In psychedelic therapy, clinician-patient bond may matter most

Study links relationship strength to reduced depression for up to 1 year

READ LEARY AND ALBERT 

Peer-Reviewed Publication

OHIO STATE UNIVERSITY

COLUMBUS, Ohio – Drug effects have dominated the national conversation about psychedelics for medical treatment, but a new study suggests that when it comes to reducing depression with psychedelic-assisted therapy, what matters most is a strong relationship between the therapist and study participant.

Researchers analyzed data from a 2021 clinical trial that found psilocybin (magic mushrooms) combined with psychotherapy in adults was effective at treating major depressive disorder.

Data included depression outcomes and participant reports about their experiences with the drugs and their connection with therapists. Results showed that the stronger the relationship between a participant and clinician – called a therapeutic alliance – the lower the depression scores were one year later.

“What persisted the most was the connection between the therapeutic alliance and long-term outcomes, which indicates the importance of a strong relationship,” said lead author Adam Levin, a psychiatry and behavioral health resident in The Ohio State University College of Medicine.

Past research has consistently found that as mental health treatments changed, a trusting relationship between clients and clinicians has remained key to better outcomes, said senior author Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work.

“This concept is not novel. What is novel is that very few people have explored this concept as part of psychedelic-assisted therapy,” Davis said. “This data suggests that psychedelic-assisted therapy relies heavily on the therapeutic alliance, just like any other treatment.”

The study was published recently in the journal PLOS ONE.

Twenty-four adults who participated in the trial received two doses of psilocybin and 11 hours of psychotherapy. Participants completed the therapeutic alliance questionnaire, assessing the strength of the therapist-participant relationship, three times: after eight hours of preparation therapy and one week after each psilocybin treatment.

Participants also completed questionnaires about any mystical and psychologically insightful experiences they had during the drug treatment sessions. Their depression symptoms were assessed one week, four weeks, and up to one year after the trial’s end.

The analysis showed that the overall alliance score increased over time and revealed a correlation between a higher alliance score and more acute mystical and/or psychologically insightful experiences from the drug treatment. Acute effects were linked to lower depression at the four-week point after treatment, but were not associated with better depression outcomes a year after the trial.

“The mystical experience, which is something that is most often reported as related to outcome, was not related to the depression scores at 12 months,” Davis said. “We’re not saying this means acute effects aren’t important – psychological insight was still predictive of improvement in the long term. But this does start to situate the importance and meaning of the therapeutic alliance alongside these more well-established effects that people talk about.”

That said, the analysis showed that a stronger relationship during the final therapy preparation session predicted a more mystical and psychologically insightful experience – which in turn was linked to further strengthening the therapeutic alliance.

“That’s why I think the relationship has been shown to be impactful in this analysis – because, really, the whole intervention is designed for us to establish the trust and rapport that’s needed for someone to go into an alternative consciousness safely,” Davis said.

Considering that psychedelics carry a stigma as Schedule I drugs under the Controlled Substances Act, efforts to minimize negative experiences in future studies of their therapeutic potential should be paramount – and therapy is critical to creating a supportive environment for patients, the authors said.

This study ideally will help clearly position psychedelics treatment as a psychotherapeutic intervention moving forward – rather than its primary purpose being administration of a drug, Levin said.

“This isn’t a case where we should try to fit psychedelics into the existing psychiatric paradigm – I think the paradigm should expand to include what we’re learning from psychedelics,” Levin said. “Our concern is that any effort to minimize therapeutic support could lead to safety concerns or adverse events. And what we showed in this study is evidence for the importance of the alliance in not just preventing those types of events, but also in optimizing therapeutic outcomes.”

This work was supported by the Center for Psychedelic and Consciousness Research, funded by the Steven & Alexandra Cohen Foundation, the RiverStyx Foundation and private donors. It was also supported by the Center for Psychedelic Drug Research and Education (CPDRE), funded by anonymous donors.

Additional co-authors are Rafaelle Lancelotta, Nathan Sepeda and Theodore Wagener of Ohio State, and Natalie Gukasyan, Sandeep Nayak, Frederick Barrett and Roland Griffiths of the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where Davis is an affiliate.

#

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JOURNAL

PLoS ONE

DOI

10.1371/journal.pone.0300501 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial for major depressive disorder

‘Magic mushrooms’ for therapy? Vets help sway conservatives

By LINDSAY WHITEHURST

Matthew Butler, who spent 27 years in the Army, holds a 2014 photograph of himself during his last deployment in Kabul Afghanistan, on Wednesday, March 30, 2022, in Sandy, Utah. Butler is now one of the military veterans in several U.S. states who are helping convince conservative lawmakers to take cautious steps toward allowing the therapeutic use of hallucinogenic mushrooms and other psychedelic drugs. The therapeutic used of so-called magic mushrooms and other psychedelic drugs is making inroads in several U.S. states, including some with conservative leaders, as new research points to their therapeutic value and military veterans who have used them to treat post-traumatic stress disorder become advocates. 

(AP Photo/Rick Bowmer)


SALT LAKE CITY (AP) — Matthew Butler spent 27 years in the Army, but it took a day in jail to convince him his post-traumatic stress disorder was out of control.

The recently retired Green Beret had already tried antidepressants, therapy and a support dog. But his arrest for punching a hole in his father’s wall after his family tried to stage an intervention in Utah made it clear none of it was working.

“I had a nice house, I had a great job, whatever, but I was unable to sleep, had frequent nightmares, crippling anxiety, avoiding crowds,” he said. “My life was a wreck.”

He eventually found psychedelic drugs, and he says they changed his life. “I was able to finally step way back and go, ‘Oh, I see what’s going on here. I get it now,’” said Butler, now 52. Today his run-ins with police have ended, he’s happily married and reconciled with his parents.

Butler, who lives in the Salt Lake City suburbs, is among military veterans in several U.S. states helping to persuade lawmakers to study psychedelic mushrooms for therapeutic use.

Conservative Utah has become at least the fourth state over the last two years to approve studying the potential medical use of psychedelics, which are still federally illegal. A string of cities have also decriminalized so-called magic mushrooms and an explosion of investment money is flowing into the arena.

Experts say the research is promising for treating conditions ranging from PTSD to quitting smoking, but caution some serious risks remain, especially for those with certain mental health conditions.

Oregon is so far the only state to legalize the therapeutic use of psilocybin, the psychedelic active ingredient in certain mushrooms. But studying them for therapy has made inroads not only in blue states like Hawaii, Connecticut and Maryland, but also GOP-led Texas, Utah and Oklahoma, which passed a study bill through the state House this year.

The progress stands in contrast to medical marijuana, which Utah lawmakers refused to allow until a ballot measure helped push it through. However, the proposal to study a broad range of psychedelic drugs passed easily this year.

Texas has yet to legalize medical marijuana, but former Republican Gov. Rick Perry helped shepherd through a bill last year to use $1.4 million to fund a study of psilocybin for treating PTSD.

