By AMERICAN HEART ASSOCIATION NEWS

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Psilocybin, the active ingredient in hallucinogenic “magic” mushrooms, is playing a mystical role for terminally ill patients by helping them come to terms with unresolved problems, emotions and even their imminent death, according to those who have worked with such individuals.

The psychedelic drug is illegal in the United States and cannot be used for medical purposes. But among those who have used the drug as part of strictly monitored medical trials over the past few years, nearly everyone has walked away feeling a sense of spiritual calm and gratitude, according to a panel discussion that was part of a summit looking at how best to help dying patients.

“Almost everyone has benefited in one degree or another,” William Richards, Ph.D., told the audience Wednesday at the third annual National Summit on Advanced Illness Care in Washington, D.C., hosted by the Coalition to Transform Advanced Care.

Richards, a clinical psychologist in the psychiatry department at Johns Hopkins School of Medicine, has investigated the impact psychedelic drugs have in the treatment of alcohol and narcotic addictions, personality disorders and other diseases for the past 16 years. More recently, he has used psilocybin in his work with more than 100 patients who have terminal cancer and other incurable illnesses.

George Goldsmith, co-founder and director of the medical research organization COMPASS, said his team has been working on a new research protocol that could lead to the largest clinical trial for cancer patients in numerous European nations.

He described current work with psilocybin as part of a renaissance of psychedelic research taking place at renowned institutions such as Johns Hopkins, University of California, Los Angeles and, across the pond, Imperial College in London.

“This is real science,” he said.

Goldsmith said his team is currently trying to determine the logistics and protocols that need to be in place to scale up the types of psilocybin experiments currently happening for only several dozens of patients each year.

“If we look at just a half of 1 percent of cancer patients in the U.K. who would be interested in this treatment, we have to figure out how to do that for 14,000 people,” Goldsmith said.

“This is real work and it really needs to be looked at carefully and that’s what we’re aiming to do, to build the evidence to bring this into practice and to see how to do it safely.”

Panel moderator Michael Pollan, a journalism professor at the University of California, Berkeley and author of The Omnivore’s Dilemma, dove into the area of psychedelic drug therapy while researching an article for The New Yorker published last year. The piece, “The Trip Treatment,” profiled New York University scientists who had administered psilocybin among trial participants with terminal cancer.

Pollan noted Wednesday that the research was not new but a resumption of work looking into LSD and other psychedelic drugs beginning in the 1950s. That work came to a stop when President Nixon signed the 1970 Controlled Substances Act, which, among other things, prohibited the use of psilocybin as a medicine.

Pollan said he interviewed more than a dozen patients for his article and each described their treatment with psilocybin as “substantially different from the kinds of recreational psychedelic experiences we’ve all read about.” Each treatment was given in a highly controlled environment and setting.

“The idea of a bad trip becomes, in the hands of an experienced clinician, an important opportunity for self-knowledge,” Pollan said.

Patients emerge from treatment with a tremendous sense of perspective, he said.

“It’s as if the camera pulled back further than ever on their lives,” Pollan said. “Matters that seemed so challenging now appeared smaller and more manageable – whether smoking, cancer or the prospect of their death.”

Richards said he has seen the drug surpass outcomes of traditional psychotherapy when it comes to helping patients deal “with guilt and grief and fear and anger and all the repressed emotions we tend to have inside of us.” Patients also emerge from their session with an extremely sharp sense of clarity that allows them to resolve any interpersonal relationship problems they may have.

Psilocybin differs from traditional drugs used in psychotherapy because it appears to target existential and spiritual distress. Its use in therapy involves only a single administration. Patients reported an immediate decline in anxiety and depression and most said their fear of death either diminished greatly or was entirely eliminated, panelists said. Results of the treatment lasted for several months, even up to half a year, they said.

Richards said psilocybin has a number of advantages over other psychedelic drugs when it comes to potential medical treatment.

It is not LSD and it doesn’t evoke crazy responses. Psilocybin has a long natural history,” he said. “It’s been used by Indian communities for probably thousands of years. It has a very good safety profile.”

Psilocybin also lasts just the right amount of time on patients – roughly six hours. Comparatively, the duration of LSD is about eight hours. Mescaline can take about 12 hours.

“It works into the clinical day,” Richards said about psilocybin.

He also added: “A great advantage of psilocybin is that it’s hard to spell. It just doesn’t get the negative press.”