Download Marilyn Bender - ConvergentEmergence

PSILOCYBIN: A NATURAL PHARMACEUTICAL WITH
INDISPUTABLE POTENTIAL FOR USE IN PSYCIATRY
AND PSYCHOTHERAPY
Prepared by
Jacob M. Parker
[email protected]
August 4, 2009
Parker 1
PSILOCYBIN: A NATURAL PHARMACEUTICAL WITH INDISPUTABLE
POTENTIAL FOR USE IN PSYCIATRY AND PSYCHOTHERAPY
ABSTRACT
This paper covers the basics regarding the identity of Psilocybin, its historical use
in humans, and the research that has ultimately led to its classification as a schedule I
drug under the United States’ Controlled Substance Act; which, among other things,
classifies psilocybin as having no medicinal value. Further discussion will present
credible studies and experiments conducted in the past, whose bases explore the effects of
Psilocybin and its potential for use in human subjects for the treatment of certain
psychiatric disorders. The results of referenced studies will then be compared to the
rationale that currently defines Psilocybin as a schedule I controlled substance in the
United States. Consequent discussion will reference both current and future studies and
experiments being and to be conducted that intend to determine the possible medicinal
uses (if any) of psilocybin, and what the results of these experiments may say regarding
its viability of use in the fields of psychiatry and psychotherapy.
INTRODUCTION
Have you ever considered that many pharmaceutical drugs prescribed by
specialists to treat psychiatric conditions may only hide the symptoms of the condition
and undermine the doctor’s or patient’s ability to confront the issue(s) from which the
condition stems in the first place? This paper aims to highlight the potential of psilocybin
in its use as a medicinal tool by professional psychiatrists and psychotherapists in their
treatment of certain psychiatric conditions. Through additional research, the medical
community will become more aware of the medicinal uses that the effects of psilocybin
may offer, and how professionals may utilize this chemical in the fields of psychiatry and
Parker 2
psychotherapy as a crucial tool for the broadening of comprehension (by both doctor and
patient) of the complexities of the individual human mind and resulting interpretations of
reality.
DISCUSSION
Increased research efforts in to the effects of psilocybin on the human mind will
undoubtedly provide us with a more direct understanding of our individual
consciousnesses and afford an important tool for those professionals in the field of
psychiatry and psychotherapy. With the help of the results past research and realizing the
effects those studies had on our world, modern researchers may finally begin to study the
medical potential of psilocybin from an entirely objective perspective.
Psilocybin Identified
Psilocybin is a “naturally occurring tryptamine alkaloid” (Griffiths 1) that has
been traditionally thought of and generally defined as a hallucinogenic compound—
meaning its active chemicals and chemical metabolites induce sensory reactions to
impulses that cannot be reasoned to exist in reality. However, there appears to be a great
deal of debate among drug researchers as to whether hallucinogenic drugs such as
psilocybin actually induce hallucinations.
In fact hallucinogenic drugs do not, in general, bring hallucinations…a
true hallucination is a perception occurring in the absence of
environmental stimulation…So-called hallucinogenic drugs to not cause
this. Instead, these drugs simply bring about an alteration in perception or
a sense of increased insight or awareness. (Gahlinger 46)
Parker 3
Psilocybin is most commonly found as an active chemical constituent of many
different species of mushrooms that belong to the psilocybe genus. Ritualistic ingestion
of psilocybin by numerous indigenous cultures for spiritual growth is proven to have
occurred as early as the sixteenth century, while historical suggestions declare its use up
to two-thousand years prior (Jerome 3). In spite of this, several indigenous cultures, who
ritualize(d) the ingestion of psilocybin also practice(d) customs whose ideological bases
sharply contrast our modern moral understandings, may not necessarily be ideal role
models for psilocybin’s medicinal use. For instance, the Aztec people, who were avid
users of psilocybe mushrooms, also routinely practiced human sacrifice rituals. Though,
a majority of early information concerning the use and effects of hallucinogenic
compounds in humans came directly from published field experiences with indigenous
peoples who followed strict guidelines surrounding their use of these mushrooms for
ceremonial purposes (Johnson et al. 605).
