Psilocybin, otherwise known as magic mushrooms, is most commonly thought of as a recreational drug. The person who consumes it goes through an hours-long ‘trip’, during which they may experience hallucinations and other psychedelic effects. This is, however, only one way in which the naturally-occurring compound is used. Over the past couple of decades, studies have been testing its effectiveness at treating mental illness.
What is psilocybin and how might it be used to treat mental health and addiction? Is it safe to use a substance of this kind for any purpose?
The History of Psilocybin Use
Magic mushrooms or psilocybin has been used throughout history, especially by ancient Mesoamerican cultures. It played a part in religious and spiritual ceremonies. The Aztecs referred to them as “teonanácatl,” meaning “flesh of the gods,” and used them in rituals to connect with the divine. The use of psilocybin waned after colonization suppressed many indigenous practices.
In the mid-twentieth-century, however, the use of magic mushrooms became popular again. Psilocybin became known as a psychedelic – a term coined by author and philosopher Aldous Huxley to describe substances that gave their users a different perspective. Huxley’s seminal work, The Doors of Perception, explored the potential importance of psychedelics at shifting people’s views of life. He saw this as a kind of ‘shortcut’ to enlightenment which could be used occasionally for a glimpse of what spiritual people were striving for.
But the use of psychedelics in counterculture led to a crackdown on the substances, with heavy regulations and criminalisation.
Despite these barriers, researchers realized that psilocybin and other psychedelics may have therapeutic benefits. They began to carry out studies within regulatory guidelines (along with the use of anecdotal evidence) to test their theories. As results proved promising, regulators began to allow for further experimentation. Although regulations remain a barrier to some clinical trials, the use of psilocybin in the treatment of mental illness is becoming more mainstream within legal guidelines.
The Science of Psilocybin
What exactly is psilocybin and how does it work?
Psilocybin is a psychoactive compound that belongs to the tryptamine class, closely resembling serotonin, a neurotransmitter that regulates mood, cognition, and perception. When ingested, psilocybin is converted in the body into psilocin, the active molecule that binds to serotonin receptors in the brain, particularly the 5-HT2A receptor. This interaction results in altered sensory perception, enhanced introspection, and vivid hallucinations.
Studies suggest that psilocybin promotes neuroplasticity—the brain’s ability to form new connections. This may explain its potential to alleviate entrenched mental health conditions such as depression and PTSD. Brain imaging studies have shown that psilocybin reduces activity in the default mode network (DMN), a region linked to self-referential thoughts and rumination, allowing users to experience a sense of “ego dissolution” and interconnectedness.
What are the Therapeutic Uses of Psilocybin?
The resurgence of interest in psilocybin in scientific and medical communities in recent years has led to studies highlighting its potential to address various mental health challenges:
Treatment-Resistant Depression
Clinical trials have demonstrated that psilocybin can produce rapid and sustained improvements in depressive symptoms, even in individuals unresponsive to conventional therapies. Traditional antidepressants are not effective for everyone. Alternatives are needed, and psilocybin is one of the most promising potential options.
Anxiety and Existential Distress
Psilocybin has shown promise in alleviating anxiety and existential fear in patients facing terminal illnesses. Participants in studies often report reduced fear of death and an increased sense of peace. This is due to a wider sensory perception of the world and the reflection it brings.
Addiction
Research indicates that psilocybin-assisted therapy can help individuals overcome substance use disorders, such as alcohol and tobacco dependence, by fostering transformative insights and behavior changes. Since psilocybin is not considered an addictive substance, it can be used responsibly for addiction treatment within a clinical environment.
Post-Traumatic Stress Disorder (PTSD)
While still under study, psilocybin’s ability to reduce rumination and increase emotional openness may make it a valuable tool for PTSD treatment.
Additionally, microdosing—taking sub-perceptual doses of psilocybin—is gaining traction as a means to enhance creativity, focus, and emotional well-being. However, more rigorous studies are needed to substantiate these claims.
Legal Status and Controversies
Psilocybin’s legal status varies widely across the globe. It remains classified as a Schedule I substance in the United States, indicating a high potential for abuse and no accepted medical use. However, several cities and states, including Denver, Oakland, and Oregon, have decriminalized its use or approved therapeutic applications.
Globally, countries like the Netherlands permit the sale of psilocybin truffles, a less potent form of the compound, while others, such as Canada, allow limited medical use under special exemptions. These shifting legal frameworks reflect growing recognition of psilocybin’s therapeutic potential, though debates about safety, accessibility, and ethical considerations persist.
Critics argue that recreational use without proper guidance can lead to psychological distress or abuse. Moreover, concerns about “pharmaceuticalization”—restricting access to medical contexts dominated by large corporations—highlight the need for equitable policies.
Risks and Side Effects
The most common short-term side effects of psilocybin are unlikely to cause major harm and include:
- Nausea
- Dizziness
- Increased heart rate
- Temporary anxiety
As we can see, psilocybin has few major side effects, but that does not mean it is harmless. While it is considered physiologically safe and non-addictive, its effects are highly dependent on “set and setting” – the user’s mindset and environment. Negative experiences, or “bad trips,” can result in intense fear, paranoia, and confusion.
In other words, when used without clinical oversight, it can worsen the symptoms of mental illness. Panic attacks can lead to setbacks and particularly bad trips can exacerbate depression.
Long-term risks are minimal for most users but may include exacerbation of pre-existing mental health conditions like schizophrenia. Psilocybin should be approached with caution, especially by individuals with a family history of psychosis.
The Future of Psilocybin
The future of psilocybin looks promising, with increasing research, decriminalization efforts, and public interest. Advances in neuroscience are shedding light on its mechanisms, while high-profile studies are bolstering its case as a transformative mental health treatment.
Emerging trends include:
- Integration of psilocybin-assisted therapy into mainstream mental health care.
- Development of synthetic psilocybin formulations for precision dosing.
- Exploration of its use in non-clinical settings, such as wellness retreats.
However, challenges remain. Ensuring safe and equitable access while preventing misuse will require robust regulations and public education. Continued advocacy and research will play crucial roles in shaping psilocybin’s trajectory.
Conclusion
Psilocybin is a very exciting potential treatment for mental illness and addiction. It has properties and effects that are unlike traditional antidepressants. It is not addictive and is not meant for chronic use, meaning that there should be no withdrawal symptoms.
However, due to regulatory hurdles and stigma, research on psilocybin has been limited. The substance is getting increased interest in the scientific and medical fields, and leniencies have been applied, but it will take time for extensive studies and trials to show conclusively how effective it may prove.
At present, psilocybin remains illegal even for clinical use in many parts of the US. Certain states and cities have nonetheless legalized its use in therapeutic settings.
Remember, without the proper oversight and therapy, psilocybin can exacerbate the symptoms of mental illness. Only use psilocybin as part of a clinical treatment recommended and administered by a licensed mental health provider.
Sources
- Proceedings of the National Academy of Sciences: Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. Accessed 28 November 2024.
- Journal of Psychopharmacology: Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Accessed 28 November 2024.
- Journal of Psychopharmacology: Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Accessed 28 November 2024.
- Cell: Psychedelic psychiatry’s brave new world. Accessed 28 November 2024.
