begin testing psilocybin’s therapeutic value. In 2011, Charles
Grob, MD, and colleagues at Harbor-UCLA Medical Center
published the result of a small pilot study demonstrating the
drug’s potential for reducing anxiety in cancer patients (JAMA
Larger studies, using higher doses of the drug, have recently
been completed at NYU and Johns Hopkins and the results are
being prepared for publication. Those studies investigated the
drug’s effect on anxiety and depression, as well as measures such
as spirituality, quality of life and existential distress.
Patients grappling with a potentially fatal cancer diagnosis
often suffer such distress, says Anthony Bossis,
PhD, a psychologist specializing in palliative
care and one of the lead investigators of the
NYU trial. “We’ve gotten better at targeted
chemotherapies and pain control, but there’s
really a paucity of approaches to address end-of-life distress and existential suffering,” he says.
Such distress can affect treatment
adherence, decrease quality of life and increase
suicidal thinking, adds Griffiths. Cancer
patients experiencing anxiety, depression
and distress are “an at-risk population for
which we don’t have good treatments, either
pharmacological or psychological,” he says.
Griffiths, Bossis and their colleagues hope
psilocybin could address that treatment gap.
To test that possibility, they’ve designed their
studies in cancer patients to be double-blind
and methodologically rigorous. Volunteers
in the trials each participated in two blinded
sessions, receiving an active placebo in one and
psilocybin in the other. In several meetings
before and after the trials, volunteers met with
a therapist who helped them establish expectations and discuss
the feelings and emotions stirred up by the psychedelic session.
That therapist was also present to guide and help volunteers, if
necessary, during the drug sessions.
The researchers say patients have described impressive
“As soon as [the psilocybin] started working, I knew I had
nothing to be afraid of,” one volunteer said after a session. “I
thought about being involved with people I loved, things I
would do with people I knew, things I would tell them. … It
reconnected me to the universe.”
Another said, “I emerged from that first session … having
an extremely strong sense of self and the importance of me, and
my relationship to everything around me. I came out of this
feeling assured. … I just knew everything was going to be OK.
The study has changed everything in my life. I am more patient.
I am more thoughtful. … I am present.”
Although psilocybin is technically a hallucinogen, visual
hallucinations are not necessarily a hallmark of the experience,
Bossis says. Some volunteers reported seeing images such as
landscapes, celestial scenes or childhood memories — but the
transformative nature of the experience seems to have more to
do with insight than with eyesight.
While there is variety in people’s individual experiences with
the drug, volunteers often walk away having similar changes
in outlook. Anxiety surrounding death is decreased, while
spirituality, altruism and a sense of meaning tend to increase.
“My sense is that these experiences open people up to a sense
of existential wonder. The fear starts dissolving,” Griffiths says.
And encouragingly, he says, those positive changes appear to
last for months — after just a single session.
Other research groups have begun exploring the effects
of psilocybin in the brain using fMRI. A team at Oxford
University, for instance, found the drug decreased activity and
connectivity in hub regions of the brain such as the anterior
cingulate cortex and the medial prefrontal cortex, thus allowing
“unconstrained” cognition (PNAS, 2011).
But one unique aspect of psilocybin is that it doesn’t appear
to create lasting changes in brain structure or function. Unlike
medications such as antidepressants, psilocybin doesn’t remain
in the body, and it has no lasting neurochemical effects.
“It’s the experience that changes the person, not the drug,”
says Jeffrey Guss, MD, another lead investigator of the NYU
Still, the drugs are not risk-free. So far, volunteers have been
“In my opinion, the best and safest
way to use psychedelics is to
take wisdom from the shamanic
model used around the world,
where an experienced guide and
valued healer in the community
administers the drug to a person
who is suffering.”
Jeffrey Guss, MD
Lead investigator of the NYU psilocybin project