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The mortality risk and therapeutic potential of hallucinogens
A research article in CMAJ examines mortality risk among people hospitalized for hallucinogen use. The study found that individuals who required acute hospital care for hallucinogen-related issues had a nearly fivefold increase in mortality risk compared to the general population.
Dr. Daniel Myran, a public health and preventive medicine physician, family physician, and researcher at the University of Ottawa, discusses the study’s findings and why the growing perception of psychedelics as therapeutic may be influencing increased use. He explains how individuals hospitalized for hallucinogen-related issues often have additional risk factors, including other substance use and underlying health conditions, which may contribute to their elevated mortality risk.
Dr. Ishrat Husain, a senior scientist and the scientific head of the clinical trials unit at CAMH in Toronto, explores the controlled medical use of hallucinogens in treatment-resistant depression. He outlines the intensive screening and psychological support involved in clinical trials and compares psilocybin therapy to other treatments such as electroconvulsive therapy (ECT) and ketamine. While early evidence is promising, Husain cautions that psilocybin remains experimental and requires significant resources, raising questions about its future accessibility.
The findings highlight the need for clear public health messaging and policy decisions that distinguish between medical and recreational use of hallucinogens.
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Dr. Mojola Omole
Hi, I'm Mojola Omole.
Dr. Blair Bigham
I'm Blair Bigham. This is the CMAJ podcast.
Dr. Mojola Omole
So Blair, so hallucinogens are everywhere.
Dr. Blair Bigham
Everywhere right now
Dr. Mojola Omole
But so I always pass the shops that, you know, they look like they have a lava lamp, like, and I just thought it was like they're selling mushroom paraphernalia. I didn't know they were actually selling mushrooms.
Dr. Blair Bigham
There's real shrooms in there, yeah. We have one right across the street from our house.
Dr. Mojola Omole
And it seems that these are growing. And so the public interest is growing around the use of these, whether it's using them or microdosing.
Dr. Blair Bigham
Yeah, they're in the media all the time, like either getting shut down or starting up again, or even just like some of these studies out there around LSD, microdosing, the future of hallucinogens. And so I thought it was really interesting that we take on this paper in the CMAJ.
Dr. Mojola Omole
It looks at the actual risk of hallucinogens, specifically is what happens when people end up in the ER because of the use of them. So this is outside of the study setting for hallucinogens.
Dr. Blair Bigham
And our second guest will help us step back and look at the clinical side. What's down the road for the future of hallucinogens in medicine?
Dr. Mojola Omole
Dr. Daniel Myron is the lead author of the article in the CMAJ entitled, Mortality risk among people receiving acute hospital care for hallucinogen use compared with the general population. He's the Canadian Research Chair with the University of Ottawa's Department of Family Medicine and Investigator at Bruyère Health Research Institute.. Thank you so much for joining us today.
Dr. Daniel Myran
Thanks for having me on the podcast.
Dr. Mojola Omole
So there seems to be a lot of mushroom shops, which I actually thought it wasn't real. Like, I thought they were selling something paraphernalia around mushrooms, but how much are people actually using mushrooms and other hallucinogens?
Dr. Daniel Myran
Yeah, so there was actually, they just released data for 2023 about the number of Canadians who are using hallucinogens and 5.9% of Canadians reported use in the past year in 2023.
Dr. Mojola Omole
So what's driving this increase in the use?
Dr. Daniel Myran
So I think that really, it's very much driven by increasing interest in the general public, and I think that in turn is being driven by a lot of the trials that are coming out. So in the past decade or so, there's been a resurgence of interest in psychedelic-assisted therapy as a treatment for a variety of mental health conditions and for some substance use disorders. And as you've seen a lot of headlines about these trials and a lot of buzz about them, I think that there's been a general sense of hallucinogens as potentially having therapeutic properties and then interest amongst people of using them.
