Psilocybin - Ibogaine - Other Hallucinogens

A Return of the Magic Mushroom

Psilocybin-The Return of the Magic Mushroom

In November 2020, voters passed Oregon Ballot Measure 109  to legalize psilocybin for people aged 21 and older.  In another vote, psilocybin was decriminalized. Proponents of psilocybin legalization in Oregon promote its use for medical conditions, such as depression, anxiety, or PTSD.

The new law will make psilocybin more accessible to people who need them clinically.  Measure 109 will be enacted after a developmental stage is completed, expected to be a two year process. Washington, DC also decriminalized psilocybin in Nov. 2020. So why did this happen? 

What is Psilocybin and what benefits of use makes this so popular?      

Psilocybin is a hallucinogenic product of  certain types of mushroom that grow in regions of Europe, South America, Mexico, and the United States. The mushrooms containing psilocybin are known as ‘magic mushrooms’- and under Federal laws is a Schedule I controlled substance, meaning that it has a high potential for abuse and serves no legitimate medical purpose

Historically used as a recreational drug, it provides feelings of euphoria and sensory distortion that are common to hallucinogenic drugs, such as LSD.  Many medical experts do not consider psilocybin to be an addictive substance, and users can experience disturbing hallucinations, anxiety, and panic from using the drug.

Psilocybin Facts: 

  • Psilocybin has both positive and negative physical and psychological effects.
  • Psilocybin is not naturally addictive.
  • The drug can trigger psychotic episodes.
  • Individuals with a family history of schizophrenia or early onset mental illness face an increased risk of an adverse psychiatric reaction to psilocybin.

Medical News Today reports: 

“Psilocybin is a hallucinogen that works by activating serotonin receptors, most often in the prefrontal cortex. This part of the brain affects mood, cognition, and perception. Hallucinogens work in other regions of the brain that regulate arousal and panic responses.

“Psilocybin does not always cause active visual or auditory hallucinations. Instead, it distorts how some people that use the drug perceive objects and people already in their environment.  The quantity of the drug, past experiences, and expectations of how the experience will take shape can all impact the effects of psilocybin. After  digesting,and absorbing psilocybin, the body converts it to psilocyn. The hallucinogenic effects of psilocybin usually occur within 30 minutes of ingestion and last between 4 and 6 hours. In some individuals, the changes in sensory perception and thought patterns can last for several days. 

Mushrooms containing psilocybin are small and usually brown or tan. In the wild, people often mistake mushrooms containing psilocybin for any number of other mushrooms that are poisonous. People usually consume psilocybin as a brewed tea or prepare it with a food item to mask its bitter taste. Manufacturers also crush dried mushrooms into a powder and prepare them in capsule form. Some people who consume these mushrooms cover them with chocolate. The potency of a mushroom depends on:

  • the species
  • origin
  • growing conditions
  • harvest period
  • whether a person eats them fresh or dried

The amount of active ingredients in dried mushrooms is about 10 times higher than the amount found in their fresh counterparts.” 

https://www.medicalnewstoday.com/articles/308850#what-is-psilocybin

Effects

The effects of psilocybin are generally similar to those of LSD.  They include an altered perception of time and space and intense changes in mood and feeling.  Possible effects of psilocybin include:

  • euphoria
  • peacefulness
  • spiritual awakening
  • quickly changing emotions
  • derealization, or the feeling that your surroundings are not real
  • depersonalization, or a dream-like sense of being disengaged from your surroundings
  • distorted thinking
  • visual alteration and distortion, such as halos of light and vivid colors
  • dilated pupils
  • dizziness
  • drowsiness
  • impaired concentration
  • muscle weakness; lack of coordination
  • unusual body sensations
  • nausea
  • paranoia
  • confusion
  • frightening hallucinations
  • vomiting
  • yawning

The effects of psilocybin vary between people, based on differences in the mental state and personality of the user and the immediate environment.  If the recreational user experiences issues with mental health or feels anxious about using the hallucinogen, they face a higher risk of having a bad experience.

Psychological distress is the adverse event most often reported after recreational use of psilocybin. This distress can take the form of extreme anxiety or short-term psychosis   https://www.medicalnewstoday.com/articles/308850#what-is-psilocybin

Psilocybin as a treatment for depression

Discussions are on-going about whether psychological specialists can use psilocybin and similar hallucinogens as a treatment for depression. Two very recent studies have looked at psilocybin as a treatment.

