Psilocybin As A Mental Health Treatment A Few Things You Should Know.

Comment A few weeks ago, I mentioned to a friend that I was interested in learning more about psychedelics, specifically how they might help me with depression and anxiety. This is a broad class of herbal drugs, including psilocybin (“magic”) mushrooms, MDMA (ecstasy), DMT (Dimitris’ or businessman’s trip), ketamine (“special K”), and a few others. I’ve been hesitant to be open about my quest because I’m old enough to remember the warnings about “bad trips” that mess with your brain. Imagine my surprise when my friend told me that he had recently taken his first “trip”, which he described as life-changing. I asked him – a real estate developer living in Northern California, married with children – why he decided to try a psychedelic substance. “My work seemed more and more stale and meaningless,” he explained to me over a beer. “Despite tremendous reflection and guidance on how to break the finish line, I felt like I was still off track.” He and the others who used the drugs spoke on condition of anonymity because most of these psychedelics are Schedule I substances, meaning they are illegal to manufacture, purchase, possess or distribute. When I confided my interest in psychedelics to a few other friends, several said they had tried the drugs and had many benefits: from relieving anxiety to finding spiritual insights to combat depression and, among some with cancer, reducing fear of death. They are hardly extreme. According to a new study by YouGovAmerica, “one in four Americans say they’ve tried at least one psychedelic drug,” amounting to about 72 million U.S. adults. (The study included the drugs mentioned earlier, plus LSD, mescaline, and salvia.) Did I miss a beat because I didn’t get on board? When I asked my psychiatrist to participate to help improve my mental health, he was supportive, with two caveats: Do it with a trained therapist or guide, and do your best to make sure the substance is what it says it is. . These days, it’s hard not to see, hear, or read about psychedelic use, whether it’s Michael Pollan’s best-selling book (and accompanying Netflix documentary) “How to Change Your Mind,” online ads for psychedelics “trip” spas, underground therapists (also referred to as “sitters” or “guides”) with websites that promise consciousness-expanding journeys, and an online DIY ketamine program — with a medical professional connected by video conference — that you can at home. (Ketamine was approved by the Food and Drug Administration in 1970 as an anesthetic/analgesic, making it legal to prescribe. For more than 20 years, it has been prescribed off-label for depression, anxiety, and other mental health issues. A derivative of H ketamine, called esketamine—sold as Spravato—was approved by the FDA in 2019 specifically for depression.) Biggest Depression Advance in Years, FDA Approves New Treatment for Toughest Cases Recent headline-grabbing clinical trials and studies have shown efficacy in the treatment of a variety of conditions, including depression, addiction, obsessive-compulsive disorder, and post-traumatic stress disorder. And a growing number of studies are underway. Intrigued but cautious, I wanted to know: How should I approach this in a smart and safe way? I started by interviewing Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS). He reminded me that, aside from ketamine, none of these generically illegal psychedelics are FDA-approved, so he would only be talking about “minimizing the risks.” “I don’t want people to think this is like going to a carnival,” he said. “There is always danger.” Matthew Johnson, professor of psychiatry at the Johns Hopkins Center for Psychedelic and Consciousness Research, who has conducted numerous studies on psychedelics, also addressed the issue of safety. At this point, Hopkins’ clinical trials are looking at people with schizophrenia, bipolar disorder or severe heart disease. I mentioned that, like millions of Americans, I take an anti-depressant (an SSRI or selective serotonin reuptake inhibitor), which he explained would likely reduce the effect of psilocybin or MDMA. To go on psychedelics, he said I would want to taper off the SSRI first, which is best done under medical supervision (and which I’ve had trouble with in the past). I wasn’t suicidal, until suddenly, terrifyingly, I was I also have heart disease, so he warned me to talk to my cardiologist (who texted me that he doesn’t know anything about psychedelic use). In other words, these drugs are not for everyone. Johnson reiterated that despite public testimony to the positive therapeutic effects of psychedelic use, “there are risks and it’s illegal.” Was he trying to discourage me? “I don’t encourage anyone to do this alone,” he said After researching this column, I have no interest in making this journey alone. But supposing I were to have a guide or healer, where would I begin? Doblin suggested that anyone with a “clinical indication” (such as depression, PTSD or anxiety), should go to ClinicalTrials.gov to find and potentially participate in nearby studies. Recently, when I checked the database for “psilocybin” studies in the United States, 67 trials came up. All are conducted at well-known academic medical centers, which means the studies are done with pure drugs, approved by the FDA and licensed by the Drug Enforcement Administration, which means the trials have regulatory approval. What about people without a clinical indication, but who are on a spiritual quest? Here are the thoughts I came up with: Setup and Setup: Time and time again I have heard this phrase, which refers to finding a healthy mindset and a relatively safe environment. For obvious reasons, Johnson called the roof of a tall building a bad idea, as was being around cars or sharp objects. Robert Mitchell, who has practiced psychedelic and herbal medicine for 30 years and has treated “hundreds of clients”, said “the most important thing is to feel safe, comfortable and not to be disturbed”. Based in Los Angeles, he said he often has clients rent a cabin in the Santa Monica Mountains, which serves as a “sacred space.” Find an experienced, trusted therapist: If you’re looking for a psychedelic guide, word of mouth can be helpful. My property developer friend said “for the first time, I feel strongly about advising others to find a guide, ideally referred by someone you trust”. Hopkins’s Johnson urges people not to take just one of these psychedelic drugs. although there are still risks, it is less dangerous when there is someone with knowledge of the identity of the substance and the dose. (He said this can be especially critical for psilocybin mushrooms, which are known to vary widely in potency.) New programs are available, such as the California Institute for Integrative Studies’ Assisted Psychedelic Certificate Program. to serve the growing need for skilled psychedelic therapists to meet the demand. Ask questions in advance: Many therapists include a preparation session before any journey or treatment begins. Questions to be discussed in the preparatory session include discussion of the therapist’s background and experience, your intention to take a psychedelic drug (and which one), your personal health history, how he or she might handle a problem that arises (such as a medical side effect or a “bad” trip), the supply of the drug and, of course, the fee. A woman from Colorado gave me this advice: “I would make sure to work with a therapist who has experience and a clear protocol for the use of psychedelics, including pre-trip discussions and post-trip integration appointments.” Know what you’re consuming: Doblin said there is one DEA-licensed facility in the United States: Narcotics Detection Laboratories. It accepts anonymous samples of illegal drugs and will analyze them and publish the results online. (You send it in with a specific code and pay a fee for the analysis.) Additionally, you’ll want to talk to potential drivers about the source of their substances. Mitchell told me he knows where his psilocybin mushrooms are grown and can vouch for their purity. In the end, a friend who had two sessions of psilocybin said he “had to rely on the guide and the trust he was born with.” This will always be incomplete. Do your homework: MAPS is an educational nonprofit group whose first phase 3 study — on the effective use of psilocybin for severe cases of PTSD — was published last year in Nature Medicine, a leading peer-reviewed journal. The agency publishes information on the functions, uses and legality of psychedelics. Offers an introductory course, Psychedelic Fundamentals. Another resource is the “MAPS Code of Ethics for Psychedelic Psychotherapy,” which discusses psychological and physical risks. So am I going on a psychedelic trip? I read everything I can and talk to whoever I can about their experiences. I also remember the legal issues. Yes, Pollan and others are trying psychedelics and writing about their experiences – and not getting arrested or having their careers derailed or apparently suffering ill effects – but that shouldn’t be taken as a whitewash for the rest of us. I’ll be back here in a few months, so stay tuned.