Dr. Mojola Omole
So you think that because we're talking more from the scientific world about the use of hallucinogens, it's making people have a bigger interest in actually using it recreationally?
Dr. Daniel Myran
Yeah, and I think that there's this interesting blurring of the lines between medical and recreational use that you have a lot of. Again, the trials are very much, almost exclusively, these are therapy paired with psychedelics or paired with a hallucinogen. And that you have the mainstream or the popular presentation of this is that the hallucinogen on its own, and as a result, many people are thinking that I've seen this promising trial of psilocybin for treatment-resistant depression, and perhaps if I take some psilocybin that I acquire myself, that it'll have benefits for mental health.
Dr. Mojola Omole
Besides the mushrooms, what other hallucinogens are we studying? I say we as if I'm doing it, but are you studying?
Dr. Daniel Myran
So in the study, and it's actually one of the limitations, we end up capturing just very broadly hallucinogens. And you're relying on healthcare providers to say this was an emergency room visit where I think that hallucinogens were involved or this is a hospitalization. And because there's no diagnostic coding for specific types of hallucinogens, you just end up with this broad grab bag.
There is one code for LSD poisoning, but we don't get to know that this one is psilocybin, and this was ketamine, and this was PCP. But generally, hallucinogens, you end up having dissociative hallucinogens like ketamine and PCP, and then serotonergic hallucinogens like LSD, MDMA, and psilocybin. And then those are the two broad categories, but it is this big capture of different substances.
Dr. Blair Bigham
So what happens to people who end up in the ER who actually have a documented hallucinogen exposure? First of all, as an emerg doc, I have to say, I don't think I would ever write down hallucinogen. I just write down overdose or something generic.
And a lot of the people who are coming in on hallucinogens, I just send home. What happens to them?
Dr. Daniel Myran
I think the people who are getting captured in this study are probably either having a quite severe mental health crisis, that there is also use of hallucinogens that's there, and the treating team is saying, oh, we think this might have contributed to it. So someone might be there with severe depression, and the team is saying, actually, this person's using quite a bit of psilocybin, and we don't think that's helping, and perhaps it's making worse, or they might have had a severe panic attack that was related to it. And then I think the other side is that people are probably there with, quote-unquote, a bad trip, where they've developed severe hallucinations or intense paranoia.
And either they themselves are so distressed that they're coming in, or that people around them are like, this person feels like an active risk to themselves because they've lost the ability to make safe judgments and might be having them come in.
Dr. Mojola Omole
So we also notice, like, in terms of there's an increase in the mortality associated with these. What is behind this? Is it the hallucinogen itself, or are there other factors at play?
Dr. Daniel Myran
I think it's absolutely with, like, I have full confidence that some of the risk that we observe in the study is related to other factors. So for example, we see that with people that come in for, they have an emergency room visitor hospitalization involving hallucinogen, and they're at increased risk of lung cancer, of dying from lung cancer from cancer. And again, that to me is just...
Dr. Mojola Omole
I don't understand. How does that work? Can you explain that?
Dr. Daniel Myran
So I think that that's why this is confounding. So what I'm saying is they are probably much more likely to be tobacco smokers and to have a substantial history of it. So when we see that they're at higher risk of dying from cancer and lung cancer, that's confounding from tobacco use, which we couldn't adjust for.
We didn't have data on that because this is like big population level data where we look at everyone's healthcare visits. And I think there's a variety of other risky factors and behaviors that these people have. They probably are more likely to use opioids and other drugs.
And even though we adjust for care, like past care for those, I don't think we fully adjust for that. And I think so very confident that drives part of the risk that we see. I think that other things like where you see an increased risk of death by suicide might be driven by the hallucinogens themselves.
So there could be a contribution.
Dr. Mojola Omole
What factors of hallucinogen users actually end up in the ER?
