Change is upon us; magic mushrooms have officially made an appearance in the Utah legislative chambers, so it’s high time we talk about the exciting benefits of this ancient medicine. Rep. Brady Brammer, R-Highland has proposed a bill for the 2022 session that would create a task force of experts to consider future state legalization and research of psychedelics like psilocybin for medicinal use.

History 

Boomers, caps, mushies and shrooms are all slang for magic mushrooms – varieties of fungi that produce an intoxicating molecule known as psilocybin. The use of psychoactive mushrooms is almost as old as humans – dating back 5.3 million years. Indigenous people from Central America to Siberia used psilocybin in spiritual ceremonies to heal mind and body and connect with each other and higher powers. In fact, some ethnobotanists like Terrance Mckenna have a theory called the “Stoned Ape Theory” where psilocybin may have expedited human evolution especially with language development.

In the 1950’s, amateur mycologist Gordon Wasson visited the small town of Oaxaca Mexico where he met Shaman Maria Sabina who guided him through a psilocybin ceremony. He returned to America and wrote an article in Time Life Magazine about his experience, introducing many Americans to psilocybin for the first time. The counterculture movement in the 1960s encouraged many to try these “magic mushrooms” and in response the federal government decided to add psilocybin to the Controlled Substance Act of 1970. Similar to cannabis, psilocybin appears to be one of the safest of the “recreational drugs” and is not considered addictive, but prohibition of these mushrooms has left a major gap in knowledge and information, limiting how much we can definitely say about these fungi.

Numerous municipalities are considering legalizing or decriminalizing magic mushrooms. Oregon has approved a medical program where psilocybin will be administered in office. There are over 200 species of psychoactive mushrooms that grow in every continent except Antarctica and thrive in most ecosystems. Psilocybe Cubensis is a common species of mushroom that contains psilocybin. Much like cannabis we are beginning to see a large variety of different strains and crosses with names like Golden Teacher, PE, and Blue Magnolia. 

How does it work?

Despite the name, there is little magic in taking these mushrooms. Their dirt-like taste and off-putting texture can make it difficult for some people to chew and swallow the dried mushrooms, which is the most common way to consume. In the mushrooms there are many compounds, but most important to the psychedelic effect is psilocybin, which is a prodrug. This means that it must dephosphorylate or “activate” in stomach acid to form the active compound psilocin, which is what causes the psychedelic effects, also known as “tripping”.  After ingestion it usually starts to work within 30-60 minutes with effects lasting 4-8 hours. People report euphoria, altered thinking, visualizations, altered sense of time, synesthesia (mixing up senses like hearing colors), and profound spiritual experiences. Side effects include nausea (some people call this “the weirds”), runny nose, teary eyes, yawning, anxiety, and psychosis. 

Psilocin works in our brains by binding to Serotonin 2A receptors, also known as the “psychedelic receptor”. Many of these 2A receptors are located in the primary visual cortex which results in visual hallucinations like the walls breathing. Psychedelics also constrict veins which some speculate pushes more blood volume into the capillaries and this is thought to enhance connectivity and allow different parts of our brain to receive more oxygen and communicate in new ways. A study from the 1960’s showed that psychedelics can help humans solve complex problems by boosting creative thinking. Psychedelics are also described as rebooting our brain by allowing rigid patterns to be shaken up and facilitate escaping unhealthy habits and ruts which may be helpful in addiction. It’s common for people to describe a psychedelic experience as feeling more real than waking consciousness. There is a transcendence of time and space, love, gratitude, peacefulness and many describe their experience as ineffable or too great to describe in words. People also report positive personality changes such as an increase in openness, broadmindedness, and the ability to approach new situations in a creative and flexible way.

We can see from brain imaging studies that psilocin alters blood supply to something in our brain called the default mode network. Our default mode network controls the gates of consciousness. It creates a veil between perceived reality and actual reality. Ego is the gatekeeper and this temporary lack of blood supply causes an “ego death” and allows the doors of perception to open. And the most exciting thing about psychedelics is something we call after-glow, where these positive effects are long lasting. Recent animal studies show one dose of psilocybin leads to a long-lasting increase in the number and strength of neuronal connections. This is why experts suggest that psychedelics may be more curative than any other tool we have to treat depression. Imagine…instead of taking an antidepressant 365 days a year you could achieve the same results with only 2 doses of psilocybin. A recent Johns Hopkins study published February 2022 shows “substantial antidepressant effects of psilocybin-assisted therapy may be durable at least through 12 months following acute intervention in some patients”.

