Transcript of The science of psilocybin and its use to relieve suffering

[Music] [Applause] [Music] so like trying to mix oil and water most people assume that science and spirituality don't play well together but it's it's not true Einstein said that the most beautiful and profound emotion we can experience is the sensation of the mystical he said it's the source of all true science today I want to tell you about research with the classic psychedelic psilocybin that's showing that under supported conditions psilocybin can occasion mystical type experien is associated with enduring positive changes in attitudes mood and behavior the results are fascinating in their own right have implications for Medical Therapeutics and implications as well for the nature of Consciousness and ethics and altruism so by way of background I've been conducting research on mood altering drugs for the past 40 years about 20 years ago I started a meditation practice that profoundly shifted my worldview and got me very curious about the nature of spiritual experience I became reacquainted with research conducted mostly in the 1950s and 60s showing that under some conditions classic cusens like psilocybin could could occasion mystical experiences that looked very much like those that occur naturally and that have been reported by Mystics throughout the ages I became interested in psilocybin psilocybin is the principal psychoactive component of of the pilos genus of mushroom psilocybin in the form of these mushrooms have been used for hundreds possibly thousands of years within various cultures for healing and spiritual purposes well while I was interested in studying psilocybe and research with this whole class of compounds had been blocked for decades because the risks which are real but manageable were thought to totally outweigh the benefits so it seemed like a long shot at the time but my colleagues and I sought and ultimately obtained approval to administer psilocybon to healthy volunteers who had never before had an experience with this class of drugs and as I'll show you the results were lifechanging for many of those participants and turned out to be career changing for me because psilocybin has become one principal focus of of my research program so what I want to do today is tell you about the Johns Hopkins psilocybin research project it's in its 15th year we've given cyon over about 250 volunteers over 600 sessions I'm going to tell you about psilocybin studies in healthy Volunteers in cancer patients smokers long-term meditators and end with some conclusions so we've conducted three rigorous double blind studies and healthy volunteers we've looked at dose effects we've added controls for expectancy kinds of things uh and uh and the these sessions for these studies are held in a living room like environment before the first session volunteers develop a trusting relationship with our session monitors which reduces adverse effects of Pyon on session days volunteers come in in they swallow a capsule they're encouraged to lay on a couch use eye mask and headphones through which they listen to a musical program and direct their attention inward if fear anxiety arise then the monitors are there to provide reassurance so um not surprisingly a high dose of psilocybin under these conditions uh produces hallucinogen like effects so there are perceptual changes like visual illusion iions there's greater emotionality like increased sense of Joy less frequently fear and there are cognitive changes but to me the most interesting effect was that in most volunteers study psilocybin uh produced uh great increases in questionnaires that had been specifically designed to measure naturally occurring mystical experiences these these experiences are characterized by a sense of unity a feeling that all people and things are connected accompanied by a sense of sacredness uh a sense of positive mood love joy and a deeply felt sense of encountering Ultimate Reality these experiences are felt to be more real and more true than everyday waking consciousness now cybin is a relatively short acting drug so by the end of the session day these effects are gone but Vivid memories for these Salient experiences endure in one study we had volunteers return a month after each session to complete some questionnaires 80% of the volunteers in that study after having one or two high doses of psilocybin reported that the experience was among the five most personally meaningful and spiritually significant experiences of their lives in in fact about 50% said it was the single most personally and spiritually significant experience of their life comparing it for instance to the birth of a firstborn child or death of a parent these are stunning and remarkable findings long-term followup of these kinds of effects shows uh that their sustained these positive effects are sustained for at least a year and probably longer and it wasn't just the volunteers who reported these effects we did structured interviews with friends family members and colleagues at work and and they and and this statistically verified the volunteers reports so we've continued this whole line of research over the last several years and studied other populations the first of which are psychologically distressed uh cancer patients so uh We've recently completed a study in 51 cancer patients with life-threatening cancer diagnosis who met clinical criteria for having an a depression or anxiety disorder these volunteers were randomly assigned to receive either a low dose or a high do of psilocybin under double blind conditions now these results are still preliminary but they're very promising and what this graphic shows is the percentage of volunteers showing clinically significant Improvement movement in depressed mood the orange bar shows that 92% of those people who receed the high do of psilocybin five weeks after the session we're reporting or we're showing clinically significant improvements much greater than the green bar that shows the effects after the low dose of