It may have taken decades, but we’ve finally arrived at a place where marijuana is medically prescribed in about 29 states and Washington, D.C., and used often and everywhere. Cannabis—at the gym, in your morning smoothie and your lip balm—is becoming more mainstream by the day. So naturally, many wonder: What’s next? According to researchers at Johns Hopkins, it’s psilocybin, also known as the hallucinogen found in “magic mushrooms.”
And with good reason: The team there has been studying the effects of psilocybin for years, and this week they released a paper recommending the Food and Drug Administration reclassify the drug from Schedule I (where substances with no accepted medical use, and a high chance of abuse, rank) to Schedule IV (which contains drugs with a low risk of abuse and dependence, and are generally available with a prescription). Why? Their research suggests that psilocybin could be useful in treating, among other things, anxiety and depression—two illnesses that affect millions of people in today’s fast-paced, tech-driven world.
“We studied 51 cancer patients with substantial depression and/or anxiety attributed to their cancer—people with existential distress who can’t live their lives,” says the researcher Matthew Johnson, PhD, an associate professor of psychiatry and behavioral sciences at Johns Hopkins. “We found drastic reductions [in levels of anxiety and depression] after one high dose session, and the reductions remained six months later,” he says. Yes, there were fewer symptoms after a single dose of synthetic psilocybin—no typical cocktail of pills necessary (in fact, participants in the study were not permitted to take prescription antidepressants or antianxiety medications).
As for what exactly makes psilocybin so effective? Much is still unknown, says Johnson, though “our best take is that the substance has—in a safe setting, with minimized risks and maximum therapeutic intention—a radical effect on the conscious experience, a profound effect on one’s sense of self, making for a powerful learning experience.” When those senses are altered in a major way, you might end up reframing your whole existence, he continues, feeling more at peace with concepts like mortality and enjoying a greater sense of unity with the universe—all of which can be beneficial when combating anxiety and depression. “And there’s probably a change in biology that accounts for that psychological exploration too,” he says. “We do see that brain areas that don’t normally talk to each other talk to each other more [on psilocybin].” Which begs the question, he continues: “Is there a change in the way the brain is communicating with itself?”
Perhaps the most important aspect when it comes to using mushrooms? How it’s done. Taking psilocybin for anxiety and depression isn’t the same as trendy micro-dosing—in fact, Johnson says that a placebo group actually did receive continuous, extremely low doses of psilocybin and reported they didn’t feel any effect whatsoever. If you’re using the drug for psychiatric treatment, it needs to be done with corresponding psychiatric care. Because “bad trips” can and did happen, he says, and frequently—because of the high dosing. “We call them ‘challenging experiences,’ ” says Johnson of the effort that goes into conjuring up an experience such as trauma, and working through it with a trained professional. “They can be very difficult in the short term, but if the safety and support is there, they can be harnessed into powerful learning experiences.”
There’s a lot of promise for the future—which is likely more than five years away, given that it takes that long for studies and trials to take place before the FDA will reclassify a drug. Still, “I think this is a whole new area of medicine; a different paradigm in psychiatry,” says Johnson. “We need all the tools in the tool box. Selective serotonin reuptake inhibitors have helped many people, but there are a lot of people who aren’t helped sufficiently by them. People feel like [mushrooms] open a window, and what they do with that opening is up to them. They’re in control.”