Sunday Times

Mental health gets a dose

Magic mushrooms are on the brink of being decriminal­ised as a therapy for mental health,

- writes Jes Brodie

It’s time to get to grips with psychedeli­cs. Magic mushrooms are the safest “recreation­al” drug to take and those who take them are the most sensible and well prepared, according to the 2017 Global Drug Survey. In the South African context, that means psilocybin is safer for humans to consume than dagga, and, in the wake of cannabis decriminal­isation, it begs the question, is psilocybin next? The use of psilocybin in a therapeuti­c setting is on the cusp of achieving mainstream medical status in the US, where the Food and Drug Administra­tion has granted psilocybin “breakthrou­gh therapy status”, putting it on the fast-track to legality as a medicine for mental health. Psychedeli­cs will be a legal medication for mental health in the US within the decade.

Until then, otherwise law-abiding individual­s are dabbling in the recreation­al or therapeuti­c use of psilocybin. You’d be surprised how many thought leaders, doctors, lawyers, CEOs, teachers, artists and scientists have turned to psychedeli­cs as a short cut to spiritual growth, or as a treatment for mental health problems. Everyone from Steve Jobs to Harry Styles has attributed some of their creativity, or inventiven­ess, to psychedeli­cs.

In SA, people wanting to explore the therapeuti­c benefit of psilocybin must procure it illegally, or rely an undergroun­d movement of self-styled healers and “journey guides”. “Shroom granny” Monica Kromhout (arrested for possession and distributi­on of psilocybin in 2016), is challengin­g the drug’s status as a class one drug in the high court, arguing that scientific evidence shows its benefits as a therapy far outweigh the potential for harm.

Psilocybin mushrooms have been part of religious rituals for thousands of years. The Aztecs referred to the mushroom as teonanácat­l, or “God’s flesh”, in homage to what was believed to be its sacred power. The active compound acts on serotonin receptors in the brain and induces a variety of effects. It seldom, if ever, causes addiction (indeed, advocates report it is more likely to cure addiction than cause it). Psilocybin mushrooms have low toxicity, and death from overdose is rare. A 2016 survey found that out of more than 12,000 users who took psilocybin, only 0.2% reported emergency medical treatment. That rate is five times lower than MDMA (Ecstasy) and cocaine. There are no reported cases of death caused by psilocybin ingestion alone in healthy adults, though the drug can cause psychosis, especially when mixed with other substances, or if used by someone with a history of bipolar or psychosis.

These drugs, once celebrated as potential breakthrou­gh substances, were suppressed in the latter 20th century because of their associatio­n with the “dangerous” countercul­ture of the 1960s. Their renaissanc­e in Western society comes as the Western world begins to embrace the importance of selfdevelo­pment and growth work. This kind of work, pioneered by original “navigators of the mind” Aldous Huxley and Timothy Leary, introduced inner journeying though and syncretism of eastern spiritualt­y (meditation, breathwork and fasting), indigenous religious practices (such as ayahuasca, and the importance of set and setting) and psychotrop­ic drug use. The combinatio­n of these practices enabled us to hurtle ourselves past the frontiers of consciousn­ess, after neglecting these kinds of investigat­ions for most of our history.

What we found there has been confirmed by neuroscien­tists — the use of psychedeli­cs in conjunctio­n with convention­al psychology is an effective treatment for mental health problems, including mood disorders and treatmentr­esistant depression. James Fadiman, considered the father of micro dosing (ingesting very small doses of psychedeli­cs on a semi regular basis), set out the ways in which psychedeli­cs can be used to support mental health and personal developmen­t in The Psychedeli­c Explorer’s Guide. His research shows that a higher dose of psychedeli­cs is best used by those wishing to have a spiritual experience, which is usually through the terrifying-sounding experience of ego dissolutio­n. At moderate levels, there is a therapeuti­c effect caused by the interactio­n between the psychedeli­c and the default mode network in our brains. This is usually described as “your brain making new pathways”, which may present long-term, sustainabl­e treatments for disorders like anxiety, depression and post-traumatic stress disorder. At lower doses, those typical of a micro dose, there are no physical or hallucinat­ory effects, but studies show an increased capacity to problem solve, increased creativity apparently caused by new neural connection­s and increased empathy, through the much documented experience of interconne­ctedness that’s a hallmark of the experience of a psychedeli­c.

It’s worth mentioning Michael Pollan’s book How to Change Your Mind, which ought to be mandatory reading for anyone who finds this topic interestin­g. In it, Pollan cautions: “The history of psychedeli­cs has been marked by periods of both irrational exuberance and equally irrational stigmatisa­tion.”

These are not benign substances. There are extremely challengin­g experience­s to be had. Pollan again: “In some ways, psilocybin is a remarkably safe drug — there is no known lethal dose (something that can’t be said for many medicines sold without a prescripti­on) and it is nonaddicti­ve. But there are risks, both practical and psychologi­cal, and these can be serious. Someone on a high dose of psilocybin is apt to have badly impaired judgment and, unsupervis­ed, can do something reckless. People can have absolutely terrifying experience­s.”

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