psilocybon the blue bar shows that the effects of this high dose of psilocybin are sustained out to 6 months so about 80% are continuing to show clinically significant Improvement in fact in 70% of these the symptoms have remitted to the normal range we're showing similar effects for anxiety these these effects are really quite remarkable what we're showing here is a single exposure to a substance producing substantial and enduring anti-depressant and analytic effects uh such an effect actually is unprecedented within the field of Psychiatry another population we've looked at are cigarette smokers seeking absence these are long-term smokers multiple fail quit attempts in in our first pilot study 15 volunteers we integrated cognitive behavior therapy for smoking sensation with our supported psilocybin uh intervention in this study volunteers had up to three psilocybin sessions the first session session corresponded with their target quit date and this graphic shows urinary kodenine which is the major metabolite of nicotine over the course of the study you can see in the first five weeks volunteers are are showing high levels of cening and that's consistent with the fact that this is the period where they're learning the cognitive approach to smoking Sensations prior to their quit date then we hit that Target quit date urinary cening Falls dramatically remains down at 6 months we have 80% absent rat so like the cancer data these these data are remarkable because uh six-month smoking sensation rates generally run in the order of 15 to about the best about 30% so we're now proceeding with control clinical trials another population I want to talk about are long-term meditators um so I've come to think of uh meditation and psilocybin as being a complimentary processes for investigation of the nature of mind and in fact neuroimaging studies show that uh they both produce similar changes in brain regions related to a sense of of self well if meditation represents the tried and true course for investigation of the nature of mind then cocy and Shirley represents the crash course course and in this case we're interested in whether long-term meditators are showing beneficial or perhaps detrimental effects of psilocybin exposure again the data are preliminary but I can share that most long-term meditators find these experiences to be remarkably insightful and they report beneficial effects to both their sitting and their non-sitting awareness practices although none would claim that psilocybin is a substitute for meditation which results in much more stable day-to-day awareness so um so stepping back uh the the basic finding here is that psilocybin under these supported conditions can occasion in most people studied mystical type experiences having positive long-term changes in attitudes mood and behavior there are I don't want to conclude with three implications the first is scientific this is a really interesting effect and and the fact that we can show it reliably dose dependently means that we can now turn the tools of science to prospectively investigate uh the causes and consequences of these effects we can look at things like neural brain mechanisms and the effects for instance of uh genetics or personality or expectation on these effects effects the second implication is Medical Therapeutics uh our data with cancer patients are being used by two private sector organizations now the hefta research institute and the Yona Institute to ask FDA whether we can now proceed with large scale clinical trial with the goal of seeking approval of psilocybin for treatment of cancer related end of life distress and obviously ultimately end of life life distress is not limited to just cancer uh in terms of the smoking sensation our work and other and studies from other Laboratories suggest that there might be very substantial application of this approach to treatment of addictions and quite possibly other behaviorally based medical or psychiatric disorders and there's a very recent preliminary data suggesting the possibility that psilocin may have treatment or may have efficacy in treatment resistant depression but the final implication and the one that's most interesting to me is this the fact that psilocybin can occasion most people studied mystical type experiences virtually identical to those that occur naturally suggest that such experiences are biologically normal and it and it raises the question why are we wired to have these Salient felt to be sacred experiences of encountering Ultimate Reality of the interconnectedness of all people and all things experiences that are arguably provide the very basis of our ethical and moral codes common to all the world's religions well I think there's something about the mystical experience that relates intimately to the very nature of consciousness just reflect on the mysterious truth that if you direct your attention inward you become aware that you're aware an indisputable and profound inner knowing arises that we can all access individually and perhaps collectively I think this inner knowingness at the core of our Humanity we recognize at some deep level that we're all in this together and there's an Impulse that arises for Mutual caretaking I further believe that investigation of this inner knowing through contemplative and other spiritual practices can give rise to profound worldview shifts of an uplifting kind and Awakening to a sense of Freedom peace joy and gratitude that most people simply find un imaginable excitingly exploration of the pilosyan occasion mystical experience seems to provide a modeled system for rigorous and prospective investigation of these Awakening experiences further research will surely reveal underlying biological mechanisms of action will likely result in an array of therapeutic applications and more importantly because such experiences are foundationally related to our moral and our ethical understandings further research May ultimately prove to be crucial to the very survival of our species thank [Applause] [Music] you