BBC News is carrying a curious story about a study on the use of psilocybin (the main active ingredient in ‘magic mushrooms’) as a possible treatment for obsessive-compulsive disorder, otherwise known as OCD.
Despite how these stories usually appear in the media, this research isn’t particularly unique. A steady trickle of studies on the potential therapeutic effects of psychedelic drugs has been apparent for the last two decades.
Psychedelic anaesthetic ketamine has been used with some success to treat alcoholism, and MDMA (‘Ecstasy’) is being researched as an agent to assist psychotherapy, particularly to treat post-traumatic stress disorder or PTSD.
A long-running research project, headed by (the appropriately named) Prof Deborah Mash from the University of Miami, has looked at the potential of the hallucinogen ibogaine in treating addictions. There’s more at this pdf.
In fact, there was some promising work done in the 1960s on the use of LSD in treating alcoholism before it was stopped due to government worries about the rising drug culture, and we reported previously on contemporary trials of LSD and psilocybin in the treatment of cluster headaches.
So, the fact that someone is researching the potential of psilocybin for treating OCD is not as surprising as it might at first seem.
What did catch my eye, however, was this quote from psychiatrist Dr Paul Blenkiron:
“About 12% of people can suffer flashbacks after less than 10 exposures [to psychedelics] many years later, beyond the six months of this study, so long term effects should be carefully assessed.”
Despite looking, I can’t find any concrete figures on a) the frequency of ‘flashback’ experiences, and b) whether they are a genuine drug-related phenomenon or not (one study suggested they could be induced by suggestion after placebo).
If anyone knows of any good research done on this area, please let me know, as I haven’t found anything so far with some good data on this still-seemingly anecdotal experience.
Also, although the BBC mentions the study, it doesn’t say where it’s going to be published. There’s a link to the Journal of Clinical Psychiatry on the page, but there’s nothing on the JCP website or on PubMed yet.
Curiouser and curiouser.
UPDATE: The comments have some fantastic additional information on ‘flashback’ research, including the source of the figures quoted by Dr Blenkiron. Thanks very much everyone!
Link to BBC News article “Psychedelic drug ‘hope for OCD'”.
Link to great Canadian Journal of Psychiatry article on LSD.
Link to recent LA Times article on psilocybin treatments.
Mind Hacks 
If it helps, the research I’m aware of regarding “flashbacks” has been done under the rubric of “post-hallucinogenic perceptual disorder” or PHPD.
Anecdotally, I know quite a few people who have used quite a lot of drugs, and they don’t have the kind of widespread problems with flashbacks this author suggests. I suspect that he’s highballing the figure, of course, but there may also be qualities of the experience, the user, or the particular psychedelics used that contribute to determining risk of flashbacks. I understand that flashbacks also range from vivid but harmless memories to experiences closer to spontaneous drug trips, and useful research on the phenomenon would have to make that distinction as well. It’s a shame this kind of important health-relevant question is usually buried underneath the political necessity of appearing “tough on drugs.”
There’s some discussion of PHPD on the mailing list for MAPS, a great pro-psychedelic-research organization (which also helped with funding and governmental approval for Dr. Moreno’s psilocybin / OCD research). Go to http://www.maps.org/forum/search.html and search for PHPD. The mailing list attracts a mixed bag of researchers, dilettantes, and eccentrics, but it often has pointers to published research.
PHPD is also known as HPPD and is (at least according to some) a different category of perceptual distortions than flashbacks. Whereas flashbacks refer to episodic disturbances in thought and/or vision, PHPD/HPPD usually refers to permanent long-term visual distortion following psychedelic drug use. I believe Dr. Paul Blenkiron is pulling his information from McGlothlin WM, Arnold D: LSD revisited-a ten-year follow-up of medical LSD use. Arch Gen Psychiat 24:35-49, 1971. I can’t find this article online, but this article has a nice summary of the data:
A number of authors have claimed that frequent use of LSD is more predisposing to flashbacks than rare or occasional use of this drug (1, 6, 9, 10, 11, 15). Blumenfield (1) found that flashbacks were reported more frequently among heavier users. McGlothlin and Arnold (9) also presented data to support this point. Of their subjects who had used LSD fewer than ten times, 12 percent reported LSD-like recurrences; of those who had used it ten times or more 24 percent reported these recurrences. On the other hand, several different analyses of our own data did not support this finding. The figures we obtained were 28 percent for those who had used LSD one to ten times and 30 percent for those who had used it 11 times or more; the two figures did not differ significantly.