“The stigma attached to psilocybin and most psychedelics dates back to the 60s and 70s. It’s been very hard for them to overcome,” said Democratic Rep. Alex Dominguez, who sponsored the bill. “My approach was, ‘Let’s find the group that all sides claim that they are supportive of.’ And that would be veterans.”

He also heard from conservatives like Perry who support the use of psilocybin to treat PTSD — and let advocates from that end of the political spectrum take the lead publicly.

Maryland also gave bipartisan approval to spending $1 million this year to fund alternative therapies for veterans, including psychedelics. Democratic sponsor Sen. Sarah Elfreth, whose district includes the U.S. Naval Academy, noted the spike in suicides among veterans.

“I don’t envision the VA acting anytime soon,” she said. “We’re at a true crisis level and it’s time for the states to step up.”

Psilocybin has been decriminalized in nearby Washington, D.C., as well as Denver, which decriminalized it in 2019, followed by Oakland and Santa Cruz in California, Ann Arbor, Michigan, and Cambridge, Massachusetts.

There’s also plenty of venture capital being invested from people who have had positive experiences and are “highly motivated” to invest in psychedelics as treatment, said John Krystal, the chair of psychiatry at Yale University.

Rhode Island lawmakers are weighing a proposal to decriminalize psilocybin this year, and in Colorado there’s an effort to get statewide decriminalization on the ballot. But similar measures have stalled in Statehouses elsewhere, including California and Maine.

Studying psychedelics, though, has gained more traction. In Oklahoma, a bill from Republican Reps. Daniel Pae and Logan Phillips would legalize research on psilocybin.

“I believe the research will show that there is a way to use this drug safely and responsibly, and it could save the lives of thousands of Oklahomans,” Pae said in a statement. The bill passed the House last month and is now under consideration in the Senate.

It’s a stunning turnaround for a field that captivated researchers in the 1950s and 1960s, before mushrooms and LSD became known as recreational drugs. They were federally outlawed during the Nixon administration, sending research to a screeching halt.

New studies, though, have indicated psilocybin could be useful in the treatment of everything from major depression to alcoholism, said Ben Lewis, an assistant professor of psychiatry at the University of Utah Huntsman Mental Health Institute.

“People are referring to this current period of time as the psychedelic Renaissance,” he said. Up to 30% of depression sufferers are considered resistant to current treatment, and there have been few recent leaps forward in drug innovation, he added.

The risk of addiction or overdose is considered low with psychedelics, especially under medical supervision, and while some cardiac conditions can present a physical risk, many people’s physical reactions aren’t dangerous.

But there are serious psychological risks, especially for people with certain forms of mental illness or a family history of conditions like schizophrenia or bipolar disorder.

“Then there’s a possibility that a high-dose psychedelic experience could sort of trigger that and lead to long-lasting mental health issues,” said Albert Garcia-Romeu, an assistant professor at Johns Hopkins University School of Medicine.

Classic psychedelics include LSD, mescaline, psilocybin and ayahuasca. Plant-based psychedelics have long been used in indigenous cultures around the world.

Today, their therapeutic use at Johns Hopkins is carefully monitored, Garcia-Romeu said. Patients are rigorously screened and typically have at least three appointments: one for preparation, a second to take the drugs and a third to work through the psychedelic experience.

For Butler, the 2018 arrest at his parents’ home was a turning point. He started researching new ways to deal with the PTSD he has suffered since deploying six times to Iraq and Afghanistan and working in counterterrorism and hostage rescues in Somalia for the U.S. Special Forces before retiring as a lieutenant colonel in 2017.

Eventually he came across ayahuasca, long a part of traditional cultures in South America. Last summer, he took part in a ceremony involving the psychoactive brew, overseen by a woman knowledgeable about its effects. She talked to him as the experience took hold, including a feeling of euphoria, the sight of geometric shapes and a sense he was entering his subconscious.

She spoke to him about his childhood and how the military had shaped his life.

“It really was as simple as having an experienced person who understood the medicine, who understood that subconscious space and understood PTSD. It was as simple as listening to her,” he said.

He credits that single session with getting his PTSD about 80% under control, though he occasionally does another if he finds his symptoms returning.

About two-thirds to three-quarters of people in studies have experienced significant improvements in their symptoms, Garcia-Romeu said. Those are promising results, especially for quitting smoking, where current treatments only work for about one-third of people, he said.

The Food and Drug Administration designated psilocybin a “breakthrough therapy” in 2018, a label that’s designed to speed the development and review of drugs to treat a serious condition. MDMA, often called ecstasy, also has that designation for treatment of PTSD.

How quickly states move from study to wider availability remains to be seen. Connecticut recommended legal medical use only after psilocybin is approved by the FDA, which may take until 2025 or later as the agency works through its process, including risk assessment.

Approval is important to safety as well as access, the Connecticut assessment said — without it, many insurance companies likely wouldn’t cover the treatment, leaving it open only to the wealthy.

In Utah, the study team is expected to complete its work in the fall.

“We’ll see what can and can’t be done,” said Republican Rep. Brady Brammer, who sponsored the bill. “If if they feel like it’s safe, it’ll be an interesting ride.”


Associated Press writers Brian Witte in Annapolis, Maryland; Sean Murphy in Oklahoma City; Susan Haigh in Hartford, Connecticut, and Jim Vertuno in Austin, Texas, contributed to this report.

All-female psychedelic rock band takes the stage in Saudi Arabia, heralding in a new era of personal freedom

Returning to Saudi Arabia, I felt amazed seeing women driving cars. Even more surprising, I witnessed both men and women playing live music in public. One afternoon, I discovered a girl on Instagram playing psychedelic rock. It was exactly what I wanted to do.


Juan Matinez

11 mins ago
August 6, 2024

Saudi Arabian all-female rock band Seera performs in an outdoor setting surrounded by lush greenery. | Photo courtesy of Raman.3000

Journalist’s notes

interview subject

Haya Al-Hejailan, 30, is the lead guitarist of Seera, an all-female Arabian psychedelic rock band formed in late 2022. Having lived in California from 18 to 23 years old, she initially trained as a psychologist specializing in psychedelic science. However, she transitioned to the music industry and now also works in music event management to develop the local music scene. As the founder of the Arab Psychedelic Society, Haya remains active in psychoeducational advocacy and is interested in curating culturally relevant soundtracks for psychedelic-assisted psychotherapy sessions in the Arab world.
background information

Since Crown Prince Mohammed bin Salman became Saudi Arabia’s de facto leader, he has promised new opportunities for Saudi women as part of a broad modernization plan called Vision 2030. The percentage of women working outside the home has almost doubled, now at 32 percent from 18 percent. Women now work as customs officers at Riyadh’s King Khalid International Airport, as customer relations managers in banks, and as hostesses in restaurants, among other jobs. Public spaces are also becoming less gender-segregated, with coffee shops like Overdose allowing male and female customers to mingle. Women can attend certain sporting events in stadiums, apply for passports, live alone, and travel independently. However, the guardianship system remains, requiring women to obtain permission from male relatives for key decisions.