One study examined the ability of psilocybin to reduce depression symptoms without dulling emotions, and the other assessed the relationship between any positive therapeutic outcomes and the nature of psilocybin-induced hallucinations.  While some researchers are looking into some therapeutic uses for psilocybin, they still, at present, regard psilocybin as unsafe and illegal.

Some scientists believe that psilocybin intake is associated with long-term increases in openness and – as a novel finding – mindfulness, which may be a key element of psilocybin therapy. The underlying mechanisms are unknown from this study, but it is believed that psilocybin decreases activity in the parts of the brain that are overactive in depression and addictive behaviors.      https://pubmed.ncbi.nlm.nih.gov/10506904/

Risks

  • People who have taken psilocybin in uncontrolled settings might engage in reckless behavior, such as driving while intoxicated.
  • Some people may experience persistent, distressing alterations to the way they see the world. These effects are often visual and can last from anywhere from weeks to years after using the hallucinogen.
    • Physicians now diagnose this condition as hallucinogen persisting perception disorder (HPPD), also known as a flashback. A flashback is a traumatic recall of an intensely upsetting experience. The recollection of this upsetting experience during hallucinogen use would be a bad trip, or a hallucination that takes a disturbing turn.
  • Some individuals experience more unpleasant effects than hallucinations, such as fear, agitation, confusion, delirium, psychosis, and syndromes that resemble schizophrenia, requiring a trip to the emergency room.
    • In most cases, a doctor will treat these effects with medication, such as benzodiazepines. These effects often resolve in 6 to 8 hours as the effects of the drug wear off.
  • Finally, though the risk is small, some psilocybin users risk accidental poisoning from eating a poisonous mushroom by mistake.
    • Symptoms of mushroom poisoning may include muscle spasms, confusion, and delirium. Visit an emergency room immediately if these symptoms occur.

Abuse potential

Psilocybin is not chemically addictive, and no physical symptoms occur after stopping use.  However, regular use can cause an individual to become tolerant to the effects of psilocybin. Cross-tolerance also occurs with other drugs, including LSD and mescaline.

People who use these drugs must wait at least several days between doses to experience the full effect.  After several days of psilocybin use, individuals might possibly experience psychological withdrawal and have difficulty adjusting to reality.

Medical Uses and Clinical Studies for Psilocybin      

For centuries, psilocybin has been used in rituals around the world; recently, modern medicine has also conducted clinical studies.  .A report was published in the Journal of Psychopharmacology detailing two small studies that noted the ingredient in “magic mushrooms” – psilocybin – can reverse the feeling of “existential distress” that patients often feel after being treated for cancer.

Reportedly, cancer can leave patients with this type of psychiatric disorder, feeling that life has no meaning.  Typical treatments such as antidepressants may not be effective. However, use of a single dose of synthetic psilocybin reversed the distress felt by the patients and was a long-term effect.

Some advanced cancer patients described the effect from the drug as if “the cloud of doom seemed to lift.”  Two additional studies using psilocybin were completed: one at New York University (NYU) Langone Medical Center in New York City and one at Johns Hopkins Medical School in Baltimore. For both studies, trained monitors were with patients as they experienced the effects of the drug, which can lead to hallucinations.

  • In the NYU study, 29 patients with advanced cancer were given either a single dose of psilocybin or the B vitamin known as niacin, both in conjunction with psychotherapy. After seven weeks, the patients switched treatments (a cross-over study). In 60% to 80% of the patients receiving psilocybin, a relief from distress occurred rapidly and lasted over six months. The long-term effect was evaluated by researchers looking at test scores for depression and anxiety.
  • In the Johns Hopkins study, researchers treated 51 adults with advanced cancer with a small dose of psilocybin followed five weeks later with a higher dose, with a 6-month follow-up. As with the NYU study, about 80% of participants experienced clinically significant relief from their anxiety and depression that lasted up to six months.    https://www.drugs.com/illicit/psilocybin.html

“Psilocybin has shown to cause short-lived increases in blood pressure, heart rate, headaches and a number report subjective effects such as fear and anxiety, but these are readily managed in a clinical setting if under the appropriate care. “         https://pubmed.ncbi.nlm.nih.gov/28541119/

At the Center for Psychedelic and Consciousness Research at Johns Hopkins University in Baltimore, Maryland, researchers are focusing on how psychedelics affect behavior, mood, cognition, brain function, and biological markers of health. This research group was the first to obtain U.S. regulatory approval to continue research with psychedelics in healthy volunteers.  Additional studies with psilocybin are expected, and one is comparing the chemical against a leading traditional antidepressant.                                                                              

As reported by Johns Hopkins, upcoming studies will evaluate the use of psilocybin as a new therapy for

  • opioid addiction
  • Alzheimer’s disease
  • post-traumatic stress disorder (PTSD)
  • post-treatment Lyme disease syndrome (formerly known as chronic Lyme disease)
  • anorexia nervosa and
  • alcohol use in people with major depression

A focus on precision medicine tailored to the individual patient is expected.

