April 14, 2004

Studies probe psychedelic benefits

Medicine: Researchers at Harbor-UCLA centers will examine the effectiveness of the drug psilocybin for terminal and end-stage cancer patients.

By Lee Peterson Daily Breeze, Torrance, California.

Little-known scientific studies like a local one that will treat terminal cancer patients with the hallucinogenic drug psilocybin comprise a small but growing effort to find acceptance in mainstream medicine for psychedelic drugs.

Doctors at the Research and Education Institute at Harbor-UCLA Medical Center near Torrance will study the effectiveness of the active ingredient from "magic mushrooms" in relieving anxiety, depression and pain in terminal or end-stage cancer patients.

A University of Arizona research team is investigating the use of the same drug, which can cause hallucinations, in treating obsessive-compulsive disorder.

It's been an uphill climb for proponents of the study of illegal drugs like MDMA -- also known as ecstasy -- and psilocybin, given the public's general impression of psychedelic drugs as the domain of counter-culture rebels and reckless pleasure-seekers.

But there is evidence, much of it from the 1960s and early '70s--before such research was stopped by the government--that in controlled, clinical settings, certain psychoactive drugs can be beneficial for people suffering from terminal illness or from some psychiatric disorders.

That's why Dr. Charles Grob, a psychiatrist at Harbor-UCLA and Harbor-UCLA REI, decided to investigate the potential benefits of psilocybin.

"Anxiety is quite common among people with end-stage disease," Grob said. Published studies from the '60s and the early '70s show that psilocybin produced a marked improvement in mood and improved rapport with family and friends. It also led to a dramatic reduction in pain perception and the need for pain medication.

"We are very interested to see if we can replicate such findings," Grob said.

As opposed to the image of a cancer patient who would be zonked out on hallucinogenic drugs, the old reports indicated that even after the drug had "worn off," the patients used less pain medication, and thus were more lucid.

That "after effect," a possible lasting improvement in their psychological state, is one of the more intriguing findings, Grob said.

His study is starting small, and he is looking for 12 patients with end-stage cancer, but who also fit a strict set of qualifications, such as not having any cancers of the brain or central nervous system.

Participants must have good liver function, no diabetes, no kidney disease, and no history of personal or family psychiatric disorder, for example. As one can imagine, finding a terminal patient who can fit the requirements is difficult.

But Grob and his office are working with cancer support groups and oncology departments, and have the assistance of a charity that will fly in patients from a radius of 1,000 miles to take part. The study requires only three visits per patient: one screening, once to take the drug and once to take a placebo.

Eventually, if it proves feasible, Grob will seek permission to expand the study.

MDMA, or ecstasy, hasn't been outlawed as long as psilocybin, but its proposed use as a therapeutic drug has been just as controversial.

Slowly, however, proponents have witnessed a growing acceptance that more should be done for terminal patients, for example, and that even illegal drugs may hold some promise as medicines.

Grob said the climate change may be due to the sunset of '60s-era recreational drug-use enthusiasts like Timothy Leary, whose legacy has been more of an obstruction than anything else to research.

"It's only now that we have evolved to the point where we are able to do something like this," Grob said.

If successful, studies like Grob's will help to generate acceptance for vilified drugs, showing that there are benefits that outweigh risks, said Rick Doblin, president and founder of the Florida-based Multidisciplinary Association for Psychedelic Studies.

Doblin said one reason for the potential for mainstream acceptance is that the proponents have changed their message.

"We are making more reasonable claims," Doblin said. Instead of promising spiritual awakenings and such through unbridled recreational use, the proponents of these drugs are talking about relief for cancer patients and those suffering from psychiatric disorders within the context of controlled medical settings.

His nonprofit group, MAPS, has a five-year, $5 million plan to gain approval from the FDA to market MDMA as a therapeutic drug.

Getting approval to study some of these drugs has not proved as difficult as getting permission from drug agencies to obtain legal supplies. Legal supplies of marijuana for scientific use are so tightly controlled, Doblin said, that it's actually easier to do clinical trials with such drugs as MDMA and psilocybin.

Dr. Rex Greene, an oncologist and expert in end-of-life care, welcomed the study of psilocybin as a possible treatment for cancer patients.

"Insofar as a hallucinogenic is used as a tool, properly supervised, it could well be helpful," said Greene, a former South Bay resident who last year, became medical director of the cancer center at Mills Peninsula Medical Center in San Mateo County.

A deep-seated cultural resistance to drugs -- even legal pharmaceuticals like morphine -- can make it difficult to treat terminal cancer patients, he said, as family members for example might fear their mother will become an addict at the end of her life from a single dose of morphine.

"We just need to be very careful to address the fears of the larger culture," Doblin said.