RIYADH, Saudi Arabia — Music has always been integral to my life. At home, it was deeply valued, though public opportunities to perform remained scarce. A piano teacher taught my sisters and me, and by age four, I discovered my unique musical talents.

In my thirties now, I am living a dream I never thought possible as a child. I formed a psychedelic rock band with other women, and we perform live. Growing up in Saudi Arabia, music remained a private joy amid a society with restricted personal freedoms and limited rights for women. Now, I witness and partake in change.

Read more Sex & Gender stories at Orato World Media.
From Saudi to California: Kurt Cobain sparked my dream of rock stardom

Growing up, I yearned to stand out. The haunting voice of Kurt Cobain and Nirvana’s music resonated with me, despite the different worlds we expeirenced in our lives. His influence sparked my dream to become a rock musician, to be cool, and play the guitar.

I listened to Nirvana at home and during car rides to school, but I kept my musical tastes private. The social restrictions in Saudi Arabia felt natural to me, like the sky being blue. I never realized things could be different.

As a teenager, I began to feel the gender distinctions more acutely. My liberal family valued freedom, but at 18, I hit a wall when I realized society restricted me from driving. This made me notice other restrictions, like the absence of rock music in public spaces, not just for women, but in general.

At that age, I followed my sisters’ path and moved to California to study. Although my school and family’s diplomatic background exposed me to American culture, when I went to California, I experienced significant culture shock. Access to freedoms like public cultural openness and apparent gender equality felt startling. However, part of that shock also felt negative. I needed to adjust to the stark differences in social norms and expectations.

In the United States, I encountered an individualistic society where people seemed more self-focused and less considerate of others. This made me appreciate certain aspects of my own culture more deeply. Despite the greater freedoms and cultural openness, I felt a lack of genuine connection. I found it difficult to form close relationships and, consequently, felt uninspired to start a band. I experienced plenty of interactions, but none led to meaningful bonds.
Returning home to Suadi Arabia and embracing cultural change through music

Meanwhile, I began to see from afar the changes happening in Saudi Arabia that I wanted to be part of. From my room, I discovered many female bands I admired playing in my country. Local bands emerged and I felt called to action. “That’s where I want to be,” I thought. I decided to return home to join my first band and to create music with people who understood the depth of my culture. Additionally, I hoped to bring back what I learned abroad.

Saudi Arabia’s population remains young with a large percentage of people under the age of 35. Change seemed inevitable. Now, we share a different perspective. The country feels full of energy and excitement. The things we create lead to a palpable effervescence in society.

Returning to Saudi Arabia, I felt amazed seeing women driving cars. Even more surprising, I witnessed both men and women playing live music in public. One afternoon, I discovered a girl on Instagram playing psychedelic rock. It was exactly what I wanted to do. I immediately messaged her, saying, “I want to start a band and make music like you. Would you be interested?” She agreed, and we met at my house for a jam session.

Seera in a dynamic outdoor performance | Photo courtesy of Raman.3000

When we started playing together, I sensed something special. It felt like planting seeds that, if nurtured, may grow into something beautiful. Allowing the process to proceed naturally, I knew something great would emerge. Throughout my life, I pondered what success meant to me. I studied psychology, earned a master’s degree, and read extensively on the topic, but certain questions always haunted me. That day, during our jam session, for the first time I felt like everything I needed to be successfully in art was within reach.

Seera breaks barriers: All-female rock bands rise in Saudi Arabia

Meesh’s sister joined us, and soon after, I reached out on Instagram to our fourth member, whom we nicknamed Thing. From the start, I made it clear: “Seera is a [musical] project that rquires commitment. We need to get somewhere with this.” Meesh replied, “It’s a dream for me.” The group of us shared passion, dedication, perseverance, and resilience.

I do not view myself as an activist. As a child, all my musical idols were male, because I lacked a female role model. I want to be that person for the next generation. An all-female band inspires people. When young women see us on stage, having fun and being ourselves, they feel something.

I think of myself at 13 years old and I imagine attending a Seera show. Certainly, it would have made me very happy. Many people tell us they started playing an instrument because of us. It feels beautiful and makes getting up every morning a little bit easier.


 

Seera performing live on stage | Photo courtesy of Raman.3000

Our first live show at The Warehouse became a moment marked by powerful sensations. It felt like riding a bike. Though difficult at first, we possessed the skills and desire within us to succeed. On stage, it feels as if time stands still and everything flows naturally. Seeing people touched by our music feels sensational, making me a part of something bigger.

We do this for ourselves because we love making music, but also for the people around us. We do it for the community. Talking about this makes me emotional because people are so important to us—they are why we do what we do. We want to show the world that Saudi Arabia possesses a rich cultural heritage and diversity. We aim to demonstrate the creation of a new era for our country, modernizing our cultural heritage. I hope to be only the first of many all-female rock bands emerging from Saudi Arabia.

#GlobalCooperationNow

Pledge to be a #ConsciousCitizen today and demand #GlobalCooperationNow! by signing this petition. Sign Our Petition.

Psychedelic mushrooms for depression: 'This is the one that changed things'

Psychedelic drugs like psilocybin are back in human trials to treat people with mental health conditions. It's a second revolution for a class of drugs shunned by 1960s society. But more research is needed. Here's why.



Psilocybin was shunned by mainstream society in the 1960s as "Substance 1" — dangerous and of no medical use. And for decades, evidence suggesting that psilocybin could be therapeutic lay buried in books. But over the past decade, a resurgence in psychedelic research has yielded new insights, with some labs running human trials.

David Nutt calls it the "brave new world of psychedelic psychiatry." Nutt is a neuro-psycho-pharmacologist and professor at Imperial College London. He suggests psychiatry is slowly emerging from a 30-year dark age, during which anti-depressants were the only accepted medicinal treatment for mental health conditions.

Apart from being costly, Nutt says anti-depressants help only a small percentage of the people who take them. Side effects can include a blunting of the emotions.

"I like to think of it as a force field," says Nutt. "They protect you. They cocoon you from the stresses of life, which are many and repeated, and they allow your brain to heal."

But the effects only last as long as you take anti-depressants. When you come off them, you can experience severe withdrawal symptoms. And perhaps more importantly, anti-depressants do not deal with the root cause of depression or anxiety, says Nutt.

Meanwhile, psilocybin appears to offer a different and longer-lasting alternative.

Nutt and his team of researchers have been concluding a second human trial of psilocybin to treat depression.

Read more: Coronavirus and mental health: 'We are not made for social isolation'

Neuropsychopharmacologist David Nutt warns of severe withdrawal symptoms of anti-depressants.

