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  1. 5-HT2A
    A new pilot trial at the University of Alabama at Birmingham is examining the potential of a surprising tool for treating cocaine addiction: the psychedelic compound psilocybin.

    Peter Hendricks, associate professor at the UAB School of Public Health, hopes to determine if the controlled administration of psilocybin in conjunction with behavioral therapy proves helpful in treating cocaine dependence.

    Psilocybin, which Hendricks described as “a chemical cousin of LSD,” is a naturally-occurring psychedelic chemical compound that is famously found in hallucinogenic mushrooms. Psilocybin is considered a Schedule I drug under the Controlled Substances Act, putting it in the same category as heroin and LSD.

    As strange as it may sound to turn to a psychedelic to treat cocaine addiction, there have been other studies that have found psilocybin to be useful in treating different kinds of addiction: a 2012 study at John Hopkins found psilocybin helped participants kick their cigarette habits, and other studies have shown it might be effective in combatting alcoholism.

    Hendricks, who in previous studies has examined the associations between psilocybin use and suicidal thoughts and criminal behavior, is optimistic that psilocybin could prove useful in treating cocaine addiction. He is emphatic, however, that the medical potential of psilocybin-facilitated therapy is no excuse for recreational use of an illegal drug.

    “Recreational use is completely different from very carefully controlled use in a therapeutic setting,” Hendricks said. “We know that there are individuals who use recreationally, and the effects in these contexts are completely different than what you might expect [from taking psilocybin] with a very specific intention and the assistance of a therapist.

    “In the appropriate setting and with the appropriate mindset and preparation, [psilocybin] can occasion a mystical-type experience sometimes called a ‘peak experience,’” Hendricks continued. “These would be mystical-type experiences that would qualitatively be indistinct from the sort of experiences reported by or experienced by the world’s great saints and sages… There’s often a sense of timelessness and spacelessness, there’s often a sense that all is one, and all people are one, that all of creation is one. There’s often an encounter with an unconditionally loving higher power, what most people would call God, and a sense of serenity or bliss.”

    Individuals undergoing peak experiences caused by psilocybin often find that they have “increased recall of autobiographical memories,” Hendricks explained, which can help them gain a greater degree of self-insight and see their how current behavior conflicts with their ideals and goals.

    “I think people are essentially having these types of experiences where they’re in a short amount of time confronted with what is most meaningful to them and how their behavior may stand in conflict with what they hold to be most sacred,” Hendricks said. “So imagine if we were struggling with cocaine dependence or cocaine addiction, and often people who are addicted will — and they’re aware of this — they will prioritize the drug use over their relationships with people they love, over their careers, over their living situations and in some situations even over their basic living needs like food and shelter. And in this amount of time [of the peak experience], it’s as though people have a profound degree of insight and introspection that allows them to see the degree to which they prioritize that drug.”

    Peak experiences are not unique to psilocybin users, Hendricks added, noting that many former alcoholics speak of finding the strength to quit drinking after undergoing intense “religious-like” experiences in which they report encountering a higher power and discovering that they have the power to reject the bottle. He noted that Bill Wilson, the co-founder of Alcoholics Anonymous, seems to have based some of the theories that went into the Twelve-Step Program on his experiences taking LSD, which at the time was a legal psychiatric medication, to treat his depression.

    “I think the thing that is very exciting for me is that if used very responsibly and respectfully, [psilocybin] can produce the kind of therapeutic changes that we in the field of addiction therapy have been unable to produce,” Hendricks said. “Whereas before we would have to wait for someone to have an experience that would occasion a quantum change, as we would call it, now we can time it to happen at just the right moment to capitalize on what these sort of experiences can produce.”

    Though he stressed that this is only a pilot trial and that many more tests are needed, Hendricks predicted that should the data prove that psilocybin is safe and effective in treating cocaine addiction, the FDA could potentially reclassify psilocybin as a Schedule III or IV drug, allowing therapists and psychiatrists to prescribe psilocybin to their patients looking to break cocaine addiction. He noted that researchers at John Hopkins are looking into using psilocybin to treat end-of-life anxiety in terminal cancer patients, and that if previous positive results are replicated, that might also cause the FDA to reclassify psilocybin.

    “Science, as I’m sure you know, is a cumulative process, and what we’re seeing time and again is that data tells the same story. What I would say is that if the data time and again points you in the same direction, down the same path, you should be willing to explore that path further,” Hendricks said. “And I’m certainly not at the point now where I’m saying, ‘Hey, psilocybin is going to cure all our ills,’ but what I am saying is that it certainly deserves further attention.”

    If you are interested in participating in Hendricks’ no-cost research treatment program, call UAB at (205) 975-7721.

    by Ryan Scott

    July 19, 2016



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