Psilocybin is my friend

A few small doses that changed a few lives, and through them a little of the world: a banker in a Mazatec hut, a Harvard professor on his kitchen floor, a stockbroker in a detox ward, a chemist on a mountain road. The stories, the people they cost, and the plain numbers on who should and shouldn't, with equal parts hope and caution.

By Reid Robison, MD. 4,267 words, with a timeline of the experiences, what the surveys found about bad trips, the hype cycle drawn as a curve you can walk along, and a short list of the things that change the odds.

The title is Ram Dass's. In the summer of 2018, a year and a half before he died, the composer East Forest sat with him in his study on Maui and recorded conversations for an album. When East Forest asked him a long question about the new psilocybin research, the first thing Ram Dass said was "Psilocybin is my friend." His answer became the song "Home," about the session in 1961 that started everything, which East Forest called "the springboard of his spiritual life."¹ Listen to it if you can; it is his voice, slowed by a stroke two decades earlier and entirely clear. The sentence captures something real about how a small number of people talk about this molecule: as a companion that showed them something and then, if they were wise, sent them home to do the work themselves.

This post is about those people. I picked a handful of documented experiences, mostly psilocybin and a few LSD, that changed the course of one life and, through it, nudged something larger: a religion's encounter with modernity, the founding story of Alcoholics Anonymous, the most-used technique in molecular biology. Then the other side, because I run these trials and I see both: what the surveys say about the experiences that go badly, the short list of things that change the odds, and the hype cycle that a few colleagues warned us about in 2022 and that the field has been riding ever since. It follows on from my piece on Timothy Leary, who appears here only at the edges.

1Eight experiences, in order

Here is the set, from the oldest to the newest, with what each one led to. Tap one for the story. The blue ones are psilocybin, the yellow ones LSD, and the grey one is something else entirely, for reasons that will become clear.

2Why it was Ram Dass's friend

On March 6, 1961, Richard Alpert, a young Harvard psychology professor with a Mercedes, a Cessna and, by his own account, a deep sense of being a fraud, took psilocybin at Timothy Leary's house.² What he found, in his words, was "a place in myself, or a quality in myself, behind the way I knew myself to be," and it "felt incredibly natural and familiar to me, even though as an adult I had never experienced that space before." He felt "incredible love and compassion towards everything." The rug crawled and the picture smiled, he wrote later, "all of which delighted me."⁹

That is the part people quote. The part I find more useful came after. For years he took psilocybin and LSD and kept coming down, and he got interested in why. His conclusion: "my high was my natural state," and what brought him down "was the attachment I had to my own thoughts." At first he had assumed "that the chemical was taking me someplace other than myself." Eventually he decided it was showing him somewhere he already was, and that getting back there without it was the work: "you try to unglue the sticky fingers of thoughts and you do that through meditation."²

In 1967 he went to India carrying LSD, met the teacher he would follow for the rest of his life, Neem Karoli Baba, and gave him, at his request, a very large dose. By Ram Dass's account nothing visible happened, then or when they repeated it three years later.⁹ Whatever you make of that story, its moral is the one he drew: the drug was a door, and the room was already there. He came home as Ram Dass, wrote Be Here Now, and spent fifty years teaching meditation and service to people who mostly never took anything at all. That is what I think a psychedelic "friend" looks like when the friendship goes well. It introduces you to someone and then gets out of the way.

3Bill W., the white light, and a very careful fellowship

In December 1934 a failed New York stockbroker named Bill Wilson was admitted to Towns Hospital for the fourth time to dry out. The treatment there, the Towns–Lambert "cure," included a mixture containing belladonna and henbane, plants that can cause delirium, and during that stay he had the experience he would describe for the rest of his life: "my room blazed with an indescribably white light," a mountain, a great wind, and the thought "you are a free man."¹⁰³ He never drank again. Six months later, in Akron, he and Dr. Bob Smith founded what became Alcoholics Anonymous. Whether the belladonna had anything to do with the light is unknowable and has been argued over for decades; I mention it because it means the founding spiritual experience of the most successful addiction program in history took place, at minimum, in a chemically altered state.

Twenty-two years later, on August 29, 1956, in California, Wilson took LSD under the supervision of the UCLA psychiatrist Sidney Cohen, with the writer Gerald Heard as a guide.¹¹¹⁰ He was enthusiastic. According to AA's own biography of him, the experience "helped him eliminate many barriers erected by the self."³ He kept at it into the early 1960s, invited his wife, his secretary and a Jesuit friend, and watched with interest as Humphry Osmond and Abram Hoffer in Saskatchewan reported striking results giving LSD to severe alcoholics before sending them to AA. In 1961 he wrote to Carl Jung, who had decades earlier told one of Wilson's sponsors that an alcoholic's craving was, at bottom, a thirst for wholeness. Jung replied with the line AA still quotes, that the Latin for alcohol is spiritus, "the same word for the highest religious experience as for the most depraving poison." Wilson's second letter described his LSD sessions with AA friends, taken "frequently and with much benefit." Jung was ill when it arrived and died that June without answering.¹²¹⁰

