When you read the
heart-wrenching stories of how people with epilepsy, migraines, and other
debilitating illnesses receive comfort and relief from cannabis, you wonder how
our governor, our legislature and our church can be against it.
Medical marijuana
DJ Schanz, director of the Utah Patients Coalition, estimated that his
group gathered nearly 200,000 signatures to put legalizing medical marijuana on
the ballot.
Support found by signature gatherers “parallels the support shown in
the polls: about 75 percent support us, and 25 percent do not.”
Since then, the Utah Medical Association opposed the initiative and The
Church of Jesus Christ of Latter-day Saints praised the UMA’s stance without
quite directly opposing the initiative itself. Herbert also has come out
against the initiative.
Schanz said in response Monday that the UMA “doesn’t represent the
majority of Utah doctors much less the LDS Church” members, and added “we are
moving full steam ahead.”
The Legislature sought to offer a compromise to stop the initiative. It
passed laws allowing terminally ill patients to try medical marijuana and for
the state to arrange growing it for them. Supporters said that is far too
little to satisfy them, and leaves out many people whose pain and suffering
could be eased by using cannabis.
A panel started writing the rules for a new medical marijuana law by
listening to suggestions from people like Mark Newman, who travels to Nevada
every few months and spends up to $1,000 to buy marijuana that he uses to treat
his migraines.
“I was sick and tired of taking opioids,” Newman said Thursday. “You
just keep taking them and taking them and taking them. Then all the sudden you
forget how many you’ve taken.”
Where’s our empathy?
Then I listened to a podcast
with Doug Fabrizio and Michael Pollan, author, journalist, professor (incidently,
his sister, Tracy, is married to Michael J. Fox). He’s also a gardener and writes
about the benefits of living close to the soil—human engagement with the
natural world. About three years ago, he
got interested in psychedelic drugs to relieve depression, fear, and anxiety in
terminal cancer patients. It’s still
about plants. Psilocybin comes from mushrooms. Controlled tests show that patients
were happier, more content, less depressed and fearful of death after participating
in the study. It gives me immense comfort. So much better than being drugged to death as
you approach death.
The
Trip Treatment
Research
into psychedelics, shut down for decades, is now yielding exciting results.
By Michael Pollan (Excerpts from an article in The New Yorker, February 9, 2015.)
Psilocybin may be useful in treating anxiety, addiction, and
depression, and in studying the neurobiology of mystical experience.
Illustration by Stephen Doyle
On an April Monday in 2010, Patrick Mettes, a fifty-four-year-old
television news director being treated for a cancer of the bile ducts, read an
article on the front page of the Times that would change his death.
His diagnosis had come three years earlier, shortly after his wife, Lisa,
noticed that the whites of his eyes had turned yellow. By 2010, the cancer had
spread to Patrick’s lungs and he was buckling under the weight of a
debilitating chemotherapy regimen and the growing fear that he might not survive.
The article, headlined “hallucinogens have doctors tuning in again,” mentioned
clinical trials at several universities, including N.Y.U., in which
psilocybin—the active ingredient in so-called magic mushrooms—was being
administered to cancer patients in an effort to relieve their anxiety and
“existential distress.” One of the researchers was quoted as saying that, under
the influence of the hallucinogen, “individuals transcend their primary
identification with their bodies and experience ego-free states . . .
and return with a new perspective and profound acceptance.” Patrick had never
taken a psychedelic drug, but he immediately wanted to volunteer. Lisa was
against the idea. “I didn’t want there to be an easy way out,” she recently
told me. “I wanted him to fight.”
Patrick made the call anyway and, after filling out some forms and
answering a long list of questions, was accepted into the trial. Since
hallucinogens can sometimes bring to the surface latent psychological problems,
researchers try to weed out volunteers at high risk by asking questions about
drug use and whether there is a family history of schizophrenia or bipolar
disorder. After the screening, Mettes was assigned to a therapist named Anthony
Bossis, a bearded, bearish psychologist in his mid-fifties, with a specialty in
palliative care.