Controlling the trip

Volunteers with moderate to severe depression are given a 25 milligram (0.000881849 ounce) pill of psilocybin. That's a macrodose which causes a powerful, deep "trip" for about four hours.

But it's not like hippies tripping in a field. The tests are done in a controlled environment, with two therapists assigned to each volunteer.

"Depressed people having a trip aren't having fun," says Nutt. "They are often going back to the most horrible experiences of their lives and reliving things which they've often forgotten but which are causing the depression."

The therapists prepare the volunteers for what they might experience. They hold the volunteers' hands during the test to provide a sense of security. And after the trip, the therapists help the volunteers make sense of the experience through psychotherapy.

"This is not something you just go and do outdoors by yourself," says Nutt. "This is serious medicine. This is powerful medicine." A glimpse of the first clinical trial at Imperial College London can be found in this youtube video:

Rapid and lasting effects

In one trial, 20 patients who had not responded to treatment for depression, were given two doses of psilocybin one week apart. Nutt's team found rapid and long-lasting improvements in the patients' health. None of the patients required traditional anti-depressants for the first five weeks after the tests. Six months later, they had follow-up tests that showed many of their symptoms had stayed away.

But there was no control group—no way to compare the results directly. A team under Robin Carhart-Harris at the Centre for Psychedelics Research in London is now running similar tests with such controls in place.

Patient testimonies, available online, report huge improvements in health. One patient, called Andy, says that all standard treatments had failed him. No therapy had helped him find an underlying cause for his depression. But he says psilocybin gave him a missing piece of the jigsaw puzzle. It was "the one that changed things."

Read more: Happiness, where are you?


Andy participated in the first ever clinical trial of psilocybin to treat depression

Science and society

It's been difficult for some health professionals and scientists to accept any therapeutic benefits of psilocybin despite the evidence.

For decades, doctors have told people how dangerous these drugs are—and those dangers or risks are real when psychedelics are taken in uncontrolled, so-called "recreational," settings.

In controlled settings, however, psychedelics could offer patients, suffering from depression or addiction, treatments that work better for them than traditional anti-depressants, or plain will power.

"They should at least have the opportunity of treatments which might work for them," says Nutt. "To deny them that on the basis of some kind of moral philosophy against drugs is, I think, unethical."

Stephen Ross, a psychiatrist based in New York, has had to confront that belief himself. In his entire medical training at the University of California, Los Angeles, there was no mention of psychedelics.

Psilocybin is the active ingredient found inside magic mushrooms

Psychedelics buried deep in literature

Then in 2006, Ross heard about a conference, marking the 100th birthday of Albert Hofmann, a Swiss scientist who discovered lysergic acid diethylamide and synthesized psilocybin.

Ross was puzzled. "Why would anybody be celebrating the discovery of LSD? All I had heard about LSD from my training was that it was a bad, dangerous drug."

So, he started looking into the medical history and found a huge body of research hidden in plain sight. The 1950s, 60s and 70s were a rich time for psychedelic research. Among the reports Ross found, there was a strong focus on using LSD to treat alcoholism. As an addiction psychiatrist, Ross' curiosity was piqued.

But with LSD shunned as a Substance 1 drug, it was a struggle to get funding for research.

To increase his chances at success, Ross turned to psilocybin, a psychedelic that like LSD had been branded a Substance 1 drug, but it was one with "less cultural baggage." And he turned to a condition with less social stigma than depression or addiction: cancer.

Read more: Never tried LSD - the drug my father discovered

Stephen Ross is conducting clinical trials of psilocybin on terminal cancer patients.

Psilocybin and cancer
"Cancer is a very scary thing in any culture. Cancer patients start to have this existential distress, where they feel hopeless, that life is meaningless, pointless," says Ross, now associate professor at New York University's School of Medicine. "And there's no treatment for that kind of existential distress."

In 2016, Ross completed the first human trial with psilocybin to reduce depression and anxiety in 29 patients with terminal cancer.

He says that psilocybin helps people reconceptualize cancer as "a part of their life," rather than it being their whole life.

"A lot of patients come out of the experience and say that they connected to this profound sense of love or universal love or God's love, or that the feeling of love was profoundly healing to them," says Ross.

Read more: Differences in personality: What psychiatrists can learn from mice to treat depression

The spheres show connectivity inside a human brain.

Under the influence of a psychedelic drug like psilocybin, more and more neurons interact with each other. These neurons may not have been interacting before because the mind was in a rut or fixed pattern of thinking. Psychedelics add flexibility. A placebo is shown to compare how evident the effect is.

Careful, it's a new revolution
Psychedelics could also be used to treat other conditions, including anorexia, obsessive compulsive disorder, post-traumatic stress disorder and personality disorders.

But Ross says we still need to be careful with psychedelics. He says there may be a bias among researchers—after years of struggling to get psychedelic studies funded, combined with the excitement of new results—to believe that psilocybin will cure everything.

Their work is finding a new audience and perhaps a new form of acceptance, with popular science books out on the shelves. But researchers say there is a lot more work to be done before psychedelics can be used in medicinal treatment.

"I'm not saying that psychedelics should be used clinically yet at all. We need more research," says Ross. And even then, psychedelic treatments may not be for everyone. Researchers warn against using psychedelic treatments with patients suffering a psychosis, or young people whose brains are still developing.

Link to the documentary: A New Understanding: The Science of Psilocybin

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HIP CAPITALI$M

What to know about the booming psychedelics industry, where companies are racing to turn magic mushrooms and MDMA into approved medicines

ylee@businessinsider.com (Yeji Jesse Lee) 

© jackfoto/iStock/Getty Images Plus Psilocybin mushrooms on a mossy log jackfoto/iStock/Getty Images Plus

A year ago, nonprofits and scrappy startups made up the psychedelics space.
Now, companies are raising millions from investors and going public on major exchanges.

Here's what you need to know about the booming psychedelics industry.

The psychedelics space is booming.

Over the few years, startups focused on turning psychedelic compounds into approved medicines have raised hundreds of millions of dollars from private investors and dozens have gone public.

Research on compounds like psilocybin, the active compound found in magic mushrooms, and MDMA is resurfacing after years of neglect amid the war on drugs.

As companies get closer to receiving approval from the Food and Drug Administration to bring their psychedelic treatments to patients, they've also been planning out their patent strategies to carve out their share of the market.

Here's a look at the booming psychedelics industry:

© Anitram/Shutterstock Psilocybin mushrooms Anitram/Shutterstock

VCs have deployed millions into psychedelics startups — here's what they say will happen next

Venture-capital investors have been at the center of the psychedelics boom. In early 2020, startups in the space said they were beginning to see signs that investor appetite was growing.

Then, we saw a flurry of activity, which one industry exec called a "psychedelic renaissance."

Soon, VC firms focused on psychedelics companies specifically began to emerge. Insider's list of the top 11 venture-capital investors in the space collectively deployed $139.8 million into startups in just a few short years.

