Published: May 27, 2024
By Ben Adlin
A newly posted page about psilocybin on a federal health agency’s website acknowledges the potential benefits the psychedelic substance might provide—including for treatment of alcohol use disorder, anxiety and depression. The page also highlights psilocybin research being funded by the federal government into the drug’s effects on pain, migraines, psychiatric disorders and various other conditions.
The page, “Psilocybin for Mental Health and Addiction: What You Need To Know,” was posted this month on the website of the National Center for Complementary and Integrative Health (NCCIH), which is part of the National Institutes of Health.
It includes basic information about what psilocybin is, where it comes from, the legal status of the drug and preliminary findings around safety and efficacy.
Though psilocybin remains a Schedule I controlled substance, the page notes, it’s been granted “breakthrough therapy” status by the Food and Drug Administration (FDA) and “has been either decriminalized or deprioritized in some states and the District of Columbia.”
“The legal status in the United States of psychedelic drugs including psilocybin continues to evolve.”
In terms of potential benefits, the NCCIH page highlights three possible areas of application: alcohol use disorder, anxiety and existential distress and depression.
It highlights a 2022 study that “suggested that psilocybin may be helpful for alcohol use disorder.” That research found people who were in psilocybin-assisted therapy had fewer heavy-drinking days over 32 weeks than the control group, which the NCCIH page says “suggests that psilocybin may be helpful for alcohol use disorder.”
As for anxiety and existential distress, the page says a “small amount” of research has studied psilocybin as a treatment for distress in people with serious medical illnesses, like advanced cancer.
“A 2020 analysis of 4 small studies in 117 people, most with life-threatening cancer, concluded that psilocybin combined with psychotherapy may be safe and effective for improving anxiety, depression, and existential distress, as well as quality of life,” it says, adding that “Because of limitations in the design of the studies and the small number and health status of the people involved, the authors note that the conclusions may have been biased.”
Regarding depression, a “growing body of research has suggested that psilocybin combined with psychotherapy may be helpful for depression in the short and medium term,” the page says, citing three separate studies.
A 2023 review and meta-analysis found that psilocybin-assisted therapy “reduced depression symptoms for up to 5 weeks,” while a separate study that year found that a single dose of psilocybin combined with therapy “rapidly reduced symptoms of depression within 8 days, with benefits lasting for 6 weeks.”
Other research, from 2021, found that psilocybin-assisted therapy “did not reduce symptoms better” than a common antidepressant medication combined with psychotherapy.
The NCCIH page reminds readers to not use psilocybin “to postpone seeing a health care provider about a medical and mental health problem” and encourages people to “take charge of your health—talk with your health care providers about any complementary health approaches you use.”
One promising application for psychedelics could be pain management. NCCIH notes on its psilocybin page that the agency is currently funding research to study the safety and efficacy of psychedelic-assisted therapy for chronic pain, while other federally funded research is looking into “the effect of psilocybin on people with chronic low-back pain and depression in regard to their emotions and perceptions of pain.”
Other inquiries seek to better understand the chemistry of psilocybin and the possible risk of interactions with selective serotonin reuptake inhibitors (SSRIs), commonly used to treat psychiatric disorders, migraine headaches and certain types of pain, the NCCIH page says.
Separate research published this month on psilocybin found that it’s unlikely that a single experience with the drug changes people’s religious or metaphysical beliefs—though it may affect their perception of whether animals, plants or other objects experience consciousness.
Findings of another recent study suggests that the use of full-spectrum psychedelic mushroom extract has a more powerful effect than chemically synthesized psilocybin alone, which could have implications for psychedelic-assisted therapy. The findings imply that the experience of entheogenic mushrooms may involve a so-called “entourage effect” similar to what’s observed with cannabis and its many components.
A separate study recently published by the American Medical Association found that single-dose psilocybin use was “not associated with risk of paranoia,” while other adverse effects such as headaches are generally “tolerable and resolved within 48 hours.”
That study, published in JAMA Psychiatry, involved a meta-analysis of double-blind clinical trials where psilocybin was used to treat anxiety and depression from 1966 to last year.
AMA published another recent study that similarly contradicted commonly held beliefs about the potential risks of psychedelics use, finding the substances “may be associated with lower rates of psychotic symptoms among adolescents.”
Also, results of a clinical trial published by AMA in December “suggest efficacy and safety” of psilocybin-assisted psychotherapy for treatment of bipolar II disorder, a mental health condition often associated with debilitating and difficult-to-treat depressive episodes.
The association also published research last August that found people with major depression experienced “clinically significant sustained reduction” in their symptoms after just one dose of psilocybin.
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