If you live in downtown Toronto, you may have noticed a magic mushroom dispensary in your neighbourhood — one of many popping up in cities across the country, signalling that psychedelics could be the next frontier in the movement to decriminalize recreational drug use.
As stigmas around psychedelics like psilocybin – the active ingredient in magic mushrooms – are torn down, there’s a corresponding push among scientists to expand our understanding of how they work and the role they could play in improving our health and well-being.
In Toronto, a team of researchers backed by the University of Toronto has launched a clinical trial that will study the impact of microdosing as a treatment for depression.
One of several trials launched in Canada in recent years studying the impacts of psychedelics, it is being run by Rotem Petranker, associate director at the university’s Psychedelics Studies Research Centre.
The trial is expected to last just over two months, with participants being given either psilocybin or a placebo for the first half and open-label psilocybin for the remainder of the time.
The team decided on a sub-hallucinogenic dose that is about 10 per cent of the dosage used in most clinical studies of psilocybin.
“Deciding on the dosage was a long, drawn-out process. Because really, for many of our other hypotheses, we were just basing it on what he heard from people reporting what they were doing,” said Petranker, adding that they designed the study to closely mimic the way people consume psychedelics in everyday life.
“But the dose that people are using is very inaccurate – both for psilocybin-containing mushrooms and for LSD, because those are substances that people obtain on the black market.”
Research into psilocybin has shown that the drug in higher doses appears to increase neuroplasticity, the ability to form or reorganize synaptic connections in the brain. It’s thought that this rewiring can help people suffering from depression or other mental disorders.
Researchers, however, have spent far less time studying the impact of microdosing – taking much smaller doses to get the potential benefits with fewer of the unwanted side effects.
There are ample anecdotal accounts on social media and across the internet from people who claim a sub-hallucinogenic dose of psilocybin can improve cognitive function, creativity, and well-being. But a limited number of placebo-controlled studies exist, and so far, the evidence has not proven a small dose of psilocybin has a positive impact.
“Our quest here is to find the lowest dose that is still conducive to improved well-being,” says Petranker.
John Sayer, a B.C.-based advocate, says microdosing psilocybin has helped him overcome his PTSD. Sayer had a implantable cardioverter difibrillator (ICD) installed over a decade ago and says he was defibrillated dozens of times.
Then five years ago, he was in a “near-fatal” accident. He lost his leg and received more than 30 upper body fractures as a result, he says.
“I consider myself pretty strong-minded and, you know, emotionally stable. But when the PTSD hits, there’s nothing you can do about it. It takes over and it controls everything. And I go into shock and almost panic,” he says. “I’m getting through it because of microdosing.”
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While Sayer is not a participant in the Toronto-based study, it is people like him that Petranker hopes could potentially benefit from the findings of this clinical trial and others like it.
“We want to be able to really help people that are suffering, and current treatments are not working for them,” he says.
What do we know about psychedelics so far?
Psychedelic research has early roots in Canada.
In fact, the term “psychedelics” was coined by a Canadian psychiatrist, Humphrey Osmond, whose institution in Weyburn, Sask., was home to some of the first LSD trials.
Erica Dyck, Canada Research Chair in the history of medicine, says through these trials researchers had hoped to develop a “model psychosis” to “empathize with their psychotic patients” and that they also experimented with the drugs as a treatment for alcoholism.
But in 1970, when the U.S. outlawed psychedelic drugs under the Controlled Substances Act, the drugs, Dyck says, became associated with the counterculture.
Experiments continued into the 1970s in Canada and the U.S., but the drugs now carried a stigma that ultimately, came to be a death knell for psychedelic research.
“The restrictions on the recreational use of psychedelics also had damaging effects for medical researchers, some of whom found it very difficult to collect naïve drug users or subjects who didn’t come into the trials already with a preconceived idea of what they were going to experience,” Dyck explains.
“So, there were these kinds of domino effects on the research itself, in combination with the reputation of psychedelics, or acid in particular, affecting the reputation of researchers.”
This all started to change in the 2000s, when Johns Hopkins, the prestigious research university in Baltimore, MD., received regulatory approval to resume psychedelics research and in 2006 released a milestone study on the “positive effects” of psilocybin-induced “mystical experiences.”
Since then, there has been a groundswell of support for psychedelic research, and governments, including Canada, have taken notice.
The U.S. in 2017 granted “breakthrough” status to MDMA and to psilocybin in 2019 – putting them on a quicker path towards potential regulatory approval.
And last year, Health Canada began allowing doctors to request permission to use psychedelics for research and to treat some patients who haven’t responded well to other treatments. That same year, Alberta also became the first province to regulate psychedelics for therapy.
Certain pharmaceutical companies, like Filament Health in B.C., which is providing the psilocybin for Petranker and his team, have also obtained licenses from Health Canada to produce psychedelics under strict guidelines.
“The evidence that is already out there for some of these psychedelic substances is kind of earth-shattering, I think, in the field of psychiatry,” says Ryan Moss, chief science officer at Filament Health, explaining why his company is focused on psychedelics.
Moss says the company grows more than 70 different strains of psilocybin-containing mushrooms but makes its capsules of a single strain they’ve grown to meet specific parameters.
Their focus is on naturally derived psilocybin rather than synthetic, because of the suite of tryptamine compounds the mushrooms naturally produce that are believed to play a key role in the potentially beneficial effects on the brain.
What are some of the remaining challenges?
As researchers take a new interest in psychedelics, however, it will be important to learn from those who have experience with these drugs.
Unfortunately, whatever lessons we could learn from past historical research will not be easy to uncover.
First, the language around disorders has changed. Take, as an example, PTSD, a term that emerged only after the Vietnam War and wasn’t immediately recognized in Canada.
Research methods have also changed.
“We have hundreds of paper files with patients describing their experiences. They’re not digitized, they’re not standardized, they’re not made into statistics,” Dyck explains.
“And they don’t match the same kinds of methodologies we have today. So, we don’t have randomized controlled data. We have case reports in most instances. And so, it’s really hard to compare these things across the board when you’re trying to urgently make a case for psychedelics in this new 21st century.”
A lack of government funding is also holding back research on psilocybin and other psychedelic drugs.
Petranker himself has had some cash flow problems and is raising money through GoFundMe. He says he’d like to see much more government funding for clinical trials.
“The vast majority of psychedelic studies are funded by private companies. These companies have a vested interest in showing that it works, and I think that is to the detriment of the quality of science produced,” he says.
The University of Toronto study is in its early stages and a lot of work will need to be done before results can be published. But the next step, Petranker says, depending on the results of the study, will be to replicate its findings.
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