A diagnosis of incurable leukemia had knocked the optimism out of the retired plant nurserywoman living in Phoenix. So she signed up for a clinical trial to test whether psilocybin ? the active ingredient in "magic mushrooms" ? could help with depression or anxiety following a grim diagnosis.
Delaney swallowed a blue capsule of psilocybin in a cozy office at Johns Hopkins University in Baltimore. She donned a blindfold, a blood pressure cuff and a headset playing classical music. With two researchers at her side, she embarked on a six-hour journey into altered consciousness that she calls "the single most life-changing experience I've ever had."
What a long, strange trip it's been. In the 1960s and '70s, a rebellious generation embraced hallucinogens and a wide array of street drugs to "turn on, tune in and drop out." Almost half a century later, magic mushrooms, LSD, Ecstasy and ketamine are being studied for legitimate therapeutic uses. Scientists believe these agents have the potential to help patients with post-traumatic stress disorder, drug or alcohol addiction, unremitting pain or depression and the existential anxiety of terminal illness.
"Scientifically, these compounds are way too important not to study," said Johns Hopkins psychopharmacologist Roland Griffiths, who conducted the psilocybin trial.
In their next incarnation, these drugs may help the psychologically wounded tune in to their darkest feelings and memories and turn therapy sessions into heightened opportunities to learn and heal.
"We're trying to break a social mind-set saying these are strictly drugs of abuse," said Rick Doblin, a public policy expert who founded the Multidisciplinary Assn. for Psychedelic Studies in 1986 to encourage research on therapeutic uses for medical marijuana and hallucinogens. "It's not the drug but how the drug is used that matters."
Regulators and medical researchers remain wary. But among at least some experts at the National Institutes of Health and the Food and Drug Administration, the shift in attitude "has been dramatic," Doblin said.
Researchers explored the usefulness of hallucinogenic agents as an adjunct to psychotherapy in the 1950s and '60s. But allegations that hallucinogens were used in government-funded "mind control" efforts, freewheeling experimentation by proponents like Dr. Timothy Leary, and the drugs' appeal to a generation in revolt quashed legitimate research for decades.
The thaw has been slow in coming. In 2008, Griffiths co-wrote a report in the Journal of Psychopharmacology comparing psilocybin with a placebo for people dealing with incurable diseases. Psilocybin resulted in "mystical experiences having substantial and sustained personal meaning and spiritual significance," according to the study, the first since 1972 to explore a hallucinogen's therapeutic value.
In January, a team led by UCLA psychiatrist Charles Grob reported in Archives of General Psychiatry that psilocybin improved the mood of patients with "existential anxiety" related to advanced-stage cancer. The benefits lasted at least three months.
Janeen Delany is a typical case: The insights she gleaned during her encounter with psilocybin continue to shape her attitudes toward life and death.
Delany said her "trip" awakened a deep and reassuring sense of "knowing." She came to see the universe and everything in it as interconnected. As the music in her headphones reached a crescendo, she held her breath and realized it would OK ? no, really easy ? not to breathe anymore. She sensed there was nothing more she needed to know and therefore nothing she needed to fear about dying.
And that, paradoxically, has allowed her to live.
"When you take the veil of fear away from your life, you can see and experience everything in such a present way," she said. "I don't have to know what the future is. Every day is the day of days."
Fighting addiction
Such mystical insights are central in another potential use for psilocybin ? as an addiction treatment. Griffiths is conducting a pilot study combining psilocybin with cognitive behavioral therapy to help smokers quit. Four people have completed the program, and so far none has returned to smoking, Griffiths says.
At the University of Arizona in Tucson, addiction specialist Dr. Michael P. Bogenschutz has proposed a clinical trial to test whether psilocybin can help ease alcohol dependence. If the NIH agrees to fund the study, it would be the first instance in decades of government financial support for a trial involving any drug of abuse.
Psilocybin's effect on the brain can be described, if not explained. It increases the activity of serotonin, a chemical that affects mood. Brain networks associated with emotions are highly active in the presence of psilocybin, as are structures involved in higher reasoning and judgment, MRI scans show.
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