They also gave us their predictions for the coming months. Some told us that biotech giants were looking to get into the space, while others predicted a boom in tech companies and clinics that would lay the groundwork for when medications come to market. We can also expect to see new compounds and a slew of startup failures, they said.

The top 3 VC firms told Insider about the green and red flags they see among startups in the space.

Read more:

Meet the top 11 VCs who've bet the most cash on turning MDMA and magic mushrooms into medical treatments

Top VCs in psychedelics say Big Pharma is knocking at the door — and it could fuel a wave of deals

Top VCs predict new compounds and impending failures will shape the future of the psychedelics industry

3 top VCs who've sunk the most cash into psychedelics say they prioritize data, deep expertise, and a clear market strategy when placing their bets

Mainstream startup accelerators are also eyeing the space

© Provided by Business Insider Woven Science and Founders Factory are teaming up to create an accelerator program for psychedelics startups. From left: Sahil Sachdev, head of venture design at Founders Factory; Nick von Christierson, CEO & Co-Founder at Woven Science; Shona Chalmers, venture design lead at Founders Factory; Damian Routley, chief commercial officer at Founders Factory Woven Science & Founders Factory

In a signal that the psychedelics space is becoming increasingly mainstream, startup accelerators known for investing in tech, retail, and healthcare are jumping into funding companies in the industry.

Famed startups accelerator Y Combinator is dabbling in psychedelics: over the past few years, the organization has accepted at least four startups into its program. Insider spoke to three of the startups to ask them about their experiences and the advice they would give to other founders looking to be accepted.

Founders Factory, an accelerator that's worked with companies like L'Oréal, Johnson & Johnson, and Marks & Spencer, is an example of another mainstream player that's eyeing the $100 billion industry.

The organization is partnering with psychedelics company Woven Science to to support a handful of early-stage startups focused on psychedelics-based mental-health treatments.

Read more:

The famed startup accelerator Y Combinator is wading into the $100 billion psychedelics industry. Here's how 3 psychedelics firms got into the program.

A startup accelerator that's worked with J&J and L'Oréal is getting into psychedelics as the industry goes mainstream

CEOs set the tone for the burgeoning space

© Provided by Business Insider ATAI Life Sciences CEO Florian Brand. ATAI Life Sciences

A slew of companies have entered the psychedelics industry, but a few stand out as frontrunners.

In February 2020, Atai CEO Florian Brand said that he was turning to pharma and biotech investors as the company looked to further grow. At the time, Atai was a private company that made headlines for winning over backers like Mike Novogratz and Peter Thiel.

In March of this year, the company raised a record $157 million, pushing psychedelics further into the mainstream.

Meanwhile, change has been bubbling on the state and local levels. In November, Oregon legalized psilocybin for therapeutic purposes — but that doesn't mean you'll see the giants rush in.

The biggest companies in the space told Insider they were focused on seeking approval for their experimental substances from the Food and Drug Administration. Atai founder Christian Angermayer said recently that while he personally supports decriminalization, he thinks legalizing psychedelics could create a backlash for the industry.

Compass Pathways CEO George Goldsmith told Insider soon after the company's IPO last fall that he expects treatments to come on the market by 2025. Atai's Brand said there are challenges to address between now and when treatments become widely available, such as scalability and reimbursement.

Read more:

The CEO of a $1.2 billion psychedelics company told us he expects psilocybin-based treatments by 2025 and predicts a 'Cambrian explosion' of innovation in the industry

The founder of the biggest psychedelics company says legalizing magic mushrooms risks creating a backlash that could undermine the industry

The CEO of the biggest psychedelics company lays out the 3 challenges he has to address before treatments hit the market

Startups are raising big sums for drug development and clinics

© Provided by Business Insider The first page of Compass Pathway's 2019 pitch deck. Compass Pathways

Drug development takes a lot of capital, and startups are focused on getting the funding they need.

Insider got ahold of three pitch decks that companies used to raise tens of millions of dollars. Beckley Psytech raised $18.6 million in December to develop a slew of new treatments focused on rare diseases and mental health.

Compass Pathways raised $80 million from investors like Founders Fund in 2019, fueling its rise to the top.

Meanwhile, startups focused on clinics, where psychedelic treatments are expected to be administered, are raising capital too. Novamind raised $7.8 million with this pitch deck.

© Provided by Business Insider Psilocybin found in magic mushrooms is a type of psychedelic Alexander Volkov/Getty Images

Another way to get access to capital is to go public, and there are now dozens of psychedelics companies in the US and Canada.

We broke down the 7 companies with the biggest market caps and laid out their business models, drug pipelines, and timeline to get treatments to market.

Read more:

What to know about the major public psychedelics companies, including a guide to their business models and when they expect to sell medications

See the pitch deck a psychedelics startup just used to raise $18.6 million to develop new treatments derived from the Sonoran Desert toad

See the 20-slide pitch deck a psychedelics startup used to raise funds to build out a network of ketamine clinics

See the pitch deck that Compass Pathways used to raise $80 million and fuel its rise into one of the world's biggest psychedelics companies

The top startups are racing forward

© The Synthesis Institute A look at a legal psychedelic retreat hosted by The Synthesis Institute The Synthesis Institute

Private startups are still a core part of the space.

Earlier this year, we published a list of the psychedelics startups that raised the most cash in 2020. The 14 names on that list raised over $222 million.

We recently asked the biggest investors in the space to name two top startups in the industry — one they had invested in and one in which they hadn't — and came back with 15 names.

Read more:

Meet the top 14 psychedelics startups raising the most cash to develop new ways of treating depression, addiction, and more

VCs name the top 15 startups in the psychedelics industry

As drug discovery and development heats up, companies are using patents to raise money and protect market share

© Provided by Business Insider Psychedelics companies are using patents to raise funds and protect future market shares. Marianne Ayala/Insider

Psychedelics treatments based on psilocybin and MDMA are inching closer to FDA approval.

In November, Compass Pathways, one of the few psychedelics companies in mid-stage trials of its psychedelic treatment, released data around its phase IIb trials for its a synthetic version psilocybin, the psychoactive component found in magic mushrooms, to treat treatment-resistant depression, or depression that doesn't get better with at least two other treatments.

Compass is also in the midst of a brewing debate over the role that patents should play in the world of psychedelics, which has traditionally been a field defined by open science and natural compounds. Critics say the psychedelics giant is attempting to dominate the industry with its overreaching patent strategy, while Compass says it is only using patents to protect new inventions.

But virtually every company developing psychedelics as FDA-approved treatments is employing a patent strategy to protect its market share and raise money from investors. Patent lawyers told Insider that a slew of patent disclosures could determine the winners and losers of the space.

Read more:

Experts share how a brewing fight could shape the future of the $100 billion psychedelics industry

Compass Pathways released its latest study on a psychedelic to treat depression. A top Wall Street analyst says the results are 'very encouraging.'