Other News

In November 2019, the FDA designated psilocybin therapy as a “breakthrough therapy” for depression to the Usona Institute, an action the agency uses to speed up development and review of investigational drugs. Breakthrough therapies are expected to provide a major improvement over currently available agents for an unmet medical need.

Usona’s PSIL201 psilocybin U.S. clinical trial is a Phase 2 study evaluating psilocybin as a treatment for Major Depressive Disorder (MDD). This research will use a randomized, double-blind, placebo-controlled study design to measure the antidepressant effects of a single dose of psilocybin in 80 patients between 21 to 65 years of age with MDD.

According to the manufacturer, “psilocybin potentially offers a novel paradigm in which a short-acting compound imparts profound alterations in consciousness and could enable long-term remission of depressive symptoms.”

If FDA-approved, psilocybin would have to be reclassified by the DEA for it to be available for patients; it is currently classified as a Schedule I drug.”

Psilocybin Vs. Ibogaine

  • While we move into the future with studies and testing of the efficacy and safety of psychedelics for the treatment of drug dependency, there are some critical concerns.  Research studies are popping up, and some are showing promising results.  However, these are not without risks-initial results are all preliminary and longitudinal studies are not yet available.
  • In addition, most results are pointing to an interruptive conclusion- meaning that while withdrawal symptoms may be eliminated, lifestyles, habits, environments and support systems must still be addressed to support a drug free recovery.

Physical risks and mental health risks

Physical risks and mental health risks for treatment are real and exist.  Patients entering into treatment must be thoroughly screened for

  • blood pressure
  • heart abnormalities and
  • other cardio conditions. 

Ibogaine affects heart functioning; it is unclear if other vital organs, such as kidneys or liver, are also impacted.  Psilocybin affects similarly although initial studies appear to be of lesser intensity.  Repressed traumas, unresolved adverse childhood events may surface, and without trained and intensive support, may cause severe mental health damage. 

Ibogaine is currently undergoing scientific ‘tweaking’ to try and remove some of the more harmful effects, such as the impact on the heart and hallucinations.   These scientists named their creation tabernanthalog, or TBG.

Psychedelics Currently Being Explored as Therapeutic Tools

LSD

  • (Lysergic acid diethylamide) was first synthesized in 1943. By the 1960s, it had found widespread use and acceptance among many in academia and elsewhere for its ability to provide users with profound and impactful experiences. It was the most powerful psychedelic known at the time, and the discovery of its chemical structure led to major innovations in brain research due to its similarities with serotonin.
  • Early studies of LSD-assisted treatment of alcoholism were quite promising. Conducted throughout the 1950s and through 1970, researchers usually provided patients with a single dose of LSD, sometimes along with psychotherapy.  Some compared LSD to a control condition, like amphetamine or another stimulant, and many occurred with male inpatients seeking specialty treatment for “alcoholism”.
  • A review of the 6 most comprehensive, well-designed studies throughout this time showed LSD to be quite effective at reducing problematic drinking.  This research came to a close thanks to the Controlled Substances Act and its labeling as a Schedule 1 substance (no medicinal value).
  • More recently, academic institutions and international governments have started opening the door again to human trials involving LSD.  The Multidisciplinary Association for Psychedelic Studies (MAPS) has recently performed a Phase 2 pilot study showing LSD-assisted psychotherapy is effective in treating anxiety associated with a recent terminal illness diagnosis. The trial, completed in Switzerland, the US and elsewhere, has shown that LSD is safe, effective, and well-tolerated by the patients involved and will hopefully lead the way to additional studies both internationally and here in the US.