Dr. Daniel Myran
So there isn't fantastic data on this. We were doing a back of the envelope calculation, and I think it's quite rare. So something like, you know, we were saying something like 3% of people, like if you crunch the numbers of the number of people during the study timeframe who are reporting hallucinogen use and the number of people, of the number of emerg visits and hospitalizations we get, something like 3% are showing up.
Dr. Mojola Omole
What does it say about the general safety for hallucinogens?
Dr. Daniel Myran
I think that it's, and classically hallucinogens have thought of having a fairly low addictive potential or no addictive potential in having and being safer than some of the other substances. And that, well, may be true. It can be true that some of these drugs have less risk of major adverse effects than other substances.
And for example, like I would really believe that for opioids or for comparisons to things like cocaine. But you do have to worry that as the number of people who are using this increases, as it moves from something, you know, in 2013, like in the early, early 2010s, less than 1% of Canadians were using a hallucinogen in the past year. And that's increased sixfold.
And so as the use of the substances becomes more common, even if adverse effects are relatively rare, if you have enough people using it, you can see quite a large number of people, of net people who experience adverse events.
Dr. Mojola Omole
So if we're having a sixfold increase in a decade or so, how, I'm assuming this is most likely going to continue to grow. How can people, like, is there a safe way that people are going to use them if they're going to use them?
Dr. Daniel Myran
So I think that thinking about what they're doing in trial settings is relevant. So in a clinical trial, people who are there have someone who's with them, and they're providing support and therapy in case the trip or the use of the hallucinogens is causing a lot of distress, they're making sure that the person isn't doing something that's potentially dangerous. There's contact.
So there's like a lot of effort that goes into making the environment somewhere that's supportive and calm. People who have a history of schizophrenia and psychosis should be really cautious about using hallucinogens and other substances like cannabis. And similarly, people who have a history of bipolar and mania, I think should be quite cautious about these substances.
Dr. Blair Bigham
Ok so as a public health physician, what do you the important policy implications of this research are?
Dr. Daniel Myran
To me, the policy side is really interesting, because I find the conversation about this is a promising therapeutic, and we should legalize this for recreational use or being blended. And I think that's a real mistake. That there might be very compelling reasons as a society to make this available non-medically or recreationally. We might say that this fits within our current conception of people's rights and freedoms, or we're interested in doing this for harm reduction purposes.
But that is a very different conversation with very different policy implications and solutions than saying this is a promising novel therapeutic that we think should be prescribed in a specific setting by trained healthcare providers with oversight and regulation. And again, I really worry that if we blend them, that if we do our policy as if they're both the same indication, that you end up with a totally unsatisfying set of regulations and approaches that does disservice to both ideas.
Dr. Blair Bigham
Fascinating. Thank you so much for joining us.
Dr. Daniel Myran
Thanks for having me.
Dr. Mojola Omole
Dr. Daniel Myran is a public health and preventative medicine physician and a family physician and researcher at the University of Ottawa.
The article in the CMAJ examines recreational use of hallucinogens. At the same time, though, clinical trials are exploring the effectiveness as therapy for various conditions. The Centre for Addiction and Mental Health (CAMH) in Toronto is leading several of these trials in Canada. Dr. Ishrat Hussain is a senior scientist and the scientific head of the clinical trials unit at CAMH. He also leads the CAMH Mood Disorder Service. He's also a co author on the CMAJ paper. Thanks so much for joining us today Ishrat.
Dr. Ishrat Husain
Thanks for having me.
Dr. Mojola Omole
So, CAMH has been involved in some clinical trials. What are you learning so far?
Dr. Ishrat Husain
Yeah, so we've been involved from the very early stages, from when psilocybin was really put forward for clinical development as a treatment for depression, and specifically for what's called treatment-resistant depression. So, that's depression that hasn't responded to at least two trials of evidence-based treatments like SSRI antidepressants. And our involvement in this area has shown that for a group of people with refractory depression, psilocybin, when it's combined with psychological support, can improve substantially and rapidly improve symptoms of depression, and for some people, for a sustained period of time as well.
