Unlocking a magical treatment
In March, just as anxiety over Covid-19 began spreading across the US, Erinn Baldeschwiler of La Conner, Washington found herself facing her own private dread.
Just 48 and the mother of two teenagers, Baldeschwiler was diagnosed with stage 4 metastatic breast cancer. Doctors gave her two years to live.
But instead of retreating into her illness, Baldeschwiler is pouring energy into a new effort to help dying patients gain legal access to psilocybin – the mindaltering compound found in socalled magic mushrooms – to ease their psychic pain.
‘‘I have personally struggled with depression, anxiety, anger,’’ Baldeschwiler said. ‘‘ This therapy is designed to really dive in and release these negative fears and shadows.’’
Dr Sunil Aggarwal, a Seattle palliative care physician, and Kathryn Tucker, a lawyer who advocates on behalf of terminally ill patients, are championing a novel strategy that would make psilocybin available using state and federal ‘‘ right- to- try’’ laws that allow terminally ill patients access to investigational drugs.
They contend that psilocybin – whether found in psychedelic mushrooms or synthetic copies – meets the criteria for use laid out
by more than 40 states and the 2017 Right to Try Act approved by the Trump administration.
The pair admit that they’re pushing a legal theory still untested in the courts.
This month, Aggarwal, who works at the Advanced Integrative Medical Science Institute, took the first step towards federal authorisation of the substance in Washington state and perhaps across the nation. He submitted an application to manufacture psilocybin to the state’s Pharmacy Quality Assurance Commission, which would allow him
to grow psilocybin mushrooms from spores at his clinic and administer them for therapeutic use.
An agency spokesperson said there ‘‘would be a path’’ for possible licensing and use if the application met the requirements of state regulators and the federal Drug Enforcement Administration.
Currently, psilocybin use is illegal under federal law. Recently, however, several US cities and states have voted to decriminalise possession of small amounts of psilocybin.
This month, Oregon became the first state to legalise psilocybin for regulated use in treating intractable mental health problems. The first patients will have access beginning in January 2023.
Aggarwal points to a growing body of evidence which has found that psilocybin can have significant and lasting effects on psychological distress.
The Johns Hopkins Centre for Psychedelic and Consciousness Research, launched this year, has published dozens of peerreviewed studies based on two decades of research. They include studies confirming that psilocybin helped patients grappling with major depressive disorder, thoughts of suicide, and the emotional repercussions of a cancer diagnosis.
Psilocybin therapy appears to work by chemically altering brain function in a way that temporarily affects a person’s ego, or sense of self. In essence, it plays on the out-of-body experiences made famous in portrayals of the psychedelic 1960s.
By separating their minds from all the fear and emotion surrounding death, people experience ‘‘ being’’ as something distinct from their physical forms. This leads to a fundamental shift in perspective, according to Dr Ira Byock, a palliative care specialist and medical officer for the Institute for Human Caring at Providence St Joseph Health in Renton, Washington.
‘‘What psychedelics do is foster a frame shift from feeling helpless and hopeless and that life is not worth living to seeing that we are connected to other people and we are connected to a universe that has inherent connection,’’ he said.
The key is to offer the drugs under controlled conditions, in a quiet room while being supervised by a trained guide.
The FDA has granted ‘‘breakthrough therapy’’ status to psilocybin for use in US clinical trials conducted by British psychedelic research group Compass Pathways and the Usona Institute, a non- profit medical research group in Wisconsin. More than three dozen trials are recruiting participants or completed.
‘‘This therapy is designed to really dive in and release these negative fears and shadows.’’ Erinn Baldeschwiler cancer patient