Researchers have used illicit substances like psilocybin, MDMA and cannabis in studies for decades to test their effectiveness in treating psychiatric disorders. Now, those studies are laying the groundwork for clinical trials that enable researchers to find new, effective treatments.
What is Psilocybin?
Psilocybin is a natural hallucinogenic substance in mushrooms. This substance is a member of the psychoactive drug family. Psychoactive drugs are those that change a consumer’s perception, mood, and cognitive process when ingested.
There are many different types of “magic mushrooms,” all of which resemble ordinary mushrooms. Consumers can eat the mushrooms fresh, dried or cooked, as well as smoked or brewed into tea. However, psilocybin also comes in a synthetic form, which is similar to a powder, and can be taken in capsule form, according to the Alcohol and Drug Foundation (ADF).
No matter how it’s ingested, studies show that psilocybin can increase mystical experiences, life satisfaction, cause personality changes and alter emotions.
The Center for Psychedelic and Consciousness Research also finds that psilocybin effectively treats depression, cancer-related anxiety, and tobacco and nicotine addictions.
Studying Psilocybin’s Effects
Throughout the late 1970s, researchers explored the behavioral effects of psilocybin before it was categorized as a Schedule 1 drug, according to the Usona Institute, a clinical research organization.
U.S. officials placed it on the list of Schedule I Controlled Substances, which they deem to have no medical value. Psilocybin was then effectively removed from clinical and scientific studies for decades due to concern over its widespread, non-medical use.
Although it remains a Schedule 1 substance, this psychedelic has caught the attention of researchers who believe it could be a treatment for psychiatric disorders.
Studies show long-lasting therapeutic effects after as little as one exposure to psilocybin, Dr. Frederick S. Barrett – an affiliate with the Center for Psychedelic and Consciousness Research – told Medscape.
A study published in the Psychopharmacology journal also noted that psychedelic experiences can produce “substantial personal meaning and spiritual significance and […] sustained positive changes in attitudes and behavior.”
This double-blind study, which meant that neither the participants nor the researchers knew who was receiving treatment, studied over 30 volunteers over two months, with a follow-up after one year. During the first three sessions, half or more of participants who received psilocybin had a mystical experience, or reduced anxiety and dysphoria.
Psychedelic-assisted psychotherapy (PAP) is when professionals supervise the use of substances such as psilocybin, MDMA, ketamine, LSD and ibogaine as part of psychotherapy programs.
In a clinical study published in the journal of Frontiers in Pharmacology, psilocybin proved to be a safe, low-risk substance.
Although still in their beginning stages, PAP trials are running in Oregon, Colorado, California, Maryland, and a few other states. In these highly regulated studies, psilocybin administers screen patients prior to treatments and monitor them throughout the process.
The psychedelic is administered in controlled settings to allow researchers to explore the effects that psilocybin has on the nervous system. More specifically, these trials advance researchers’ understanding of the effects of psilocybin on consciousness.
Many of the trials are ongoing. But completed studies show psilocybin as a promising therapy, even for “treatment-resistant” conditions, or those in which patients do not respond to medication.
What is MDMA?
Methylenedioxymethamphetamine (MDMA), aka ecstasy, appeals mostly to consumers’ emotions. This synthetic substance is an empathogen, which means it increases the presence of empathy and benevolence towards others, as well as feelings of social connectedness, according to the ADF.
The ADF also stated that these positive reactions can come with mood swings, dehydration and potentially depression. This is because empathogens like MDMA release dopamine and serotonin in the brain that can cause a mixed bag of effects.
Consumers can swallow the substance in pill or capsule forms, or snort it as a powder after crushing the crystals. However, experts do not recommend this method due to its negative respiratory and nasal impacts.
MDMA as a “Breakthrough Therapy”
In 1912, the German pharmaceutical company Merck developed MDMA as an appetite suppressor, according to the Journal of Psychoactive Drugs. Three decades later, scientists used the substance in toxicological studies. They did not test it on humans until the 1960s.
MDMA was first introduced in the U.S. as a “street drug” after underground chemists sought legal alternatives to a similar drug, MDA, a controlled substance.
But the classification of MDMA as an illicit, controlled substance has prohibited its legal use for decades. Nevertheless, this has not prevented people from using MDMA for its therapeutic effects.
In MDMA-assisted therapy sessions, the drug proved to be helpful in treating PTSD, eating disorders and anxiety. In fact, the FDA recognized MDMA as a “breakthrough therapy for PTSD,” in 2017, reports Forbes.
More specifically, a Frontiers in Pharmacology study found that MDMA had substantial, long-lasting effects on PTSD. In patients with PTSD, roughly 70% of participants did not qualify for the diagnosis after 12 months; 30% experienced less intense symptoms; and a majority of the improvements from the treatment lasted up to four years. Improvements also took place after a few exposures to the substance.
The psychoactive substance has also shown significant effects on treating social anxiety in adults with autism, and alcohol use disorder.
Multidisciplinary Association for Psychedelic Studies (MAPS) conducted a double-blind study where 12 adults with autism participated in two experimental sessions that were one month apart, with a six-month follow-up. Participants showed significant improvement in their Liebowitz Social Anxiety Scale, which assesses social phobias and how they affect one’s life. Participants with social anxiety also showed slight improve after treatments.
Setting MDMA Apart from its Street Version
While MDMA offers clear benefits for psychiatric disorders, its “street drug” version has caused confusion over its safety.
Illegal versions of MDMA are commonly referred to as “molly.” They are sold in underground markets and rarely contain MDMA. Most times, molly consists of adulterants. Adulterants are substances that mimic MDMA, like para-methoxymethamphetamine (PMMA). PMMA has a slower onset and does not produce the same euphoric effects as MDMA.
This confusion further caused the clinical research of MDMA to stop for decades. But in 2011, the first clinical trial evaluating MDMA as a therapeutic was completed.
Since then, MAPS has done multiple studies on MDMA for PTSD, and a variety of anxiety-related disorders and phobias.
The association has also used MDMA to assist in relationship counseling, meditation, trauma therapy, chronic pain relief. They also used it to treat eating disorders, bipolar disorder, fibromyalgia, Parkinson’s disease and arthritis.
MAPS’ clinical trials are currently underway to test the safety and effectiveness of MDMA and ensure it merits legal prescription for the treatment of PTSD. Upon their completion in 2022, the FDA could approve MDMA as a treatment for PTSD as early as 2023.
The Future of Cannabis Research
In 2019, the association completed the first clinical trial of smoked cannabis as a treatment for PTSD symptoms in veterans. However, MAPS has yet to release the results.
Prior to that, MAPS studied the effects of vaporizers and water-pipes in filtering the fumes of inhaled cannabis until 2009. The study compared the number of cannabinoids in consumers’ blood and carbon monoxide levels in their exhaled breath. Researchers wanted to determine if water-pipes or vaporizers are less harmful than other forms of smoking. They found that vaporizing produced similar levels of cannabinoids in the blood and similar effects as smoking, but less carbon monoxide.
Aside from these MAPS studies, other scientific studies have continued research on the effectiveness of cannabis in treating stress, anxiety and sleep.
Most recently, researchers studied the effects of cannabis in treating symptoms of coronavirus. A study out of Canada concluded that cannabis extracts can help reduce a specific type of inflammatory distress called a “cytokine storm,” which causes acute respiratory distress, as well as treats other inflammatory conditions.
Although scientific cannabis research remains less stigmatized than psilocybin and MDMA studies, these substances continue to face a slow turnaround with FDA approval. Nevertheless, leaders in psychedelic research remain vigilant in creating safe and legal psychedelic experiences that advance psychotherapy treatment.