Americans say that cannabis is much less dangerous than opioids, alcohol, and cigarettes, according to a new survey conducted by the American Psychiatric Association (APA) and Morning Consult last week. The survey results come from interviews with 2,201 adults conducted between April 20 and 22 of 2023, with a +/-2 percentage point margin of error, analyzing public opinion on the dangers and addictiveness of six different substances—and technology. 

Regarding cannabis, 38% said that it is “very or somewhat unsafe.” Comparatively, 84% of respondents said they regarded cigarettes as unsafe. Sixty-four percent believe alcohol to be unsafe, 66% found prescription opioids unsafe, and 75% found non-prescription opioids unsafe. Reminding us of the negative public perception of vapes, 76% responded that vapes are unsafe. While technology will lose in other categories (here’s where we unintentionally ironically tell you to keep scrolling on your screen to find out), people said that technology was safer than cannabis, with only 23% described as very or somewhat unsafe, making it the only category deemed safer than marijuana. 

The survey also analyzed the public’s perception of addiction. In that category, they perceive cannabis to be less addictive than all of the substances mentioned, in addition to technology. Sixty-four percent said that cannabis can be addictive. Eighty-seven percent say cigarettes are addictive, and 84% deem alcohol addictive. Prescribed opioids are considered 83%, a figure that drops to 74% for non-prescribed opioids. Eighty-one percent think vapes are addictive, and 75% find technology addictive. 

“It is clear that we have gotten the message through that cigarettes are dangerous and addictive,” APA President Petros Levounis said in a press release. “We can help prevent more Americans from other potentially addictive behaviors, like drinking alcohol and technology use.” “For instance, vaping is just as, if not more, addictive than cigarette smoking,” Levounis adds. 

However, even though science agrees that addiction is a medical condition (check out this study published in the Journal of Psychiatry and Neuroscience), 47% said that addiction results from “personal weakness,” which gives us insight into the stigma surrounding substance use disorders. While cannabis is generally not considered physically addictive, remember that other substances the survey covers, such as opioids, are highly addictive due to how they affect the brain, research confirms. If someone is prescribed opioids after sustaining injuries in an automobile accident, for instance, and they develop an addiction, it is scientifically proven to be due to changes in the brain rather than a lackluster set of morals. 

However, Levounis says the survey can be helpful by offering insight into how to educate the public best. “We can also make sure that people know about our current safe and effective treatments for both substance use disorders and behavioral addictions,” he says. “Addiction treatment works.”

And the numbers are higher for those with less regressive views regarding the cause of addiction. Seventy-six percent of respondents answered that addiction is a medical condition, and 93% of those polled said substance use disorders can be treated, with 76% responding that the condition is preventable. 

The survey also offers insights into the importance of increasing awareness regarding naloxone, a life-saving opioid anti-overdose drug. Only 58% said they were aware of naloxone, and only 35% said they’d know how to access it if they needed it for an overdose. Naloxone can reverse an overdose, but only if used 30 to 90 minutes after the incident is discovered. As a result, it is something everyone should have on hand rather than search for when discovering an overdose. Considering that the study found that 71% of Americans say they’d know how to help someone in their life who’s struggling with addiction, it’s clear that one of the biggest takeaways from the research is the importance of naloxone awareness. 

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At the American Psychiatric Association (APA) 2022 Annual Meeting that began on May 21 in New Orleans, Louisiana, COMPASS Pathways unveiled the “largest randomized, controlled, double-blind study of psilocybin therapy ever completed,” according to a May 24 press release, and the data shows “significant” improvements to treatment-resistant depression (TRD) symptoms.

Participants were given a single dose of investigational COMP360 psilocybin, in doses of 25 mg or 10 mg, compared to 1 mg in patients with TRD. For the study, 233 patients with TRD received either 1 mg, 10 mg, or 25 mg COMP360 psilocybin, along with psychological support from therapists. Symptoms of depression were calculated using the Montgomery-Åsberg depression rating scale (MADRS).

The MADRS system has been used in the world of psychiatry since 1979 and measures apparent sadness (despondency, gloom), reported sadness, inner tension (discomfort, turmoil, dread), reduced sleep, reduced appetite, and concentration difficulty, typically in a ten-item questionnaire.

The people who received a 25 mg dose of COMP360 psilocybin with psychological support experienced a “highly statistically significant reduction in symptoms of depression after three weeks.” The difference between the group that received 25 mg and the group that received 1 mg was -6.6 on the MADRS depression scale at week three.

The effects also lasted very long—for three months, in some cases. The findings show that psilocybin provides “a rapid and durable response for up to 12 weeks.”

Twice the number of patients who received 25 mg (20.3%) had a “sustained response” at week 12, versus those who received 1 mg (10.1%). Tolerability and adverse effects were both reported mostly favorably, despite some reports commonly seen in people with TRD such as self-injury, but it was typically over a month after treatment.

“Treatment-resistant depression is one of the biggest challenges we face in psychiatry, and chances of success decreases with each treatment that a patient tries,” said David J Hellerstein MD, a Principal Investigator on the trial and Professor of Clinical Psychiatry at the Columbia University Irving Medical Center. “It’s rare to see such positive outcomes of clinical trials in this disease area, which is why these results are so significant. I hope this represents a major step in finding new options for people living with treatment-resistant depression.”

Columbia University’s Department of Psychiatry said last year that its study is the “largest to date using psilocybin to treat depression in people who aren’t helped by existing therapies.” Tough challenges require thinking outside the box, in this case, with the active alkaloids from psilocybin mushrooms. Even Canadian Senator Larry Campbell admitted that he takes microdoses of psilocybin for the treatment of depression.

“Our mission is all about developing mental health innovations through scientific evidence, which is why we’re so honored to present the largest study of its kind at the APA,” said Dr. Guy Goodwin, Chief Medical Officer, COMPASS Pathways. “In this study, a significant number of patients experienced improvement in their symptoms of depression after just a single dose of 25 mg psilocybin with psychological support, with effects lasting for up to three months of the study. We now need to continue our research to understand if this can be replicated in even larger trials.”

COMPASS is based in London, with offices in New York City and San Francisco, with clinical studies in North America and Europe.

There’s a divide in beliefs surrounding serotonin reuptake inhibitors (SSRIs). While some say SSRIs are a life-saver, others say they instead create an unnatural imbalance of neurotransmitters. Only a doctor can give you the final answer to that, and it’s assumed that people with TRD have already ruled out SSRI drugs like Prozac, Paxil, Zoloft, and Celexa.

The study cites data showing that over 320 million people globally suffer with major depressive disorder (MDD). About a third of these patients—a whopping 100 million people—aren’t helped by existing therapies and therefore have TRD.

And the most sobering data point? As many as 30% of them attempt suicide at least once during their lifetime.

In any case, psilocybin presents an entirely new mechanism for controlling treatment-resistant depression. The APA will also hold an online experience June 7-10 in case you missed the May event in New Orleans.

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