CU to Study How Psilocybin Affects Mental Health of Cancer Patients

Our mortality is too scary for most of us to consider, but people with terminal cancer don't have a choice. Receiving such terrible news can bring on feelings of anxiety, depression and despair, according to researchers with the University of Colorado, but they believe there's something out there that can lessen the mental suffering: psilocybin.

For the first time ever, the National Cancer Institute is funding a study that will look into psilocybin's effect on the emotional and mental suffering of terminal cancer patients. Led by CU doctors Stacy Fischer and Jim Grigsby, the study will monitor patients who undergo extensive sessions of psychotherapy, during which each participant will receive 25 milligrams of psilocybin, a "moderate to high dose" that is enough for ego dissolution, according to Fischer.

The relatively new clinical method is part of palliative care, a form of medical care for terminally ill people that focuses on the mental aspects of their final days as much as the physical. If the results of the study are promising, Fischer and Grigsby hope to see more federally approved exploration into medical psychedelics like psilocybin and MDMA. To learn more about the study, Westword interviewed the CU researchers.

Westword: What made you each interested in psilocybin?

Dr. Stacy Fischer: For me, personally, it was reading Michael Pollan's article in the New Yorker. After that, I independently reached out to a researcher at NYU and asked if we could talk so I could learn more. My hope was that we would soon get involved in the next phase of these cancer studies, but the field in general had started moving away from cancer and toward general depression studies. That's where things were sitting for me, and then Jim became independently interested and was working on a study with MDMA. He reached out to one of my colleagues about getting involved in more work, and so we were connected and began collaborating. After a lot of blood, sweat and tears, we finally received the funding.

Dr. Jim Grigsby: Through a chance occurrence, I became an investigator and facilitator on a study in Boulder that looked at MDMA as a treatment for post-traumatic stress disorders that had proven to be refractory to treatment. We had people who were in traditional therapy for up to 25 or 30 years without much improvement. It was a phase-two trial for the FDA, and the MDMA was very successful. Right around 75 percent of patients in the study no longer met the diagnostic criteria for PTSD after their involvement in the study. After working on that, I thought this was a fascinating field that I'd like to explore more.

In regard to your study, what makes depression and mental suffering related to cancer different from other forms? What is specific about this scenario?

Fischer: I think a lot of it is facing your own mortality, which can cause tremendous existential distress, knowing that your time may be more limited. Most of us live under this illusion that we're all promised tomorrow, even though we see on the news that accidents and earthquakes happen. Yet we operate in our daily lives [assuming that] we'll have many more days. When people receive a life-limiting diagnosis of a serious cancer, that can really bring about feelings of demoralization, hopelessness and fear of mortality and death.

Grigsby: Among the clinical trials of psychedelics was a series of studies from a physician named Eric Kast in Chicago in the 1960s, and he worked with people who had terminal illnesses, especially cancer. So it's been known for quite a long time that it looks like a promising approach, but the research then was not very good, so we're going to try and do a better job of it.

When you talk about existential feelings of mortality, is that where the psychedelic impact has an effect?

Grigsby: Yes. It's been known for a while that psilocybin, LSD and other psychedelic substances can have really profound effects on people. In early work on it from Johns Hopkins University and New York University, a large percentage of people participating in the study reported that they'd had the most profound, or one of the most profound, experiences of their lives. It appears that those kinds of experiences can have very significant and long-lasting effects on people through a number of different indications, not just depression or palliative care.

Fischer: One important point on the research we're doing is that it's not only the drug, but the drug in conjunction with psychotherapy, so it's sort of structured and manualized with an evidence base, as well. People do experience very profound events, but when combined with psychotherapy, there may be really lasting benefits against anxiety, addiction, depression and other struggles.

This study will use synthetic psilocybin. What is that, exactly, and how is it made or derived? This won't be from mushrooms, then?

Grigsby: You can derive it from psilocybin mushrooms, but the synthetic form was actually first developed by Albert Hofmann, who also discovered LSD in 1956. I think the method he devised is the one that is used currently for this kind of research. What's going to happen under [Colorado's] Proposition 122 is that people are going to be using a fungi, or plant medicine — so it will be mushrooms that people are taking, and not this synthesized version.

The different varieties of cannabis play a big part in the effects experienced by users. Is it like that for psilocybin, too? Could different "strains" of mushrooms affect how we respond to anxiety or depression?

Fischer: The research that we're doing fits within federal law. That's a distinction, because in practice it's not fitting in with federal law. A nuance of cannabis research is that the federal government required all the federally compliant studies to use cannabis from one supplier, and it wasn't reflective of the product that was on the street or in dispensaries. That's been a real challenge in cannabis research versus what's out in the community. I think this is a little different because the synthetic version allows us to say with total confidence that everyone is getting the same amount, which I think is very difficult to do when talking about an actual mushroom fungus. We'll also know that this is a pure product that has an intense effect on people.

Grigsby: The purity of it is important, because a lot of other alkaloids could be found in psychedelic mushrooms, and those could have effects of sorts on people taking them. Those won't be present in this study.

Did you face many obstacles or challenges in getting the study or its funding approved, given the psychedelic nature of the research?

Fischer: We did a number of grant submissions. I wouldn't call those barriers, but anyone in biomedical research seeking money from the [National Institutes of Health] knows that they only fund studies that are able to demonstrate the highest-caliber science. They really pressed us on our research design and how we presented our ideas to be able to convey the most rigorous science possible. In terms of other barriers, we haven't faced many. There are processes and there is bureaucracy, for sure, and a lot of paperwork. But in terms of our university, DEA, FDA and agencies involved, they've been extremely collaborative and willing to work with us.

What are you excited to learn about the most in this study?

Fischer: Working with younger patients who feel a sense of hopelessness and helplessness, the tools to help people in those situations are very limited. When people are facing the end of their life, perhaps before it's even begun, to have some tools that can help them feel a sense of peace and meaning, and adjust their existential distress effectively.

Grigsby: I agree very much with Stacy. It's going to be an important and interesting result of the study. I'm also interested in different types of palliative care, and not just people who have late-stage cancer or terminal illnesses. I've done a lot of work with people who have progressive neurological disorders, and there's really not much that can be done to cure them. Sometimes symptoms can be managed and sometimes they can't. I'm interested to see if it can be beneficial for neurological disorders, autoimmune disorders or conditions like ALS.