hulu Nine Perfect Strangers
At Tranquilum, the resort run by Nicole Kidman’s character Masha Dmitrichenko on the new show Nine Perfect Strangers, the guests are getting microdoses of psilocybin, a psychedelic. Masha believes she’s helping them deal with their deeply-rooted traumas, from anxiety to depression to addiction to grief — and so far, the small doses of the drug are working for the characters.
In the fourth episode, when they figure out that Marsha is dosing them and they confront her, she defends her choice, arguing that psilocybin “cures addiction, it can treat mental illness, it can treat PTSD, schizophrenia, dementia. It can make you eat better, sleep better, f— better, and it has the capacity to change the world.”
While what Marsha is doing is completely illegal — both drugging her guests against their knowledge and having the drugs at all — there is some truth to her claims. The use of psilocybin and other psychedelics are not FDA approved as a medical treatment, but the concept has been around since the 1950s, and it’s part of ongoing clinical trials around the country.
HULU Nine Perfect Strangers
Dr. Albert Perez Garcia-Romeu, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine, is one of the people working on those clinical trials.
“These drugs have been studied as far back as the fifties, to see if they had some sort of therapeutic potential,” he says of substances like psilocybin, MDMA and LSD. “At the time, there were psychiatrists and other medical researchers and scientists who were looking at using these drugs in conjunction with psychotherapy, and finding for some conditions like depression and alcoholism, that there could be a good potential there that these could be helpful to assist people in getting over some of these mental health conditions. But the work was not ever very conclusive.”
Now, researchers like Garcia-Romeu are working on getting more conclusive research. They work with study participants for several weeks, beginning with lengthy psychological counseling to understand the person’s life experiences and treatment goals, before giving them high doses of psilocybin and monitoring their reactions.
“It’s not like you take two and call me in the morning,” he says. “It’s really a package that includes a supportive care before, during and after the drug administration that seems to help create long-lasting psychological improvements, including improvements in mood reductions and anxiety and helping some people overcome different types of addiction to alcohol or other drugs.”
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Their research began with a control group of healthy volunteers who do not have medical or mental health conditions to see how they react.
“We were finding that people had these experiences that they consider very personally meaningful, very insightful and spiritually significant,” Garcia-Romeu says. “And not just the day of the drug experience, but even a year or more later, people are still saying, ‘That was one of the most powerful things that’s ever happened to me.’ “
Their research has since expanded to people with health conditions such as depression, alcohol dependence, post-traumatic stress disorder and opioid addiction, among others.
“One of the major ones we’ve looked at has been cancer patients who have anxiety and depressed mood — we published two big papers on that back in 2016, showing that oftentimes when people are dealing with a life-threatening illness like cancer they’re having reduced quality of life and a lot of anxiety and depressed mood as a result,” he says. “And so with those patients, you found that a single high dose of psilocybin, was leading to reductions in anxiety and depression that lasted for several months after that dosing.”
“And this is not trying to treat the cancer,” he adds, “but what it’s trying to do is help these people have a better quality of life and better mood and reduce their anxiety.”
The high dose of the drug, coupled with the counseling sessions, “seems to facilitate behavior change and insight and emotional catharsis, that is often underlying some of the difficulties that the person is having,” Garcia-Romeu says.
What most research has indicated, though, is that a high dose of a drug is needed for long term effects, and the microdoses on Nine Perfect Strangers are unlikely to do much.
“Almost all of the work that’s been published that’s shown clinical and therapeutic potential was done using high dose sessions,” Garcia-Romeu says. “There’s only been maybe three studies I can think of that have actually rigorously looked at microdosing with a placebo control. It hasn’t really shown any clinical benefits yet, but that’s largely because it hasn’t been studied very well.”
Currently, using these drugs is illegal — they’re considered Schedule 1 Drugs by the Drug Enforcement Administration (DEA), and “if you’re in possession or using these drugs, the DEA can come raid your home and take you to jail,” even in cities like Oakland where the local jurisdiction has decriminalized psilocybin and other “magic mushrooms.” They can only be used as a treatment in clinical trials like those at Johns Hopkins, though Garcia-Romeu expects that to change in the next few years.
“Another Schedule 1 drug, MDMA, which is also called ecstacy or molly, has been working its way through the clinical trial approval process for around 20 years,” he says. “They’ve been using a therapeutic package of therapy before, during and after with drug dosing of MDMA for people with post-traumatic stress disorder, and they’ve published some really great findings. They’re going to do a follow-up study now, but once that’s wrapped up, that ought to be enough data to bring to the FDA to basically establish that the drug is safe and effective to treat PTSD.”