Albert Hoffman, a Swiss chemist, first isolated psilocybin from psilocybe
mushrooms in 1957, and in 1958 while continuing his research for Sandoz
Pharmaceutical became the first person to synthesize the chemical. Throughout the
1950s and early 1960s, psilocybin was studied and used by psychiatrists and
psychotherapists in their research of improved treatment techniques. Psilocybin and
other hallucinogens were completely legal to use and possess by all Americans until
1965. Upon its official induction in to the United States’ list of controlled substances in
1970, psilocybin’s use and research for use in medicine was effectively discontinued. It
was not until the mid-1990s that psilocybin resurfaced as the base of research in to its
effects on the human mind (Jerome 3).
Parker 4
Effects of Psilocybin on the human mind
The most notable overall effect induced by psilocybin is the radical alteration of an
individual’s conscious perception. In a recent study testing the acute effects of
psilocybin, Hasler and his colleagues clarify this perceptive phenomena in their claims
that psilocybin has the ability to loosen one’s ego or effectively disintegrate the boundary
between the inner self and existing external environment (Hasler et al. 8). They go on to
declare: “The loosening of the demarcation between self and environment was generally
accompanied by insight and experienced as ‘touching’ or ‘unifying with a higher reality
(OB)’” (Hasler et al. 8). Beginning research of psilocybin produced claims that suggest
experiences of after-images (the persistence of a perceived image to remain in an
individual’s visual field, when in reality the visual stimulus observed had already ceased)
as evidence of participant claims of obvious changes in their visual perceptions. Other
reports included unusual thought patterns, general feelings of anxiety, and irregular
bodily sensations tied to perceived environmental stimuli. A majority early study
participants were observed to exhibit noticeable difficulty in performing certain thought
related tasks, i.e. basic arithmetic calculations (Jerome 8).
When administered orally, the initial effects of psilocybin become apparent to the
user within twenty to thirty minutes after ingestion. The peak effects begin to appear
between sixty and ninety minutes after ingestion, with all noticeable effects subsiding
approximately four to six hours post-initial-ingestion (Jerome 7).
The psychological effects of psilocybin include significant alterations in
perceptual, cognitive, affective, volitional, and somatesthetic functions,
Parker 5
including visual and auditory sensory changes, difficulty in thinking,
mood fluctuations, and dissociative phenomena. (Griffiths 2)
Physical Effects of Psilocybin
The physical effects of the chemical are far less pronounced than those effects
seen by the psyche. In addition, various physical effects experienced by a person under
the influence of psilocybin may actually be directly triggered by psychological miscues
resulting from the psychological effects being experienced. However, research has
produced conclusive data that shows consistent physical reactions to the chemical in
humans. These effects include: dilation of pupils, and an occasional temporary increase
in blood pressure typically in individuals who suffer from cardiovascular conditions such
as hypertension (Hasler et al.). A recent investigation into the acute psychological and
physiological effects of psilocybin provided the following results:
Our investigations provided no cause for concern that administration of PY
[(psilocybin)] to healthy subjects is hazardous with respect to somatic
health…[and] indicate that PY-induced ASC [(altered states of
consciousness)] are generally well tolerated and integrated by healthy
subjects. However, a controlled clinical setting is needful, since also mentally
stable personalities may, following ingestion of higher doses of PY,
transiently experience anxiety as a consequence of loosening of egoboundaries. (Hasler et al. 155)
Parker 6
Negative effects
The most common adverse effects associated with psilocybin are: distorted
awareness of time and space, general feelings of anxiety, “derealization” (losing the
ability to tell what is real and what is not), depersonalization (feeling like the idea of the
self belongs to someone or something else), experiencing rapid and sometimes powerful
changes in positive and negative moods, dizziness, inability to maintain normal levels of
concentration, nausea, nervousness, and unusual thoughts and thought patterns. The
majority of these effects exist only while the drug is active in the body (four to six hours).
(Jerome 15-16)
Psilocybin is not linked to any disease of the human body or organ systems
(Jerome 15); however the potential for strong psychological reactions while under the
influence of chemical have lead some researchers to question whether hallucinogens can
be linked to any lasting psychological effects in humans. A study in 2008 sought to
answer this question directly, though focused mostly on the lasting effects hallucinogens
may potentially have on adolescent minds. The results found that “acute psychotic
syndromes in adolescents are rarely due to intoxications with hallucinogenic drugs”
(Hermle et al., 1). Nevertheless, psilocybin—if used while not under the supervision of
professionals or by individuals who are not aware of the profound psychological
alterations the chemical may induce—has the potential to provoke extreme degrees of
psychosis in mentally unstable individuals (Jerome, 16-18).