Dr. Mojola Omole
What's a sustained period of time?
Dr. Ishrat Husain
So, up to three months following one single administration of the drug when it's combined with psychological support.
Dr. Mojola Omole
So, can you just walk us through it? How do you pick a patient that would be eligible for a trial, and what would they expect as they go through the trial in terms of the treatment protocol?
Dr. Ishrat Husain
It's a really important question because even though the results from these preliminary studies are really encouraging, I think people need to know that they are in highly selected groups of patients. And also in really controlled settings. So, we really thoroughly screen people both physically and psychologically for their suitability for this treatment.
For example, people with severe physical health condition like cardiovascular illness, history of recent strokes are excluded. Anybody who has abnormalities in their blood work, like liver function or renal function is excluded. And then psychologically, we screen for any history, personal or family history of psychotic illness or manic episodes, because it's thought that psychedelic drugs may trigger psychotic relapse in an individual with psychotic illness like schizophrenia.
So, yes, there's a lot of screening involved to select what may be a good candidate for this treatment. And then in the way that the treatment is delivered as well, it's highly resource intensive. So, we have trained psychedelic therapists that are trained in delivering the psychological support for people before they receive the treatment, during the treatment, afterwards as well.
So, we deliver up to four hours of preparation therapy. So, that involves educating the patient about what will be involved when they receive the drug, setting intentions for what they hope to achieve with the treatment, and just setting guidelines for what to do if they're feeling distressed during the treatment as well. And then we have a specialist sort of psychedelic treatment room, which is a non-clinical type environment.
Imagine a living room or bedroom-like environment, ambient lighting, music playlists as well, because music is thought to be a really important part of the therapeutic experience. And then the therapists are monitoring the patient continuously for up to eight hours for the whole day.
Dr. Mojola Omole
Sorry, so the patient is there for a whole entire day?
Dr. Ishrat Husain
Yeah, they come in at CAMH, they come in at eight o'clock, they're usually done by four or four thirty.
Dr. Mojola Omole
So, are they having a full psychedelic experience for this treatment to be effective?
Dr. Ishrat Husain
Yeah, so that's another really interesting question that we're trying to move the needle on. Is it that you need that full quote-unquote trip, as it's called, for the therapeutic outcome? At this point, it's assumed that you do.
But we're doing a study to try and understand whether that's actually required, because psychopharmacologically, you can actually block the trip with serotonin 2A antagonists. So, we're trying to do that in one of our studies. But yes, if you're getting an active treatment, you're going to have the full experience, and that involves up to eight hours of psychoactive effects.
Dr. Mojola Omole
That's a really long time.
Dr. Ishrat Husain
Is that possible? I mean, we've had situations where people have not had a positive experience, the so-called bad trip. And that's why we need the trained therapists there to help ground the patient, help them through that period of distress.
And then really importantly, it doesn't just end there, because a lot of people experience a lot during that eight hours and need to debrief about it and integrate it. So, we have up to two sessions of therapy post each drug administration so that the patient can meet with the therapist to debrief about what they went through, to integrate what they learned to move forward with their sort of experience.
Dr. Mojola Omole
This is really resource intensive.
Dr. Ishrat Husain
Yeah, absolutely. It's incredibly resource intensive. Even for our federally funded grants that are funding this work, the majority of our expense is on the therapy resource. And in fact the, sort of, some preliminary cost effectiveness analysis on these studies has shown that unless you're able to titrate or tailor the dose of the psychological support, then we're not sure if this is going to be a cost effective treatment option compared to other treatments that we have for treatment resistant depression.
Dr. Mojola Omole
I was going to actually ask you what are other like, how does this in terms so far in your work, how does this compare to other treatments for refractory mood disorder in terms of effectiveness, but also in terms of the resource that goes into it?
