Katherine Ellison
© Julien Pacaud Hallucinogenic drugs are showing promise in treating various health conditions. One writer explores their history and tries one for cluster headaches.
The beefy armed guard at the door of the Church of Entheogenic Plants chuckled at the sight of me, and I guessed what he might be thinking: What’s that 60-something lady doing here?
It wouldn’t have been unreasonable to wonder—and not just because everyone else waiting to pass through the metal detector that day last winter was roughly 40 years younger than I. Vice News has called the Oakland, CA, church, also known as Zide Door, America’s “most prominent ‘magic mushroom club,’ ” implying that its religious decor is a ruse to evade state and federal laws against selling psychedelic drugs. In accepting “contributions” for strains of ’shrooms with names like “Blue Meanies” and “Penis Envy,” Zide Door claims the same exemption that lets the Navajo legally ingest peyote, a traditional sacrament.
Ruse or not, that hasn’t offered much protection. In August 2020 police raided the premises and seized about $200,000 worth of cash and drugs. Pastor David Hodges told me he planned to sue the city government for violating his congregants’ religious freedom.
Potentially breaking the law was not my only concern when it came to trying magic mushrooms. I was an unusually suggestible child in the 1960s, when well-meaning parents scared their kids straight with stories about acid trippers who went blind from staring at the sun, mistook a baby for a turkey and stuffed it in the oven, or woke up convinced they’d turned into a glass of orange juice. In the late 1970s, when many of my college pals were experimenting, I declined even to smoke weed.
The pain in my brain
But last February, I was standing in front of the church out of desperation, hoping that psilocybin, the active ingredient in mushrooms, would relieve my excruciating pain. I was in my 12th week of a siege of cluster headaches, and I felt as if a Lilliputian with a tiny ice pick were jabbing at the back of my right eye for an hour each day, starting at 5 a.m.
Cluster headache is a rare disorder, estimated to affect roughly one or two in 1,000 people (migraines are at least 120 times as common). They’d plagued me for a month or so every two years since 2005, and usually prednisone knocked them out. But this time the only thing that brought even brief respite was—no joke—snorting cayenne pepper, which made me sneeze until I felt as if I might pass out. I also worried that it might be corroding the inside of my nose.
I’m far from the only person seeking out these long-demonized drugs for medical reasons. Using LSD, psilocybin, and MDMA (Ecstasy) to relieve suffering appears to be on the rise. While most self-experimenters use psychedelics to enhance well-being, a portion “self-medicate preexisting mental health conditions,” wrote psychiatrist Adam Winstock, M.D., in the Global Drug Survey. His annual polls of more than 500,000 people suggest that the use of LSD and psilocybin among respondents has roughly doubled over just the past five years. An honorary clinical professor at the Institute of Epidemiology at the University College of London, Dr. Winstock joins other experts in comparing the drugs favorably with prescription antidepressants. “The benefits are really clear for patients,” he says. “They want things that work, work quickly, and don’t require them to take medications every day.”
Americans’ interest in hallucinogens was supercharged by Michael Pollan’s 2018 best seller, How to Change Your Mind. A year later, Johns Hopkins launched a $17 million center to study a variety of illicit-drug therapies that showed promise in treating disorders such as depression, trauma, anorexia nervosa, tobacco addiction, and even post-treatment Lyme disease. Researchers are excited, even as psilocybin and LSD continue to be classified as Schedule I substances, which are seen as having no medical use, a high potential for abuse, and unacceptable risks even under professional supervision.
But if you’ve ever had cluster headaches, you know why they’ve been called“suicide headaches.” People in the midst of an attack are believed to die by suicide at roughly three times the rate of the general population, and sufferers describe the attacks as more painful than childbirth, gunshot wounds, and kidney stones, according to University of West Georgia psychology professor Larry Schor, Ph.D., who has conducted a large survey of cluster-headache patients (and suffers from them himself). On average, cluster-headache patients take more than five years to be properly diagnosed, after which even prescribed drugs may fail. Early on, I tried taking sumatriptan, a drug for migraine headaches, and at first it was helpful, but then made my headaches worse, sending me to an emergency room three times. As this latest attack stretched on, I knew I had to try something new
The beefy armed guard at the door of the Church of Entheogenic Plants chuckled at the sight of me, and I guessed what he might be thinking: What’s that 60-something lady doing here?
