses of psilocybin in a supported environment showed improved attitudes, mood, and social relationships in follow ups both two and 14 months later, demonstrating the long-term benefits of magic mushrooms. In this study, 78% of participants said that the psilocybin sessions were among the top five meaningful experiences of their lives, and 94% said the same in a follow up 14 months later. None of the volunteers reported negative consequences resulting from the experiences.

The improved results in this second study likely had to do with repeated trips; each participant had four sessions. They found that the most effective distribution of the doses was from lowest to highest dose. The researchers also further optimized set and setting, providing each participant with eight hours of preparation.

At the 14 month follow up, participants were asked to describe how the psilocybin experiences had impacted their lives. Here are some of their responses:

 

“I have a stronger desire for devotion, have increased yoga practice and prayer. I have better interaction with close friends and family and with acquaintances and strangers… I feel more certain of my career as an author. I need less food to make me full. My alcohol use has diminished dramatically… I consider myself to be better [at self-care] now than before the study…”

 

“I feel that I relate better in my marriage. There is more empathy – a greater understanding of people and understanding their difficulties and less judgment. Less judging of myself too.”

 

“I am more aware and accepting [of everyone]. I have a thousand ideas to write about and am making time and space in my life to accommodate them.”

 

Magic mushrooms, depression, and anxiety

 

Aside from mystical experiences and benefits like creativity, researchers are in a dash to discover – and prove to regulators – the benefits of magic mushrooms for treating psychological disorders.

In a study of cancer patients published in 2016, those who took a high dose of psilocybin reported increased well-being and optimism, a higher quality of life, and lower depression and anxiety scores. Over 80% of patients continued to experience positive life changes at a six month follow up. Though in this study the patients didn’t receive therapy as a part of the experiment, they did talk about their lives beforehand and debrief their experiences afterwards with monitors. These findings have been replicated in other studies.

In a recently published study, 27 non-cancer patients with major depression were treated with psychotherapy and two sessions of psilocybin. Four weeks later, 71% had a 50% or more reduction in their depression scores, and over half of participants were in complete remission.

In another study looking at the effects of psychedelics in non-clinical contexts, users reported being less depressed or suicidal after their trips. An examination of existing data from a national survey also found lifetime psychedelic use to be negatively correlated with psychological distress and suicidal tendencies (though there was a positive correlation for other types of drug use).

 

Magic mushrooms and OCD

 

Mushrooms may also be useful in alleviating OCD. In a small study, OCD symptoms were reduced by at least 25% in 90% of participants (and by more than 50% in 67% of participants). It’s unknown how long these effects might last, as the study only measured symptoms up to 24 hours after ingestion. However in one case study,  a man found his OCD symptoms were greatly alleviated for about three weeks after consuming two grams (a moderate dose) of mushrooms.

Scientists have tested this theory in mice, finding that psilocybin reduces compulsive behavior.

 

Magic mushrooms and PTSD

 

There’s little direct so far research of psilocybin on PTSD, but what we know strongly suggests that magic mushrooms can help people who have been traumatized to heal.

Researchers tend to study effects in mice and rats first, so here we find more data. One study found that mice unlearn fear responses faster when given low doses of psilocybin, suggesting that they’re more easily able to let go of negative memories, or at least, stop being triggered by reminders of them.

A separate study looked at the impact of psilocybin on the connection between the amygdala (the area of the brain that processes fear), the visual cortex (which perceives threats in the environment), and the prefrontal cortex. Hyperconnectivity between the amygdala and visual cortex has been linked to an increase in perceived threats and anxiety, which is characteristic of people with PTSD.

The authors explain:

 

“the amygdala may actually determine the affective meaning of visual percepts by its effects on sensory pathways — an effect which mainly occurs subconsciously and which may be greatly amplified in psychopathological conditions, such as anxiety disorders or depression. In this context, increased [amygdala] reactivity may lead to an increased attentional focus on negatively valenced environmental or social stimuli and thus effectively blocks out the processing of positive information.”

 

So, the researchers found that psilocybin reduces the amygdala’s connectivity with the visual cortex in response to threat-related stimuli. Which, theoretically, means that after taking psilocybin, we perceive our environments as less threatening. This could be an important mechanism for resolving PTSD.

Back from mice to men. The Canadian Center for Mental Health Disparities has been doing important work researching the potential of psychedelics to heal racial trauma.

We commonly think about PTSD in terms of extreme, violent experiences like sexual assault or physical abuse. However many Black, Indigenous and People of Colour (BIPOC) experience racism throughout their lives in overt or subtle forms. Everything from systemic discrimination to microaggressions and hate crimes, negative experiences based on racism have long-term impacts that may result in PTSD.

