The doom hung like an anvil over her head. In 2012, a few years after Carol Vincent was diagnosed with non-Hodgkin lymphoma, she was waiting to see whether her cancer would progress enough to require chemotherapy or radiation. The disease had already done a number on her, inflating lymph nodes on her chin, collar bones, and groin. She battled her symptoms while running her own marketing business. To top it all off, she was going through menopause.
“Life is just pointless stress, and then you die,” she thought. “All I’m doing is sitting here waiting for all this shit to happen.”
When one day at an intersection she mulled whether it would be so bad to get hit by a car, she realized her mental health was almost as depleted as her physical state.
That’s when her 27-year-old son sent her a link to an invitation from the Johns Hopkins University School of Medicine, seeking cancer patients to sign up to take psilocybin, the active ingredient in magic mushrooms, to alleviate their anxiety and depression. “Start thinking about all the existential questions you want to ponder while your window is open to the universe!” her son wrote.
Vincent, who is 5 foot 1 and 61 years old, has never been a big drug user. She doesn’t like taking aspirin, and the one time she used cocaine in her 20s, she fainted. But she’s taken other risks—she was a sky-diver for 10 years—and she figured there was a chance the experience might “reboot” her. She signed up and, after being screened, flew down to Baltimore from her home in British Columbia.
The results of Vincent’s mushroom trip—and those of 79 other study subjects like her—are now being made public, and they’re very encouraging. A pair of randomized, blinded studies published Thursday in The Journal of Psychopharmacology provide the most robust evidence to date that a single dose of psilocybin can provide relief from the anxiety and gloom associated with cancer for at least six months.
Roughly 40 percent of people with cancer suffer from a mood disorder, which increases their risk of suicide and impairs treatment. Evidence they can be helped by antidepressants is weak. “People are facing their own mortality, their own demise,” said Roland Griffiths, a professor at the the Johns Hopkins University School of Medicine and the lead author of one of the studies. “That’s a very special and quite poignant vulnerability that many people have in facing life-threatening illnesses.”
Two teams of researchers, one led by Griffiths and the other by psychiatrist Stephen Ross at the New York University Langone Medical Center, simultaneously ran the studies on participants who had life-threatening cancers as well as a psychiatric diagnosis of anxiety or depression.
For the treatment sessions, guides would bring the participants into a comfortable, living-room-like lab and equip them with an eye mask and headphones connected to a playlist of instrumental music. In New York, the guides held the participants’ hands and told them to state their intention for the day.
The guides at Johns Hopkins told Vincent, “If you see something scary, open up and walk right in,” she said. Then, they gave her a dose of psilocybin inside a gelatin capsule and stood back.
Vincent describes her six-hour trip as “spectacularly gorgeous” and “beyond words.” She saw a sea of green and purple shapes, then a deep-space emptiness with a monolithic presence, similar to the Borg Collective from Star Trek. At one point, a series of Egyptian ships and Russian dolls paraded before her. As she laughed and wept, something popped out at her from the mental kaleidoscope: A small, creamy-white, animated crab.
“It’s Cancer the crab,” she thought later, referring to the zodiac sign. “It could have been a big, horrifying monster crab that was about to tear me up and eat me. But it wasn’t, it was comic relief. There is still humor in life, there’s still beauty in life.”
In the Johns Hopkins study, half of the 51 participants were given a low dose of psilocybin as control, followed by a high dose five weeks later. (For the other half, the order of the doses was reversed.) The results were remarkable: Six months later, 78 percent of the participants were less depressed than they started, as rated by a clinician, and 83 percent were less anxious. Furthermore, 65 percent had almost fully recovered from depression, and 57 percent from their anxiety, after six months. By comparison, in past studies antidepressants have only helped about 40 percent of cancer patients, performing about as well as a placebo. At the six-month follow-up, two-thirds of the participants rated the experience as one of the top five most meaningful of their lives. They attributed their improvements to positive changes in their attitudes about their lives and their social relationships. Their quality of life improved, as did their feelings of “life meaning” and optimism—even though several of them would later die. “People will say, ‘I know I’m dying, I’m sad that I’m dying, but it’s okay,” Griffiths said. “Things are going to be alright.”
Improvement of Depression and Anxiety Symptoms After Psilocybin
The New York University study was very similar, but it had only 29 participants and used niacin, a vitamin, as a placebo. (Halfway through the experiment, the participants switched groups.) It also included a more formal psychotherapy component, in which the participants would discuss their trips. That study similarly found that the psilocybin had both immediate and enduring effects. Six months after the treatment, 60 to 80 percent of the participants saw improvements in various measures of depression and anxiety, and 70 percent considered it one of the top five most personally meaningful experiences of their lives.
“The most surprising thing to me is that this actually worked. I was highly skeptical,” said Ross, the lead NYU study author. Before the treatment, some of the participants would cry and shake when they talked about their cancer. But “the moment they get psilocybin, their distress comes down. That’s very new in psychiatry, to have a medication that works immediately for depression and anxiety and can last for that long.”
