Oregon first state to legalize magic mushrooms, does evidence verify its mental illness treatment ability?
Oregon has become the first state in the country to legalize psilocybin, the active ingredient in magic mushrooms, for mental health treatment in supervised settings at licensed centers. Oregon’s Measure 109 will give legal access to psilocybin. As of Wednesday, November 4, Measure 109 — which allows the manufacture, delivery and administration of psilocybin at supervised, licensed facilities — was passing with 55.74% support and over 2 million votes cast, according to Oregon’s Secretary of State.
The vote also creates a two-year period in which lawmakers will determine how the drug will be regulated, including the qualifications therapists need to meet to administer it. Accordingly, the state health authority would create a program for administering it to people 21 and older. Chief petitioners wife-and-husband Sheri and Thomas Eckert of Beaverton, both psychotherapists who backed the measure, told The Oregonian/OregonLive that psilocybin could help people struggling with issues from depression to anxiety to addiction.
Previously, the US Food and Drug Administration (FDA) had designated psilocybin as a “breakthrough therapy”, an action meant to accelerate the drug development and review process after clinical trials found psilocybin to be a promising therapy for treatment-resistant anxiety and depression. “(The) designation is a process designed to expedite the development and review of drugs that are intended to treat a serious condition and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over available therapy on a clinically significant endpoint(s),” explains the agency.
The measure in Oregon comes as people in Washington DC voted to decriminalize the growing, possession, and noncommercial distribution of hallucinogenic mushrooms, and some other psychedelic substances. About 76.26% of voters in the nation’s capital supported the initiative (measure number 81), according to the district’s Board of Elections. The move does not legalize them but makes their possession among the “lowest enforcement priorities” Metropolitan Police Department. “This change would help thousands of DC residents suffering from anxiety, PTSD, addiction, or depression who currently fear arrest or prosecution for pursuing healing through natural, entheogenic substances. The initiative has the support of prominent medical professionals, police officers, and DC residents,” explain experts.
What is psilocybin?
The US Drug Enforcement Administration (DEA) describes psilocybin as a hallucinogenic chemical obtained from certain types of fresh and dried mushrooms. Psilocybin mushrooms are found in Mexico, Central America, and the US. The street names are magic mushrooms, shrooms, or mushrooms. They have slender stems topped by caps with dark gills on the underside. Currently, psilocybin is a Schedule I substance under the Controlled Substances Act in the US, which implies that it has a high potential for abuse, no currently accepted medical use in treatment in the US, and a lack of accepted safety for use under medical supervision.
Psilocybin mushrooms are ingested orally. They may also be brewed as a tea or added to other foods to mask their bitter flavor. “The physical effects may include nausea, vomiting, muscle weakness, and lack of coordination. Panic reactions and a psychotic-like episode also may occur, particularly if a user ingests a high dose. Overdose may (also) result in death,” warns the DEA.
What does research suggest?
In a small study of adults with major depression, published on November 4, Johns Hopkins Medicine researchers found that two doses of psilocybin, given with supportive psychotherapy, produced rapid and large reductions in depressive symptoms, with most participants showing improvement and half of the participants achieving remission — meaning they no longer qualified as being depressed — through the four-week follow-up.
The authors recruited 24 people with a long-term documented history of depression, most of whom experienced persisting symptoms for approximately two years before enrolling in the study. The average age of participants was 39, of which 16 were women. Participants had to taper off any antidepressants before the study with the help of their personal physician to ensure safe exposure to this experimental treatment. Thirteen participants received the psilocybin treatment immediately after recruitment and after preparation sessions, and 11 participants received the same preparation and treatment after an eight-week delay.
For the entire group of 24 participants, 67% showed a more than 50% reduction in depression symptoms at the one-week follow-up and 71% at the four-week follow-up. Overall, four weeks post-treatment, 54% of participants were considered in remission. The team will now follow the participants for a year after the study to see how long the antidepressant effects of the psilocybin treatment last and will report their findings in a later publication.
“The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market. Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game-changer if these findings hold up in future 'gold-standard' placebo-controlled clinical trials,” writes Dr Alan Davis, adjunct assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. The findings were published in JAMA Psychiatry. Entrepreneur and philanthropist Tim Ferriss, who supported the funding campaign for the research, says that he believes the finding “to be a critically important proof of concept for the medical approval of psilocybin for treatment of depression, a condition I have personally struggled with for decades”.
In 2016, Johns Hopkins Medicine researchers had first reported that a substantial majority of people suffering from cancer-related anxiety or depression found considerable relief for up to six months from a single large dose of psilocybin. The latest analysis suggests that psilocybin may be effective in the much wider population of patients who suffer from major depression than previously thought.
The 2016 analysis that involved 51 patients showed that psilocybin decreased clinician- and patient-rated depressed mood, anxiety and death anxiety. The compound increased quality of life, life meaning and optimism. Six months after the final session of treatment, about 80% of participants continued to show clinically significant decreases in depressed mood and anxiety, with about 60% showing symptom remission into the normal range. While 83% reported increases in well-being or life satisfaction, 67% of participants reported the experience as one of the top five meaningful experiences in their lives. About 70% reported the experience as one of their top five “spiritually significant lifetime events”.
The team back then had cautioned that the drug was given in tightly controlled conditions in the presence of two clinically trained monitors and said they do not recommend the use of the compound outside of such a research or patient care setting.
A similar analysis in 2016 also found that a single dose of psilocybin relieves anxiety and depression in patients with advanced cancer. According to the results of the clinical trial led by researchers at NYU Langone Medical Center, one-time treatment with the drug quickly brought relief from distress that then lasted for more than six months in 80% of the 29 study subjects monitored, based on clinical evaluation scores for anxiety and depression. “Our study showed that psilocybin facilitated experiences that drove reductions in psychological distress. And if it’s true for cancer care, then it could apply to other stressful medical conditions,” said co-investigator Dr Anthony Bossis, a clinical assistant professor of psychiatry at NYU Langone.