The study surveyed BIPOC in the US and Canada who had experienced racial trauma and recently taken psychedelics in non-clinical environments. The study concluded:

 

“Our lab has found that a single positive experience with a psychedelic drug can help reduce stress, depression, and anxiety symptoms in Black, Indigenous and People of Colour (BIPOC) whose encounters with racism have had lasting harm.”

 

This is one of the CMHD’s first studies on the subject, however it has many more in the pipeline, so if you’re interested in psychedelics and PTSD, and especially its intersections with racial trauma, watch their page.

Psilocybin also favors positive emotional processing, and this, coupled with its tendency to promote introspection and increase neural plasticity, could help patients form new understandings of their trauma experiences. New insights, emotional breakthroughs, and perceiving the world as less threatening all make psilocybin a likely candidate for the treatment of PTSD.

Anecdotal data support these theories, with more veterans taking matters into their own hands, and reporting dramatic improvements in PTSD symptoms after taking magic mushrooms.

 

Magic mushrooms and addiction

 

Psilocybin has been found to reduce dependency on drugs and alcohol. Studies from the 1950s on the subject are typically discarded by modern science since they don’t employ current methodologies, and limited research has been carried out in the past decade, but it’s promising.

One study of 10 alcohol dependent people showed that they reduced their consumption following four weeks of psychosocial therapy and two psilocybin trips. Number of drinking days fell by 27%, and heavy drinking days fell by 26%.

An experiment with smokers was even more promising. Participants took part in a 15 week course on quitting tobacco and received four weeks of cognitive behavioral therapy. Starting at week five, they had three separate psilocybin trips. Six months later, 80% of the subjects were completely abstinent from smoking.

These were pilot studies, so it’s possible further research will discover ways to improve their efficacy as a treatment here.

 

Qualitative research and personal accounts

 

While the explosion in research is quite recent, the quantitative research produced just in the past few years into the uses of psilocybin is daunting. So it was refreshing to see that a group of researchers had taken a qualitative approach to what is ultimately a very subjective experience, using an interpretive phenomenological analysis. Meaning, they focused on how volunteers made sense of their own experiences. Thefindings may offer more insight into what it’s like to trip on psilocybin – as well as why it’s effective in relieving anxiety, depression, and PTSD and addiction – than neurobiological explanations. Here are some excerpts from the study:

 

“General themes found in all or nearly all transcripts included relational embeddedness, emotional range, the role of music as conveyor of experience, meaningful visual phenomena, wisdom lessons, revised life priorities, and a desire to repeat the psilocybin experience. 

“Typical themes found in the majority of transcripts included the following: exalted feelings of joy, bliss, and love; embodiment; ineffability; alterations to identity; a movement from feelings of separateness to interconnectedness… 

“Variant themes found in a minority of participant transcripts include lasting changes to sense of identity, synesthesia experiences, catharsis of powerful emotion, improved relationships after treatment, surrender or “letting go,” forgiveness, and a continued struggle to integrate experience.”

 

Researchers and other officials recommend taking psilocybin under professional supervision and in conjunction with therapy, though the benefits of magic mushrooms are often pronounced in its absence.

Other sources of direct experience can be found in Erowid vaults, going back to the early days of the internet. A recent account describing a four gram trip reads:

 

“I was seeing very interesting visuals on the walls and when I closed my eyes. My thought processes were becoming absolutely ridiculous and indescribable. I couldn’t help but find meaning in absolutely everything, as if my life were some divine narrative…

“I felt myself fading away. Everything sounded as if I was very far away. I was having a hard time understanding anyone because I could not hear them very well. As I began to drift away, I was expanding. I was feeling the ground underneath me, the car, the trees and the mountains in the distance. I had the strangest feeling like my head was blooming or exploding in directions I cannot communicate.

“But one of the most interesting sensations was of being in my friends minds. Not that I could read their thoughts or anything, but I felt as I was swimming around in their heads. It was very peaceful. I felt in communion.”

 

How do magic mushrooms work?

 

Psilocybin acts like serotonin, activating its receptors, specifically binding to 5-HT2A and 5-H2C receptors. However it doesn’t follow the usual serotonergic pathways of our brains. Instead, normal pathways are disrupted, and the psilocybin activates new 5-HT2A/C receptors, forging new pathways, new connections, strengthening synapses, and creating new thoughts. When the psilocybin finally leaves us, our brain remembers some of those new thoughts, which we may experience as profoudn insights.

Psilocybin’s serotonergic stimulation is also supposed to reducethe connectivity of the default mode network (DMN). The DMN is the part of our brain involved in self-referential thought, reflection but also rumination. It’s where we go when we’re thinking about ourselves, and deactivating these pathways when we’re depressed may be a key mechanism for psilocybin’s therapeutic effect.

