A couple weeks ago, UC San Diego researcher Fadel Zeidan led Voice of San Diego reporters through the antiseptic hallways of the Altman Clinical and Translational and Research Institute. We walked past hospital beds and medical equipment bathed in white light. It felt so clinical. But this wasn’t just a stuffy lab.
The first hint that this visit contained anything out of the ordinary came when Zeidan, an associate professor of anesthesiology, stopped at the institute’s pharmacy. He poked his head in and cheerily asked to see the medicine. He emerged with a bag stuffed with plastic bottles. Each contained pills with the equivalent of 5 grams of synthetic psilocybin, the psychedelic property in magic mushrooms.
“This is a hero dose,” Zeidan said with a grin, referring to a term coined by famed ethnobotanist and psychedelic advocate Terrence McKenna.
And it’s ingested right there at the institute. Zeidan and his team at UCSD’s newly minted Center for Psychedelic Research are part of a growing cohort of academics studying the potential medicinal effects of psychedelics, in this case psilocybin. Johns Hopkins was the first university in the United States to gain regulatory approval to conduct psilocybin research over two decades ago. Their study focused on potential benefits for the treatment of addiction, depression or anxiety.
The researchers at UCSD want to figure out if it can help treat phantom limb pain, a sensation sometimes felt by people who have lost a limb, the effects of which can range from discomfort to excruciating pain.
Setting the Vibe
A research lab isn’t the first place many would want to take a 5 gram dose of mushrooms.
But Zeidan said “A lot of our patients say, ‘I wouldn’t have done this if it wasn’t in a hospital setting.’ These aren’t necessarily psychonauts, these are people that are suffering.”
Still, the team is sensitive to the spiritual and almost vibe-based elements of the psychedelic experience. On dosing days, they transform the room into something of a psychedelic oasis, complete with lava lamps, fruit, blackout curtains, an assortment of crystals, big comfy pillows and an hours-long playlist crafted specifically for psilocybin trips by researchers at Johns Hopkins’ Center for Psychedelic and Consciousness Research.
The “setting the scene” aspect of the study is indebted in part to the thousands of years of Indigenous psychedelic traditions, something Zeidan wants to respect.
“We’re honoring how you should deliver and maintain the medicine, but we’re also trying to bring as much rigor and remove as much bias as possible, so that we can actually get to the answers and not fall into the same mistakes that happened in the ‘60s and ‘70s where people kind of got ahead of what this stuff is and what it does,” Zeidan said.
Even getting to this point was no easy task. The center co-founded by Zeidan and Tim Furnish, the chair of UCSD’s division of pain management, spent years jumping through federal, state and university hoops before it was approved to administer the first dose. But the roots of the center, and its current research, predate even that careful regulatory choreography.
The Origin Story
Back in 2016, UCSD researcher Albert Yu-Min Lin, a sort of Indiana Jones figure for the digital age sans all the artifact stealing got into a wreck while off-roading in the desert.
His leg was trapped under the vehicle and the bones below his knee were crushed. His doctors tried to stabilize his leg, but ultimately amputated it below the knee. Immediately afterward, Lin began to experience severe phantom limb pain.
Furnish was one of the doctors who treated Lin after the accident and said none of the medications prescribed to treat the pain seemed to work. Lin decided to push some boundaries and experimented with magic mushrooms.
“We’re happy when a drug that somebody takes reduces their pain by 50 percent, and his pain went to zero for several hours, which is somewhat unusual for a drug that treats especially chronic pain,” Furnish said.
Furnish was careful not to directly tell Lin what to do, since mushrooms are still a Schedule I drug meaning there is “no currently accepted medical use and a high potential for abuse,” according to the federal government.
Furnish thought it would be interesting to pair the mushrooms with a mirror therapy program that’s been shown to help ease phantom limb pain. Luckily for Lin, V.S. Ramachandran, the neurologist who’d developed the therapy also worked at UCSD, so he connected with him and gave it a shot.
Within a couple of months, Lin’s pain was gone. Furnish went on to co-author a paper with Ramachandran on the results.
“All of that was kind of a dramatic story, but in the world of literature, it’s an anecdote. It’s one person’s story,” Furnish said. “That doesn’t necessarily mean that the psychedelics even played a role there, but it certainly is suggestive of it.”
That story, which Lin himself has recounted frequently, was fascinating enough to unite a group to create the Psychedelics and Health Research Initiative, which is what the center Furnish co-founded with Zeidan was originally dubbed.
“As a pain scientist, the pain doesn’t make sense to me,” Zeidan said.
After all, there are no nerves going to a limb that is no longer there, he said. The thinking is that the emotional and psychological trauma of losing that limb may play some role in the pain itself.
“So we think the medicine may be working on treating the whole self, not just the pain,” Zeidan said.
This first study won’t incorporate the mirror therapy Lin found so helpful but aims to determine whether psilocybin by itself has any effect on phantom limb pain. Patients initially have a series of sessions where they meet with the institute’s facilitators – individuals who are trained in both therapy and are experts at “holding a psychedelic space,” Zeidan said – to develop intentions for their experience and acclimate to their facilitators. Then, they are brought in and administered either a dose of psilocybin or a control dose of Niacin.
The study is double-blind, meaning neither the researchers nor the participants know whether they’ve received a dose of psilocybin or niacin. It also means the researchers don’t have access to the data yet, but they hope to complete their initial study in the coming months, assuming they can find enough participants who meet the specifications.
“This is a patient process, and it won’t be the first study. We’ve got a lot to learn as we build up,” Zeidan said.
The Next Frontier
Researcher Jon Dean has the kind of rugged beard one would expect to see in a shipwreck movie instead of in a prestigious research lab, but his scientific bona fides are no joke. His previous research revealed that DMT, a powerful psychedelic found in all manner of life forms, exists naturally in rat brains at levels comparable to the neurotransmitter serotonin. His research is partly why he will lead the center’s new DMT research division.
The molecule, which has been associated with near death experiences is what got Dean into science. It’s usually smoked, and unlike other psychedelics, its effects dissipate within minutes. The team, however, plans to follow the lead of other academic institutions and administer it intravenously for 30 to 90 minutes at a time.
“Long term, we’re in the business of trying to understand if these compounds and medicines can be beneficial to people with depression,” Dean said.
First, they plan to ask some basic science questions like how to safely administer doses and what’s going on in the brains of people who take DMT. But there are also some more heady questions at play, like what’s up with the encounters with mysterious entities often reported by people who’ve taken DMT?
“We want to know … is this something that’s just inherent to the psychology of the mind? Or is it even more basic visual processing, like is the first thing you see right when come you out of the cosmic soup an entity?” Dean asked.
While getting psilocybin into the hallowed halls of academia was a challenge, the center’s next venture won’t be any easier. They recently received a $1.5 million gift from a benefactor to study the effects of DMT, and this time, they’ll be embarking on the process of regulatory hurdle-jumping without the trail blazed by Johns Hopkins. UCSD would be the first American university to get regulatory approval to study the effects of DMT.
But Zeidan is no stranger to feeling like a scientific black sheep. When he started studying mindfulness around 20 years ago, long before it became a household concept, his professors told him it would be a career killer.
“I never could have dreamed of being a co-founder of a psychedelic research center,” he said with a laugh.
Regardless of his excitement and his hope, he’s focused on letting the research guide him.
“It’s a long story and it’s still being written. If the data don’t show that it does good things, then I think (psychedelic research) will just kind of go by the wayside,” Zeidan said. “If the evidence is there though, people are going to have to start changing their minds.”
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