In the fall of 2021, John Bigley was sitting on the floor of an apartment in downtown Denver. He held a cup of psilocybin mushroom tea, trying to calm his nerves.
For more than 30 years, he’d kept the sexual abuse he experienced as a child a secret, buried in the back of his mind where the abusers couldn’t hurt him. That’s also where he relegated the grief about his father, who died when Bigley was just 13.
He’d kicked an alcohol addiction and tried counseling, but nothing restored his sense of self. In an effort to save himself and his marriage, Bigley hired a life coach to help him prepare for a different kind of treatment.
“I want to find the freedom to feel again,” Bigley, 42, recalled saying in that apartment as he sat in a circle with about 10 other people, plus four sober facilitators assigned to offer support. They discussed their hopes for the impending journey.
Then, Bigley and the others drank the tea dosed with three grams of dried mushrooms containing the psychoactive compound psilocybin. He put on an eye mask and a pair of headphones, laid down on his yoga mat, and waited for the trip to begin.
Bigley is among a growing number of Americans turning to psychedelic-assisted therapy as an unconventional or last-ditch treatment for their mental health. For decades, they had to travel underground or abroad to find these substances and services. But psychedelic-assisted therapy soon will be accessible to anyone who is age 21 or older in Colorado after voters approved a measure in 2022 legalizing the practice and certain drugs, including psilocybin.
Small-scale clinical trials conducted by Johns Hopkins University, the University of California San Francisco and others have shown promising results for psilocybin’s ability to treat severe depression, existential distress, nicotine and alcohol addiction, among other ailments.
Now, regulators in Colorado and Oregon are preparing to take the lead in the burgeoning industry as they formalize best practices for the medicinal use of psychedelics — and pave the way for other states to follow suit. Local leaders are developing laws to govern legal, licensed healing centers, expected to open in 2025.
The U.S. Food and Drug Administration also recently weighed in for the first time this summer, offering guidance for clinical trials involving psychedelic substances.
While Colorado’s new law also decriminalized several psychedelics statewide, experts are quick to note that the medical model of treatment is not a recreational affair or a legal avenue for individuals to get high.
“We think the mind-altering effects of all these different types of psychedelics may actually facilitate the therapeutic process,” said Dr. Albert Garcia-Romeu, a researcher and assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine, which is a leader in this field.
“People who have real, intractable, difficult-to-treat conditions — like treatment-resistant major depression — these are people who have tried multiple types of treatments, talk therapies and medications (without) finding any relief, and then are getting some sort of improvement, in many cases, after the dosing.”
Research into psychedelics is still young; however, as far back as the 1950s and 1960s, researchers explored their potential to treat ailments such as substance use disorder. Much of that enthusiasm was quashed by the Controlled Substances Act of 1970, but studies and trials have since rebounded — leading many researchers to proclaim the arrival of a “psychedelic renaissance.”
The University of Colorado Anschutz Medical Campus now is preparing a clinical trial to evaluate psilocybin’s efficacy for treating depression that’s otherwise been treatment-resistant. It’s set to begin in Aurora this fall.
Despite the tight controls on psilocybin mushrooms and other psychoactive substances, psychedelic therapies have gone on in the shadows for years and are now adding to the medical knowledge being collected in the field.
The research conducted today also builds upon centuries of expertise within indigenous communities that have used psychedelics for religious and spiritual purposes, as well as the experiences of recreational users, Garcia-Ramoeu said.
“I agree there’s medical use for these substances,” he said, “but they’ve also been used for religion and recreation for so long, they’re equally as valid and have knowledge we can learn from because Western medicine is so far behind in studying (them).”
Experts and those who have participated in psychedelic-assisted therapy warn that the drugs themselves are not a panacea, but rather a tool to help address mental illness.
Psychedelic experiences also can be deeply influenced by set and setting, meaning the mindset or intention users have going into administration sessions and the environment in which they do so.
Psilocybin is not a fit for everyone, experts told The Denver Post. There are still risks associated with its use, such as elevated blood pressure and heart rate as well as challenging emotional experiences. Clinical trials typically exclude individuals with a family history of schizophrenia or bipolar disorder out of concern for the risk of inducing psychosis.
The voter-approved Natural Medicine Health Act legalized psilocybin and psilocin in therapeutic settings while also decriminalizing personal possession, use, growing and sharing of the substance. However, psilocybin still is considered a Schedule I substance, meaning federal regulators maintain it has no currently accepted medical use and a high potential for abuse.
