With the legalization of marijuana in Canada and many states in the U.S., consumers, psychologists, and other medical professionals have called for a reassessment of other natural drugs. The most promising case is that of psilocybin, a compound found in magic mushrooms.
In November 2021, the U.K-based company Compass Pathways concluded the largest study so far on the effects of psilocybin on treatment-resistant depression. Conclusions found that those who were treated with 25 mg of psilocybin experienced a significant decrease in depressive symptoms and stayed in remission for up to three months after the treatment.
Psilocybin is the psychoactive compound found in magic mushrooms. Although psilocybin is most notorious for causing temporary hallucinations or sensory distortions, it also contains the immense potential for physical and psychological pain relief from ailments such as depression. While recreational users often consume the mushroom itself, medical researchers have been separating the psilocybin from the mushroom for easier ingestion and dose control.
As of 2021, the FDA has granted Compass Pathways therapy designation to their treatment, meaning that drug approval will be accelerated if studies continue to yield such positive results.
And yet despite Compass Pathways’ promising findings, the company’s stock price has been on a continued downward trend, indicating hesitancy from investors.
One reason for the backlash from investors could be the side effects experienced by 12 participants who were non-responsive to the treatment and ultimately experienced suicidal ideations.
But, more realistically, the hesitation to back psilocybin treatments could also come from decades of fear and stigma around magic mushrooms.
To understand their fear, it helps to understand the history of how it was criminalized and stigmatized in the first place.
Magic mushrooms have been consumed for centuries by many, dating back to the Mesoamerican period in Indigenous history. Originally, it was used for ritualistic and spiritual purposes. It wasn’t until much later, in the 1960s flower power era of America, that mushroom consumption increased drastically as an experimental psychedelic drug alongside other hallucinogens like LSD.
In a largely Anglo-Christian religious and politically conservative U.S., magic mushrooms along with other psychedelic substances were classified as category 1 drugs and made illegal in the 1970s. Around this time, the negative stigma for these substances meant that magic mushrooms were viewed as taboo substances. (Although it’s worth noting that some hallucinogens like Peyote were still allowed to be consumed on Indigenous reservations.)
Fast forward to the past decade and the case for the legalization of magic mushrooms is growing, not only as a recreational drug, but as a substance to manage many otherwise incurable conditions like depression, cluster headaches, alcoholism, and PTSD.
States like Oregon have already decriminalized medical psilocybin with other progressive states like California looking to do so as well. In Canada, a handful of doctors have been permitted to prescribe terminally ill patients with low doses of psilocybin to manage depression and to increase physical comfort.
The Future of Psilocybin as a Prescription Anti-Depressant
Large-scale clinical trials, like the one conducted by Compass Pathways, allow medical professionals to learn the ideal dosages for patient conditions, how much induce hallucinations, and what the possible risks and side effects are. While most of the side effects are expected — like nausea, tingling sensations, and hallucinations or sensory distortions — risk mitigation is necessary for patient use and education.
Because we do not exist in an overall culture where psychedelics are consumed as a part of spiritual ritual, like they were centuries ago in Indigenous communities, there are some proposed safety measures for medical psilocybin.
Some of these precautions include mandatory training sessions that would be required prior to being prescribed psilocybin. These sessions would inform patients on what to expect, how to navigate a possible high, and the importance of having a trusted friend or family member with them to act as a source of stability and safety during the treatment.
Other precautions include doing thorough assessments on the psychological histories of the patients, as those who are genetically predisposed to psychosis may be at risk of experiencing negative, panic-inducing hallucinations that could result in more harm and trauma than healing.
By and large, however, reports from those who have taken psilocybin to alleviate severe symptoms of pain and depression reported that they have increased feelings of spirituality, connectedness to nature and others, and a deeper understanding of the root of their ailments, all of which are associated with increased feelings of happiness and life satisfaction.
With the green light from the FDA and promising results from the study conducted by Compass Pathways, we can hope to see a wider acceptance and backing of psilocybin as a medical treatment for depression and other ailments.