Finally, when we’re under a lot of stress, depressed, or have PTSD, that stress response over time suppresses, atrophies, or even kills off a lot of our neurons.  Regions of our brain may even be seen begin to shrink as a result, especially the prefrontal cortex and hippocampus.

Serotonergic psychedelics such as psilocybin, LSD, and DMT have been found to directly reverse some of that atrophy by increasing the number of dendritic spines on neurons, and strengthening and creating new synapses. Psychedelics may or may not stimulate the creation of new neurons, but they at least help them grow, and these extra dendritic spines and synapses create more opportunities for diverse thoughts and new connections to be formed. This neural flourishing lasts well beyond the trip, which bodes well for future resilience, learning, decision-making, empathy, and creativity.

Scientists call the increased ability to form new connections “neuroplasticity”, and credit these structural brain changes with the revelations as well as long-lasting benefits that can come from psychedelic therapy. However our subjective, metaphysical experiences feel more than biological; there must be an element of magic. Huxley called it cleansing the doors of perception, while McKenna might say we are awakening to new realities and our own divinity.

 

Effects of magic mushrooms

 

“When we look within ourselves with psilocybin, we discover that we do not have to look outward toward the futile promise of life that circles distant stars in order to still our cosmic loneliness. We should look within; the paths of the heart lead to nearby universes full of life and affection for humanity.”

― Terence McKenna

During the trip itself, magic mushrooms can induce euphoria, divergent thought patterns, feelings of empathy, insights and realizations, and minor hallucinations in small to moderate doses. In larger doses they can induce spiritual experiences, ego dissolution and intense hallucinations.

In moderate and large doses there’s often an element of anxiety at some point in the trip as your mind is immersed in another world and may have doubts or irrational worries. This is normal, and one should just let it pass. However by preparing for the trip you can minimize the anxiety, as well as the possibility of it spiralling out of control and having a “bad trip”.

After the trip, people tend to feel happier, more empathetic, and more spiritual, with a greater sense of purpose and reduced anxiety.

The extent of the benefit will be dependent on the dose, as well as your state of mind and how much you’ve prepared, or what’s generally referred to as “set and setting”. Here, set refers to the individual person’s personality and mood, and setting is the environment. Are you well-slept? Is it outdoors or indoors?  Is it quiet or noisy? What kind of music is playing? Are the other people friendly?  All of these factors and more can play a role in how your mind responds to psilocybin, and the quality of your trip.

 

 

DIY psilocybin therapy

 

With more knowledge and mainstream acceptance of their impacts, but limited availability in a medical context, many are going the DIY route to get the therapeutic benefits of psilocybin. And now that they’ve been decriminalized in Oregon and DC, they’re becoming easier to get your hands on.

Shamans and the medical community alike warn that psilocybin is a medicine, and should be taken for spiritual or therapeutic, rather than recreational purposes. So keep this in mind if you’re intending to trip, and take a leaf from the therapist’s (or shaman’s) notebook by doing mental prep work beforehand. This could be journaling, meditation, getting out in nature, or talking to a good friend or therapist about any issues you want to resolve, as well as what you want to get out of the trip.

The environment in which you take magic mushrooms has a major effect on a trip, negative surroundings can lead to bad experiences, so it’s best to take them in a place and with people you’re comfortable with.

People who intend to use psychedelics therapeutically should be aware of the possibility of falling back into old habits and patterns, which are more easily surmountable in therapeutic contexts. The insights arrived at while tripping are easily forgotten over time. Without corresponding long-term changes in our habits, relationships, or environment, the benefits of magic mushrooms can fade.

This is why Huxley emphasized meditation. It can only help to begin a meditation or regular yoga practice. And to reiterate, if you’re DIY tripping for spiritual purposes or to heal yourself, it’s advisable to plan your trip in an intentional way. Discuss your intentions abd experiences with a therapist, a friend, or even with yourself by journaling. Remember that a light trip may be less transformative, but if you’ve never tripped before, it’s best to start small and work your way up to a larger dose as you feel more comfortable.

 

Can magic mushrooms be harmful?

 

A review of eight different studies involving psilocybin found no increased risk of adverse psychological effects such as drug abuse or psychosis at follow ups 8 to 16 months later. So basically, they’re not addictive, and even a very bad trip is unlikely to cause long-term harm.

However, they may adversely effect people with a history of psychosis, though there’s no good data on it, since they’re excluded from most studies. It also must be said that those who take large doses unprepared can experience adverse effects in the form of a bad trip. This is why I emphasize preparation, and that high doses are not for the novice.

Physically, magic mushrooms are well tolerated. However, psilocybin is metabolized by the liver, and probably shouldn’t be taken by people with serious liver problems such as cirrhosis. If you have serious health issues, check with a doctor first.

