Five Minutes With Stephen Ross, MD, Expert in the Therapeutic Application of Psychedelic Drugs
As part of Center on Addiction Speaker Series, in which leading experts present their latest findings, Stephen Ross, MD, Associate Professor and Director of Addiction Psychiatry at NYU Medical Center, discussed his latest findings on using psilocybin to reduce the psychological effects and severe stress that many advanced stage cancer patients face. We spoke with Dr. Ross to hear a little bit more about this fascinating area of research.
Given your background in addiction and substance abuse, what got you interested in evaluating the use of psychedelics to treat psychiatric conditions, such as alcoholism and end-of-life anxiety?
Dr. Ross: In my general psychiatry and addiction psychiatry training, I learned nothing about the history of research with psychedelics within psychiatry and psychology from the 1950s-70s. A colleague informed me of this research in 2006, and when I looked into it, I was surprised to find that the most studied and most promising indication for using psychedelics to treat medical conditions was for alcoholism and terminal cancer-related psychological distress. I found this very interesting, and there appeared to be promising results that were never followed up on because of the passage of the 1970 Controlled Substances Act, which classified psychedelic drugs as Schedule I (indicating “no current medical use” and “high abuse potential”).
You mentioned in your talk that psychedelic research, which was once banned, is making a comeback. Can you briefly describe why that is and what you think the potential value could be for patients?
Dr. Ross: It is experiencing a resurgence because a small but growing group of academic psychiatrists and psychologists at major academic medical institutions are interested in this line of research and see its potential application to patient care. There could be value in these treatment models if the data definitively show that they work. However, we need much more research to be able to know this. The potential value, if they do work for various problems, is a new model of treatment that is novel (i.e., single to a few doses per treatment episode with sustained clinical benefits).
You recently conducted a trial looking at the use of psilocybin on anxiety and psychosocial distress in advanced cancer patients. Can you tell us what that trial involved and the outcomes?
Dr. Ross: We tested single dose psilocybin vs single dose placebo to treat cancer-related psychological distress (anxiety, depression). The results are currently being written up, but we found that patients showed dramatic changes in anxiety, depression and orientation toward death, and that a single dose effect may last as long as eight months.
The psilocybin-assisted psychotherapy you have evaluated requires a male and female therapist to be present with the patient throughout the day. Is this method necessary for the effectiveness of the treatment or is it mostly to insure safety?
Dr. Ross: This is the model developed by the psychiatrist Dr. Stanislav Grof in the 1960s. Having two therapists in the room is important from a safety perspective, as it is a long day of treatment (eight to 12 hours), and if one therapist gets ill or has an emergency, the other therapist will need to be there.
You spoke about how you were able to obtain permission from the government to use psychedelic medications in your clinical trials. Can you briefly describe?
Dr. Ross: There is a path to get approval to conduct this type of research, but it is painstaking and laborious. It requires governmental approval, specifically, an Investigational New Drug application from the U.S. Food and Drug Administration and a Schedule I license from the state’s Bureau of Narcotic Enforcement and the Federal Drug Enforcement Administration. It also requires a local institutional approval from a review board.
What do you predict the benefits may be from using psilocybin-assisted psychotherapy to treat alcohol use disorders?
Dr. Ross: We need much more research to answer this question, but based on the LSD clinical trials used to treat alcoholism in the 1960s, this line of research looks promising.
Stephen Ross, MD
Stephen Ross is an Associate Professor and Director
of Addiction Psychiatry at NYU Medical Center