HPPD/PHPD further clouds diagnostic lines in schizophrenia. People whose psychosis was initiated by drug use are 1. more likely to have visual hallucinations; 2. have shrinks raise their dosage when they claim risperdal is making the symptoms worse. Some research supports this:
“LSD-like panic from risperidone in post-LSD visual disorder”
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=8784656&query_hl=4&itool=pubmed_docsum
Regarding frequency of flashbacks, I’m going to guess and say that it only takes one bad trip for someone with a genetic predisposition to “schizophrenia” to develop a full-blown psychotic epsiode (and eventually schizophrenia), whereas someone without that predisposition is more likely to suffer residual visual disturbances after repeated drug use.
I’m about to read this review: “Hallucinogen persisting perception disorder: what do we know after 50 years?”
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12609692&dopt=Citation
I have to share the following line from the review linked above (Hallucinogen persisting perception disorder: what do we know after 50 years? Halpern, 2002):
“some cases have been reported to improve with the use of sunglasses (Abraham, 1983)”
About flashbacks, I would be skeptical of percentage rates in the double digits. As per the US national survey (NSDUH), typically 10% of age 12+ are estimated to have tried LSD i.e. ~25 million. From an earlier administered survey when such questions were asked, typically 70% of users have used upto 10 times in their lifetime, and 30% 11 or more. So, if Blenkiron is correct, then roughly 4 million Americans have experienced flashbacks, and yet unlike other conditions with similar prevalences , there’s only one support group that I know of for flashbacks/HPPD and one specialist in the entire US. This is not to deny that no such phenomena exists (although I or my friends have never experienced it) but either their severity is low or the prevalence is nowhere near as much as quoted.
It should also be noted that apart from the internationally (?in?)famous practice in the Netherlands of tolerating cannabis sale in coffeeshops, there are other shops (roughly 150) that sell psilocybin mushrooms and mescaline-containing cacti and have been doing so for a decade or a bit more now. In 2000, an agency that reports to the Dutch Ministry of Health, upon commission, reviewed the risks of ‘paddos’ (mushrooms) and declared them as posing a low risk to individual and public health, based on the literature and review of the magnitude and severity of cases of toxicity encountered in the Netherlands till then.
What is commonly referred to as flashback” seem to be more like a panic attack. The imprint experience creates a chemical imbalance that is memorable and intense. Later chemical imbalances, of whatever cause, are interpreted as connected to the previous experience(s).
It may simply be a matter of sensitivity. A person with no past psychedic experience could experience a nearly identical chemical imbalance, and might barely notice it.
I agree with Malgwyn, as someone who has used psychedelic substances in the past I’ve experienced something you could describe as ‘flashbacks’, often at random. I think neuroscience has a long way to go before it will be able to tell us how certain brain states lead to subjective experience (if it ever will, and without the hand waving that has filled the field since Skinner). At the risk of sounding unfashionably Leary-esque I’d say the fact that the vast majority of these researchers haven’t experimented with these drugs themselves compromises their objectivity in a certain sense. Based on my experience and accounts from friends and acquaintances I find it likely that due to 1960s LSD hysteria doctors and researchers mis-judge ‘flashbacks’ as something more severe and sinister than they actually are. I don’t doubt that they are a severe phenomenon, but when a doctor cites figures like ‘12% of infrequent users and 24% of heavy users’ I’m really skeptical because ‘flashbacks’ are a vague and nebulous term for a field of experience that has barely been studied. From my understanding a flashback can be anything from a short lasting rush of feeling ‘high’ or increased sensitivity to color to a full-blown ‘trip’ (which I’ve never experienced or heard a first hand report of, but there are many points in between the two extremes I guess). It’s a shame objective scientific inquiry by the mainstream of researchers in this field is hindered by decades of continuing prohibitionist rhetoric/hysteria and a scarcity of the data needed to combat the former.
It’s interesting to read people’s views on flashbacks and HPPD – actually, as someone who’s being diagnosed with the latter and knows one or two individuals who have experienced the former, I am certain that they are (at least phenomenologically) different. Flashbacks seem to be precipitated by stress or cannabis, and are psychologically and perceptually similar to the psychedelic experience, and tend to arise in those who have a larger dose-history, and are intense whereas HPPD is purely visually similar to drug experience (though it can entail psychological problems too), and not as intense.
I recall reading (I’ve lost the link) that flashbacks are uncommon among LSD research subjects, what with controls over set and setting, dosage etc. HPPD, if you have a look at David Kozin’s survey on the matter, is unrelated to dose or set and setting, and can begin months or years after the actual drug use. What is astonishing is that no doctor I’ve ever spoken to was aware of any of this. It is a devastating condition, and I think that these two “side-effects” would rule out the use of psychedelics for treating OCD, also given the inconvenience of having to trip every 24 hours when you’re already struggling with OCD. Studying the pharmacology of this OCD-reducing effect might be very useful though.
zhqhqn: I think that these two “side-effects” would rule out the use of psychedelics for treating OCD, also given the inconvenience of having to trip every 24 hours when you’re already struggling with OCD.