It wouldn’t have been unreasonable to wonder—and not just because everyone else waiting to pass through the metal detector that day last winter was roughly 40 years younger than I. Vice News has called the Oakland, CA, church, also known as Zide Door, America’s “most prominent ‘magic mushroom club,’ ” implying that its religious decor is a ruse to evade state and federal laws against selling psychedelic drugs. In accepting “contributions” for strains of ’shrooms with names like “Blue Meanies” and “Penis Envy,” Zide Door claims the same exemption that lets the Navajo legally ingest peyote, a traditional sacrament.
Ruse or not, that hasn’t offered much protection. In August 2020 police raided the premises and seized about $200,000 worth of cash and drugs. Pastor David Hodges told me he planned to sue the city government for violating his congregants’ religious freedom.
Potentially breaking the law was not my only concern when it came to trying magic mushrooms. I was an unusually suggestible child in the 1960s, when well-meaning parents scared their kids straight with stories about acid trippers who went blind from staring at the sun, mistook a baby for a turkey and stuffed it in the oven, or woke up convinced they’d turned into a glass of orange juice. In the late 1970s, when many of my college pals were experimenting, I declined even to smoke weed.
The pain in my brain
But last February, I was standing in front of the church out of desperation, hoping that psilocybin, the active ingredient in mushrooms, would relieve my excruciating pain. I was in my 12th week of a siege of cluster headaches, and I felt as if a Lilliputian with a tiny ice pick were jabbing at the back of my right eye for an hour each day, starting at 5 a.m.
Cluster headache is a rare disorder, estimated to affect roughly one or two in 1,000 people (migraines are at least 120 times as common). They’d plagued me for a month or so every two years since 2005, and usually prednisone knocked them out. But this time the only thing that brought even brief respite was—no joke—snorting cayenne pepper, which made me sneeze until I felt as if I might pass out. I also worried that it might be corroding the inside of my nose.
I’m far from the only person seeking out these long-demonized drugs for medical reasons. Using LSD, psilocybin, and MDMA (Ecstasy) to relieve suffering appears to be on the rise. While most self-experimenters use psychedelics to enhance well-being, a portion “self-medicate preexisting mental health conditions,” wrote psychiatrist Adam Winstock, M.D., in the Global Drug Survey. His annual polls of more than 500,000 people suggest that the use of LSD and psilocybin among respondents has roughly doubled over just the past five years. An honorary clinical professor at the Institute of Epidemiology at the University College of London, Dr. Winstock joins other experts in comparing the drugs favorably with prescription antidepressants. “The benefits are really clear for patients,” he says. “They want things that work, work quickly, and don’t require them to take medications every day.”
Americans’ interest in hallucinogens was supercharged by Michael Pollan’s 2018 best seller, How to Change Your Mind. A year later, Johns Hopkins launched a $17 million center to study a variety of illicit-drug therapies that showed promise in treating disorders such as depression, trauma, anorexia nervosa, tobacco addiction, and even post-treatment Lyme disease. Researchers are excited, even as psilocybin and LSD continue to be classified as Schedule I substances, which are seen as having no medical use, a high potential for abuse, and unacceptable risks even under professional supervision.
But if you’ve ever had cluster headaches, you know why they’ve been called“suicide headaches.” People in the midst of an attack are believed to die by suicide at roughly three times the rate of the general population, and sufferers describe the attacks as more painful than childbirth, gunshot wounds, and kidney stones, according to University of West Georgia psychology professor Larry Schor, Ph.D., who has conducted a large survey of cluster-headache patients (and suffers from them himself). On average, cluster-headache patients take more than five years to be properly diagnosed, after which even prescribed drugs may fail. Early on, I tried taking sumatriptan, a drug for migraine headaches, and at first it was helpful, but then made my headaches worse, sending me to an emergency room three times. As this latest attack stretched on, I knew I had to try something new
.
