If mere mention of “magic mushrooms” brings you back to blacklight posters, lava lamps and the rhythmic snare drum of White Rabbit by Jefferson Airplane, you’re not alone and you’re also probably over the age of 50.
Today, ‘shrooms are making a comeback, along with LSD, MDMA and other hallucinogens, not as recreational drugs, but as potential treatments for a wide range of mental health conditions. Numerous studies have reported encouraging outcomes using psilocybin - mushrooms' main psychoactive compound—for treating depression, anxiety as well as smoking, alcohol dependence and even migraines. Ongoing and planned clinical trials are testing hallucinogens for conditions that include opioid dependence, PTSD and anorexia nervosa.
The federal Food and Drug Administration is expected to approve MDMA for treating PTSD and psilocybin for depression within the next two years and federal funding for psychedelic research recently re-started after a 50-year “war on drugs” hiatus. Dozens of publicly traded psychedelic start-ups have landed more than 1.8 billion in private capital and influencers like Tim Ferriss are changing minds about the drugs our parents warned us about.
Increased investments are welcome because despite the hype, most scientific studies have been limited to animals and small human cohorts – details that typically get lost as mainstream media outlets and entrepreneurs trip over themselves to rebrand psychedelics.
“Forty percent of the country is suffering,” quipped Mind Medicine’s former CEO as the company went public last year. “That’s a big, big market,” he told Shark Tank investor Kevin O’Leary.
Plant medicine marketers are already cashing in by offering guided psychedelic trips, Ketamine-infused “journeys” in zero-gravity chairs and pricey psychedelic retreats in Costa Rica and closer to home in the Catskills. The promotional promises of finding peace, comfort and connections to a higher level of consciousness echo 1960’s counterculture, but unlike Dr. Timothy Leary who was a Harvard psychologist, the retreats are unregulated, the “healers” are unlicensed and the stock photo “shamans” aren’t going to save you from a bad trip.
It's not all peace signs and rainbows.
Psychedelics can trigger psychotic episodes in those with certain neurological predispositions and can be harmful and traumatizing if taken without proper preparation, the guidance of a trained therapist by your side and appropriate debriefing. Participants also need to discontinue the use of traditional psychotropic medications – antidepressants, anti-anxiety drugs and anti-psychotics – which can be destabilizing at best.
Reports of sexual abuse and violence during ayahuasca ceremonies and psychedelic retreats have climbed. Post-retreat suicides have been reported and hyper-suggestable participants have fallen prey to financial exploitation.
Participants under the influence of psychedelics are vulnerable, but it is in this transient state where they can better access and process memories, feelings and past trauma, and potentially re-emerge with fresh perspectives that are freeing and healing.
At the risk of oversimplifying complex brain science, psychedelics typically stimulate the creation of new neural pathways in the brain while the resting state of the brain loses connectivity before restoring itself, akin to rebooting a computer.
Potent drugs like psilocybin and MDMA aren’t being investigated as cures for mental illness per se, but as an adjunct to traditional therapies, including psychotherapy. Psychiatrists like Dr. Casey Paleos, who practices on Long Island, told The Drum this spring, “these drugs are like any really powerful tool – you can use a scalpel to save somebody’s life in surgery, or you could stab somebody to death with it. The tool itself has to be handled with a level of training and expertise and knowledge around how to keep a person safe through the process, [and] that shouldn’t just be treated trivially.”
That training is emerging in our own backyard as Mount Sinai launched a Center for Psychedelic Psychotherapy and Trauma Research early last year and NYU Langone established a Center for Psychedelic Medicine, joining bold name pioneers at John’s Hopkins who started their own center in 2019.
Researchers at that institution recently bemoaned the “psychedelic hype bubble,” observing that “a disturbingly large number of articles have touted psychedelics as a cure or miracle drug” and warning that “extreme shifts in perception can create impediments to rigorous science and reasonable clinical applications.”
That would be a shame because the millions of Americans who suffer from devastating, disabling psychiatric disorders aren’t looking for utopia. They just want some relief.