Dr. Ishrat Husain
Yeah, so if you look at what's currently available for treatment resistant depression, probably the one of the oldest treatments in psychiatry, in fact, and one of the most evidence based is something called electroconvulsive therapy, ECT. Historically, it's been called shock therapy. If you look at that particular intervention, 60 to 70 percent of people with treatment resistant depression will have a response.
So they'll have at least a 50 percent reduction in their symptoms.
Dr. Blair Bigham
ECT Is that effective?
Dr. Ishrat Husain
ECT is that effective?
Dr. Mojola Omole
For how long is that effect?
Dr. Ishrat Husain
So for again, the studies have looked at a course, acute course of treatment of ECT, which is 12 to 20 sessions. So anywhere from four to eight weeks of treatment that can lead to a remission for up to six months. And that remission, that's a total absence of symptoms, would be in about 40 to 50 percent of people.
A response, which is a 50 percent reduction, would be in up to 70 percent of people for up to six months. So ECT is an underutilized treatment because of the stigma involved. And again, because it does involve resources.
So you need a psychiatrist, anesthesiologist, nursing staff to administer the treatment. It's usually reserved for specialist centers because it does involve some resources as well. Nobody has done a comparison of the costs on the health care service of ECT versus something like psilocybin therapy, because I think psilocybin therapy is still very much in the sort of phase two clinical trial phase.
We are conducting phase three trials at the moment, but we don't have the results for those yet.
Dr. Mojola Omole
So you mentioned that ECT has about a 60 to 70 percent effectiveness. What is the effect of using psilocybin in this clinical setting?
Dr. Ishrat Husain
I'm going off the largest phase two trial, which was in over 230 patients with treatment resistant depression. In that study, it showed that between 30 to 40 percent of people responded to psilocybin therapy compared to active comparators. So it's a little bit lower than the effectiveness for ECT.
Dr. Blair Bigham
Do you ever combine the two? Do you ever do, because there was, wasn't there something, no, wait, wait, wait, hear me out. Wasn't there something about, wait, because you sedate people for their ECT, right? Wasn't there something about using ketamine preferentially and it had some sort of like, additive or synergistic effect.
Has that ever been looked at with psilocybin?
Dr. Ishrat Husain
So, no, it's an interesting idea, but we do think yes, combining psilocybin with other types of treatment for maintenance of a response is a good idea. Maybe not ECT, maybe something like transcranial magnetic stimulation, which is less invasive.
Dr. Blair Bigham
What is that?
Dr. Ishrat Husain
So that is a brain stimulation treatment that involves the use of a magnet over the dorsolateral prefrontal cortex to, sort of, change the neurocircuitry for people with depression. A very effective treatment as well. About 30 to 40 percent of people get better with RTMS as well, and it's not as invasive as ECT.
But no, nobody has looked at the combination of psilocybin with other treatments as yet. I mean, also that sort of...
Dr. Mojola Omole
Next research question.
Dr. Ishrat Husain
Yeah, that combination of ECT and ketamine is still spurious. There's some sort of issues with combining the two. I think the results aren't definitive by any means.
Dr. Mojola Omole
How do you select patients for this? Are there traits or populations that this would be the next course in terms of this is the patient that should be trying this if they have refractory depression and mood disorder?
Dr. Ishrat Husain
So the question, the way I see it, is where in the treatment pathway would psilocybin therapy come in when it's ready for prime time? The answer is I don't think we know at this point because we don't have enough data to show, to give us an idea of the profile of people that get better with this particular type of treatment. My own sort of anecdotal assessment, having been involved and treated over 40 or 50 patients with psilocybin therapy, would be that I feel that in individuals that are very much stuck in their own internal world, unable to see outside of that, we consider disorders like depression, anxiety, OCD as internalizing disorders.
People are very much in their own internal space. Psilocybin therapy seems to open up and help people break out of that internal world to feel more connected with the outside world. So perhaps there's a psychological or clinical profile of individuals that may benefit from it.
But definitively, we don't know at this point.
