He’s been struggling with depression for nearly 20 years. Traditional antidepressants weren’t working.

Losing hope of being cured, he began researching alternative treatments. That’s when he read about psilocybin, the hallucinogenic drug found in “magic mushrooms,” and how it was emerging as a promising treatment for major depressive disorder.

In 2015, he took the leap. Because psilocybin is an illegal drug, he had to be discreet. He secured the psychedelic fungus from black market sources, then found people he trusted to stay with him and guide him through the experience. He lay down, put on a blindfold and headphones playing music, and embarked on an inward journey.

“There’s no words to explain it,” said the 43-year-old man, whose first name is Patrick. The newspaper agreed to not use his full name or identify him because the drug is illegal and he fears criminal enforcement. “I felt self love in a way that was impossible before. Forgiveness for myself. Forgiveness for those who have hurt me in my life.”

While not a cure, Patrick said the drug provided valuable insights and has helped him finally manage his depression.

It’s an option that could soon become accessible – and legal – for more people seeking alternative treatments in Maine.

But some are urging caution, warning that psilocybin is not safe for certain people, especially those with schizophrenia. And not everyone who eats psychedelic mushrooms has a positive experience like Patrick did. Using too much or without proper supervision can produce a terrifying experience and lead to physical or psychological harm.

Long associated with the mind-expanding counterculture movement in the 1960s, psychedelic mushrooms are making their way into mainstream medical research as a treatment for conditions such as depression, anxiety and substance use.

Early studies have shown that psilocybin-assisted therapy can dramatically reduce severe depression in people not helped by traditional medications, which suppress feelings and emotions and can carry side effects.

The U.S. Food and Drug Administration designated psilocybin as a breakthrough treatment for drug-resistant depression in 2018 and for major depressive disorder in 2019. And researchers at Johns Hopkins Medicine are studying the use of psilocybin to help people quit smoking or drinking, relieve anxiety among cancer patients and treat depression.

Denver became the first city to decriminalize psilocybin mushrooms in 2019, followed by the California cities of Oakland and Santa Cruz. Voters in Detroit voted to decriminalize mushrooms in November.

Now there’s an effort afoot to lay the legal groundwork for psilocybin-assisted therapy in Maine. Proponents are looking to capitalize on Mainers’ acceptance of medical marijuana, but some caution that the state should wait until more research emerges.

BILL TO ALLOW PSILOCYBIN THERAPY 

State lawmakers will hold a public hearing Tuesday on a bill that would establish a legal framework for psilocybin-assisted therapy for people over the age of 21. The Health and Human Services Committee held an informational briefing this month.

Patrick, who agreed to be interviewed only if his full name was not used, said he uses psilocybin to treat his own depression and has helped other people prepare for their sessions and then help them process the experience afterward. Ben McCanna/Staff Photographer

The bill’s sponsor, Sen. Donna Bailey, D-Saco, said she believes her colleagues are open to the idea. Even if they support her proposal, she predicted they would struggle with how broad the program should be and how soon it could be implemented.

But Bailey believes the bill should advance.

“I have heard from so many folks from across the state saying they’re waiting anxiously to try this or they have used it in other places and how tremendously it has helped them,” Bailey said in an interview. “I really believe we need to put forward the framework to allow the folks in Maine to be able to benefit.”

The bill is based on a similar one in Oregon, which became the first state to legalize psilocybin-assisted therapy in 2020.

Maine’s 40-page bill would add psilocybin to the state’s marijuana law. It would establish a professional 19-member advisory board to keep up with the evolving research and issue program recommendations to the Department of Health and Human Services, which would oversee the program. It would legalize the production of psilocybin, but only at licensed facilities. Licensing requirements would be imposed on psilocybin service centers, production and testing facilities, and professional facilitators, who would sit with people during an hourslong dosing session.

The drug would be administered only at a psilocybin service center and under the supervision of two licensed facilitators. Patients would have to participate in a preparation session with a counselor to set goals and expectations. And they would be offered two implementation sessions to help process and integrate their experience into their lives.

DHHS would be required to establish rules about the maximum concentration of psilocybin in a single dose and the number of doses per package. The bill appears to be worded to allow for a variety of psilocybin products, which include whole mushrooms or psilocybin pills.

Unlike medical marijuana, patients would not be able to purchase psilocybin for at-home use. Doses could be taken only at a licensed service center, which would face tracking requirements and limits on the amount of psilocybin it can possess.

‘MEDICINE-BY-POLITICS’

While initial studies by Johns Hopkins and other researchers suggest the treatment is promising, some warn that psilocybin is not a panacea and urge caution against widespread legalization before clinical trials are completed and potential long-term effects can be studied.

