Whatever shirt I put on was somehow wrong. It didn’t fit right, or there was a small stain: either way I was making a mistake. But the next shirt was even worse—and now the anxiety was too. I’d spend hours compulsively putting on and taking off shirts, frantically trying to find one that felt right. Once I did finally leave the apartment, I had to decide which side of the street to walk down, where to sit on the subway: even the most trivial choices were freighted with terrible significance, and I lived in constant dread of making the wrong one.
My diagnosis was obsesssive-compulsive disorder, and like many with OCD, my condition was termed “treatment-resistant”. Prozac, Paxil, Zoloft, Xanax, Luvox, Lamictal, Lexapro and Effexor had all failed to halt my steady slide. Ditto twice-weekly therapy sessions, yoga, meditation, acupuncture, herbal remedies. Inch by inch, the need to make the perfect decision swallowed relationships, career and everything else I’d once cared about until I was spending weeks on end holed up in my apartment.
So when I read that University of Arizona researchers had found psilocybin, the psychoactive compound in hallucinogenic mushrooms, could alleviate symptoms of severe, treatment-resistant OCD, I figured I didn’t have much to lose by trying shrooms.
Roughly 2% of the population has OCD, which studies show can be as debilitating as schizophrenia in its impact on everyday functioning; one in seven OCD sufferers eventually attempts suicide. About half of OCD patients don’t respond to medication, and those who do almost always still suffer from significant symptoms. The last truly novel OCD drug was Prozac, and after decades of R&D dead ends, the pharmaceutical industry has given up searching for the next one. The situation is so bleak that psychosurgery, in which parts of the brain are permanently destroyed, is an accepted OCD treatment, even though it’s only moderately effective and can cause severe cognitive impairment and even paralysis.
Yet despite this desperate need for better treatments, in the years since I read that psilocybin study, there has been no further investigation of psilocybin for OCD.
Psilocybin, along with LSD and most other psychedelics, was classified in 1970 as a Schedule I drug, defined as having high risk of abuse and addiction and no medical use. While this was perhaps an understandable reaction to the excesses of the Woodstock era, the reality, as a large population study recently concluded, is that “psychedelics are not known to harm the brain or other body organs or to cause addiction.” Another recent study found that people who’ve used psychedelics actually had significantly reduced risk of severe psychological problems compared to those who’ve never tried these drugs.
As for medical use, a growing body of recent research suggests psychedelics have a capacity for rapidly effecting lasting, positive change that science simply hasn’t found elsewhere. For example, NYU investigators report that after a single dose of psilocybin, cancer patients “almost uniformly experienced a dramatic reduction in existential anxiety and depression... and the changes lasted a year or more and in some cases were permanent.” Johns Hopkins researchers found that psilocybin enabled 80% of long-term smokers to quit—more than double the rate of the most effective current treatments. University of New Mexico researchers reported that a single psilocybin dose dramatically reduced drinking among alcoholics throughout their study’s eight month follow up period. Psychedelics have also shown tremendous promise in treating severe depression and PTSD.
Given such singularly promising results, why isn’t there more research on psychedelics?
In a word: money. Virtually all drug development is financed by two sources: pharmaceutical firms and government agencies. The former have little interest in medications that can’t be patented, and the latter are squeamish about drugs still officially deemed a dire menace. So all funding has come from a handful non-profit organizations, foremost among them the Multidisciplinary Association for Psychedelic Studies (MAPS), which backed the OCD study that inspired my own quest. While MAPS continues to fund groundbreaking research on psychedelic-assisted therapy for conditions such as PTSD and end-of-life anxiety, their annual budget is around $4 million; in comparison, last year Pfizer spent over $200 million just to advertise Cialis. (You can donate to MAPS here, and to Heffter Research Insitute, another worthy organization that played a key role in that OCD study, here.)
Thanks in part of psychedelics, I’m now not only able to leave the house; I’m well enough to share my story in the form of a monologue called The Mushroom Cure, currently playing at the Theatre 80 in New York through January 7th.
While there may be more urgent challenges facing humanity (war, hunger, climate change—take your pick) I believe there’s no other area where so little can change so much: with psychedelic research, right now every dollar really does make a difference. We’re barely scratching the surface on what may well be the most effective treatments we have for mental illness. (I also believe that problems like war, hunger, and climate change are far more likely to be solved if we avail ourselves of the empathy and compassion that are often the fruit of psychedelic experience.)
Despite skyrocketing use of psychiatric medications, psychological disorders are now the leading cause of disability in America, afflicting one in four adults each year. For growing numbers, their condition is fatal: suicide, which research shows is almost always tied to mental illness, is the fourth-leading cause of death among Americans under age 66.
Whether psychedelics can meaningfully change this grim picture is still an open question. But in the face of so much unrelieved suffering, it’s one that’s clearly worth answering.
Sometimes the right choice is clear.