After four meetings with Bossis, Mettes was scheduled for two
dosings—one of them an “active” placebo (in this case, a high dose of niacin,
which can produce a tingling sensation), and the other a pill containing the
psilocybin. Both sessions, Mettes was told, would take place in a room
decorated to look more like a living room than like a medical office, with a
comfortable couch, landscape paintings on the wall, and, on the shelves, books
of art and mythology, along with various aboriginal and spiritual tchotchkes,
including a Buddha and a glazed ceramic mushroom. During each session, which
would last the better part of a day, Mettes would lie on the couch wearing an
eye mask and listening through headphones to a carefully curated playlist—Brian
Eno, Philip Glass, Pat Metheny, Ravi Shankar. Bossis and a second therapist
would be there throughout, saying little but being available to help should he
run into any trouble.
The effects of psilocybin resemble those of LSD, but, as one researcher
explained, “it carries none of the political and cultural baggage of those
three letters.” LSD is also stronger and longer-lasting in its effects, and is
considered more likely to produce adverse reactions. Researchers are using or
planning to use psilocybin not only to treat anxiety, addiction (to smoking and
alcohol), and depression but also to study the neurobiology of mystical experience,
which the drug, at high doses, can reliably occasion.
As I chatted with Tony Bossis and Stephen Ross in the treatment room at
N.Y.U., their excitement about the results was evident. According to Ross,
cancer patients receiving just a single dose of psilocybin experienced
immediate and dramatic reductions in anxiety and depression, improvements that
were sustained for at least six months.
“I thought the first ten or
twenty people were plants—that they must be faking it,” Ross told me. “They
were saying things like ‘I understand love is the most powerful force on the
planet,’ or ‘I had an encounter with my cancer, this black cloud of smoke.’
People who had been palpably scared of death—they lost their fear. The fact
that a drug given once can have such an effect for so long is an unprecedented
finding. We have never had anything like it in the psychiatric field.”
Many researchers I spoke with described their findings with excitement,
some using words like “mind-blowing.” Bossis said, “People don’t realize how
few tools we have in psychiatry to address existential distress. Xanax isn’t
the answer. So how can we not explore this, if it can recalibrate how we die?”
The idea of giving a psychedelic drug to the dying was conceived by a
novelist: Aldous Huxley. In 1953, Humphry Osmond, an English psychiatrist,
introduced Huxley to mescaline, an experience he chronicled in “The Doors of
Perception,” in 1954. (Osmond coined the word “psychedelic,” which means
“mind-manifesting,” in a 1957 letter to Huxley.) Huxley proposed a research
project involving the “administration of LSD to terminal cancer cases, in the
hope that it would make dying a more spiritual, less strictly physiological
process.” Huxley had his wife inject him with the drug on his deathbed; he died
at sixty-nine, of laryngeal cancer, on November 22, 1963.
The recreational use of psychedelics is famously associated with
instances of psychosis, flashback, and suicide. But these adverse effects have
not surfaced in the trials of drugs at N.Y.U. and Johns Hopkins. After nearly
five hundred administrations of psilocybin, the researchers have reported no
serious negative effects. This is perhaps less surprising than it sounds, since
volunteers are self-selected, carefully screened and prepared for the
experience, and are then guided through it by therapists well trained to manage
the episodes of fear and anxiety that many volunteers do report.
Apart from the molecules involved, a psychedelic therapy session and a
recreational psychedelic experience have very little in common.
“Ineffability” is a hallmark of
the mystical experience. Many struggle to describe the bizarre events going on
in their minds during a guided psychedelic journey without sounding like either
a New Age guru or a lunatic. The available vocabulary isn’t always up to the
task of recounting an experience that seemingly can take someone out of body,
across vast stretches of time and space, and include face-to-face encounters
with divinities and demons and previews of their own death.
Volunteers in the N.Y.U. psilocybin trial were required to write a
narrative of their experience soon after the treatment, and Patrick Mettes, having
worked in journalism, took the assignment seriously. His wife, Lisa, said that,
after his Friday session, he worked all weekend to make sense of the experience
and write it down.
