Twenty-one times now, a cancer patient suffering from anxiety has shown up early in the morning at Stephen Ross’s New York University lab, clasped hands with two therapists, and taken a dose of psilocybin, the active ingredient in magic mushrooms. When the effects of the drug start to take hold, the patient lies down on a couch in the lab—which could pass for a living room—and is given eye shades and headphones playing music he or she has chosen in advance. The therapists stay on hand as the patient has a hallucinogenic experience, until, near the end of the day, the effects wear off and they can all go home.
Ross, director of NYU’s psychedelic-research group, is leading a Phase 2 clinical trial of the treatment. It began in 2009 and has so far seen 21 of 32 patients dosed. Each makes two visits to the lab, about two months apart, receiving psilocybin at one appointment and a placebo on another (although patients have little trouble telling the difference). Before taking the drug, each patient has attended a series of meetings with therapists to prepare for the experience.
Exactly how psilocybin might help treat people’s severe anxiety is unclear. Ross says it may “dislodge them from their stuck percept or state of fear,” allowing them to respond more actively to psychotherapy. “It is not just the drug itself but a kind of medication-assisted psychotherapy model,” he says, adding that the researchers disabuse participants of the notion that “here is the drug, here is an experience, you will get better.”
When a patient is under the effects of the drug, therapists sit by quietly unless the person wants to talk or appears to be distressed. After the drug has worn off, integrative psychotherapy sessions begin, aimed at helping subjects fuse their psilocybin experiences into their lives. Follow-up meetings continue for six months after the last dosing session to look for any changes in anxiety, depression, or pain.
A similar trial taking place at the Johns Hopkins University has treated 30 out of 44 patients. Both studies are expected to be complete next year, and are similar to a pilot study at the University of California at Los Angeles, in which 12 people with advanced-stage cancer were given a slightly lower dose of psilocybin. The UCLA study, published in the Archives of General Psychiatry in 2011, demonstrated the safety of administering moderate doses of the drug. Answers to questionnaires given to participants suggested a positive effect on mood and anxiety.
The idea of using hallucinogens for cancer anxiety has even deeper roots, in research from the 1950s and 1960s in which LSD was given to terminally ill cancer patients. Stanislav Grof, of the Maryland Psychiatric Research Center, administered LSD-assisted psychotherapy to about 60 patients at the Spring Grove State Hospital, outside Baltimore, and several hundred received the drug from Eric Kast, of the Chicago Medical School. The studies were uncontrolled (Grof’s work was cut short by political and cultural pressures) but showed promising improvements in mood and anxiety and a diminished need for narcotic pain medication.
Ross told attendees of the Psychedelic Science conference this year that anecdotal reports from his patients have been “remarkable,” and that data analyzed from the first five patients seem to show a “general trend” of falling anxiety after psilocybin treatment, but that it was too early to draw firm conclusions. “I think we have to look at the data. It looks as though there may be an effect, but there may not be,” he says. Ross is particularly interested to see if psilocybin can lead to reductions in pain, something that the UCLA study did not observe.