Scott Gagnon, a substance use counselor who opposed Maine’s medical marijuana program, said he was not aware of the bill. But he expressed concerns about Maine lawmakers moving to legalize psilocybin-assisted therapy before it’s been thoroughly studied and deemed safe. He said science, not politics, should determine what’s an effective treatment.

“We seem to be in this era of medicine-by-politics,” said Gagnon, noting that misguided politicians have encouraged people to use unproven medical treatments, such as the de-wormer Ivermectin, to treat COVID-19.

“It’s all part of this larger, I think dangerous trend, to ignore the scientific process when it comes to medicine,” Gagnon said in an email. “Psilocybin should go through the same, rigorous scientific process as the COVID vaccines, phased clinical trials, to gather data to determine if it is a safe AND effective treatment. Otherwise what happens is people get led down treatment paths that are unproven, and drawn away from treatments that are evidence-based, and proven to be safe and effective. We can’t base medicine on anecdotal evidence, it needs to be based on actual, rigorous data.”

A spokesperson said the Maine Department of Health and Human Services does not have a position on the bill.

Augusta Police Chief Jared Mills, president of the Maine Chiefs of Police Association, said he was still reviewing the bill. As is the Department of Public Safety, a spokesperson said.

Spokespeople for Gov. Janet Mills did not respond to an email sent last week seeking the governor’s position.

Michael Burman, a psychology professor at the University of New England, said he supports efforts to legalize psilocybin-therapy in Maine, which has already legalized medical and recreational marijuana. He said the state generally has higher rates of depression than the national average and the pandemic is exacerbating mental health challenges.

But he cautioned that it’s not the right approach for everybody, especially those with a history of schizophrenia or other mental health disorders.

“Hallucinogens are not safe for everyone,” Burman said. “There’s a real selection process that has to concur about who this treatment is appropriate for and who it’s not appropriate for.”

Burman said the bill builds in the appropriate process and precautions.

“There should be some caution, but I think this bill builds that in,” he said. “It’s incredibly effective for the right people in the right setting with the proper guidance and care. There are other people for whom it’s entirely inappropriate.”

‘HUGE SPIRITUAL EXPERIENCES’

A 2019 study conducted by researchers at Johns Hopkins Medicine found a remarkable improvement among a small group of people struggling with depression after only two sessions of psilocybin-assisted therapy.

The institute noted that psilocybin “produces visual and auditory hallucinations and profound changes in consciousness over a few hours after ingestion,” adding that the drug penetrates the central nervous system in ways that scientific and medical experts are just beginning to understand.

The study involved 24 people with a long-documented history of depression, who had persistent symptoms for two years before enrolling in the study. They were carefully weaned off their antidepressants before receiving two doses, two weeks apart. Each treatment took about five hours, with participants lying on a couch wearing eyeshades and headphones that played music. Each session had trained monitors.

Before their sessions, participants had an average rating of 23 of a possible 24 on the depression scale, indicating severe depression. But after the treatments, the average score dropped to 8, one point shy of a score that would indicate no depression. After four weeks, 71 percent of the participants reported an improvement in their symptoms, including 54 percent of the participants were considered in remission.

“The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” Alan Davis, an adjunct assistant professor of psychiatry and behavioral sciences, said in a news release. “Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future ‘gold-standard’ placebo-controlled clinical trials.”

Lynnette Averill, a psychologist in the VA HealthCare System who teaches at Baylor College of Medicine in Texas and also is affiliated with Yale University and the National Center for post-traumatic stress disorder, briefed Maine lawmakers on the treatment this month. But first she noted that her research is personally motivated.

“On a personal note, I’m also the daughter of a U.S. Marine who died by suicide after years of struggling with ineffective treatments,” Averill, who was a consultant on a Texas bill allowing psilocybin trial for veterans with PTSD, told members of the HHS Committee Jan. 18.

Averill said that traditional antidepressants only work for about 30 percent of people with major depressive disorder. Even then, it can take weeks or months, she said, to get any clinical benefits, which often come with side effects, including cognitive impairment, weight loss or gain, or sexual dysfunction.

Psilocybin, on the other hand, works rapidly, she said, and carries a low risk for addiction or abuse, but should only be used in a safe setting, under supervision and in concert with therapy.

“This very rapid shift (in cognitive activity) results in very rapid shifts in symptoms,” Averill told lawmakers. “If we think about ourselves or a loved one struggling with these symptoms, the thought of having someone feeling remarkably better in a number of hours or days relative to four to eight weeks is incredibly exciting and is quite literally is a lifesaving thought.”

