A recent Colorado University study is investigating the use of the naturally occurring psychedelic prodrug compound, psilocybin, in treating anxiety, depression, and existential distress in people with advanced cancer.  During the clinical trials, a single 25mg dose of psilocybin 25mg was tested against a single 100mg dose of niacin, which acted as the active placebo. These medications were administered alongside brief psychotherapy to patients suffering with advanced cancer. The researchers found that such psilocybin-assisted psychotherapy (PAP)  was effective in treating anxiety, depression, and existential distress and improving the quality of life of outpatients.

The participants in the study receive six hours of therapy across multiple sessions, and then, take psilocybin eight hours later. Half receive psilocybin and the other half receive niacin. The therapy is important to prepare the participants for the experience, because releasing control is an important aspect of benefiting from it. When the participants have taken the drugs, therapy is also used to help patients process their experience. There is also research into whether the therapy or the psilocybin is responsible for most of the effectiveness of the treatment.  There is then a six-month follow-up, after which patients may opt to receive the drug under a different protocol. 

According to Dr. Stacy Fischer, the initial study had 200 participants and will be widened and the diversity of the group increased, in order to verify these results more conclusively. Nonetheless, these results are an important breakthrough. Studies of psychedelics in the 1970s were often highly unscientific and the conclusions were often outlandish, and this led to a certain stigma around the field, so that it is only in the last decade or so that mainstream science has taken psychedelics seriously. So while psychedelics have had a large role in the popular imagination, there is a paucity of scientific evidence. This can be seen from the fact that although psilocybin mushrooms, commonly known as magic mushrooms, have been used since before recorded history, psilocybin is classed as a Schedule 1 drug, under the Controlled Substances Act, meaning that the U.S. Drug Enforcement Administration (DEA) sees it as being prone to abuse, and not having any medical use, and there not being any accepted safety of use under medical supervision. Thankfully, the U.S. Food and Drug Administration (FDA) issued guidance for clinical trials for psilocybin and other psychedelics, designating them as “breakthrough” therapies for select mental health conditions. This has opened a route for psychedelics-based treatments to be approved. 

Currently, no drug companies have indicated that they plan on seeking approval for psilocybin-based drugs to treat anxiety, depression and existential despair. So, the information that researchers will gather will help to widen the legal use of psilocybin under the FDA’s rules. Colorado is one of many institutions that are exploring the possibilities of psychedelics. The University of Washington is studying the use of psilocybin in treating anxiety in people with metastatic cancer. There is also research on how PAP can help people receiving hospice care deal with demoralization. Separately, researchers from the Center for Psychedelic Medicine at the New York University (NYU) School of Medicine are also studying the use of PAP in treating existential distress in people with advanced-stage cancer. This research is building on work first done at NYU in the 2010s. According to Dr. Xiaojue Hu, a researcher at the Centre, said that, “Now, there are many other studies using psilocybin in cancer patients, including a study using psilocybin in combination with multidisciplinary palliative care to treat demoralized cancer survivors with chronic pain going on at Emory University”.  Hu believes that PAP could be a more sustainable and effective way of treating anxiety, depression and emotional distress than antidepressants and other commodity prescribed alternatives. This is because the effects of PAP can last as much as 14 months, whereas antidepressants have to be taken daily, and often for years, carrying with it the risk of a flattening out of their effectiveness and a relapse.