© Julien Pacaud woman with a headache on a bench
From hedonism to healing
Researchers first investigated the potential therapeutic benefits of psychedelic drugs in the 1950s and 1960s, when hundreds of Americans, including actors Cary Grant, Rita Moreno, and Jack Nicholson, joined a series of supervised experiments in California. (Grant credited acid with helping him control his alcohol use and cope with the long-unexplained disappearance of his mother when he was a child.) The backlash began after Harvard lecturer Timothy Leary and psychologist Richard Alpert (who became known as Ram Dass) championed wider use of LSD and psilocybin, with Leary’s call to “turn on, tune in, drop out” becoming a slogan of the counterculture. President Richard Nixon branded Leary “the most dangerous man in America” and in 1971 launched the war on drugs.
These days, the hope is that psychedelics may help the many millions of Americans who suffer from depression and other serious mental disorders, particularly when nothing else has worked. The National Institute of Mental Health estimates that 17.3 million U.S. adults have at least one major depressive episode each year, while up to 30% don’t receive sufficient help from mainstream anti-depressants. PTSD affects nearly 8 million people, including more than half a million U.S. veterans, while 40 million adults have anxiety. (Some of these rates were higher during the pandemic.) Researchers have been studying psychedelics to alleviate cluster headaches since 2006, but I learned of them through an activist patients’ group called Clusterbusters, which has touted their use since 2002.
Amid all the hoopla, some people may get a boost from just the idea of psychedelics: More than 60% of participants in a 2020 study said they’d experienced mind-altering effects after taking a placebo. Still, researchers have gathered sufficient evidence of psilocybin’s power to convince the FDA in 2019 to classify it as a“breakthrough therapy” for two types of severe depression. That fast-tracked it for approval, similarly to how esketamine (related to ketamine, an illegal party drug) was OK’d for treatment-resistant depression that same year.
Video: We're bring back these psychedelic drugs, 'but as a medical treatment against various forms of mental health issues': atai Life Sciences Founder (Yahoo! Finance)
The treatment of PTSD may be the next potential boon: Some scientists have found MDMA both safer and more effective in treating trauma than conventional antidepressants. In May, a major study published in Nature Medicine provided new evidence along these lines, and late last year Rick Doblin, executive director of the nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS), predicted that MDMA-assisted psycho-therapy for PTSD could win federal approval as soon as next year.
It’s not clear just how psychedelics might supply mental and emotional benefits—or, in my case, relieve physical pain—but scientists have some ideas. Studies suggest that psilocybin and other psychedelic drugs affect levels of serotonin, a neurotransmitter and hormone involved in regulating mood. MDMA is believed to activate receptors for oxytocin, a peptide linked to trust and bonding, possibly helping soften trauma sufferers’ defensive shells. So far the explosion of discoveries has involved small studies that need to be expanded and replicated. Yet the drumbeat of positive developments has likely helped increase official tolerance in some parts of the nation.
Risky business
Many jurisdictions are considering rewriting their laws on psychedelics. In May 2019, Denver became the first U.S. city to decriminalize psilocybin mushrooms, and Oakland, CA, followed suit. Voters in Oregon and Washington, DC, have approved the therapeutic use of psilocybin, while California lawmakers recently took up a bill to decriminalize some hallucinogens. The trend is familiar: Whereas barely 20 years ago cannabis was outlawed everywhere in the United States, today 36 states and four territories have legalized it for medicinal purposes. (Decriminalization doesn’t make a drug legal. It simply reduces penalties associated with it. Selling psychedelics is still illegal everywhere, and possession of them can lead to federal prosecution that could result in up to a year in prison and $1,000 or more in fines.)