But in the medical community, Garcia-Romeu said, the compound is considered physiologically non-toxic — meaning it’s difficult if not impossible to fatally overdose — and non-addictive.
As Colorado navigates the largely uncharted waters of legalized access, residents who sought out psychedelic-assisted treatment for their mental health say the experiences impacted their lives positively.
Physical relief from agony of headaches
For 40 years, Joe Stone has suffered the stabbing agony of “suicide headaches.”
The cluster headaches strike in cycles that act as monthslong bombardments. With minimal warning, it feels like the jab of a hot poker into his eye, over and over again. The attack subsides, sometimes after hours — only to erupt again, up to eight or nine times a day.
An hour of agony here. Several hours of torture there. For months.
Night can be particularly brutal, Stone said. The pain shatters his sleep, leaving him lying in agony. Only the sheer physical exhaustion of hours of wracking pain allows him to catch a few winks.
At 50 years old, Stone was ready to try anything. Lithium, high-strength painkillers, steroids and even anti-anxiety medicine already had failed him. Doctors had begun “just throwing darts” to try to ease the problem, he said, to marginal-at-best results.
Stone had heard about psilocybin therapy for cluster headaches but was wary. It sounded like snake oil.
But after a particularly brutal bout in 2019, “I was just destroyed,” Stone said. With his wife’s blessing, he took what he described as a sub-psychedelic dose.
He didn’t hallucinate, he said, and he stopped short of calling the sensation euphoric. Instead, he felt a blessed reprieve from the physical pain, along with a peace of mind around his condition.
Far from snake oil, Stone found relief — even if he’s not quite ready to call it a miracle.
“It’s not a super drug,” Stone said. “It’s not a cure. But it’s the most effective drug I’ve tried in 40 years.”
Cluster headaches were specifically referenced by Colorado’s Natural Medicine Health Act as an ailment that may benefit from psychedelic therapy. Some early research, led by Yale psychiatrists and neurologists, has shown promise and pointed to the need for more research.
Stone describes himself as “a normal suburban dad,” raising four kids in Westminster. He works an IT job from home. He didn’t expect a substance known for psychedelia to become part of his routine.
Since that fateful 2019 experiment, Stone has continued to use sub-psychedelic doses of psilocybin, which he defines as a gram to 1.5 grams of mushrooms, usually ground into capsules or steeped in tea. It has broken several cycles of headaches completely and has served as a peerless balm even when the headaches don’t break.
He takes a preventative dose every couple of months and finds the frequency and severity of the headaches lessened. For him, the psilocybin brings both physical and mental relief.
“Are we getting relief from this pain because of physiology? … Or is it the experience?” Stone wondered. “Or is it a combination of the two things?”
Coming to terms with cancer
In November 2019, Erin Carpenter woke from surgery to a shattered world.
She’d gone in for emergency surgery to treat ovarian torsion, a serious condition affecting the reproductive system. Instead of receiving bright news of a cured ailment, the 34-year-old mother with two young daughters at home learned that doctors discovered she actually had a rare form of cancer: Stage 3 soft-tissue sarcoma.
Amid her shock, her sadness and her anger, Carpenter was told to get her affairs in order. She scrambled to treat her physical health while the diagnosis gnawed at her emotions.
Carpenter knew about psychedelic therapy through her work as a therapist and licensed clinical social worker, though it was never in her area of expertise. With anxieties about her mortality and her family hanging heavily — and with her own therapist’s blessing — Carpenter sought out a guide to try the recently decriminalized treatment.
She took a high dose of psilocybin mushrooms, donned eyeshades and headphones, and laid down, with her guide there as a layer of safety and comfort. Carpenter described the session as “diving inward, instead of focusing on the outside.” She hesitated to use a cliché but said it was “like years of therapy in one day.”
The experience didn’t cure her or take away her fear of death. But it helped her come to terms with her new future, she said. She continued to work with her therapist, and the psychedelics helped her to unpack her feelings in that setting.
“The experience helped me process a lot of grief and a lot of emotion that I had been hanging onto — but hadn’t been able to dive into because I had been in survival mode,” Carpenter said. She’d been “focusing on my physical body and recovery from surgeries and beginning my treatments.”
