Psychiatrist to lead state-mandated psilocybin trial

UW Medicine will facilitate a small-scale study to explore the potential benefit of psychedelic mushrooms with psychotherapy.

In early May, Washington Gov. Jay Inslee signed Senate Bill 5263 governing recreational and medical use of psilocybin. The new law mandates that the University of Washington School of Medicine facilitate a study to explore the potential therapeutic value of the psychedelic compound found in mushrooms.

“The big benchmark in the bill says that we need to start (treating) people Jan. 1, 2025. We have about a year and a half to get all the infrastructure developed,” said addiction psychiatrist Dr. Nathan Sackett, who will oversee the trial. He’s an acting assistant professor of psychiatry and behavioral sciences.

Little is known about how psilocybin affects mental health. Early studies have shown positive results, and clinical trials underway in the United States and abroad are intended to explore more deeply how psilocybin, in concert with psychotherapy, might help people with depression, anxiety and other difficult-to-treat maladies.

Sackett said the Seattle-based trial will include 30 to 40 military veterans and first-responders who have documented problems with post-traumatic stress and alcohol use disorders, which are often linked. Participants will likely be recruited through community groups who already work with prospective participants.

“Our hope is that in targeting this specific population with these two co-morbidities we could better understand if this could be a viable treatment moving forward,” said Sackett, who co-directs the Center for Novel Therapeutics in Addiction Psychiatry.

Once the province of hippies in pop culture, the active compound in “magic mushrooms” has become a prospect of therapeutic research over the last decade. More study is needed because scientists still don’t know psilocybin’s mechanisms enough to predict its effects. 

Sackett said the trial will be conducted in a controlled environment, with psychotherapy sessions before and after. Participants will undergo their psychedelic experiences with two therapists present. The trial group will be split in two, with half receiving a placebo in the first round. The participants who initially receive a placebo will then be given a chance to undergo the test treatment, as well. 

This is one of many medical trials exploring the use of psilocybin. Along with depression, anxiety and substance use disorders, “There's a dizzying number of new indications being explored,” Sackett said. “A lot of these disorders are very challenging to treat.  We have very limited options for our patients and it's very frustrating. These are life-debilitating disorders. I think at this stage, my general attitude is (that) we are desperate for new solutions.”

Before use of psilocybin is allowed widely, though, we have to better understand how it works in mental health treatments. Sackett hypothesizes that the compound essentially allows us to get out of our own heads for a bit.

“For a lot of people, we have a story in our mind that kind of loops around, that’s informed from our childhood and our history and our experiences,” he said. “That story is often reinforced kind of day in and day out. And if your story is that you're depressed or that you have trauma or that you need to use alcohol or substances, it gets very difficult to step out of that story.

“My hypothesis is that, in using these compounds in a therapeutic setting, you are allowed to step outside of that narrative for a certain time period and question the validity of that story.” 

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-- Written by Chris Talbott,, (206) 543-7129

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