Policy in focus: Is psilocybin the next cannabis?

Research interest in the therapeutic use of psilocybin, or “magic mushrooms,” is growing alongside a “wild west” of dispensaries in Canada and the United States.

The past decade has seen a revival of research exploring the clinical use of psychedelics in treating depression, addiction, eating disorders and other psychiatric conditions. Studies have shown potentially positive benefits with minimal safety concerns, but have often had major limitations, in part because of difficulties securing funding and regulatory approvals.

Now, the field appears to be gaining a measure of legitimacy.

The National Institute of Health in the United States recently awarded its first federal grant for psychedelic treatment in more than 50 years to Johns Hopkins University School of Medicine.

Researchers at Johns Hopkins, along with scientists at New York University and the University of Alabama at Birmingham, received more than $4 million to study the use of psilocybin and psychotherapy to help people quit smoking.

In a pilot study, 9 of 15 people who had previously failed to quit smoking and then received psilocybin-assisted therapy were able to quit and maintain that change over 2.5 years. According to lead author Matthew Johnson, the “deeply introspective experiences” associated with psilocybin appear to increase mental flexibility and openness to change, as well as reduce irritability and cravings in people quitting smoking.

In Canada, Toronto’s University Health Network (UHN) recently announced it would establish a psychedelic psychotherapy research centre with $5 million in backing from tech entrepreneur and venture capitalist Sanjay Singhal. According to Dr. Susan Abbey, psychiatrist-in-chief at UHN, psychedelics hold promise for difficult-to-treat disorders like posttraumatic stress disorder and end-of-life distress. “Every major academic centre in mental health in the world is trying to begin to conduct research in psychedelics, particularly psychedelic-assisted psychotherapy,” she told CTV News.

In Western Canada, the University of Calgary is conducting an international search for Canada’s first psychedelic research chair after establishing the position last summer.

Dr. Valerie Taylor, a psychiatrist and clinician-researcher at the University of Calgary, told The Globe and Mail that improving the quality of research on psychedelics is the next step to win over regulators. So far, most studies have been small and “haven’t been particularly designed to properly carry weight with the regulatory bodies,” she said. “We’re hoping to take it to the next level.”

Last year, Oregon became the first U.S. state to legalize the use of psilocybin under medical supervision to treat mental disorders. The U.S. Food and Drug Administration has also designated psilocybin and MDMA as “breakthrough” therapies for depression and posttraumatic stress disorder, respectively — an indicator that the agency is open to approving formulations of the drugs proven to be safe and effective.

Although psilocybin remains illegal in Canada, the federal government has started to grant legal exemptions, mostly to people with terminal illness and treatment-resistant depression.

Meanwhile, businesses and advocates for legalization appear to be cribbing from the cannabis playbook in their effort to expand access to psilocybin.

Companies like Schroom Room and Canada Mushrooms are openly marketing psilocybin products online, while brick-and-mortar dispensaries are selling it over the counter in major cities like Vancouver.

Although authorities appear to be ignoring these operations, some dispensary owners say they want to attract legal action to force the question of decriminalization before the courts.

Dana Larsen, who owns the Coca Leaf Care & Mushroom Dispensary in Vancouver, predicts the number of retail outlets selling psilocybin will mushroom in the next few years — just as cannabis dispensaries did prior to legalization.

Other companies, such as Field Trip Health, are setting up private clinics offering psychedelic-assisted therapy with approved drugs like ketamine.

And manufacturers are racing to get their own formulations of psilocybin ready for market in anticipation of therapeutic approvals. Compass Pathways recently secured the first patent for a synthetic form of psilocybin that isn’t specifically intended for use in clinical trials.

One analysis by Data Bridge Market Research estimates the potential market for psychedelics will balloon to $7 billion by 2027.