This review (2018) argues for the safety of psilocybin when used in medical/research settings. The authors recommend rescheduling to Schedule IV (less restrictive than the current Schedule I).
Abstract of The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act
“This review assesses the abuse potential of medically-administered psilocybin, following the structure of the 8 factors of the US Controlled Substances Act (CSA). Research suggests the potential safety and efficacy of psilocybin in treating cancer-related psychiatric distress and substance use disorders, setting the occasion for this review. A more extensive assessment of abuse potential according to an 8-factor analysis would eventually be required to guide appropriate schedule placement. Psilocybin, like other 5-HT2A agonist classic psychedelics, has limited reinforcing effects, supporting marginal, transient non-human self-administration. Nonetheless, mushrooms with variable psilocybin content are used illicitly, with a few lifetime use occasions being normative among users. Potential harms include dangerous behavior in unprepared, unsupervised users, and exacerbation of mental illness in those with or predisposed to psychotic disorders. However, scope of use and associated harms are low compared to prototypical abused drugs, and the medical model addresses these concerns with dose control, patient screening, preparation and follow-up, and session supervision in a medical facility. Conclusions: (1) psilocybin has an abuse potential appropriate for CSA scheduling if approved as medicine; (2) psilocybin can provide therapeutic benefits that may support the development of an approvable New Drug Application (NDA) but further studies are required which this review describes; (3) adverse effects of medical psilocybin are manageable when administered according to risk management approaches; and (4) although further study is required, this review suggests that placement in Schedule IV may be appropriate if a psilocybin-containing medicine is approved.”
Authors: Matthew W. Johnson, Roland R. Griffiths, Peter S. Hendricks & Jack E. Henningfield
Summary of The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act
Psilocybin is under development for treating depression and anxiety in patients with life-threatening cancer diagnoses and addiction to tobacco and alcohol. A clinically tested drug product would be available that provided psilocybin doses demonstrated to be safe and effective. The drug would be administered in clinic settings with the psychological support of specially trained staff, and a post-marketing surveillance plan would be in place.
Psilocybin was marketed in the US in the 1960s as an adjunct to psychotherapy for depression, anxiety and other disorders. However, the societal backlash led to a ban on marketing and possessing “hallucinogenic” drugs in the US in 1965. Psilocybin was placed in Schedule I of the CSA in 1970, despite the mixed scientific evidence. This was primarily due to the perception that psilocybin posed serious risks to patients and the public that did not outweigh its benefits.
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https://doi.org/10.1016/j.neuropharm.2018.05.012
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Cite this paper (APA)
Johnson, M. W., Griffiths, R. R., Hendricks, P. S., & Henningfield, J. E. (2018). The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act. Neuropharmacology, 142, 143-166.
Study details
Compounds studied
Psilocybin
Topics studied
Safety
Study characteristics
Literature Review
Theory Building
Authors
Authors associated with this publication with profiles on Blossom
Peter HendricksPeter Hendricks is a Professor in the Department of Health Behaviour at the University of Alabama. Hendricks's area of expertise lies in substance abuse treatment and prevention.