The future of the psychedelics industry hinges on patents. Whoever wins could make billions.
Academics, lawyers, and analysts are wading into the burgeoning space

© Provided by Business Insider DMT research at Imperial College London Thomas Angus, Imperial College London

Meanwhile, it's not just investors and companies that are building out the foundation for what could become a $100 billion market.

Academics have continued to publish promising studies on the benefits of psychedelic compounds.

Wealthy philanthropists are responsible for the rush of funding entering academia as prestigious universities set up psychedelic research centers. One scientist told us that as psychedelic research has emerged from the fringes, donors have begun to catch the "psychedelic bug."

"What psychedelics seems to do is, when it grabs you, you really seem to get it," he said.

Lawyers and analysts are also wading into the space. As a slew of companies began to go public, analysts at investment banks began to cover the industry. Lawyers originally focused on cannabis clients also took the plunge.

Read more:

A Canadian investment bank that capitalized on the cannabis rush is now looking toward a new market. Meet the first analyst covering the burgeoning psychedelics industry.

Cannabis lawyers are wading into the psychedelics industry as companies push forward with mega-deals and medical trials to win a slice of the $100 billion market

Wealthy donors are fueling a psychedelics renaissance as universities vie for funding to study 'magic mushrooms' and MDMA

A landmark study shows the main compound in magic mushrooms could rival a leading depression drug

This article was first published on Aug 3, 2021 and was updated on Jan 14, 2022.

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Psychedelic users tended to have better mental health outcomes during the COVID-19 pandemic

2023/10/20


A recently published study, which was conducted during the COVID-19 pandemic, suggests that individuals who have used psychedelic substances experience lower psychological distress, improved well-being, and enhanced post-traumatic growth. The new findings appear in the journal Scientific Reports.

The use of psychedelic drugs has long been a subject of fascination and debate. Historically, these substances have been associated with counterculture movements, and their effects have been portrayed in various ways in popular culture. However, in recent years, researchers have started to examine their therapeutic potential, particularly in addressing mental health issues like depression, anxiety, and post-traumatic stress disorder (PTSD).

The COVID-19 pandemic presented an unusual opportunity to investigate the relationship between hallucinogenic drug use and mental health. With much of the world facing lockdowns and isolation, the researchers wondered whether these substances could play a role in mitigating the psychological toll of the pandemic.

“In a previous paper, we found for the first time that psychedelics may help with coping processes in stressful situations. The pandemic was a perfect opportunity to test the hypothesis,” said study author José Carlos Bouso, the scientific director for the International Center for Ethnobotanical Education, Research, and Service (ICEERS)).

For their study, the researchers recruited a sample of 2,971 participants for the baseline assessment, with 1,024 participants at the first follow-up (two months later) and 455 participants at the last follow-up (six months after the baseline assessment).

To gather data, the team developed an online survey specifically designed for this study, which was made available in Spanish, Portuguese, and English. The survey reached individuals from over 80 countries, including Spain, Brazil, and many others, thanks to snowball sampling and online dissemination through various channels, including social media, scientific journals, and community websites.

“The survey was released to the general population,” Bouso noted. “We did not disclose that we were conducting research about psychedelics to avoid biasing the answers.”

The study employed well-established psychometric measures to assess various aspects of mental health. These included the General Health Questionnaire (GHQ-12) for screening psychological distress, the Brief Symptom Inventory (BSI) for evaluating specific symptoms of psychopathology, the Peritraumatic Stress Inventory (PSI) to measure symptoms associated with traumatic experiences, and the Post-traumatic Growth Inventory (PGI) to assess positive changes following such experiences.

Participants were also asked about their use of psychedelic drugs, including MDMA, ayahuasca, psilocybin-containing mushrooms, LSD, peyote, and others. The study categorized participants as regular users, occasional users, or never-users at the baseline assessment and tracked changes in drug use during follow-ups.

Individuals who reported lifetime use of psychedelic drugs tended to have better mental health outcomes during the pandemic. These outcomes included reduced psychological distress, fewer symptoms of mental health disorders, and enhanced psychological well-being.

Users of psychedelic drugs experienced fewer symptoms across various mental health dimensions, including obsessions or compulsions, depression, hostility, phobic anxiety, paranoid ideation, and psychoticism. The overall severity of psychological symptoms, as indicated by the General Severity Index (GSI), was also lower among this group.

Compared to occasional and never-users, regular users of psychedelic drugs reported higher scores on the Post-Traumatic Growth Inventory (PTG), a measure of positive changes perceived following a traumatic event. These changes encompassed areas such as forming new possibilities, personal strength, spiritual growth, improved relationships, and an increased appreciation for life.

“Our hypotheses were confirmed: participating in structured psychedelic sessions seems to help with the adaptive process in stressful situations and may thus be a protective factor for mental health,” Bouso told PsyPost.

Another notable discovery was that hallucinogenic drug users were less reliant on information from the media and politicians. This is noteworthy because excessive exposure to pandemic-related news and information has been linked to higher levels of distress.

The study also explored differences between respondents from different language backgrounds (English, Spanish, and Portuguese). While variations were observed in their responses, no consistent pattern emerged, suggesting that these findings transcend cultural boundaries.

While these findings offer intriguing insights, it’s essential to acknowledge the limitations of this study. One notable limitation was the high dropout rate during follow-up assessments, which may have influenced the results. Additionally, the survey relied on self-report measures, which can introduce biases.

“This was an observational study,” Bouso said. “The next step should be to conduct a controlled trial.”

Future research should explore the mechanisms through which psychedelic drugs influence mental health and well-being, potentially shedding light on their therapeutic potential. The study’s authors also highlighted the need for reevaluating drug policies and reconsidering relationship between psychedelic experiences and mental health resilience.

“This study opens the door to using psychedelics as preventive strategies in mental health, not just as treatments when the problem has already become entrenched,” Bouso said.

The study, “Longitudinal and transcultural assessment of the relationship between hallucinogens, well-being, and post-traumatic growth during the COVID-19 pandemic“, was authored by José Carlos Bouso, Dóra Révész, Genís Ona, Giordano N. Rossi, Juliana M. Rocha, Rafael G. dos Santos, Jaime E. C. Hallak, and Miguel Ángel Alcázar-Corcoles.

© PsyPost

© Orlando Sentinel

These Florida researchers are giving depressed, anxious people psychedelics
2023/10/17

Patricia Brown, vice president of clinical operations at CNS Healthcare in Orlando, in one of the clinic’ s patient therapy rooms used for the treatment of anxiety, depression and other mental health issues.

 - Joe Burbank/Orlando Sentinel/TNS

ORLANDO, Fla. — A therapy session with Patricia Brown starts like any other. She leads her clients into a peaceful, quiet room, draped in beige and generic, calming artwork.