The researchers aren’t sure exactly how psilocybin works—a rather common problem in drugs aimed at brain chemistry. Psilocybin seems to quiet the prefrontal cortex, a part of the brain where increased activity has been associated with depression. It also might be acting on the brain’s use of glutamate, a neurotransmitter that affects learning and memory. Ross said what might be happening is a sort of “inverse PTSD”—a profoundly positive memory that affects participants for months, much like a severe trauma might in post-traumatic stress disorder.
It’s also possible that the sheer mysticism of the experience was enough to prompt a change in mood. “There’s a sacredness or a reverence to that experience ... it’s also accompanied by positive mood, in the sense of an open-heartedness, love or benevolence,” Griffiths said. Participants might have a sense that “the experience is more real and more true than everyday waking consciousness. Although the effects of the drugs are gone by the end of the day, the memories of these experiences and the attributions made to them endure.” It’s not uncommon, he said, for study participants to say they think about their psilocybin experience every day.
Vincent has since taken an art class, and she found herself making paintings that included themes from some of her psilocybin-induced visions. Her past feelings of anxiety and depression haven’t re-surfaced, she said. “I have a feeling that I tapped into something bigger than me,” Vincent said. “It did feel like it was connecting me to the universe.”
It didn’t seem to matter whether the participants were religious. In the New York study, half the participants were non-believers—not that you would know it, hearing some of their remarks in the aftermath. One participant, an avowed atheist, said she was “bathed in God’s love.” (She’s still an atheist.)
There were no serious negative side-effects of the treatment, allaying concerns that the cancer patients might “look into the existential void and come out even more fearful,” as Griffiths put it. About 15 percent of the Johns Hopkins participants became nauseated, and a third experienced temporary paranoia and elevated blood-pressure. In the New York University study, 28 percent of participants developed a headache, and 17 percent became temporarily anxious. But more than 2,000 doses of psilocybin have been given out in clinical settings since the early 1990s, the NYU researchers pointed out, and there have so far been no reports of lasting medical or psychiatric issues.
Still, researchers from both universities cautioned their findings don’t suggest everyday people should experiment with magic mushrooms. Some groups, such as people with schizophrenia, might find psilocybin worsens their condition, and in surveys, a small fraction of people who report having used magic mushrooms said they put themselves or others at risk of physical harm during their trip.
The studies were accompanied by 10 largely supportive editorials by experts in psychiatry, end-of-life care, and other medical fields. The use of psilocybin “may signal that medicine has come full circle to embrace the earliest known approach to healing our deepest of human agonies—by ‘generating the divine within,’” wrote Craig Blinderman, the director of Adult Palliative Care Service and a professor at the Columbia University Medical Center.
These studies add to the evidence that psilocybin might help people who struggle with different types of intractable mental-health issues. Smaller studies have hinted at the drug’s effectiveness in treating alcoholism, obsessive-compulsive disorder, treatment-resistant depression, and smoking. It’s also been found to help change peoples’ personalities, making them more “open,” meaning imaginative or broad-minded. The study has implications for terminally ill individuals considering physician-assisted suicide, a decision sometimes prompted by the kind of existential dread that psilocybin alleviates.
However, psilocybin is still many years from becoming a prescribed treatment for cancer-related dread. Though researchers can acquire psilocybin for studies, it’s still illegal, adding an extra hurdle to the drug-development process.
“Current laws, not based on evidence, impede research by onerous storage and security requirements, difficulty in obtaining funding, and the near impossibility of actually obtaining restricted compounds without having them synthetically produced at great cost,” wrote Columbia University psychiatrists Jeffrey Lieberman and Daniel Shalev in one of the psilocybin editorials.
In a New Yorker story about the curative potential of psilocybin published last year, Michael Pollan wrote, “As the drug war subsides, scientists are eager to reconsider the therapeutic potential of these drugs.”
However, president-elect Donald Trump’s choice of Alabama Sen. Jeff Sessions, a staunch hard-liner on drugs, to lead the Justice Department, suggests the drug war might not be wrapping up as promptly as some hoped.
George Greer, the medical director of the Heffter Research Institute, which funded these studies, said he doesn’t yet have “total clarity” on what recent political developments mean for his work with regulators.
“What I can say is this: We expect the FDA’s assessment of psilocybin to move forward,” he said. “As the research evidence grows on psilocybin's safety and effectiveness, we think the FDA will want to learn more, and the process for helping cancer patients with depression and anxiety will continue to advance.”
For now, above-board psilocybin treatments will be limited to people like Vincent, who sign up for studies. To paraphrase the aphorism, it’s a nice remedy—if you can get it. A few months after her psilocybin experience, Vincent was driving on a sunny day and listening to music. She found herself cheerily singing along. “Oh my God,” she thought, “I’m happy! I’m me again!”