Some researchers are looking at the effectiveness of more frequent use of small doses, or microdoses, that may reduce the risks of a negative experience but also could carry other health risks.

C.J. Spotswood, a psychiatric nurse practitioner in Winthrop with 20 years’ experience, has been working in psychedelic research for the past five years. His book “The Microdosing Guidebook: A Step-by-Step Manual to Improve Your Physical and Mental Health through Psychedelic Medicine” will be published in March.

Spotswood has he’s seen a “huge shift” in interest in this sort of treatment, by both professionals and people struggling with depression. Some who have been helped by psilocybin-assisted therapy rank the experience in the top five experiences of their life, he said.

“It absolutely changes the their whole way of thinking,” he said. “(Hallucinogens are) actually evoking these huge spiritual changes.”

With a body of evidence growing, Spotswood is urging lawmakers to lay the legal groundwork for psilocybin-assisted therapy now, so desperate people don’t have to turn to the black market.

“People are looking for alternatives, and when they start looking, they look in other places,” Spotswood said. “It’s going to happen.”

Psilocybin does not come with the same risk of addiction as other drugs, according to researchers. Spotswood said that’s because it doesn’t activate the dopamine reward system in the brain.

‘SEA OF COLOR AND MUSIC’

Three Maine residents shared their experiences using psilocybin to treat longstanding depression on the condition they not be identified because possessing psilocybin is a crime.

One middle-aged professional from central Maine described himself as religious and politically conservative. He turned to psilocybin five years ago. After struggling with lifelong depression, he began to spiral downward in 2016. He contemplated suicide daily. Traditional medications did not help.

“It just made me numb,” he said. “I didn’t feel good. I didn’t feel bad. I mostly didn’t feel.”

The only things he felt were the side effects – nausea and vertigo.

Desperate, he began conducting his own research and learned about magic mushrooms. Despite growing up in the 1980s amid the war on drugs, he ordered some spores and grew his own mushrooms. He engaged his wife and a trusted friend to help guide him through his trip.

“I wasn’t high – I just felt good,” he said. “Everything was clicking. My brain was working right. I didn’t have this self-loathing talking to me. It was relief.”

The experience has helped ease his depression for extended periods. His last dose was a year ago, though he’s planning another session since his symptoms are beginning to return. Prior to that, he’d gone as long as 2 1/2 years between doses.

Another person who turned to psychedelics was a 44-year-old veteran who lives in western Maine. He said service-related trauma left him him with PTSD, depression and anxiety. Traditional antidepressants made him numb, and he continued to have panic attacks, he said.

“I wasn’t feeling any better at all,” he said. “It was frustrating.”

After consulting with his doctor and his counselor, he tried MDMA (ecstasy) – another FDA-designated breakthrough treatment for PTSD – before trying psilocybin less than a year ago. He said he microdoses every few days and occasionally does a “deep dive” using a higher dosage.

Preserving his anonymity, this 44-year-old veteran who lives in western Maine says service-related trauma left him with PTSD, depression and anxiety. Traditional anti-depressants made him numb and he continued to have panic attacks, he said. Ben McCanna/Staff Photographer

Psilocybin has helped alleviate feelings of guilt, he said.

“You just sort of sit down and open yourself up to whatever the medicine is going to bring to you,” he said.

His licensed clinical professional counselor also agreed to speak with a reporter on the condition she not be identified because she fears losing her license. She said the veteran is one of two patients using either psilocybin or MDMA to treat their symptoms. In each case, she has noticed “profound results,” but stressed the drug alone is not a panacea and that screening candidates and ongoing therapy are essential.

“It hasn’t cured everything,” she said. “There’s still work to do. It seems to be particularly good in helping people release their learned defense mechanism, particularly around difficult relationships. It seems to be able to allow folks to let go of those defenses, step outside of themselves, and experience the connection they’re really longing for with their loved ones.”

Patrick, meanwhile, said his experience led him to seek training to become a preparation and integration coach for others looking to psilocybin-assisted therapy. The Portland resident said he’s helped about 30 people integrate their experience into their lives.

“Mushrooms by themselves are not a cure, but a carefully structured experience can result in remarkable insights which, in my experience, then need to be acted on in order to create long-term changes,” he said. “This is why I believe integration is so key in maximizing the benefits of the session. In the days following your experience, you may be open to introducing practical changes and anchoring in new insights. Without integration, it’s possible that the insights will slowly fade away over time.”

He said he’s encouraged that psilocybin is being studied as a way to address substance use, noting that Maine saw a record number of fatal drug overdoses last year.

For him, it’s personal in more ways than one.

“I have lost a brother and countless friends and loved ones to addiction,” he said.

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