The occurrence and intensity of anxiety or panic responses to psilocybin
can be reduced through informing participants about drug effects prior to
drug administration, supervision and monitoring participants throughout
Parker 7
the duration of drug effects by people trained to deal with panic or anxiety,
including anxiety in response to hallucinogen effects, and exposure to
lower doses before receiving higher doses. (Jerome 16-17)
“To date, there have been no verified fatalities directly due to ingesting psilocybin or
mushrooms containing only psilocybin and related compounds” (Jerome 15).
While there are obviously potential risk factors involved with the use of
psilocybin in humans, they compare with those risks taken with the use of various
pharmaceutical drugs currently approved for prescription in the United States. For
example, psychostimulants such as amphetamine used to treat a variety of disorders from
ADD and ADHD to narcolepsy—most notably found as the main ingredient in brand
name prescription drugs such as Adderall and Vyvanse (interestingly, both drugs
marketed by the same pharmaceutical company, Teva Pharmaceuticals)—have very
similar side effects to Psilocybin. These include nervousness including agitation, anxiety,
irritability, feelings of suspicion and paranoia, and visual hallucinations. A key
difference between the two drugs, however, is the fact that the legal drugs composed of
amphetamine have the potential to cause overdose and death, while the illegal drug
Psilocybin does not. (www.adderall.net)
Past Clinical Studies
Throughout the 1950s and early 1960s hundreds of clinical studies were
conducted testing the effects of psilocybin and other hallucinogens as means to further
the understanding of the human mind. During the same time period, the United States
Army and CIA were performing their own experiments with psilocybin on both soldiers
and civilians alike. Often times these experiments were seen through without the prior
Parker 8
consent of the study subjects, and sought to identify the capacity of hallucinogens to act
as truth serums for use in interrogation efforts by the U.S. military (Johnson et al. 605).
The majority of early researchers of psilocybin did not anticipate how direct an
influence a person’s mindset and perception of their environment actually have on the
psychological and physical effects encountered through the experience induced by
psilocybin (Griffith 2). Timothy Leary, an early proponent and frontier researcher of
hallucinogens, defined these antecedents to the experience (mindset and perception of
environment) as “set and setting.”
The nature of the experience depends almost entirely on set and setting.
Set denotes the preparation of the individual, including his personality
structure and his mood at the time. Setting is physical — the weather, the
room's atmosphere; social — feelings of persons present towards one
another; and cultural — prevailing views as to what is real. (Leary 4)
The results of some initial studies reflected an array of negative experiences encountered
by study volunteers. Ensuing studies suggested these negative reactions were in part due
to the stark environments to which volunteers were subjected throughout the research
procedures.
Subsequent research, which included more preparation and interpersonal
support during the period of drug action, found fewer adverse
psychological effects, such as panic reactions and paranoid episodes, and
increased reports of positively valued experiences. (Griffith 2)
There were also those studies conducted with the direct intention of harnessing
the effects of psilocybin and other hallucinogens to be used for the advancement of
Parker 9
psychiatric treatments. In this regard, Gahlinger comments on the results of research in
the late 1950s to early 1960s, which suggests the potential of hallucinogen-assisted
therapy sessions:
All psychiatric medications in the 1950s were essentially tranquilizers—
they all improved mental illness simply by suppressing the patient’s
problems and conflicts. By enhancing awareness, rather than suppressing
it, hallucinogens held the possibility that they could resolve these
problems instead. (Gahlinger, 49)
Results and Effects of the Results of Early Studies
The initial research conducted on psilocybin gave doctors and scientists great
insight into what the drug could ideally be used for. By the mid-1960s research of
psilocybin led to its utilization by psychiatrists and psychotherapists in their patient
therapy sessions. Continued research proved that psilocybin could assist
psychotherapists and psychiatric researchers in activating an individual’s sub conscious
memories and conflicts (Jerome 13). Several experts believed that access to such areas of
a person’s psyche would essentially provide the ability of the patient (with the guided
support of therapy) to confront their issues and find inner peace. Psilocybin-assisted
therapy, as it came to be known, followed either one of two models: the psycholytic
model or the psychedelic model. The former involved the ingestion of lower doses of a
hallucinogenic drug, and the patient’s active interpretation and analysis of their
experience during the session. The psychedelic model used higher doses, and called for
the patient to recount their interpretation of their experience after completing the session
(Jerome 13).
