The NYU and Johns Hopkins psilocybin cancer trials

The NYU and Johns Hopkins psilocybin cancer trials brought a once-interrupted line of psychedelic research back into prominent medical discussion. Conducted at New York University and Johns Hopkins University, the studies tested whether a single high dose of psilocybin, given with therapeutic support, could relieve the anxiety and depression that may accompany a life-threatening cancer diagnosis. Their results, published together in 2016, were unusually encouraging; their small scale and the difficulty of separating a drug’s effects from the experience surrounding it kept those results from being definitive.

Origins and Research Design

The trials resumed an inquiry that had been cut off when sanctioned psychedelic therapy ended in the 1970s. New York University’s study was directed by psychiatrist Stephen Ross, whose interest began when a colleague mentioned earlier LSD treatment for alcoholism. Research led him to a largely forgotten body of clinical work. By the time he began his psychiatric residency in the 1990s, that history had effectively disappeared from professional training. The new studies were therefore not simply tests of an unfamiliar drug: they were attempts to recover and reassess knowledge that cultural and institutional pressures had pushed out of medicine.

The two cancer trials formed part of a broader revival. Charles Grob’s 2011 pilot study of psilocybin for cancer-related anxiety helped clear a path for the New York and Johns Hopkins research. Grob described the later work as picking up a torch earlier researchers had been forced to put down. The new investigators returned to questions already explored in the mid-twentieth century, but had to reprise them under contemporary scientific standards before psychedelic therapy could plausibly gain acceptance in modern medicine.

At New York University, the clinical purpose was to determine whether one high-dose session could alleviate anxiety and depression following a life-threatening diagnosis. The treatment took place in a room designed to feel like a comfortable den rather than a hospital suite, though its medical fittings remained visible beneath the domestic setting. A couch provided the place to lie down during the session; art books, mythology, a ceramic mushroom, a Buddha, and other objects contributed to its carefully composed atmosphere. The room made tangible a central feature of the research: treatment was not only the administration of a compound, but an experience conducted in a particular environment with a guide present.

Tony Bossis, a palliative-care psychologist, guided Patrick Mettes during a turbulent six-hour session in that room. Mettes was a volunteer in the New York trial, and his experience became one of the stories through which the study’s stakes were conveyed. The research concerned measurable symptoms, but it took place in a setting designed to support an inward, emotionally consequential journey. The clinical arrangement thus joined a drug protocol to human accompaniment rather than treating the session as a pharmacological event isolated from its surroundings.

Results and Public Reception

In December 2016, the New York and Johns Hopkins findings appeared together in a special issue of the Journal of Psychopharmacology. A front-page New York Times report brought the results to a wide audience, while nearly a dozen commentaries in the journal—including contributions from two former presidents of the American Psychiatric Association—hailed the studies. The reception marked a reversal in status: psychedelic therapy, after decades in the shadows, was becoming respectable again, though not yet unreservedly so.

Across the two trials, about 80 percent of the cancer patients showed clinically significant reductions in standard measures of anxiety and depression. Those improvements lasted for at least six months after the psilocybin session. The intensity of the mystical experience participants reported was closely correlated with the degree to which their symptoms subsided. Few psychiatric interventions had demonstrated results described as comparably dramatic and sustained. The association did not establish why the treatment helped, but it made the character of the experience difficult to dismiss as incidental to the clinical outcome.

The findings also changed institutional behavior. Dozens of medical schools sought to take part in future trials, and funders came forward to support them. New York University, which had once tolerated the work more grudgingly, promoted the results and invited Ross to move his treatment room from the dental college to the main hospital. The university’s cancer center, initially reluctant to refer patients to the study, subsequently asked him to establish a treatment room there for an upcoming trial. These developments did not amount to regulatory approval, but they showed that the results had altered the research’s institutional prospects.

What the Experience May Contribute

The papers offered no settled theory of how psilocybin produced the reported benefits. The link between stronger mystical experiences and greater symptom relief invited questions about whether a changed sense of self, a sense of sacredness, or an enlarged context of meaning might help patients live with the prospect of death. None of those possibilities, on its own, accounted for the range of experiences people described. Some participants’ ways of imagining what follows death could be naturalistic, grounded in the idea of becoming part of the earth rather than in a supernatural afterlife.

A follow-up study of New York University participants, published in 2017, approached their accounts through psychotherapy and humanistic psychology as well as through the mystical-experience framework. Alexander Belser, a member of the New York team, interviewed volunteers about the transformations they experienced. The accounts emphasized connection to loved ones and a movement away from separateness toward interconnectedness. Participants described powerful joy, bliss, and love; difficult stretches in a session could be followed by surrender and acceptance, including acceptance of their cancers, as fear receded.

Psychiatrist Jeffrey Guss interpreted the session partly in terms of psilocybin’s capacity to quiet or muffle the ego. In his account, the ego helps maintain boundaries between conscious and unconscious experience and between self and other. When those boundaries loosen, rigid patterns of thought may become less compelling and new meanings easier to perceive. Before sessions, Guss prepared patients to expect possible insight into themselves and into life’s meaning, while mentioning mystical or transcendent experience without prescribing what it must mean. That preparation underscored the therapist’s role in shaping the context in which patients understood what happened.

These accounts leave open how much of the therapeutic effect belongs to the molecule, the altered experience, the therapist, or the expectations brought to the session. They also allow different interpretations to coexist. A loss of the usual sense of self might be discussed psychologically or in relation to brain activity; an experience of sacredness might be understood spiritually or as a heightened sense of meaning. The studies did not settle those disputes. Their results instead made the disputed territory—between clinical measurement and experiences commonly called spiritual—part of the medical question.

Methodological Limits and Consequences

The combined trials included only eighty subjects. Their results would need to be repeated on a larger scale before the government could consider rescheduling psilocybin and approving the treatment. The researchers and participants could often tell whether psilocybin or a placebo had been given, making conventional blinding difficult. Nor was it clear how a trial could isolate the chemical’s effect from the setting, the therapist’s presence, or the volunteer’s expectations. Those are not minor complications when the proposed treatment works through an experience that depends on context; they challenge the usual effort to isolate one variable at a time.

Earlier research offered a cautionary history. In Saskatchewan, clinicians had reported strong results treating alcohol dependence with LSD in supportive settings. A Toronto replication, designed to isolate the drug under more controlled conditions, used neutral rooms and limited interaction; volunteers were questioned extensively and, in some cases, restrained or blindfolded. Its outcomes did not match the Saskatchewan results, and some participants endured frightening experiences. The disagreement showed why a trial that controls context may also alter the treatment being evaluated. It did not prove that context explains therapeutic success, but it made the question unavoidable for later psychedelic studies.

The cancer findings themselves also called for restraint. Small early studies can select volunteers most likely to respond, and participants receive unusually attentive care from highly trained therapists. Researchers may be predisposed to find an effect, while the placebo response can be especially strong when a treatment is new. The promising results were therefore signals, not proof that psilocybin reliably cures anxiety or depression in larger populations. Their importance lay both in the outcomes reported and in the research questions they reopened: how to test an experience-based treatment rigorously, and how medicine should evaluate effects that may be inseparable from the human and symbolic setting in which they occur.