Psilocybin for anxiety in terminal patients

Charles Grob and his colleagues at UCLA-Harbor report in the current Archives of General Psychiatry that a low-to-moderate dose of psilocybin, the active ingredient in “magic” mushrooms, can relieve anxiety, improve mood, and reduce the desire for narcotic pain-relievers in patients with terminal cancer. The finding isn’t very surprising, but the facts that the regulatory machinery allowed it to be conducted and that a major journal was willing to publish the results are two more straws in the wind. After forty years, the taboo on hallucinogen-benefits research is slowly fading.

The study only involved twelve patients, largely because the Institutional Review Board insisted on such stringent inclusion and exclusion criteria that the researchers were basically restricted to dying subjects who were otherwise perfectly healthy. The attempt to “blind” the subjects and therapists to whether they were getting the active drug or a placebo mostly failed. So it’s possible that they didn’t really feel less anxious, they were merely fooled into thinking that they felt less anxious. (Clinicia, the Double-Blind Goddess of Drug Research, is a jealous goddess, and her worshippers tend toward fanaticism.)

But there’s certainly plenty here to justify getting aggressive about this line of research, given that anxiety in terminal patients doesn’t usually respond to the standard array of psychiatric interventions.

At some point, the hospice movement is going to get behind the use of hallucinogens to palliate terminal diagnoses. Then you’ll see the dam break for real.

Here’s a video made by one of the subjects, Pam Sakuda:

In my view, the fact that it will take at least another five years before patients have legal access to a safe procedure that might improve their dying is an outrage. “First, do no harm” is a good rule; isn’t withholding beneficial treatment harmful? But that’s just me: I’ve always been the impatient type.