Medical Research

In 1962 Harvard psychologist Timothy Leary conducted a study called “The Good Friday Experiment” where he gave either psilocybin or niacin to divinity students in Boston. Almost everyone in the psilocybin group reported experiencing their most profound religious experiences to date. Rick Doblin, the Founder of Multidisciplinary Association of Psychedelic Studies (MAPS) followed up with this same group of test subjects 25 years later and they reported this single psychedelic experience as life changing and still one of the most profound experiences of their life. 

It was hard to take these mystical experiences seriously in the scientific community until 2006 when a groundbreaking study from Johns Hopkins was published. It was extremely well designed and scientifically rigorous. It was a double blind, active placebo, randomized controlled trial titled “Mystical-type experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance”. Participants were given 5gm of dried mushrooms (which is considered a large dose) and simply asked to lay on a couch and listen to music. Many described a spiritual experience, interconnectedness of all people and things, sacredness, awe, reverence. There were negative experiences reported as well, where 30% reported having anxiety and “bad trips”. It’s important to note that these negative experiences can still be therapeutic. A follow-up 14 months later showed lasting benefits. 

When using psychedelics experts recommend preparation and integration. Integration is being able to talk about your psychedelic experience as soon as you return to reality and incorporate it into your life, ideally with a trained therapist. Because of this, many proposed protocols for psilocybin use require administration in an office setting. This is also suggested to keep people safe. There have been small numbers of case reports where people have walked into traffic and jumped out of buildings, so having a trained “trip sitter” or therapist is important. 

Current research on psychedelic drugs is booming and results have been better than expected. A recently published scientific review of psilocybin research showed “positive effects on existential and spiritual well-being, quality of life, acceptance of life, acceptance and reduction of anxiety and depression with few adverse and no serious adverse effects”. Researchers are currently looking at psilocybin for major depressive disorder in phase 2 clinical trials and in some published studies psilocybin is outperforming common antidepressants. Results are so promising in these trials that the FDA has designated it a breakthrough therapy for depression and is currently fast-tracking approval. We also have exciting scientific research on treating anxiety and depression in cancer patients, obsessive compulsive disorder, acceptance of mortality for end of life patients, PTSD and alcohol and nicotine addiction. There are also current clinical trials of psilocybin use for alzheimers, anorexia and opioid-use disorder.

Micro-dosing

For some these larger doses are too intense and the experience can be overwhelming. For this reason there is a growing trend towards micro-dosing. Many people swear by the anti-depressant effects of micro-dosing – taking a smaller amount of a psychedelic substance, but taking it more often. There isn’t as much clinical research supporting psychedelic micro-dosing yet and more studies are needed, but the risks are so minimal that it’s generally regarded as safe. There are a few different protocols for micro-dosing. It’s not ideal to dose every day. Some people dose 1 day on then 2 days off (James Fadiman protocol) and others prefer 4 days on and 3 days off (Paul Stamets protocol).

Final Thoughts

Psilocybin is still a federally controlled schedule 1 substance, just like cannabis. Some states are beginning to decriminalize the possession of magic mushrooms and even consider legalization of the medicinal use of mushrooms. This common sense solution worked for cannabis and it can work for mushrooms as well, particularly if we learn from the successes and shortcomings of the now burgeoning cannabis industry. 

I encourage Utah to consider a framework that supports office administration with a trained trip sitter, preparation and integration for larger doses, and an ability to easily purchase and utilize the milder effects of micro-dosing. It’s important with any substance to consider the risks vs benefits. Psychedelics are not for everyone and a trained medical professional should assess the appropriateness of usage and screen for contraindicated medical conditions and drug interactions. In general, psychedelics should be avoided in people with a risk of psychosis, schizophrenia, or high blood pressure. And with all mind-altering substances I suggest you consume with moderation, intention, and respect. A large dose of psilocybin is powerful and you can think of it as a drastic medical intervention like surgery where the benefits could be tremendous and the risks are more psychological than physical. It’s important to have a guide such as a healthcare provider, a shaman or roadman. There is quite a bit of legal risk consuming these substances in the United States and because of this I do not advise anyone to medicate with psilocybin at this moment in time. Mental health issues are increasing and I want everyone out there to know that more help is on the way. Be safe. Take care of each other and stay open-minded as we all watch this psychedelic renaissance continue to unfold.

– this article was submitted by Mindy Madeo (The Green Pharmacist), Lead Pharmacist at Beehive Farmacy in Brigham City, Utah.

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