Parker 10
Investigations into the human reactions to psilocybin led to clinical research in to
the use of hallucinogens for psychotherapy performed at various universities throughout
America. The involvement of university students in the research procedures and the call
for student volunteers for the studies eventually led to the popularization of hallucinogens
for recreational use. The most notable catalyst for the popularization of hallucinogen use
at the recreational level was Timothy Leary, a Harvard professor of psychology who,
after his initial experience with psilocybin, endlessly fought for it and other
hallucinogen’s recognition as powerful tools in the understanding of one’s own mind.
As an almost immediate reaction to the increased recreational use of hallucinogens and
other drugs in the 1960’s, the U.S. government passed the Controlled Substances Act,
which effectively listed known chemicals with the potential for abuse in to categories
known as “schedules.” These schedules have fundamentally become the last word
regarding how dangerous each scheduled substance is individually, and dictate the extent
of legal punishment in the case of violation.
Psilocybin and other hallucinogens became known as Schedule I controlled
substances. “Schedule I substances are considered to have a very high abuse potential, no
acceptable medical use, and to be unsafe for use under medical supervision” (Gahlinger
76). It is interesting to note that, preceding the U.S. government’s decision to pass the
Controlled Substances Act, psilocybin was safely and effectively utilized for psychiatric
treatment under medical supervision. A survey gathered data in 1966 that reflected the
results of 2,742 individual hallucinogen-assisted therapy sessions, and “found no
resulting psychoses, suicide attempts, or uncontrollable behavior” (Gahlinger, 49).
Nevertheless, research into the effects of hallucinogens in humans ceased after 1970, and,
Parker 11
to date, hallucinogens including psilocybin are still categorized as schedule I controlled
substances in the United States.
Current and Future Clinical Studies
Modern human research with psilocybin only recently began to reappear in the
mid-1990s. These studies have examined or are in the process of examining psilocybin’s
ability to treat: anxiety related to the diagnoses of terminal illnesses such as cancer,
cluster headaches, and obsessive-compulsive disorder. Basing their efforts on previously
conducted research with LSD-assisted psychotherapy and its uses in the management of
anxiety in advanced stage cancer patients, Charles Grob and colleagues are preparing a
study focused on psilocybin’s capacity to treat these same symptoms (Jerome 13-14).
John Hopkins partnered with Heffter Research Institute and Riverstyx Foundation is also
in the process of conducting a similar study with advanced stage cancer patients (MAPS).
In 2006 Andrew Sewell and his team studied a group of fifty-three people who
suffered from recurring cycles of cluster headaches. The group self-administered
psilocybin containing mushrooms as a means to treat their cluster headaches. “Twentyfive of the forty-eight respondents…reported that they had terminated their cluster
headache period, and 18 respondents (37%) reported that psilocybin was partially
effective in reducing attacks during cluster periods” (Jerome 14). A study done between
2001 and 2004 measured the effectiveness of psilocybin in treating the symptoms of
obsessive-compulsive disorder in nine subjects. The results of the study not only
associated psilocybin with the “transient symptomatic reduction of OCD symptoms”
(Moreno et al. 1738), but also suggested that when administered in a supportive clinical
environment, psilocybin was well tolerated and safe (Moreno et al., 1738).
Parker 12
Results of Studies and Effects of Current Studies
Thus far, nineteen documented studies have attested to the irrefutable
psychotherapeutic potential of psilocybin (Jerome 13). While contemporary
investigations with psilocybin have provide a limited catalogue of credible studies, many
results of past research and speculation regarding psilocybin’s potential role in assisting
psychiatrists and psychotherapists have been confirmed by modern research. Such results
have prompted more direct interest in researching the uses of hallucinogens for medical
purposes. Perhaps one of the most significant products of the resurgence of research with
hallucinogens is the ability of modern technologies to aid researchers in disproving
countless cultural and politically based myths concerning hallucinogens and other drugs.
A key example of such myths may be easily represented by the U.S.
government’s claim (evident in their general scheduling guidelines) that psilocybin has a
very high potential for abuse. This could not be further from the truth. In fact, recent
studies, coupled with information provided by past studies, suggest that the abuse
potential of psilocybin is effectively zero (Jerome 18). “Surveys of drug use in the U.S.
do not even ask specifically about use of “magic mushrooms, suggesting that use of these
mushrooms is relatively uncommon” (Jerome 18). Many such myths, that have tended to
become “fact,” have never had any scientific basis, though nevertheless have, for years,
fueled a close-minded war on illegal drugs. The ultimate purpose of this war is clearly
not to understand why we consider these drugs “bad,” but rather to force the acceptation
that they are bad, and forever banish their use into a figurative extinction.