The fellowship did not follow him, and it is worth understanding why. Picture the time. AA was barely twenty years old, built entirely on the claim that the only way out of addiction was complete abstinence from mood-altering substances and a spiritual awakening that came through other drunks, not through a doctor. It had survived by being careful: anonymous, unaffiliated, and bound by Traditions adopted in 1950 that said, among other things, that "Alcoholics Anonymous has no opinion on outside issues" and should never lend its name to any outside enterprise.¹³ Prohibition was within living memory, and so was the image of the morphine-addicted "dope fiend." The co-founder of a sobriety movement taking a hallucinogen, however legally and however supervised, was precisely the kind of story that could have destroyed it. The non-alcoholic chairman of AA's trustees declined Wilson's invitation to try it, members who heard about it were alarmed, and the joke that went around was that Bill "takes one pill to see God and another to quiet his nerves."¹¹¹⁰ AA never endorsed it, never discussed it officially in his lifetime, and has said nothing about psychedelics since, which is consistent with the Traditions and probably saved the organization. It also means that one of the most promising treatment ideas of the 1950s, tested by the founder of the most important addiction program in the world, went quiet for fifty years.

Wilson himself was clear-eyed about it. He called LSD "about as harmless as aspirin," which was wrong, and in the same breath said it lacked "any miraculous property of transforming spiritually and emotionally sick people into healthy ones overnight," which was right.¹⁰ Today, some of the most promising results in psychedelic research are in alcohol use disorder. I think he would have found that vindicating and would have hated the hype.

4Chemists, coders and the mountain road

Albert Hofmann, the Sandoz chemist who took the first deliberate dose of LSD on April 19, 1943, and rode his bicycle home through Basel as it took hold, is also the man who isolated and synthesized psilocybin, in 1958, from mushrooms that Gordon Wasson had brought back from Mexico.¹⁴ In 1962 he went to Huautla himself and gave María Sabina pills of the pure compound; by his account she said the spirit of the mushrooms was in them. Two of the most important molecules in psychiatry came out of one lab, and the man who made them lived to 102 and said to the end that they should be used with reverence.

Kary Mullis was driving through the redwoods of Mendocino County one night in 1983 when the idea for the polymerase chain reaction came to him, a way to copy a stretch of DNA billions of times over in an afternoon. PCR won him the Nobel Prize in 1993 and is how every COVID test you took worked. He was open about having used a lot of LSD in his younger years and said: "What if I had not taken LSD ever; would I have still invented PCR? I don't know. I doubt it. I seriously doubt it."⁴¹⁵ He was, later in life, wrong about a great many things, including the cause of AIDS. I include him partly for the discovery and partly for the warning: a psychedelic may help a mind see something new, and it does not make that mind right about everything afterward.

Steve Jobs told his biographer that taking LSD "was a profound experience, one of the most important things in my life," and that it reinforced his sense of what was important, "creating great things instead of making money."¹⁶ I am wary of the Silicon Valley version of this story, which tends to become an argument for microdosing your way to a better quarter. But it is his own account, and he gave it near the end of his life, when he had little reason to embellish.

The divinity students. On Good Friday 1962, twenty theology students sat in Boston University's Marsh Chapel; half got psilocybin, half a placebo. Most of the psilocybin group had what they described as mystical experiences, and the religion scholar Huston Smith, who was there, called his "the most powerful cosmic homecoming I have ever experienced."¹⁷¹⁸ The study had serious problems, which I covered in the Leary post, and one participant had to be sedated.¹⁹ But in 2006 a careful double-blind study at Johns Hopkins found much the same thing, and a decade later the same group showed that a single session reduced depression and anxiety in people with life-threatening cancer, with most still improved six months on.²⁰²¹ The modern field begins, in a real sense, with those twenty students.

5Who paid

None of this reached the West without a cost to someone, and the person who paid most has the least to do with the hype. In 1955 Gordon Wasson, a vice-president of J.P. Morgan and an amateur mushroom scholar, took part in a nighttime ceremony, a velada, led by María Sabina, a Mazatec curandera in the mountain town of Huautla de Jiménez. He told her he was worried about his son back home, which he later admitted was a pretext to be allowed in.⁵ In 1957 he published the story in Life magazine under the title "Seeking the Magic Mushroom," with photographs; he gave her a pseudonym, but later published her name and village in a book.²²⁵

What followed was almost certainly nothing Wasson intended or foresaw, and he had no hand in the violence. His article set off a migration he could not control. Within a few years Huautla was full of hippies, seekers, journalists and scientists, and the people who paid for that were in the village, not in New York. The Mexican police suspected her of dealing drugs and briefly jailed her. Some of her neighbors blamed her for the invasion, and her house was burned down. One of her sons was murdered during those years; the accounts I can find do not establish who killed him or why, and none of them point to Wasson.⁵ Wasson's failures were the pretext he used to get in and the decision, later, to publish her name; the rest came from the crowds, the police and her own community's anger. She said that before Wasson "nobody took the children," her name for the mushrooms, "simply to find God," and that she wished she had never shown him. She died in poverty in 1985. Every psilocybin trial, mine included, rests on a sacred practice that was taken from an indigenous woman without her meaningful consent, and the least we can do is say her name.

