Case Study: Magic Mushrooms as Medicine? Mind-Body Connection Pt. 3

SafetyNurse1968, ADN, BSN, MSN, PhD

This article is the last in a 3-part series on the connection between mind and body with childhood trauma

#1: Why Is This Patient Smelling Music?
#2: Does Childhood Abuse Prevent Weight Loss?

Magic Mushrooms

As a former oncology nurse, and a home health nurse, I have witnessed many times how people with a terminal diagnosis experience anxiety, anger and fear over death. Some folks cope fairly well, but I've seen people so crippled by a terminal diagnosis that they push friends and family away. Instead of a beautiful, light-filled, dignified death, they experience terror, darkness and pain. So, imagine my excitement when I heard about a research study in which psilocybin (the active ingredient in "magic mushrooms”) in conjunction with psychotherapy was used to treat anxiety and depression in patients with terminal cancer. The results were promising - many subjects felt uplifted, connected, unified, precious and even sacred. The results of the study showed decreased depression and anxiety in cancer patients for 8 months following a single dose of psilocybin, compared with a placebo.1

In Defense Of Psychedelics

One of my favorite authors, Michael Pollan, who wrote In Defense of Food (the one that told us to, "Eat food, not too much. Mostly plants.”) has written a book about the use of psychedelics like LSD, psilocybin, MDMA/Ecstacy, ayahuasca, and 5-MeO-DMT (From the venom of the Sonoran Desert toad) in medical research. Though his book, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression and Transcendence, was a bit dry, I found it interesting to read about the history of psychedelics in the U.S, and how their use was criminalized in the 1970s.2 The most interesting part of the book was about Pollan's guided "trips" with psychedelics. He wrote honestly and openly about his experimentation with psilocybin, toad venom and LSD. I admit that when I was younger, I tried LSD and psilocybin, and probably would have tried the toad venom if I could have gotten my hands on it, but I did it to "party.” Pollan's journey was one of self-exploration. He had recently lost his father, and he was looking for some resolution. For thousands of years, native peoples have traditionally used these drugs for these very same purposes. It wasn't until the 1960s in American that the use of psychedelic drugs began to be perceived as criminal activity; however, Pollan and others are quick to point out that no one in the medical community is suggesting that they are legalized. We are talking about approval for medical use.3

PTSD

Evidence is mounting that these drugs, when administered in controlled therapeutic settings, may be able to succeed where traditional medications have fallen short. The Multidisciplinary Association for Psychedelic Studies (MAPS) is currently engaged in FDA approved, phase 3 trials for the use of MDMA (known as 3,4-methylenedioxy-methamphetamine, and also as ecstasy)-assisted psychotherapy for PTSD. The goal of MAPS is to train at least 300 therapists in this modality before 2021 in anticipation of completion of the phase 3 trials.4

MDMA can increase feelings of trust and compassion (why it's popular on the party scene), making is an effective part of psychotherapy for patients with a PTSD diagnosis. Researchers have found that the drug, administered for two eight-hour psychotherapy sessions spaced about a month apart, can reduce symptoms for the majority of participants, and the effects may last up to six years. This is good news because PTSD is incredibly difficult to treat. Thirty to forty percent of people with PTSD get no relief from current therapies, including cognitive behavioral therapy, group therapy, and antidepressants. PTSD affects 8 percent of Americans; almost 25 million people, many of them veterans. In 2016, approximately 868,000 veterans received disability benefits for PTSD, at a cost of $17 billion to the Veterans Administration.1&4 However, MDMA isn't just for PTSD in veterans. In the references there's a link to a story about a woman who used MDMA-assisted therapy to recover from PTSD after being raped.5

Depression

Recent research has pointed to the effect of psilocybin (the active ingredient in magic mushrooms) on blood flow to the amygdala, an area of the brain associated with emotional regulation (I wrote about this in great detail in part 2). Folks with depression tend to have higher blood flow in the amygdala than those who do not have depression. After being given a dose of psilocybin, MRI scans of 19 patients with treatment-resistant depression showed reduced blood flow to the amygdala. This reduced flow correlated with a decrease in depressive symptoms in all 19 subjects one week after treatment, and in nearly half of participants five weeks later. Research is being planned for an experimental study of psilocybin as compared to existing standard-of-care antidepressant medications.1, 2&4

Alcoholism

LSD (I wrote about it in a previous article), also known as lysergic acid diethylamide, is a semisynthetic compound first developed in 1938 by Dr. Albert Hofmann at the Sandoz pharmaceutical company in Basel, Switzerland. In the 1940s LSD became recognized for possible therapeutic effects, and was even used by Bob Wilson, founder of alcoholics anonymous. It played a role in the discovery of the serotonin neurotransmitter system. From the 1950s through the early 1970s, LSD was used as a treatment for alcoholism as well as for anxiety, depression and for people with advanced stage cancer. Now, thanks to MAPS, there is increasing evidence for LSD as a treatment modality. A recent MAPS study found a reduction in anxiety following two LSD-assisted psychotherapy sessions for 12 patients.1&4

Mapping The Way

Go to the MAPS site to learn more about psychedelic research studies, including how to enroll in clinical trials.4

Current MAPS studies:

Medical marijuana (the first clinical trial of marijuana for PTSD in veterans)
LSD-assisted psychotherapy
Ibogaine (naturally occurring chemical found in West African shrubs) for drug addiction
Ayahuasca-assisted treatment for addiction and dependence (ayahuasca is derived from a South American vine, containing naturally occurring MAOIs – it is legal in the US for religious uses)

Money

As you might expect, research on psychedelics is funded mainly by academic institutions and nonprofits. Drug companies won't be making money off of these treatments since MDMA and psilocybin, the active ingredient in magic mushrooms, are off-patent substances that exist in the public domain. I'd like to encourage you to support organizations like MAPS with financial donations and to share their research with others who might be able to support funding.1

Advocating

I'm not advocating for legal, recreational drug use (though the legality of alcohol, one of the most toxic, addictive, lethal substances around does give me pause for concern...and where's the medical benefit of drinking? Don't get me started…). I am advocating that nurses share this information with patients. As the most trusted healthcare provider in the U.S. we have a duty to share these potentially life-altering, maybe even life-saving treatment modalities with those who are most vulnerable: veterans, sexual assault survivors, victims of childhood trauma, those with treatment-resistant depression, people addicted to drugs and/or alcohol and those with a terminal diagnosis.6

I'm hoping for a good discussion here. What are your thoughts, experiences and ideas surrounding the use of psychedelics to support the treatment of those with mental illness?

References

1. How a Psychedelic Drug Helps Cancer Patients Overcome Anxiety

2. Pollan, M. (2018). How to change your mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression and transcendence. Penguin Press: New York, NY.

3. Will These Psychedelic Drugs Soon be Legal?

4. Multidisciplinary Association for Psychedelic Studies (MAPS):

5. My Story of MDMA-Assisted Psychotherapy after a Life Changing Rape

6. Journal of Palliative Medicine: taking psychedelics seriously