When Mettes arrived at the treatment room, at First Avenue and Twenty-fifth
Street, Tony Bossis and Krystallia Kalliontzi, his guides, greeted him,
reviewed the day’s plan, and, at 9 a.m., presented him with a small
chalice containing the pill. None of them knew whether it contained psilocybin
or the placebo. Asked to state his intention, Mettes said that he wanted to
learn to cope better with the anxiety and the fear that he felt about his
cancer. As the researchers had suggested, he’d brought a few photographs
along—of Lisa and him on their wedding day, and of their dog, Arlo—and placed
them around the room.
At nine-thirty, Mettes lay down on the couch, put on the headphones and
eye mask, and fell silent. In his account, he likened the start of the journey
to the launch of a space shuttle, “a physically violent and rather clunky
liftoff which eventually gave way to the blissful serenity of weightlessness.”
The “same force that takes you deep within will, of its own impetus,
return you safely to the everyday world,” the manual offers at one point.
Guides are instructed to remind subjects that they’ll never be left alone and
not to worry about their bodies while journeying, since the guides will keep an
eye on them. If you feel like you’re “dying, melting, dissolving, exploding,
going crazy etc.—go ahead,” embrace it: “Climb staircases, open doors, explore
paths, fly over landscapes.” And if you confront anything frightening, “look
the monster in the eye and move towards it. . . . Dig in your
heels; ask, ‘What are you doing in my mind?’ Or, ‘What can I learn from you?’
Look for the darkest corner in the basement, and shine your light there.” This
training may help explain why the darker experiences that sometimes accompany
the recreational use of psychedelics have not surfaced in the N.Y.U. and
Hopkins trials.
Early on, Mettes encountered his brother’s wife, Ruth, who died of
cancer more than twenty years earlier, at forty-three. Ruth “acted as my tour
guide,” he wrote, and “didn’t seem surprised to see me. She ‘wore’ her
translucent body so I would know her.” Michelle Obama made an appearance. “The
considerable feminine energy all around me made clear the idea that a mother,
any mother, regardless of her shortcomings . . . could
never not love her offspring. This was very powerful. I know I was
crying.” He felt as if he were coming out of the womb, “being birthed again.”
Bossis noted that Mettes was crying and breathing heavily. Mettes said,
“Birth and death is a lot of work,” and appeared to be convulsing. Then he
reached out and clutched Kalliontzi’s hand while pulling his knees up and
pushing, as if he were delivering a baby.
“Oh God,” he said, “it all makes sense now, so simple and beautiful.”
Around noon, Mettes asked to take a break. “It was getting too
intense,” he wrote. They helped him to the bathroom. “Even the germs were
beautiful, as was everything in our world and universe.” Afterward, he was
reluctant to “go back in.” He wrote, “The work was considerable but I
loved the sense of adventure.” He put on his eye mask and headphones and lay
back down.
“From here on, love was the only consideration. It was and is the only
purpose. Love seemed to emanate from a single point of light. And it vibrated.”
He wrote that “no sensation, no image of beauty, nothing during my time on
earth has felt as pure and joyful and glorious as the height of this journey.”
Then, at twelve-ten, he said something that Bossis jotted down: “O.K.,
we can all punch out now. I get it.”
He went on to take a tour of his lungs, where he “saw two spots.” They
were “no big deal.” Mettes recalled, “I was being told (without words) not to
worry about the cancer . . . it’s minor in the scheme of
things . . . simply an imperfection of your humanity.”
Then he experienced what he called “a brief death.”
“I approached what appeared to be a very sharp, pointed piece of
stainless steel. It had a razor blade quality to it. I continued up to the apex
of this shiny metal object and as I arrived, I had a choice, to look or not
look, over the edge and into the infinite abyss.” He stared into “the vastness
of the universe,” hesitant but not frightened. “I wanted to go all in but felt
that if I did, I would possibly leave my body permanently,” he wrote. But he
“knew there was much more for me here.” Telling his guides about his choice, he
explained that he was “not ready to jump off and leave Lisa.”