Dr. Blair Bigham:
So is psilocybin competing with ketamine in terms of contributing to improving these symptoms? Where does ketamine fall into all of this?
Dr. Ishrat Husain
Ketamine is often lumped in as a psychedelic, but I actually feel it's a totally different class of treatment. We consider it a dissociative anesthetic. And the way that it's administered for the treatment of depression is also very different.
Dr. Blair Bigham
Yeah, what is the treatment protocol?
Dr. Ishrat Husain
Yeah, so as I mentioned with psilocybin, there's all this psychological support that wraps around it. With administration of ketamine for treatment of depression, it's very clinical. You come into a sort of recovery room type treatment suite, you're delivered the drug IV.
There's no psychological support pre, during or post treatment. And it's more or less, sort of, drug only treatment, although people are trying to augment it with music and psychological support like CBT. Most of the data on its effectiveness is a drug only effect.
Dr. Blair Bigham
Interesting. Okay.
Dr. Ishrat Husain
So it's administered a few times a week for an acute course like ECT. And then people are followed up. But psilocybin, for example, is one or two doses, not repeated courses of treatment.
I think in terms of ketamine, I think it probably, the more fair comparison is comparing ketamine to ECT. Because ECT is also delivered a few times a week over a course of a few weeks, much like ketamine.
Dr. Mojola Omole
And what's the effectiveness of ketamine therapy?
Dr. Ishrat Husain
Yeah, it would be, probably, 50 to 60% of people get an improvement in their depressive symptoms. So almost comparable to ECT. There was a very sort of prominent New England Journal of Medicine paper, I think it was last year or the year before, comparing ECT to IV ketamine, showing that IV ketamine was not inferior to ECT.
And we're extending some of that work now at CAMH in a much larger population to actually see if that's the case. Because then if it is, for people that are a little bit hesitant about ECT, that for whatever reason can't have it, then I think it would be great to have IV ketamine as an alternative.
Dr. Mojola Omole
And what's the duration of it?
Dr. Ishrat Husain
So we have limited data on the long term effects of ketamine. I think one of the concerns about ketamine is that the durability of its response is not as long as ECT. So I don't think it's as long as six months.
It'll probably be, if anything, two to three months in terms of the durability of its response. And then we get into the area of maintenance treatments. Is that something that's safe for something like IV ketamine, which there is a theoretical risk of physiological and psychological dependence as well with that.
Dr. Mojola Omole
How does the safety profile of ketamine compare to psilocybin?
Dr. Ishrat Husain
I don't think that there's been direct comparisons. They're very different drugs. I think, of course, ketamine really depends on the doses people are using.
And I think that you've got that risk of bladder dysfunction that's really real. I think you've got a higher risk of ketamine dependence than you would have of a hallucinogen, a use disorder or dependence. So I think ketamine is probably, I would say, a higher risk substance.
Dr. Mojola Omole
Do we know why it's more effective than psilocybin?
Dr. Ishrat Husain
I actually think it's because we have more data. We have more studies. The first study of ketamine was back in the early 2000s.
The most recent psilocybin trials were in like 10 years later. So I think we've just got a bit of catching up to do to get larger samples and longer term safety and effectiveness data.
Dr. Blair Bigham
So we have psilocybin, we have ketamine, we have ECT. What should physicians take away from today as they're listening and thinking about how they can consider ordering or pursuing some of these treatment options for their refractory patients?
Dr. Ishrat Husain
So I think the first thing that physicians need to be aware of is what is the evidence base for these each individual treatments in terms of their safety and effectiveness. That's where you start from so that you can have an informed discussion with your patient when they come to you and say, hey, doctor, my SSRI isn't working. I want psilocybin. Should I go to the dispensary down the street and get some psilocybin for myself? Right? Because it's out there.
In Toronto, on almost every street corner, there is some sort of mushroom dispensary. I drive by at least three on my way home from work. So it's like, people are, there is a real sort of movement, I think, for self-medicating.