Of course, breaking the law isn’t the only risk involved. Some recreational magic mushroom users have reported frightening bad trips, panic attacks, seizures, and hospitalizations. Scientists and drug aficionados alike warn against casual use, and participants in psychedelic studies to date have all been carefully screened and supervised, with researchers rigorously excluding subjects with preexisting conditions such as heart trouble, schizophrenia, and bipolar disorder. “I really worry about people in a time of crisis choosing to take psychedelics without supervision and making themselves worse,” says Dr. Winstock, whose surveys indicate that approximately 8% of LSD and psilocybin users had a bad experience over the past year.
Targeting my headaches
Still, in reporting a story for the Washington Post, I learned that many scientists regard psilocybin as one of the least toxic and addictive of all recreational drugs, and that the reports of bad trips involved much larger doses than the therapeutic amount for my cluster headaches. In severe pain, I decided to give it a try.
“Psilocybin’s chemical structure is similar to melatonin’s,” says Yale University neurologist Emanuelle Schindler, M.D., Ph.D., referring to a hormone that regulates circadian rhythm and is taken supplementally for insomnia as well as headache prevention. It is also akin to triptans, which are prescribed to treat one headache at a time. “Psilocybin has a longer-term effect, though,” notes Dr. Schindler, who is currently working on a study on its effects for cluster headaches.
Over the years, Clusterbusters members have offered invaluable support to Dr. Schindler and other scientists, recruiting patients for their studies and providing them with information from their self-treatment with psychedelics. In 2004, the group convinced Harvard researchers to conduct a pioneering study on psilocybin and LSD. The Harvard team gathered testimonies from 53 cluster-headache patients, most of whom said the drugs had helped. John Halpern, M.D., a psychiatrist who led the Harvard study, told me he has since seen many patients go from being “incapacitated” to “having as close to a functional cure as you can get.” The two drugs may prove to be “the best we have to offer” to cluster-headache patients, he adds, “although legally we can’t offer them.”
I followed Clusterbusters’ recommended protocol of taking small amounts of psilocybin—more than microdoses, but short of what would lead to tripping—brewed in a multi-ingredient tea containing lemon, honey, vitamin C, and a little instant coffee, with three doses spaced five days apart. The first time I didn’t feel anything remarkable until the next
morning, when I had a more-awful-than-usual headache: the “slap-back” side effect the website had warned me to expect. Over the next five days, however, I noticed that there were two days when I didn’t have a headache at all.
Maybe a little overconfident, I overestimated with my second dose. Twenty minutes after sipping the tea, I found myself staring for half an hour at our backyard pistache tree, which seemed to have grown beckoning silvery branches. I felt as if I could see the tree breathing, which was wondrous. I was back to myself within a couple of hours, and the next morning I had another slap-back headache. But the two mornings after that—nothing. For the rest of the week, the headaches were milder.
Then I took my third dose, measuring carefully this time. The only psychedelic-ish effect that I noticed—really noticed—was that my dog’s face was utterly gorgeous. Then I fell asleep next to my husband. I woke up to yet another fierce headache the next morning, but the morning after that I had zero pain. Zero again the next day, and the next. Two months have now passed without my having a single headache.
© Julien Pacaud scientist researching psychedelics
Increasing availability
As the psychedelic-therapy revolution matures, there have been calls to ensure that its potentially powerful benefits are accessible to all. That will require some significant change considering that Black people are much more likely than white people like me to be arrested for possession of any drug, even after decriminalization.
“Equity of access to these drugs will address the burden of disease we know is greatest among people of lower socio-economic status, who have higher rates of depression and PTSD,” says Dr. Winstock. MAPS has trained scores of therapists of color to prepare for the time when treatment with them becomes legal.
In the meantime, research continues. “It doesn’t strike me as weird that the same molecule used by someone in a bedroom listening to Pink Floyd can also be a healing drug,” says Dr. Winstock. He says that psychedelics’ capacity to “disrupt existing brain networks and allow new pathways and new ways of thinking is why they can have wide potential in so many different conditions.”
As for me, I can’t say whether my cluster-headache siege ended on its own or whether using ’shrooms really did do the trick. But I do know that I’ve got a plan if the headaches return—and that I’ll never look at our pistache tree the same way again.
This article originally appeared in the August 2021 issue of Prevention.
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