Psilocybin 

  • The “magic mushrooms” – has also gained traction lately as a potential therapeutic tool to treat addiction. Dennis McKenna, PhD, a founding board member of the Heffter Research Institute, has called psilocybin the “ideal” clinical psychedelic, thanks to its short duration, reliable and predictable effects, and the fact that it is non toxic.
  • Here in the US, the Heffter Research Institute has sponsored FDA-approved clinical trials of psilocybin-assisted therapy for the treatment of
    • smoking cessation
    • severe alcohol dependence, and
    • cocaine addiction. They recently published very impressive results from trials treating anxiety and depression in patients with advanced-stage cancer.
  • The Institute has developed a psilocybin-specific treatment protocol to better standardize the administration of the psychedelic, and to ensure the safety of the participants. Other studies are underway for the treatment of obsessive-compulsive disorder, as well as for cluster headaches.

Ayahuasca

  • Ayahuasca is a traditional shamanic medicine used for centuries by curanderos and shamans in the Amazon rain-forest and South America. It is brewed and prepared using two plants, Banisteriopsis caapi and Psychotria viridis, which, when combined, enable the psychedelic chemical DMT to become orally active. This results in an hours-long psychedelic experience that is traditionally guided by an experienced shaman.
  • Ayahuasca has never been part of an FDA-approved clinical trial here on US soil. However, Dr McKenna, Charles Grob, MD, and a group of US and Brazilian researchers were invited to conduct observational studies on members of the União do Vegetal (UDV) church, where Ayahusca is taken as a sacrament and is a very important aspect of worship.
  • Among their findings, Grob, et al. noted that ayahuasca-taking members of the church were actually healthier on a range of measures than a non-ayahuasca-taking comparison group. While these results were not interpreted as proof of some miracle drug, they did show that the substance was not medically harmful or toxic, suggesting significant potential as a therapeutic agent.

Since those early observational studies, organizations like MAPS and Heffter have proposed clinical trials of ayahuasca-assisted therapy for addiction, PTSD and other psychiatric conditions. While FDA approval remains elusive, Dr McKenna and others are hopeful we will be seeing some clinical trials here in the US sooner than later. 

Ibogaine

  • Ibogaine is the major active alkaloid of the Iboga plant, native to the African country of Gabon. The shrub is chewed and taken in ritual ceremonies of the Bwiti tribe, during which young adult community members are visited by ancestors during the 24-36 hour trance-like state.  While not technically a “classical psychedelic”, ibogaine acts on multiple neurotransmitter systems including serotonin, dopamine, GABA, and others. 
  • Ibogaine has developed a strong presence and following in the field of psychedelic-assisted addiction therapy, especially among people seeking treatment for opioid addiction. Thus far, most of the published research is observational, though some clinical trials are in the works internationally.
  • Unfortunately, ibogaine has a significant mortality rate among users, with some citing figures of 1 in 300 patients. This is likely due to cardiac problems that are not easily predicted, so careful monitoring and supervision is absolutely required.

Risk factors for death may include having a previously diagnosed

  • heart condition
  • using opiates in combination with ibogaine, and
  • using the dried bark (iboga) instead of the extract (ibogaine).

Considering the current attention being given to the “opioid epidemic”, it seems fair to wonder why we wouldn’t want to investigate any possible tool to address the issue of addiction. From https://www.theshroomclassroom.com/psilocybin-vs-ibogaine/ :

“The psychedelic renaissance is in full swing across the globe. Numerous research studies are popping up, examining the medicinal potential that these once-forbidden drugs could have. Early stage clinical trials have shown that when delivered safely and professionally, psychedelic medicine has a great deal of promise for treating some very serious mental health conditions and may one day offer new hope to defenseless patients with limited treatment options. 

A Natural Approach to Addiction Treatment

Psilocybin is the component that gives magic mushrooms their psychedelic tendencies. Despite its reputation as a recreational drug, it is showing promise as a therapeutic instrument for several psychiatric illnesses. Psilocybin seem to work in a different way from other treatments for addiction, such as nicotine replacement therapy, which target the same brain receptors as the drug patients are trying to wean themselves off. This difference may be central to why the treatment of addiction is just one of psilocybin’s potential uses.

Psilocybin and Mindfulness

In a just released study out of Copenhagen (Madsen 2020), scientists found that a single psilocybin dose is associated with long-lasting beneficial effects on mood and personality. Ten healthy and psychedelic-naive volunteers underwent PET neuroimaging at baseline and one week after a single oral dose of psilocybin (0.2–0.3 mg/kg).

Personality and mindfulness questionnaires were completed at baseline and at three-months follow-up. The scientists confirmed that psilocybin intake is associated with long-term increases in openness and – as a novel finding – mindfulness, which may be a key element of psilocybin therapy.