Then her clients lie down, close their eyes, put on a blindfold and headphones, and trip for six hours on psilocybin, the psychoactive chemical found in magic mushrooms.

Brown is a psychiatric nurse practitioner and head of clinical operations at CNS Healthcare. CNS in Thornton Park and APG Research near the Central Business District are two global clinical trial sites testing whether microdoses of psychedelics — typically about one-tenth of a recreational dose — can help people with depression and anxiety.

A growing number of clinical trials suggest single doses of psychedelics can have long-lasting impacts on the brain, leading the U.S. Food and Drug Administration to issue “breakthrough therapy” designations to these drugs beginning in 2017.

These treatments could have untapped potential for helping the estimated one in three people with treatment-resistant depression, meaning they have tried at least two different antidepressants that haven’t worked, said Brown. The clinical trial she’s working on right now targets this group.

“This is the opportunity for us to take treatment for depression and anxiety to the next level,” Brown said.

The rebound in psychedelics’ popularity isn’t without controversy, however. A potentially troubling trend is emerging. From 2018 to 2021,a survey published in the scientific journal Addiction.) indicates a doubling of recreational psychedelic use in the U.S., with 8% of young adults having tried hallucinogens as of 2021. This is the highest number seen since the 1980s.
Recreational use sparks concern

This isn’t the first time these drugs have been studied for therapeutic benefits. These investigations have taken place since the 1940s, though research halted in the 1970s when the federal government classified these drugs as Schedule 1 due to their potential for abuse.

Over the last few decades, there’s been a resurgence in promising scientific research, continuing the work of 50 years ago. But it’s dangerous to use these drugs outside a medical setting, especially without a guide, said Dr. Robert Molpus, a psychiatrist and addiction researcher.

Molpus leads the CNS Healthcare location of a clinical trial of small doses of LSD on people with anxiety. The study is run by Mind Medicine, a biotech pharmaceutical company seeking approval for its proprietary form of LSD.

“What we have here is pharmaceutical-grade medication produced under very strict tolerances and standards,” said Molpus. “Whatever you buy on the street, it’s not pharmaceutical grade and you actually have no idea what’s in it or what the dose is.”

Psychedelics theoretically alleviate mental illnesses by creating new connections in the brain, according to the National Institutes of Health. Negative connections can be created just as easily as positive ones, Molpus warned.

“The idea is that things are connected wrong because of experience or trauma. And so, what you want to do, is get them reconnected; you want to break this bad connection,” Molpus said. “You don’t want a different set of bad connections. That’s where the therapy piece comes in.”

Licensed mental health counselor Elizabeth Lindell Mendez says recreational psychedelics worsened pre-existing mental illnesses and addiction issues in some of her clients. She worked for six years in community mental health residential and day treatment programs before moving to Thriveworks Counseling & Psychiatry in Maitland a few months ago.

“When you actively hallucinate, the more you do it, the less likely you might be to come back, especially if you have a hereditary predisposition that you’re unaware of,” she said. “It can actually increase and exacerbate symptoms.”

She emphasized that she hasn’t seen any clients who took these drugs within a controlled medical setting.

The American Psychological Association released a statement in 2022 calling preliminary research into psychedelics “promising” but cautioned about a lack of evidence.

“There is currently inadequate scientific evidence for endorsing the use of psychedelics to treat any psychiatric disorder except within the context of approved investigational studies,” the statement read.
Studies combat stigma

Brown is confident that current clinical trials are not dangerous.

“I think there really is a stigma that we have to overcome,” she said.

The ongoing trials at CNS are regulated by the FDA and don’t allow people with psychotic and personality disorders to participate. People with other mental illnesses like post-traumatic stress disorder and people who would take other psychiatric medications during the study can’t participate either.

Brown is working on a randomized clinical trial testing the impact of a single dose of psilocybin. The study, conducted by biotech company COMPASS Pathways, will include therapy before the psilocybin dose, a therapist present for the eight-hour period a patient is high, and additional therapy afterward to process what the participant has experienced and help them integrate what they’ve learned.

Another point to keep in mind is that psychedelics do not typically lead to addiction, said Molpus.

“Can you overuse it? Absolutely, you can. But it’s actually not all that common,” Molpus said. “It can happen, and it does happen, but it’s not like meth or heroin that can really capture and trap people in addiction.”

Decades of research back up that assertion, according to the National Institutes of Health.
A push to roll back restrictions

The FDA labels psychedelics like psilocybin, LSD, peyote and MDMA (ecstasy) as having “high abuse potential” and no recognized medical use, hence their Schedule 1 classification.

This designation is theoretically reserved for the most dangerous and addictive drugs in the U.S. In recent years, advocates have questioned it. Molpus labeled psychedelics’ classification “more political than medical.”

Marijuana, too, is Schedule 1, despite decades of evidence of its potential therapeutic benefits. The majority of states, including Florida, have legalized it for medical use.

Amid mounting arguments that these drugs should be more accessible, a handful of countries and U.S. locations like Oregon have decriminalized or legalized MDMA and mushrooms.

In 2021 and 2022, Florida lawmakers introduced legislation that would have ordered state-funded research into the therapeutic applications of psilocybin, ketamine and MDMA for treating conditions including depression, bipolar disorder, post-traumatic stress disorder, chronic pain and migraines. The bills failed to achieve widespread support.

Nationally, more than 60% of U.S. voters support legalizing psychedelic therapy, a 2023 poll done by the University of California, Berkeley, found.
The future of psychedelics

A potential roadmap for magic mushrooms and LSD can be seen with ketamine, another drug with hallucinogenic or psychoactive properties.

The FDA approved a derivative of ketamine called esketamine — manufactured by Janssen Pharmaceuticals and sold as a patented nasal spray called Spravato — in 2018.

It’s only available for people with treatment-resistant depression through a restricted distribution system with strict guidelines.

Ketamine differs from traditional psychedelics, however, because it has been used in medical settings for decades and is not as tightly regulated. Physicians who don’t want to jump through federal government hurdles or work with insurance companies are allowed to prescribe traditional ketamine off-label as a treatment for mental health conditions.

Meanwhile, the only foray into selling mushrooms commercially in Florida so far was unsuccessful.

In 2022, Ybor City’s Chillum Mushroom Hemp Dispensary briefly bypassed Florida’s restrictions by selling psychedelic mushrooms that didn’t contain the banned ingredient of psilocybin. It advertised itself as the first magic mushroom dispensary in the U.S., and was so successful it opened a second St. Petersburg location.

Even though the mushrooms technically didn’t include any banned ingredients, they were not approved to be sold as food. The store tried out a loophole, labeling them as intended “only for education or spiritual purposes,” not for consumption.

This wasn’t enough to stop the Florida Department of Agriculture and Consumer Services from shutting down Chillum Mushroom Hemp Dispensary’s sales.

The dispensary reluctantly stopped offering the mushroom in August, according to a statement on its website.