6When it goes badly: the numbers

Now the other side. In 2016 the Johns Hopkins group asked people who had taken psilocybin mushrooms to describe their single worst experience, and 1,993 of them did.⁶ It is a survey of bad trips, so it says nothing about how often they happen, only what they look like when they do. Here is what it found.

Two things in those numbers are easy to miss. First, the dangerous minority is real: one in nine put themselves or someone else at physical risk, and a few dozen people sought medical help. Among those whose experience was more than a year in the past, about 8% had sought treatment for psychological symptoms that lingered, and the authors reported three cases of enduring psychosis and three suicide attempts associated with the experience.⁶ Second, even about their worst trip, most people said they had benefited, and a third counted it among the most meaningful experiences of their lives. Difficult and dangerous are different things. A hard night in a safe room with someone you trust is a very different event from the same hard night alone at a music festival.

The largest look at the really bad end comes from the Global Drug Survey. Of about 9,200 people who had used mushrooms in the previous year, 19 (0.2%) had needed emergency medical treatment.⁷ Their commonest symptoms were panic and paranoia; younger people were more likely to end up there; nearly all were back to normal within a day. More than a third had also used cannabis in the same session, and about a third had been drinking. When asked what went wrong, they named the wrong mindset, the wrong place, and mixing.⁷

7The things that change the odds

I can't write a post telling people how to take a drug that is illegal in most places, so this is not a guide. But the research points at a short list of things that separate the hard nights from the dangerous ones, and I would rather people know them than not. They are, roughly, the same safeguards that clinical trials have used since 2008.²³ The cannabis point has its own study: a prospective survey from Imperial College found that cannabis taken alongside a psychedelic changed the experience in a dose-dependent way, with larger amounts tied to more challenging experiences.²⁴ And the lithium point comes from an analysis of thousands of online experience reports, in which psychedelics taken with lithium were associated with seizures.²⁵

My own list, if a friend asked, would be shorter: not if you or a parent or sibling has had psychosis or bipolar disorder; not on lithium; not alone; not with anything else in your system; and not because the internet told you it would fix you. If you are thinking about it because you are struggling, the better first step is a clinician or therapist.

8The hype cycle

In 2022 three researchers at Johns Hopkins, David Yaden, James Potash and the late Roland Griffiths, whose lab did more than anyone's to bring this science back, wrote a short piece in JAMA Psychiatry with a title that surprised a lot of people: "Preparing for the Bursting of the Psychedelic Hype Bubble."⁸ They borrowed a picture from the technology-consulting world, the Gartner hype cycle: a new technology rises to a peak of inflated expectations, crashes into a trough of disillusionment, and then, if it survives, climbs a slope of enlightenment to a plateau of productivity.²⁶ Their argument was that psychedelics were cresting the peak, that the crash would come, and that the danger was a crash so hard it took the science down with it, as happened once before. Walk along it.

Four years on, I think they were right about the shape and lucky about the timing. The first big crash in modern psychedelic medicine came in August 2024, when the FDA declined to approve MDMA-assisted therapy for PTSD, and the headlines flipped from miracle to fraud in about a week.²⁷ The science did not change that week; the expectations did. Psilocybin for depression has since produced two positive phase 3 trials and may be approved next year, which is about as close to a slope of enlightenment as this field has been.²⁸ The work now is to get to the plateau without another crash, which mostly means saying what the effect sizes actually are, out loud, every time.

9Friend, with conditions

So is psilocybin a friend? For Ram Dass it was the kind that introduces you to yourself and then leaves. For Bill Wilson it was a hope he was not allowed to share. For María Sabina it was a sacrament that strangers turned into a commodity, and it cost her nearly everything. For about one in fifty people describing their worst trip it meant a visit to a doctor, and for some it meant much worse. For the patients in our trials it is, so far, a medicine that helps some of them a good deal and others not at all.

The honest version of the title is the one with conditions attached: the right person, the right setting, the right company, nothing else on board, and a life afterward that does the slow work. The research I run is an attempt to find out who that right person is, and to build the room. I am hopeful about it and careful about it in roughly equal measure, which is, I have come to think, the only defensible way to feel about this molecule.

Educational only. Psilocybin and LSD are Schedule I controlled substances under US federal law. Nothing here is a recommendation to use them outside a lawful, supervised setting. If you or someone you know is in crisis, call or text 988 in the US.

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