Mystical experiences during clinical trials of psychedelics correlate with more positive clinical outcomes in treating depression, substance use disorders or other conditions in participants. Such “breakthrough” experiences are more powerful and intense than the average psychedelic experience, and may be accompanied by positive feelings of “oceanic boundlessness.” Subjects often rate them as incredibly meaningful, even when the experience includes negative aspects such as fear or anxiety.
While such evidence mostly comes from trials involving tryptamine psychedelics such as psilocybin, a new study published in the Journal of Psychopharmacology suggests that hefty doses of cannabis could generate similarly meaningful breakthrough experiences, albeit with less frequency than a drug like psilocybin. The results suggest that despite differences in pharmacology, there may be a role for cannabis in the emerging psychedelic therapy paradigm alongside tryptamine psychedelics.
In fact, State University of New York at Albany Professor of Psychology and first author of the study Mitch Earlywine notes, the more liberalized rules around cannabis might make it a better choice than psilocybin in some situations.
“Our data suggested that a breakthrough is definitely more likely with a psychedelic, but cannabis might be more available sooner,” he said.
Cannabis Effective, but Less Reliable Than Tryptamine Psychedelics
The study was conducted by anonymous survey, with a total of 852 people completing questions about current and past cannabis use and then choosing a specific incident “that was the highest you ever felt.” The researchers also asked participants to guess how many milligrams of THC they consumed for that highest high, and to then answer a 27 item “oceanic boundlessness” questionnaire that is a subscale of the Mystical Experiences Questionnaire used in psychedelic trials.
“The psilocybin researchers tend to note that the folks who benefit most are the ones who score above a certain threshold” on the questionnaire, Earlywine said, with 50% to 60% of participants in such trials passing that threshold: a score of at least 81 out of 135 possible on the 27 item assessment. Fewer participants in his study scored that high, so while “lots of folks reported experiencing oceanic boundlessness, only about 1 in 5 passed the threshold in the report about cannabis.”
But while cannabis may not engender breakthrough experiences as reliably as psilocybin, Earlywine said the findings do suggest it’s worth exploring further to see if cannabis might be integrated as another tool in the emerging field of psychedelic-assisted psychotherapy.
Why Study Mystical Experiences With Cannabis?
Earlywine’s lab has published numerous studies on cannabis, he said, but a 2019 paper by his student Stacey Farmer in the Journal of Psychoactive Drugs got his team thinking about the potential parallels between intense cannabis experiences from ingesting edible cannabis products and intense experiences with psychedelics such as psilocybin.
Farmer’s paper “showed that some of the ‘challenging experiences’ people have in response to high doses of edibles are also rated as meaningful in ways that parallel the work that the crew at Johns Hopkins has done on psilocybin,” Earlywine said, referring to Roland Griffiths and other researchers at the Johns Hopkins Center for Psychedelic and Consciousness Research. “We couldn’t help but wonder if some of the mystical experiences also might overlap.”
Additionally, Earlywine said, most studies measuring the subjective experience of cannabis have tended to focus on the most negative effects — paranoia, confusion, anxiety — or the more euphoric effects that might reinforce further use.
“The best work on cannabis and mystical experiences is actually done in publications on religion or spirituality,” he said, “but those researchers often focus on documenting the few religions where cannabis serves as a sacrament or aid to prayer.”
What’s Next for Cannabis Studies?
There were limitations to Earlywine’s paper. It was an anonymous survey with participants recalling experiences that could have been years in the past, for one thing, rather than contemporary psilocybin studies where participants are taking the substance under supervision and reporting soon after.
For another, the researchers did not assess whether the study participants that reported feelings of oceanic boundlessness also experienced relief from conditions such as depression.
“We have some follow-up data under review now suggesting that people definitely think a cannabis session akin to the psilocybin session would improve depression,” Earlywine said. “Those who expect more oceanic boundlessness also tend to think that the experience would improve depression more, too.”
If data from further clinical trials, perhaps comparing cannabis to a placebo, were to support the notion that intense experiences could help depression, it could also challenge the assumed primacy of the role of the serotonin system in mood regulation.
Whether it’s Selective Serotonin Reuptake Inhibitors (SSRIs) such as Prozac boosting levels of the neurotransmitter in the brain, or psychedelics such as LSD and psilocybin acting on serotonin 2A type receptors in the brain, changes in serotonin activity have long been thought to be essential to mitigating depression. But studies with non-serotonergic substances such as ketamine, along with evidence that some tryptamines may exert antidepressant effects through other receptor systems, suggest serotonin isn’t the whole story. Now, this new study on cannabis adds additional evidence for an alternative hypothesis.
It could be that the mystical experience itself is more important than the specific vehicle for obtaining the experience, said Earlywine. “I think that the ‘mystical’ part is where the action is. I’m also not convinced that serotonin is some magical antidepressant,” he said. “An experiment with a tryptamine, cannabis, and a placebo would tell us a lot about whether the serotonin system really needs to be involved or not.”