Pubdate: Sat, 11 May 2019
Source: New York Times (NY)
Copyright: 2019 The New York Times Company
Author: Michael Pollan


Only a few days ago, millions of American probably had never heard of
psilocybin, the active agent in psychedelic mushrooms, but thanks to
Denver, it is about to get its moment in the political sun. On
Tuesday, the city's voters surprised everyone by narrowly approving a
ballot initiative that effectively decriminalizes psilocybin, making
its possession, use or personal cultivation a low-priority crime.

The move is largely symbolic - only 11 psilocybin cases have been
prosecuted in Denver in the last three years, and state and federal
police may still make arrests - but it is not without significance.
Psilocybin decriminalization will be on the ballot in Oregon in 2020
and a petition drive is underway in California to put it on the ballot
there. For the first time since psychedelics were broadly banned under
the 1970 Controlled Substances Act, we're about to have a national
debate about the place of psilocybin in our society. Debate is always
a good thing, but I worry that we're not quite ready for this one.

No one should ever be arrested or go to jail for the possession or
cultivation of any kind of mushroom - it would be disingenuous for me
to say otherwise, since I have possessed, used and grown psilocybin
myself. Like many others, I was inspired to do so by the recent
renaissance of research into psychedelics, including psilocybin.

Scientists at places such as Johns Hopkins, New York University,
U.C.L.A.-Harbor Medical Center and Imperial College in London, have
conducted small but rigorous studies that suggest a single psilocybin
trip guided by trained professionals has the potential to relieve
"existential distress" in cancer patients; break addictions to
cigarettes, alcohol and cocaine; and bring relief to people struggling
with depression. Psychiatry's current drugs for treating these
disorders are limited in their effectiveness, often addictive, address
only symptoms and come with serious side effects, so the prospect of
psychedelic medicine is raising hopes of a badly needed revolution in
mental health care.

This might help explain why the F.D.A. granted "breakthrough therapy"
status last year to psilocybin, which promises to speed its
consideration as a treatment for depression. But the research also
shows that psilocybin may have value for the rest of us: Studies have
demonstrated that, properly administered, a psilocybin journey can
have enduring, positive effects on the well-being and relative
openness of "healthy normals," as researchers put it.

This is all very exciting, especially coming at a time when rates of
depression, suicide and addiction are rising. But the history of
psychedelics has been marked by periods of both irrational exuberance
and equally irrational stigmatization, so a few cautionary notes are
in order. As much as the supporters of legal psilocybin hope to follow
the political playbook that has rapidly changed the status of cannabis
in recent years, they need to bear in mind that psilocybin is a very
different drug, and it is not for everyone.

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. Without proper attention to
setting and preparation, people can have absolutely terrifying
experiences, sometimes with lasting effects; a recent survey of people
who reported having a "bad trip" found that nearly 8 percent of them
had sought psychiatric help afterward.

There's a reason psychedelic researchers screen volunteers carefully,
excluding people at risk of serious mental illness like schizophrenia;
in rare instances, a psychedelic trip can set off a psychotic break.
The researchers also look at drug interactions, and often disqualify
volunteers who are taking certain psychiatric medications.

I look forward to the day when psychedelic medicines like psilocybin,
having proven their safety and efficacy in F.D.A.-approved trials,
will take their legal place in society, not only in mental health care
but in the lives of people dealing with garden-variety unhappiness or
interested in spiritual exploration and personal growth.

My worry is that ballot initiatives may not be the smartest way to get
there. We still have a lot to learn about the immense power and
potential risk of these molecules, not to mention the consequences of
unrestricted use. It would be a shame if the public is pushed to make
premature decisions about psychedelics before the researchers have
completed their work. There is, too, the risk of inciting the sort of
political backlash that, in the late 1960s, set back research into
psychedelics for decades. Think of what we might know now, and the
suffering that might have been alleviated, had that research been
allowed to continue.

When psychedelics like psilocybin and LSD burst upon the scene in the
1950s and 1960s, they arrived without an instruction manual. Half a
century later we're still struggling to learn how best to harness
their spooky power. One source of wisdom on that question is other
cultures with much longer experience using these medicines. (Just this
week, archaeologists reported finding a 1,000-year old set of tools in
Bolivia bearing trace amounts of ayahuasca and other psychoactive 

Whether in pre-Conquest South or Central America (where psilocybin has
been used for centuries), or Ancient Greece, psychedelic substances
were always approached with deliberateness and care. For the most
part, the substances were taken alone but usually in a group under the
direction an elder or shaman familiar with the mental territory, and
they were used only on certain occasions, surrounded by ritual and
with a clear intention. There was nothing casual about it.

We would do well to keep that in mind in the years ahead, as we begin
the work of figuring out how to make the most constructive use of
these astonishing gifts of nature.

Michael Pollan  is the author of "How to Change Your 
Mind: What the New Science of Psychedelics Teaches Us About 
Consciousness, Dying, Addiction, Depression, and Transcendence."
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