STEVE INSKEEP, HOST:
Tobacco use kills almost half a million Americans every year - almost half a million. Despite the dangers, nicotine addiction remains powerful so that many who try to stop cannot. That's led scientists to study a new therapy to help smokers quit. It's a treatment that uses psilocybin, the active ingredient in psychedelic mushrooms. Stephanie O'Neill reports.
STEPHANIE O'NEILL, BYLINE: Giving up smoking seemed an impossibility to 65-year-old Carine Chen-McLaughlin and not just because of her physical addiction to nicotine. The Baltimore resident took up smoking at 18 and couldn't imagine a life without it.
CARINE CHEN-MCLAUGHLIN: It's basically saying goodbye to a very old friend and worrying about, am I going to be OK without this good friend?
O'NEILL: But like many of today's 45 million U.S. smokers, Chen-McLaughlin wanted to quit, so she tried nicotine gum, the patch, even going cold turkey. Nothing worked. And then last year, she tried an experimental treatment at nearby Johns Hopkins School of Medicine - psilocybin-assisted therapy. Psilocybin is the naturally occurring compound in hallucinogenic mushrooms. And Chen-McLaughlin says while she was a bit nervous to try it...
CHEN-MCLAUGHLIN: I think I was more excited that maybe, maybe (laughter) this is it.
O'NEILL: Therapeutic research on psychedelic drugs isn't new. Scientists first started researching them in the 1950s, but when counterculture youth began using and abusing psychedelics in the 1960s, the feds criminalized their use, and that research skidded to a halt. Matthew Johnson leads the psilocybin smoking study at Johns Hopkins.
MATTHEW JOHNSON: Unfortunately, all of that legitimate research was really sacrificed because of the association between psychedelics and the counterculture.
O'NEILL: Today, a new wave of psychedelic research has taken hold at U.S. academic institutions. And while all of it is federally approved, the feds so far aren't providing any funding. UCLA psychiatrist Charles Grob has long studied the therapeutic potential of psychedelics. He says a dire need for new treatments and a better understanding of these compounds is helping to destigmatize them.
CHARLES GROB: Slowly but surely our colleagues throughout the health fields have started to recognize that these treatment models may have something very positive and very unique to offer.
O'NEILL: Among the advantages, he says, patients don't need long-term prescriptions. Johnson's smoking study, for instance, follows a protocol of counseling both before and after the patient takes just one dose of psilocybin during a guided session. So far, half the study participants have quit smoking, compared to 10 to 35% for conventional nicotine medication or counseling alone. And among the newly habit-free, Carine Chen-McLaughlin.
CHEN-MCLAUGHLIN: I have not smoked since March 23, 2018.
O'NEILL: That was the day she took the psilocybin under the supervision of two therapeutic guides at Johns Hopkins. As the high came on, she did as she was coached. She closed her eyes and went inward to experience whatever came up. The altered state typically lasts about six hours, and Johnson says for those like Chen-McLaughlin, the psilocybin seems to shift their addictive thinking.
JOHNSON: Our best guess, at this point, is that while the drug is active, the brain is operating in a qualitatively different fashion.
O'NEILL: Most notably, areas of the brain that normally don't communicate begin to do so and vice versa. And because psychedelics don't numb the mind in the way, say, alcohol does, patients report leaving the session with their newly found insights intact.
JOHNSON: People often report a remarkable clarity. They know what's going on. They can observe their life and themselves from a much different vantage point.
O'NEILL: This is the so-called mystical experience that psilocybin users like shamans have reported for centuries. It's thought that feelings of unity, sacredness and transcendence of time and space can help people change thought patterns that fuel addiction. But that doesn't suggest the work is easy or enjoyable. For Chen-McLaughlin, the trip she took on the therapist couch unleashed a host of fears. In her mind's eye, they became dark clouds trying to suffocate her.
CHEN-MCLAUGHLIN: And that was really super, super scary. And I cried, I think, at least four out of five, six hours.
O'NEILL: Yet, she says, through the entire experience, a vision of her recently deceased mother stood by as a sort of spiritual sentry, helping her to face her fears. And as she did, the dark clouds dissipated and so did her desire to smoke. Carine Chen-McLaughlin says she doesn't know why the psilocybin therapy worked. All she knows is that since her trip, she's not only quit smoking, she can't physically touch a cigarette.
CHEN-MCLAUGHLIN: I mean (laughter) I know it sounds really weird, but that's what happened. Something in my brain sort of got switched.
O'NEILL: Matthew Johnson at Johns Hopkins says once this study is completed, the results must be replicated in larger phase three trials before the FDA can approve it as a treatment for addicted smokers. For NPR News, I'm Stephanie O'Neill.
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