Some may simply ask “Why? Why do we advocate the ignorant rejection of
illegal drugs instead of allowing educated choices to be made? Why are certain drugs
Parker 13
legal and others illegal, while both may hold the same abuse potential or same negative
risk factors in common? While there is evidence that may offer support to an infinite
number of suitable answers to these and other related questions, it is sometimes better to
let evidence speak for itself.
A recent report by the Florida Medical Examiners Commission found that
the rate of deaths caused by prescription drugs was three times the rate of
deaths caused by all illicit drugs combined. The report’s findings track
with similar studies by the federal Drug Enforcement Administration,
which has found that roughly seven million Americans are abusing
prescription drugs. If accurate, that would be an increase of 80 percent in
six years and more than the total abusing cocaine, heroin, hallucinogens,
Ecstasy and inhalants. (Cave)
Modern research with all drugs, including psilocybin, is beginning to underline our past
misinterpretations of their uses and stress the need for further research into how these
substances truly affect the human body.
CONCLUSION
After several decades of discounting the possible medicinal uses of psilocybin—
an approach directly influenced by the reaction on the part of the U.S. government to the
widespread nonmedical use and abuse of hallucinogens in the mid to late 1960’s—
medical research in humans has finally resumed. Modern research methods and
technologies have spawned a new interest into the possible therapeutic applications of
psilocybin and other hallucinogens (Johnson et al. 616). Through the furthering of such
research, and studies that aim to further understand the effects of psilocybin on the
Parker 14
human psyche, psychiatrists and psychotherapists may finally possess a key with the
potential to unlock the doors of individual perception, and, in doing so, provide
specialists and their patients the unique ability to recognize the more deeply seated
(perhaps sub-conscious or even unconscious) concerns contributing to their condition(s),
effectively allowing for more personalized and successful therapeutic treatments of
psychiatric conditions.
Parker 15
References
"Adderall Side Effects." Drug News. Research Publishing Company, n.d. Web. 26 Aug.
2009. <http://www.adderall.net/>.
Cave, Damien. "Legal Drugs Kill Far More Than Illegal, Florida Says ." The New York
Times. The New York Times Company, 14 June 2008. Web. 26 Aug. 2009.
<http://www.nytimes.com/2008/06/14/us/14florida.html>.
CESAR (Center for Substance Abuse Research). Dept. home page. University of
Maryland. 27 July 2009
<http://www.cesar.umd.edu/cesar/drugs/psilocybin.asp>.
Gahlinger, Paul, M.D., Ph.D. Illegal Drugs. New York: The Penguin Group, 2004.
Griffiths, R. R., et al. "Psilocybin Can Occasion Mystical-type Experiences Having
Substantial and Sustained Personal Meaning and Spiritual Significance."
Springer (May 2006): 1-16. 20 July 2009
<http://springerlink.com/content/v2175688r1w4862x/>.
Hermle, L., et al. "Hallucinogen-induced psychological disorders." PubMed. U.S.
National Library of Medicine and the National Institutes of Health . 27 July
2009
<http://www.ncbi.nlm.nih.gov/pubmed/18512184?ordinalpos=4&itool=Ent
rezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportP
anel.Pubmed_RVDocSum>.
Jerome, Lisa. Psilocybin An Investigators Brochure. MAPS (Multidisciplinary
Association for Psychedelic Studies). Mar.-Apr. 2007. Multidisciplinary
Parker 16
Association for Psychedelic Studies. 20 July 2009
<www.maps.org/research/psilo/psilo_ib.pdf>.
Johnson, M. W., W. A. Richards, and R. R. Griffiths. "Human hallucinogen research:
guidelines for safety." Journal of Psychopharmacology (July 2008). 20 July
2009 <http://jop.sagepub.com/cgi/ content/abstract/22/6/603 >.
"Psychedelic Research Around the World: Psilocybin Research." M.A.P.S.
(Multidisciplinary Association for Psychedelic Studies). 4 Mar. 2009.
Multidisciplinary Association for Psychedelic Studies. 22 July 2009
<http://www.maps.org/research/>.