Can magic mushrooms and LSD treat depression and anxiety? Scientists are optimistic.

by Bethany Ao

Credit: CC0 Public Domain

When Marc Morgan tried lysergic acid diethylamide, better known as acid or LSD, for the first time as a teenager, he noticed that he could emotionally disconnect from traumatic memories of the sexual abuse he had suffered as a child.

"It allowed me to dissociate from the sharp pain that a lot of these memories can bring up, which caused me to shy away from processing them," said Morgan, who has post-traumatic stress disorder (PTSD) as a result of the abuse. "I was able to confront the topic in a more analytical way that felt healthier."

Years later, Morgan learned about microdosing—taking tiny portions of psychedelic substances, as little as a twentieth of a recreational dose, to get positive effects, like more focus and emotional balance, without negatives like hallucinations and disorientation. He realized that taking small doses allowed him to process his emotions without the stronger, visual effects and looping thoughts.

"It's basically like taking a cup of coffee," said Morgan, now 30. He said that he takes a full dose once or twice a year, and microdoses about four times a year. "You're just able to be a little more free and a little more honest with your emotions without breaking down. There's more of a mental clarity."

Morgan, who has lived in Philadelphia for the past decade, is part of a group of people who use both full doses and microdoses of psychedelic substances to process trauma, and better deal with depression. For some, it's because conventional antidepressants haven't worked for them. Others choose psychedelics because it's a more affordable option than therapy or medication.

However, medical experts don't recommend self-medicating.

"For people interested in a treatment who can't get into a trial, this is not the only thing out there," said Matthew Johnson, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University who has studied psychedelics for over 15 years. "It's one promising thing, and it's important for people to stay in treatment."

In recent months, the use of psychedelics for treatment-resistant depression, anxiety and PTSD—meaning patients do not respond to medication or therapy—has become a hot topic in the mental health field. The FDA approved a nasal spray for treatment-resistant depression (TRD) last March, which uses a derivative of the hallucinogenic ketamine called esketamine. It is the first new antidepressant in decades. (It's currently offered at a handful of clinics in the Philadelphia area.)

In November, the FDA gave psilocybin, a hallucinogenic compound found in magic mushrooms, its second "breakthrough therapy" designation in just over a year. The designation fast-tracks the development and review of drugs.

In a 2017 study of psilocybin and depression, researchers at Imperial College London gave psilocybin therapy to 20 patients with treatment-resistant depression, who reported benefits as long as five weeks after treatment. The study found that psilocybin decreased activity in the amygdala, which processes emotions like fear and anxiety.

"We know that when someone is on a therapeutic dose of a psychedelic, there's a dramatic increase in communication across brain areas," Johnson said. "My theory is that what we're seeing with psychedelic therapy is more like what we normally associate with talk therapy. Psychedelic therapy prompts a therapeutic process, and people learn something by transcending their sense of self and getting out of their own way."

Much less is known about the science behind microdosing psychedelic substances, but a 2019 study by researchers at the University of California-Davis found that the practice can provide relief for symptoms of depression and anxiety in rats.

Additionally, a 2019 survey of more than 1,000 people from across the world who microdosed on LSD found that repeated microdoses were followed by "improvements in negative moods, especially depression" as well as increased positive moods and energy levels.

"There really hasn't been substantiation of the claimed benefits of so-called microdoses," Johnson said. "That's not to say the claimed benefits aren't possible."

The benefits people feel from microdosing might be from a combination of a strong placebo effect and some possible benefit from "tinkering with the serotonin system," Johnson said. But he's open to the potential benefits of microdosing, particularly for depression.

As a result of their research on how psychedelics can be used to help smokers and cancer patients, Johnson and others at Johns Hopkins have suggested that psilocybin's FDA classification should be changed from Schedule I, which means that it has no known medical benefit, to Schedule IV, similar to prescription drugs.

Victor Pablo Acero, a 24-year-old bioengineering doctoral candidate and executive director of the Penn Society for Psychedelic Science, said that accepting both full doses and microdoses as mental health treatments is an important step in destigmatizing the substances.

"Having a mystical experience is correlated with actually getting more clinical effects," Acero said. "Microdosing doesn't recapitulate the mystical experience or ego death. Also psychedelic use ... does not magically heal you, you have to put in work and effort to integrate your experience."

Acero said that he became interested in psychedelics once he began reading research papers about how the substances can be used in clinical settings. But he said that research in this area is still lacking.

"Funding is nonexistent," Acero said. "Scientists are having to argue that they need funding to study the medical purposes of a substance that's classified as having no medical purposes."

Most people suffering from treatment-resistant depression, anxiety or PTSD won't be able to access the new treatments for at least a few years, as research groups run clinical trials. The trials have a limited number of spaces ? - the Usona Institute, a nonprofit medical research group, recruited just 80 participants for a study that's part of their Phase 2 clinical trial for psilocybin. Similarly, LSD is being evaluated in a Phase 2 clinical trial as a treatment for depression in Switzerland. MDMA, better known as ecstasy or molly, is currently in a Phase 3 large-scale clinical trial for PTSD. Upon FDA approval, the SoundMind Center will open in Cedar Park, offering MDMA-assisted psychotherapy to populations with higher rates of PTSD.

While patients wait, self-medication without the aid of a therapist or medical professional is much more common, although it is not recommended. Johnson said that there are risks to psychedelic therapy for people with existing psychotic disorders, like schizophrenia.

"Even if this stuff is approved, it's not going to work for everyone," Johnson said.

Aysha Ali, who struggles with depression and anxiety, began using full doses and microdoses of magic mushrooms about two years ago. Ali, 21, said antidepressants caused side effects like appetite loss, decreased libido and nausea. She also found that mushrooms are more accessible and cheaper for her.

"It's definitely easier to go to bed at night," said Ali, who lives in Wilmington, Del. and works in King of Prussia. "I'm a little more focused, and I feel like I can smile and giggle in the moment. I can feel myself going through my day a little bit better, and the days after feel so much better."

She said that it refreshes her brain and allows her to wake up with a positive attitude.

"It helps me see that I'm not going to be stuck where I am," Ali said. "It's not a cure for everything, but the scientific information we're getting now is helping people get out of this mindset of, 'This is bad.'"

Mike Allebach, a photographer who lives in Montgomery County, first learned about magic mushrooms for mental health through a New York Times article last year.

"It didn't really quite match up with my understanding of mushrooms," said Allebach, 37.

Allebach, who was struggling with depression when he read the article, said that he later tried magic mushrooms in California, where psilocybin mushrooms are decriminalized in Oakland and Santa Cruz. The trip brought him out of his depression. Since coming home, Allebach uses breath work and meditation to maintain his mental health.

"As a society, we're in a place where the new rich is feeling calm and having peace. And if antidepressants don't work for someone, this could be great for someone who wants to be happy again and work on themselves," he said.

Psychedelic drugs could help treat PTSD

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