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FREQUENTLY ASKED QUESTIONS

What is psilocybin?

Psilocybin is in a class of compounds that act on specific brain receptors.  Psilocybin occurs naturally in certain mushrooms that have been used sacramentally for thousands of years.  Other drugs in this class include mescaline, which is contained in the peyote cactus used in religious ceremonies by the Native American Church, and dimethyltryptamine, which is contained in the ayahuasca sacrament used by several South American religions.

Their effects include changes in perception and cognition.  In medicine they are often called "hallucinogens, " although they rarely cause "hallucinations" in the sense of seeing or hearing things that are not there.  In anthropology the term ?entheogen,’ roughly meaning "spirit-facilitating," is coming into prominence for this class of substances.

Why do you think psilocybin may be beneficial for people distressed by their cancer diagnosis?

Early research with psilocybin and related substances from the late 1950s to the early 1970s indicated that such substances may help bring about personally meaningful and often spiritually significant experiences that lead to ongoing reductions in anxiety, depression, personal isolation, and fear of death.  Regulations enacted in response to excesses of the "psychedelic 1960s" stopped almost all medical research, leaving some promising threads dangling.  However, recent regulatory changes have allowed for such research once again.  Our recent research in healthy volunteers also suggests a possible therapeutic effect of psilocybin in those distressed over a cancer diagnosis.  This research has shown that under prepared and supportive conditions, psilocybin often leads to personally meaningful and spiritually significant experiences with associated sustained positive changes in attitudes and behavior. 

Is there a difference between taking psilocybin in this study and recreational abuse of psilocybin mushrooms?

The potential therapeutic effects of psilocybin are thought to be a product of both the substance and the very specific conditions under which it is administered. In other words, the potential therapeutic effects of psilocybin do not appear to be a direct chemical consequence of psilocybin ingestion, but depend critically on expectations and the environment surrounding its use. As with other substances that have potential therapeutic effects but which are also abused by some, such as pain relievers, there may be major differences between the effects of medical/research use and the effects of recreational abuse.

Is psilocybin safe?

No drug is absolutely safe. But the risks of psilocybin can be managed in appropriate research settings, and compare favorably with the risks of many accepted medical practices. Unlike drugs of dependence such as alcohol and cocaine, psilocybin and other classic hallucinogens are not known to be physically toxic or addictive. The primary effect of psilocybin is a strong alteration of consciousness. It is possible that such experiences can trigger latent psychotic disorders in susceptible individuals. However, previous research findings from hundreds of patients indicate that triggering a lasting psychosis is extremely unlikely in well-selected volunteers. Thus in our research we disqualify potential volunteers whose personal or family psychiatric histories indicate that they may be at increased risk for such disorders. Our studies confirm that some individuals may experience temporary paranoia, extreme anxiety, or other unpleasant psychological effects during the session. If such unpleasant effects occur, they are usually of short duration.

In a non-medical context, these effects may lead to dangerous behaviors. However, research by our group and by other groups has proven such effects to be safely managed by participant selection, preparation, and providing strong interpersonal support during the sessions. Our research team is leading the field in the safe conduct of hallucinogen research. We recently published a manual providing guidelines for other researchers on how to safely conduct research trials with hallucinogens.

Where would I be when I take psilocybin, and what would I do?

The study takes place at the Johns Hopkins Bayview campus. Psilocybin is administered in a specially designed living-room style room, decorated with artwork, comfortable furniture, and soft lighting. It specifically avoids a “laboratory” look and feel. Participants take psilocybin while they are relaxed and in supportive dialogue with two experienced study monitors. During most of the session, the participant is encouraged to lie on the couch wearing eyeshades and listening to supportive music through headphones. Thus, rather than conducting invasive medical tasks, the time in which psilocybin is in effect will be spent in quiet internal reflection. The two monitors, with whom the participant has developed a trusting relationship during several preparatory meetings, are available for interpersonal support throughout the entire session.