But I think physicians need to be aware that for psilocybin, it's still an experimental treatment options. We can't confidently say if it's safe for everybody with depression. We can't confidently say that it helps everybody with depression.
So a physician's role, I think, is to do a little bit of harm reduction with regards to the use of recreational or self-medicating use of these substances and direct people to specialist centers where they're conducting clinical trials like CAMH, like UHN in Toronto, where they can be assessed for sort of participation in clinical trials. And then for IV ketamine, which yes, is a little bit more evidence based, but according to the Ministry of Health in Ontario, at least, is still an experimental treatment option. It's not funded by or covered by OHIP.
So before a patient goes to a private clinic to pay thousands of dollars that they may not have, perhaps go again, be assessed at a specialist center for your refractory depression to consider other more readily available evidence based treatment options like RTMS, transcranial magnetic stimulation or ECT.
Dr. Blair Bigham
I’m so glad we're doing this episode because there's so much out there, either in the media or on social media, the streams that you get on social media, pushing you to this, do it yourself or follow me. I've been through this and I felt better. Those personal characters really do drive people.
Dr. Mojola Omole
The grifters.
Dr. Blair Bigham
Yeah, the grifters. But we really do need to know the evidence. And this has been such an incredible chat. Thank you so much for joining us today, Ishrat.
Dr. Ishrat Husain
Oh, it was a pleasure. Thanks for having me. I really enjoyed the discussion.
Dr. Mojola Omole
Dr. Ishrat Hussain is a senior scientist and the scientific head of clinical trial unit at CAMH in Toronto. He also leads the CAMH mood disorder service.
Dr. Mojola Omole
Okay, so Blair, let me start with you. You're in the emergency department. What's running through your head right now?
Dr. Blair Bigham
I do not really associate hallucinogens with mortality, first of all. I mean, people come in, they're a little psychotic. Maybe they've done some psychedelics. I'm kind of like, sleep it off, chill out. You know, here's a lorazepam, here's a hydroxyzine. Like, let's get you back home as quick as we can.
I guess some of those people are severely psychotic and do end up maybe on a mandatory hold. Maybe they end up admitted to psychiatry. But I don't know, my assumption was just that, give them some time and they probably get discharged.
And sure, some of those cases are going to be people who have underlying psychiatric conditions. Maybe they have schizophrenia. Maybe they're not going to be discharged quite as soon. But I don't think that when I see someone on hallucinogens, I go, uh-oh, like it doesn't flag in my mind.
Dr. Mojola Omole
But I think it definitely is a great study to start, to maybe to lead the charge in trying to dissect how safe are these drugs if the use of them are increasing, especially when we talk about microdosing.
Dr. Blair Bigham
Absolutely.
Dr. Mojola Omole
In all populations who have an interest in it, it's kind of similar to cannabis.
And it sounds like it's not just recreational. It sounds like there's sort of some clinical stuff in the works here, where these might be more commonly prescribed, and it's important to know their safety profile.
Dr. Mojola Omole
For sure. And all the work that Dr. Hussain, Ishrat Hussain is doing around guided hallucinogen therapy, I think is really fascinating. It does seem very resource intensive. So there is a part of me that wonders, how much is this going to be able to be adopted as part of the algorithm for treatment of mood disorders?
Dr. Blair Bigham
And second, just to consider, if you're treating someone, maybe, with refractory depression, maybe referring to a specialist for a guided hallucinogen exposure might be helpful. That's it for this episode of the CMAJ Podcast. The link to the study is in the show notes. Thank you so much for listening. Please rate, review, or share your podcast with your colleagues or anyone else you think might be interested in Jola and I.
It goes a long way to helping us get the message out there. This podcast is produced for CMAJ by Neil Morrison at PodCraft Productions. I'm Blair Bigham.
Dr. Mojola Omole
I'm Mojola Omole. Until next time, be well.