I know one of the patients who is part of the case reports in the examination of LSD/psilocybin for cluster headaches (http://www.maps.org/sys/w3pb.pl?mode=search&c_pkey=22779&displayformat=allinfo&type=citation), and he isn’t always tripping because tolerance rapidly develops to the psychological effects and unless you abstain for a few days, the tolerance remains.
Also during the days of legal experimentation, LSD was given daily to “severely disturbed” children (ages as low as 5-6) for between 5 to 35 months and those kids weren’t in a pseudopermanent tripping state, again, because of maintained tolerance.
I suffer from OCD and i am ponding on the idea of using shrooms to cure my problem. But i have not found a site on which to use and how much of it. Can someone assist me in this matter?
Please don’t listen to the man who told you that they will only make OCD worse. This man obviously doesn’t know what he’s talking about. I have OCD and I will attest to the healing power of the shroom. You don’t have to take it everyday like the one commenter suggested you would have to. No, this is not a daily medication. I suggest a low dose (1 g) as opposed to the larger trip dose that most people take. This WILL work if you have real OCD.
DO NOT TAKE MUSHROOMS IF YOU TRULY SUFFER FROM OCD.
It will only intensify your symptoms, and you may end up fighting yourself the whole trip to stay sane. You may also find yourself having more flashbacks over the next month or so than the average person, and your anxiety may become unbearable for some time too after the trip.
How do I know this? I have suffered from extreme OCD for 25 years, since I was a toddler. I have taken my fair share of ‘shrooms. It wasn’t until my last 2 times taking then that I put 2+2 together. Not to mention my nerves were crying out to me the whole time explaining to me exactly what was going on in my system.
Maybe you took too large of a dose, because I have OCD and shrooms work like a miracle cure for it. Nothing treats OCD better than shrooms. I wonder if you really have OCD?
I also suffer from OCD and can say that from my experiences, I feel there is no miracle cure from it. There are, however, many things that you can do to alleviate the stress or symptoms. To me, the most important step starts within yourself, training yourself to rid yourself of your compulsive actions and changing your though patterns that lead to obsession. But drugs can be used effectively as a supplement to this process, as they can both assist in the process of changing your pattern of thought and can actually alter your brain chemistry, which is likely the (or a) cause of your OCD.
I have tried mushrooms a handful of times and they have worked well for me (at least so far). Conversely, though I had a good friend who suffered from a bi-polar-like disorder who took a good deal of LSD and went off the deep end. He started accusing all of his friends of conspiring against him, retreated to the confines for his room for days at a time and became generally dissatisfied with every person and thing in the world. Is it possible that the drugs had nothing to do with this and that this was merely who he had become as a person? Yes. Is it possible that the drugs changed his brain chemistry and exacerbated a predisposition? Again, yes. The point is I don’t know and no one really does. Which brings me to my point. These drugs are going to affect everyone differently (granted my friend didn’t suffer from OCD, but a different psychological condition).
Jack Hall, I don’t think it’s fair for you do say that Mucejuice doesn’t have OCD, or to assume that just because mushrooms worked for you, that they will work for everyone with OCD. Likewise, I don’t think it is fair for Mucejuice to scare away people whom mushrooms could help. I think it is certainly a risk, and you as an individual have to decide whether it is worth it to take that risk for the potential benefit. That is a scary notion, playing doctor to yourself, especially when it involves the mind, but OCD is something that is not always incredibly well understood by doctors, and sometimes us sufferers have to take matters into our own hands.
Like I said, I have enjoyed them and feel (or hope) that they have helped alleviate symptoms that I have battled for years. But, it has been a long road to get to this point, and I had to train my mind and go through a lot of pain to get to this point. I think that a certain mental strength is required when dealing with psychoactive drugs, and it isn’t that some people have it and some people don’t. It’s that you have to understand what you’re getting yourself into, understand the chemistry of what is happening to your mind and then simultaneously accept the consequences and the experience. If you go into a trip worried stiff, thinking about all the bad things that can happen, that will definitely affect your experience.
If you choose to do this, I would say find yourself a relaxing spot (a room you like or a garden, away from people who you think might judge you in any way) and do them with a good friend (again who trust or confide in, and one who doesn’t judge harshly). Then just sit back and appreciate the music you have playing, the nature around you or the conversation of a friend. That is how I’ve had my best experiences.
But make sure you are comfortable with the idea of doing mushrooms before you do them. I think this is important and can affect the way the drug works on your brain. This is all very subjective, but as an OCD sufferer who had used the drug, I think a subjective approach is most helpful (it was to me when I was researching the drug and its affect on OCD sufferers). But, again, I wouldn’t recommend it for everyone. You have to decide where you fall on this spectrum.
I hope this post has been helpful. I don’t want to advocate either way. I just want to communicate my experience and viewpoint in the hope that it could help someone else. Mushrooms are not the cure all, and definitely not the beginning point in the battle, but for me they helped.