Denver just decriminalized them, but experts say more research is needed.
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“Magic mushrooms,” or mushrooms with psilocybin, were widely studied before they were banned in 1970. Getty Images

This week Denver became the first city in the nation to effectively decriminalize psychedelics known as “magic mushrooms.”

The Colorado metropolis hasn’t technically legalized magic mushrooms. Instead, they’re classified as the “lowest law-enforcement priority.” But the change has helped draw attention to the new research being done on psychedelic medication in general.

More and more researchers are finding evidence that the active ingredient in magic mushrooms, called psilocybin, may have health benefits for a variety of mental health conditions.

In fact, psilocybin was actually widely studied in the 1960s and used in certain therapies before being labeled as a Schedule I illicit drug by the Drug Enforcement Administration (DEA) in 1970.

We talked with one researcher who has been studying how going on a “magical mushroom trip” may someday help your mental health.

Matthew Johnson, PhD, an associate professor of psychiatry and behavioral studies at Johns Hopkins University in Maryland, has been studying psilocybin’s effects for years.

While Johnson is clear that he doesn’t recommend people start self-medicating with psilocybin-containing mushrooms and says more research is needed, he explains how the drug has potential benefits for a variety of people.

Healthline: Do you have any thoughts on Denver decriminalizing the substance?

Johnson: If you look at the exact wording, it says that psilocybin mushroom use will be the lowest law enforcement priority. So, this is one form of so-called decriminalizing. And it’s certainly not legalization.

I would discourage people from using outside of an approved medical framework, like in our clinical research, which is legal.

However, the public health science is clear that criminalization as a way to minimize the real problems associated with drug use has some horrific downsides. Particularly with psychedelics, which typically involves felony convictions.

I want to be very clear to people that there are risks, like with any powerful tool. There are definitely risks with psilocybin.

Healthline: Got it. Can you talk a bit about some of the biggest misconceptions about the drug?

Johnson: The biggest misconception is that it’s an addictive drug. The classic psychedelics like psilocybin are really a different creature, compared to virtually all the other classes of abused drugs. So, it can be abused, which is to say it can be used in a way that’s dangerous to the individual or the people around them.  

But we do know that it’s not a drug of addiction. And we know that so solidly by the way it works and the rewards center, the effects of dopamine that you see with typical… with addictive drugs.

Those just don’t happen. It doesn’t have the reliable euphoria and associated dopamine response that you see with most of the other drugs of abuse, which are addictive.

Someone can use it dangerously, but no one’s jonesing for their next fix.

Healthline: Can you talk about some of your research, like trying to help people quit smoking, and some of the highlights from that? What have you seen?

Johnson: With quitting smoking [research]… we saw a very large success rate in 15 participants. So, it was small, but we saw an 80 percent biologically confirmed success rate. People were no longer smoking six months down the road. At six months and then, that rate held up at 67 percent at one year after their quit date.

And then we did a very long-term follow-up, which was an average of two and a half years. And we found that 60 percent of the people were still biologically confirmed as smoke-free.

And so, that’s just substantially better than you typically see with typical treatments. The best medication, which has been approved as Chantix (varenicline), [where] you get rates, depending on the study, anywhere from 30 to 40 percent typically, at six months in terms of success rate.

We’re currently doing a much larger, randomized study comparing psilocybin to a nicotine patch with the same cognitive behavioral therapy with both groups.

We’re always following the data. But so far… it looks like psilocybin is roughly doubling the success rates of nicotine replacement, which is great.

Healthline: Can you talk about the study session itself, who’s in the room? Are they both cognitive behavioral therapists in the room?

Johnson: During the experience, it’s only those two people [with the patient]. We call them, oftentimes, guides or monitors. But they play a therapist role, so they develop that rapport with them. And it’s those two people who gave them the smoking therapy content in the preparation sessions.

It’s those two people who are with them. And the idea behind having two people is, it’s kind of a safety net. Someone is never left alone. There’s always another human being that the participant has a rapport with, that knows them, that can grab their hand and say, “Look, I’m here with you. You’re perfectly safe.”

Healthline: If someone does have anxiety, they’re able to talk them down a little bit and reassure them?

Johnson: Right. And we kind of think of it more of talking them through it, rather than down. I know it’s a nuance, but the idea is not distraction, not to just go, “Oh, get your mind off of whatever’s bothering you,” but rather look it in the eye and kind of courageously go through it with our help and support.

But if you see a monster in your mind’s eye, metaphorically, step up to that monster, look it in the eye and say, “What are you in my head for? Let’s talk turkey.” And sometimes, it’s just amazing… It sounds cliché, but often, then that monster will turn into something cute and cuddly when they take that orientation.

But it’s like, OK, that’s all brought up to the table. Take a good look at it. Be courageous… this is your opportunity to delve within your mind and take account of things.

Don’t retreat from the experience.

Healthline: When someone is taking psilocybin, are they talking throughout the experience?

Johnson: We want them to be quiet, unless they’re having anxiety. Then, we want them to let us know so that we can be sure to reassure them… For these psilocybin sessions, the idea is we want the person to go inward and to resist the urge to kind of label everything and describe everything.

Healthline: What was studied before psilocybin was banned? How many people were studied?

Johnson: There were many thousands of people that were studied. I think estimates have been that something around 10,000 patients were treated in the earlier era of research with psychedelics.

So, we know a lot from that era. We know that when you do see long-lasting psychiatric harms, that’s… as rarely as it does happen, that happens in people that are either schizophrenic, or there’s a strong reason to think they might have that predisposition, like their twin sibling is a schizophrenic, that type of thing.

Healthline: What are your hopes for this drug, and how do you think it will be used in 5 to 10 years? Are there concerns that you have about potential pitfalls?

Johnson: My hope is that, and I’m following the data and I hope everyone does that… but my hope is that psilocybin is approved for the treatment of one, or a number of, medical disorders within the next 5 to 10 years.

The potential is there for it to transform psychiatry, not just its treatment by our understanding. I think it’s pointing us toward the fact that the idea that these different disorders, like addiction and depression, may share far more in common than we previously thought.

The idea that people are stuck in narrowed mental and behavioral repertoires, whether that be substance addiction or whether that be thinking about yourself in a certain way as in depression. So, I think that these are just incredible research tools for understanding the nature of consciousness, for understanding and for treating psychiatric disorders.

And if it is approved for FDA treatment, it looks like the evidence suggests that [it could classify as] Schedule IV, with some additional parameters, like the restriction that this is not for take-home use.

Now, in terms of local initiatives… the devil is in the details.

Healthline: Right. Is that your concern?

Johnson: I would be really throwing up the warning signals for local initiatives that actually attempt to regulate the therapeutic use. There will be casualties. There are casualties. What I wouldn’t want is for some life coach to be doing “therapy” with mushrooms under a quasi-regulated approach in a city or state.

And then someone gets really harmed. And then, for people to say, “Oh, I’ve read about that stuff. That stuff they do at Hopkins or elsewhere or NYU or in London. Oh, it turns out it’s not so safe.” I would just want people to know that everything [in research] we’re seeing is in a very well-controlled context.

This interview has been edited and condensed for clarity.