There was a sad case of a young man with bipolar disorder who had heard about magic mushrooms as a treatment for depression, and made a tea of them and injected them into his bloodstream. The mushroom spores grew there, and he almost died. Don’t do this, or anything like this! Magic mushrooms should be ingested orally; if you don’t like the taste, put them in a smoothie.

Another risk is in taking wild mushrooms. Don’t do this unless you’re a mycologist or with a skilled guide. A lot of mushrooms are poisonous, and a mistake could put you in the hospital or worse. And because of the use of pesticides, fertilizers, and hormones, they’re not as common in the American landscape.

 

An emerging magic mushroom market

 

Psychedelics have become a hot new bubble for venture capitalists, who are actively seeding the market. This, combined with amazingly positive outcomes in the research so far, means that many more studies are to come in the next years. Investor dollars, results, and a massive need are driving acceptance from the media and the government.

Historically, magic mushrooms were often consumed in the context of ceremonies and rituals. Today’s counterpart, albeit more individualistic, is therapy, and most psychedelics are being studied in the context of psychotherapy.

The benefits of magic mushrooms are likely strengthened in such a context. Having a skilled professional (or friend, if you’re going the DIY route) dedicated to exploring your experience and personal challenges before, during, and after the experience can only help realize and reinforce its potential benefits.

However what happens when a for profit company tries to administer and monopolize a sacred therapeutic experience?

In 2018, the FDA granted Breakthrough Therapy Designation to Compass Pathways to fast-track FDA approval for psilocbyin therapy with its own patented formulation, and to conduct its own clinical studies. The Usona Institute, a nonprofit, has also received Breakthrough Therapy Designation, and is conducting its own trials. Compass, however, has received a lot of criticism from the psychedelic research community. At first pretending to be a nonprofit, the for-profit company has now received $110 million from private investors including the likes of Peter Thiel, and is aggressively trying to dominate the market for psilocybin.

Magic mushrooms and psilocybin themselves can’t be patented. However Compass is trying to corner the market for psilocybin therapy by controlling the commercial production of psilocybin with its own formulation, COMP 360. In addition to patenting a method for synthesizing psilocybin, it has also submitted a patent application for using psilocybin in psychotherapy,  though this is unlikely to be approved. Compass is currently conducting phase 3 clinical trials, and recruiting and training therapists.

It’s not just Compass; hundreds of companies have been formed over the past few years to try and profit from the psychedelic renaissance. Many are doing research to find new drugs. I’m concerned that patenting psychedelics, variants, or the way that they’re used could lead to the development of a drug that more closely resembles soma than moksha.

Once approved by the FDA, psilocybin therapy could be costly – especially if it’s monopolized by Compass Pathways. As it stands, wealthier people can already access psychedelics in therapeutic contexts through expensive retreat programs in places like Amsterdam or Jamaica where psilocybin is legal.

Compass’s methods aren’t rocket science, however. The therapy consists of three sessions : a “getting to know you session”, a session in which you trip wearing an eye mask and listening to classical music and the therapist is there to reassure you, and a debriefing session where you discuss what you learned. Along with a mental health professional, you could easily replicate this or devise a better set, setting, or process.

There’s something very disconcerting about corporate therapy and tripping, like mixing the profane and the sacred. How strange that where capitalism is our religion, we go to the pharmaceutical companies or corporate clinics for healing, worship, and redemption.

While psychedelics can make the mundane appear sacred, can they transform the profane?

 

 


“Our normal word-conditioned consciousness creates a universe of sharp distinctions, black and white, this and that, me and you and it. In the mystical consciousness of being at one with infinite Oneness, there is a reconciliation of opposites… there is an immediate experience of our solidarity with all being and a kind of organic conviction that in spite of the inscrutabilities of fate, in spite of our own dark stupidities and deliberate malevolence, yes, in spite of all that is so manifestly wrong with the world, it is yet, in some profound, paradoxical and entirely inexpressible way. All Right. For normal waking consciousness, the phrase, ‘God is Love,’ is no more than a piece of wishful positive thinking. For the mystical consciousness, it is a self-evident truth.”

– Aldous Huxley

 

 

 

 

 

 

 

“The artist’s task is to save the soul of mankind; and anything less is a dithering while Rome burns. Because of the artists, who are self-selected, for being able to journey into the Other, if the artists cannot find the way, then the way cannot be found.”

― Terence McKenna

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Our culture, self-toxified by the poisonous by-products of technology and egocentric ideology, is the unhappy inheritor of the dominator attitude that alteration of consciousness by the use of plants or substances is somehow wrong, onanistic, and perversely antisocial. I will argue that suppression of shamanic gnosis, with its reliance and insistence on ecstatic dissolution of the ego, has robbed us of life’s meaning and made us enemies of the planet, of ourselves, and our grandchildren. We are killing the planet in order to keep intact the wrongheaded assumptions of the ego-dominator cultural style.”

― Terence McKenna