The underlying mechanisms are unknown from this study, but it is believed that psilocybin decreases activity in the parts of the brain that are overactive in depression and addictive behaviors.

Ibogaine and Addiction Relief

Due to its status as a Schedule I drug, ibogaine has primarily been used as a treatment in non-traditional clinical settings outside of the United States. Statistics on its efficacy are somewhat difficult to come by. It’s primarily used in treating addiction for opiates and other highly addictive drugs, though it is also becoming more common as a tool for personal and spiritual development.

Recreational use of ibogaine is nearly non-existent, which is one of the more significant differences between it and psilocybin. Ibogaine is not considered a “cure” for addiction, but rather is often called an addiction “interrupter” as it eliminates or greatly reduces withdrawal symptoms of opiates, alcohol, and other tendencies.

Ibogaine Studies

A recent observational study from the Johns Hopkins School of Medicine suggests that ibogaine treatment can significantly improve opioid abstinence in sufferers of chronic addiction. Of the 88 subjects that were interviewed, 80% reported that ibogaine either drastically reduced or eliminated their withdrawal symptoms, with nearly 30% refraining from opioid use for years after receiving the treatment (Davis 2017).

Ibogaine Experience

People often report being placed in or entering visual landscapes, rather than experiencing intrusive visual or auditory hallucinations. Not all subjects experience visual phenomena, which may be related to dose, bioavailability, and inter-individual variation. After a journey is complete, a period of heightened introspection can last several days to weeks, allowing the person to integrate these new perspectives about the issues they face into their daily lives.

The acute and reflective experience of ibogaine can also help shed much-needed intellectual insight onto a person’s emotional problems. Deeply repressed pain and trauma can often come to the surface and, while difficult and emotionally turbulent, this often allows people to confront the demons from their past. This emotional turbulence is another big difference between ibogaine and psilocybin, where the seeker may not desire to explore these darker neural pathways and would prefer a more psychedelic experience. Through this deepened emotional understanding, ibogaine has helped people deal with

  • depression
  • anxiety
  • PTSD
  • Shopping Addictions
  • Sex and food addictions and many others.

 

Understanding the Psilocybin and Ibogaine Experiences

Regular users insist that lumping Ibogaine with LSD or mushrooms is more a fallacy of its scheduling rather than a true one-to-one comparison. Many do not even consider ibogaine to be a psychedelic or drug at all, but rather a medicine plant ‘teacher’. The objective is for deep psycho/spiritual work rather than for enjoyment, mood improvement, or “tripping”.

There is generally a goal, known or unknown that is sought after for personal improvement or understanding when taking these substances. A lot of the modern psychedelic movement is geared towards pleasure seeking, people aiming to feel expanded and euphoric. Others may seek something deeper and strive towards spiritual or energetic work.

What many users seem to like about ibogaine is that it has helped reveal these qualities in themselves and shows the user the path to real maturity and wholeness on their own spiritual journey. It’s not to say that this work is devoid of joy or connectedness either, as ibogaine can help instill a deep sense of peace and happiness, profound states of calmness and centeredness – going about it in a deeper and sometimes more impactful way.

Risk Factors Summarized

The other thing to greatly consider is the safety risk when using these psychedelic medicines, which does vary slight between the two.

Psilocybin has shown to cause short-lived increases in blood pressure, heart rate, headaches and a number report subjective effects such as fear and anxiety, but these are readily managed in a clinical setting if under the appropriate care.

Ibogaine can elicit some similar symptoms, particularly deeper forms of anxiety, but there is a significant risk of taking it if you have a heart condition. Ibogaine has been known to cause deaths by temporarily changing the way the heart functions. This creates a higher risk of fatality if not properly prepared, screened, and administered.

Pre-existing conditions tend to play a major factor in the risks associated with ibogaine use, as is often noted by advocates. The higher risk and deeper experience of ibogaine is the main reason it is not used recreationally and should still be cautiously approached until more experienced physicians become involved and clinical trials are initiated.

References

  • Madsen et al (2020). A single psilocybin dose is associated with long-term increased mindfulness, preceded by a proportional change in neocortical 5-HT2A receptor binding. Eur Neuropsychopharmacology. Available online March 4, 2020.
  • Davis et al (2017). Subjective effectiveness of ibogaine treatment for problematic opioid consumption: Short- and long-term outcomes and current psychological functioning. J Psychedelic Studies 1(2), 65-73.”