Because of her background and profession, Carpenter found herself in a position to advocate for a kind of treatment that she saw as having profound potential — and she now had the personal experience to bolster it.
So the therapist, who specializes in sexual trauma, started researching and training for psychedelic therapy. About a year ago, she began working with psychiatric nurses, who are able to prescribe medications, to provide ketamine-assisted therapy.
Unlike psilocybin, ketamine already was a legal and approved option for psychedelic therapy. One Yale psychiatrist has called it “a game changer,” particularly for depression that is resistant to traditional treatments.
Ketamine’s effects are different than psilocybin, Carpenter said, but it still helps patients to break down emotional walls. She described it as helping people to step outside themselves, while psilocybin induces more of an internal experience. Ketamine, like psilocybin, is not for every patient, she said, but she’s seen promising results in those who undergo the treatment.
Psychedelic treatment in general is “really exciting professionally,” Carpenter said, especially as the state and country grapple with ongoing mental health crises.
“The field of mental health treatment has honestly not gotten much better in the past 30, 40, 50 years,” Carpenter said. “There haven’t been many breakthrough medications or types of talk therapies that have really moved the needle.”
She hopes to add psilocybin-assisted therapy to her practice as it becomes regulated.
Carpenter is looking ahead these days. Her cancer has receded, and recent scans are clean. As she goes in for regular checkups at the UCHealth Anschutz Cancer Pavilion, she hopes to one day see a psychedelic therapy office abutting it.
A 2016 study on psilocybin’s effects on cancer patients found that about 80% of participants in a double-blind trial showed “clinically significant decreases in depressed mood and anxiety.” The finding reflects Carpenter’s experience.
“I was just in really, really dire, desperate straits,” Carpenter said. “And now I’m convinced that (psychedelic therapy) can be a powerful tool for mental health and wellbeing and a powerful alternative. I want the message to get out there.”
Addressing past trauma
In that downtown Denver apartment nearly two years ago, John Bigley began to feel “fuzzy” about 30 minutes after he drank the mushroom tea.
The beat of the drums coming through his headphones intensified, as shades of green and red swirled behind his eyelids. Bigley didn’t hallucinate so much as travel through different feelings — from joy to fear, with bouts of laughter and tears in between.
At one point, when Bigley said he felt scared, one of the sober facilitators encouraged him to face those fears head-on to learn from them. Ultimately, Bigley said he found empathy for his abusers, who had been abused themselves.
Echoing Carpenter, he said it felt like undergoing “10 years of therapy” all at once. During the six-hour trip, he was able to speak his abuser’s name and forgive them. He reflected on times when he contemplated suicide and realized he had more to give the world, his wife and his daughters.
As the group session ended, Bigley remembered everyone circling up again to share their takeaways.
He couldn’t stop crying.
“It wasn’t sadness,” Bigley said. “This was honestly the first time I had tears as an adult male that felt real and felt safe and felt legit.”
Though Bigley found psilocybin helpful in processing his traumatic memories, its efficacy in treating post-traumatic stress disorder (PTSD) has not been formally studied in clinical trials, said Garcia-Romeu, the Johns Hopkins psychiatry professor. That’s largely because of multi-decade work done by the Multidisciplinary Association for Psychedelic Studies to study the use of MDMA, also known as ecstasy, to treat PTSD. He said trials using psilocybin to treat PTSD are in the works.
The substance has shown anti-depressant effects both immediately and long-term in a number of other trials, and Garcia-Romeu said that suggests it could be effective for people experiencing PTSD symptoms.
“There’s a huge amount of literature on studying psilocybin and other psychedelics in healthy people — so people who don’t have any diagnosis. And those people show enhancements in their well-being and spirituality,” he said. “If those people feel they’re having well-being enhancements, then it’s likely other people could have that, even without a clinical diagnosis.”
For Bigley, the experience with psilocybin proved so transformative that he began growing his own mushrooms. He continued his self-exploration through the use of other substances, including ayahuasca.
He plans to establish a licensed growing facility and open a retreat center when Colorado’s industry gets off the ground so that other people can access the healing he found through psychedelics.
“I realize they’re not for everybody. I realize the stigma from the ’60s that people have on psychedelics,” Bigley said. “But I also realize that if people are willing to let down their guard and dive in and explore themselves on the deepest levels, there’s so much healing that can come from it. That’s why I want to explore Colorado’s legal avenues.”
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