New Yorker article by Michael Pollan hits home

The Trip Treatment
By Michael Pollan
The New Yorker 9 February 2015

Michael Pollan's poignant article really hit home for me as it follows a cancer patient's healing journey with his diagnosis following psilocybin treatment as part of a Clinical Trial at New York University.  54 year old Patrick Mettes participated in the research at NYU after battling bile duct cancer for 3 years.  The experience with the therapeutic use of psilocybin was obviously beneficial to Patrick and offered him something no current drug in any doctors arsenal could have provided.  That this simple fungus that grows out in the real world is illegal for any patient is unfathomable.

The importance of this article and the psilocybin research for patients battling cancer can not be over-stated as a new report published in the Annals of Internal Medicine (02/03/2015) indicates suffering at the end of life (pain and depression) has increased significantly since the last study 15 years ago by the Institute of Medicine.

Our daughter also fought a courageous battle with cancer and was accepted into a similar Clinical Trial at Johns Hopkins.  Unfortunately she was offered her first professional position at the same time which made for a very difficult decision on her part.  With reservation, she choose to accept the position only to have her neoplasm return 4 months later.  Had she participated in the Hopkins study, her passing may be been easier, as it was for Patrick.

Michael's article not only provides an compassionate account of Patrick Mettes therapeutic experience with psilocybin at N.Y.U. but also provides a detailed history of the early studies involving the therapeutic use of psychedelics but also the background and motivations of the current researchers in this field.  Since this is a very comprehensive article, I will attempt to summarize what were, for me, some key points:

• The therapeutic sessions took place in a very safe, controlled environment with supportive staff available if needed.  Set and setting are key.
• In the 1950's and 60's, some of the best minds in Psychiatry conducted studies on the therapeutic potential of psychedelics with government funding.
• Cancer patients receiving just a single dose of psilocybin experienced immediate and dramatic reductions in anxiety and depression, improvements that were sustained for at least six months. People who had been palpably scared of death—they lost their fear. The fact that a drug given once can have such an effect for so long is an unprecedented finding. We have never had anything like it in the psychiatric field.”
• “We ended up demonizing these compounds. Can you think of another area of science regarded as so dangerous and taboo that all research gets shut down for decades? It’s unprecedented in modern science.”
• Griffiths (Dr. Roland Griffiths from Johns Hopkins) believes that the long-term effectiveness of the drug is due to its ability to occasion such a transformative experience, but not by changing the brain’s long-term chemistry, as a conventional psychiatric drug like Prozac does.
• Griffiths likens the therapeutic experience of psilocybin to a kind of “inverse P.T.S.D.”—“a discrete event that produces persisting positive changes in attitudes, moods, and behavior, and presumably in the brain.”
• Existential distress at the end of life bears many of the psychological hallmarks of a hyperactive default-mode network, including excessive self-reflection and an inability to jump the deepening grooves of negative thought. The ego, faced with the prospect of its own dissolution, becomes hypervigilant, withdrawing its investment in the world and other people. It is striking that a single psychedelic experience—an intervention that Carhart-Harris calls “shaking the snow globe”—should have the power to alter these patterns in a lasting way.
• “If we limit psychedelics just to the patient, we’re sticking with the old medical model,” she said. “But psychedelics are so much more radical than that. I get nervous when people say they should only be prescribed by a doctor.”
• “This culture has a fear of death, a fear of transcendence, and a fear of the unknown, all of which are embodied in this work.” Psychedelics may be too disruptive for our society and institutions ever to embrace them.
• “We still had our arguments,” Lisa (Patrick's wife) recalled. “And we had a very trying summer,” as they endured a calamitous apartment renovation. But Patrick “had a sense of patience he had never had before, and with me he had real joy about things,” she said. “It was as if he had been relieved of the duty of caring about the details of life. Now it was about being with people, enjoying his sandwich and the walk on the promenade. It was as if we lived a lifetime in a year.”
• “We are all terminal,” Griffiths said. “We’re all dealing with death. This will be far too valuable to limit to sick people.”

The article by Michael Pollan above was followed up by an article in The Week:

Why the government should be funding mass scientific studies of Ecstasy, magic mushrooms, and LSD
By Ryan Cooper
The Week 5 Feb 2015

"In a sane world, with substances as promising as the above psychedelics, the government would simply fund the research itself and be done with it. Only an increasingly anachronistic brand of drug warrior politics stands in the way. But with something like 22 veterans per day committing suicide, any treatment with a potential 60+ percent long-tem cure rate for PTSD ought to be jammed through mass trials at the highest possible speed."

Cancer patients and those with PTSD can both experience a common psychological trauma which produces an existential distress (crisis).  Psilocybin's clinical effect most likely works to help heal this trauma.