Around 3 p.m., it was over. “The transition from a state where I
had no sense of time or space to the relative dullness of now, happened
quickly. I had a headache.”
When Lisa arrived to take him home, Patrick “looked like he had run a
race,” she recalled. “The color in his face was not good, he looked tired and
sweaty, but he was fired up.” He told her he had touched the face of God.
Every guided psychedelic journey is different, but a few themes seem to
recur. Several of the cancer patients I interviewed at N.Y.U. and Hopkins
described an experience of either giving birth or being born. Many also
described an encounter with their cancer that had the effect of diminishing its
power over them. Dinah Bazer, a shy woman in her sixties who had been given a
diagnosis of ovarian cancer in 2010, screamed at the black mass of fear she
encountered while peering into her rib cage: “Fuck you, I won’t be eaten
alive!” Since her session, she says, she has stopped worrying about a
recurrence—one of the objectives of the trial.
Great secrets of the universe often become clear during the journey,
such as “We are all one” or “Love is all that matters.” The usual ratio of
wonder to banality in the adult mind is overturned, and such ideas acquire the
force of revealed truth. The result is a kind of conversion experience, and the
researchers believe that this is what is responsible for the therapeutic
effect.
I was struck by how the descriptions of psychedelic journeys differed
from the typical accounts of dreams. For one thing, most people’s recall of
their journey is not just vivid but comprehensive, the narratives they
reconstruct seamless and fully accessible, even years later. They don’t regard
these narratives as “just a dream,” the evanescent products of fantasy or wish
fulfillment, but, rather, as genuine and sturdy experiences. This is the
“noetic” quality that students of mysticism often describe: the unmistakable
sense that whatever has been learned or witnessed has the authority and the
durability of objective truth. “You don’t get that on other drugs,” as Roland
Griffiths points out; after the fact, we’re fully aware of, and often
embarrassed by, the inauthenticity of the drug experience.
This might help explain why so many cancer patients in the trials
reported that their fear of death had lifted or at least abated: they had
stared directly at death and come to know something about it, in a kind of
dress rehearsal. “A high-dose psychedelic experience is death practice,”
Katherine MacLean, the former Hopkins psychologist, said. “You’re losing
everything you know to be real, letting go of your ego and your body, and that
process can feel like dying.” And yet you don’t die; in fact, some volunteers
become convinced by the experience that consciousness may somehow survive the
death of their bodies.
In follow-up discussions with Bossis, Patrick Mettes spoke of his body
and his cancer as a “type of illusion” and how there might be “something beyond
this physical body.” It also became clear that, psychologically, at least,
Mettes was doing remarkably well: he was meditating regularly, felt he had
become better able to live in the present, and described loving his wife “even
more.” In a session in March, two months after his journey, Bossis noted that
Mettes “reports feeling the happiest in his life.”
“We still had our arguments,” Lisa recalled. “And we had a very trying
summer,” as they endured a calamitous apartment renovation. But Patrick “had a
sense of patience he had never had before, and with me he had real joy about
things,” she said. “It was as if he had been relieved of the duty of caring
about the details of life. Now it was about being with people, enjoying his
sandwich and the walk on the promenade. It was as if we lived a lifetime in a
year.”
Mettes’s equanimity exerted a powerful influence on everyone around
him, Lisa said, and his room in the palliative-care unit at Mt. Sinai became a
center of gravity. “Everyone, the nurses and the doctors, wanted to hang out in
our room—they just didn’t want to leave. Patrick would talk and talk. He put
out so much love.” When Tony Bossis visited Mettes the week before he died, he
was struck by Mettes’s serenity. “He was consoling me. He said his biggest
sadness was leaving his wife. But he was not afraid.”
“We are all terminal,” Griffiths
said. “We’re all dealing with death. This will be far too valuable to limit to
sick people.” ♦
