Ending journalism’s bad trip — why it’s important to communicate responsibly about the health effects of psychedelic drugs

Kevin Lomangino is the managing editor of HealthNewsReview.org. He tweets as @Klomangino.

Health effects of psychedelic drugsWe’ve seen some trippy coverage over the years when it comes to the health effects of psychedelic drugs.

I’ll never forget Dr. Manny Alvarez’s Fox News interview with Chris Kilham, the self-proclaimed “Medicine Hunter,” who said he was swallowed by an anaconda while tripping on Amazonian ayahusca. That’s a hallucinatory brew which according to Kilham has “extraordinary healing powers.” But those powers weren’t backed up by any evidence in the infomercial-like TV segment.

And then there was Newsweek’s coverage of the “booming, bellowing barfs” that are supposedly “part of the healing process” of an ayahusca trip. No evidence was presented in the piece, but a former Van Morrison guitarist told us how his depression, “which took the form of a dragon living in his chest,” flew away during an ayahusca trip when the musician “decided to love his sadness.”

Other stories we’ve looked at have done a much better job of exploring the costs and potential harms of psychedelic drugs. But one presented claims of “paradigm-shifting” benefits that weren’t backed up by quality evidence. Another reporting on results in 12 people didn’t acknowledge the limitations of such a small study.

This experience tempered my expectations when we assigned reviewers to look at three items — two news releases and one LA Times story — that discussed a pair of new studies on the use of psilocybin, the active ingredient in magic mushrooms, in cancer patients suffering from depression and anxiety.

Cross-comparison reveals writing that “strikes the right balance”

I was pleasantly surprised to see that all of the pieces earned praised from our teams of experts — each of which included two experienced journalists and one health professional.

Reviewers gave a Johns Hopkins release 5 stars and said it was “exceptionally thorough, addressing benefits, potential side effects and study design in a meaningful way.”

A release from NYU-Langone Medical Center earned 3 stars and was criticized for being vague about harms. But reviewers said it was better than the competing Hopkins release at “addressing conflicts of interest and placing the work in context with previous work in the field.”

A 4-star LA Times story covered the studies addressed in both releases. Reviewers said it “strikes the right balance by reporting evenly on both harms and benefits,” though they wished for better quantification of benefits and a discussion of the existing literature on psilocybin.

What can we take away from this in-depth cross comparison of how three different organizations — two academic medical centers and a major daily newspaper — treated two new studies about psychedlic drugs?

A link between news releases and subsequent news coverage

For Matt Shipman, a public information officer at North Carolina State University who reviewed all three items, the comparison suggests a correlation between the quality of news releases and the resulting coverage provided by journalists.

“This example highlights — for better or worse — the role that research institutions can play in shaping news about their research,” Shipman said. “In short, research institutions have a responsibility to write news releases that are clear, informative and address all of the key components of a conventional news release — not only those elements that make a story ‘sexy’ to news outlets.”

I’d caution that we have no way of knowing whether the LA Times relied on or was even aware of the two news releases issued about the studies it covered. And we can’t draw any broad conclusions about the news coverage of these studies based on a review of only one story.

But Shipman’s observations certainly fit with patterns we’ve seen in the past with respect to news coverage, particularly that exaggeration and overstatement in news releases is often carried through to subsequent news stories.

Kathlyn Stone, one of our associate editors and a former media relations manager for the American Academy of Neurology, emphasized that responsible reporting on psychedelics can influence public perceptions and help research on these substances move forward.

“Because substances like psilocybin mushrooms and cannabis are controlled substances and long associated with drug misuse, researchers have faced numerous restrictions on using them in controlled clinical trials to test their potential benefits,” she said. “The Controlled Substances Act of 1970 deemed these drugs as having ‘no currently accepted medical use.’ It’s only been very recently that researchers have seen an easing of restrictions – and as a result, trials are multiplying.”

For that trend to continue, Stone added, communications officials and journalists would do well to strike a cautious tone in their writing. “Now that the door has opened once again to safety and efficacy clinical research of these substances, it’s important for public relations and news reporters alike to use the same responsible approach to the research as current investigators have done.”

Psychiatrist Susan Molchan, who is typically unsparing in her assessment of how news organizations overstate study results, saw cause for optimism in these data and how they were presented. After reviewing the NYU news release she said:

“Given people’s perpetual interest in mild-altering drugs, it’s good to see psilocybin being examined in well-done studies by reputable researchers and to have results reported in a balanced way. The drug looks like it may actually be helpful to a lot of people when used under medical supervision, and given it’s quick and long-lasting effects on mood, may teach us something about developing other drugs that may treat depression more quickly than treatments available today.”

More reasons why journalists shouldn’t get carried away

My own inner skeptic tells me that writers need to remain very cautious about the potential downsides of psychedelics, however. Taking people with severe anxiety and sending them on mind-bending hallucinatory trips? Maybe I’m wrong, but I just don’t think that journey is going to end well for some of them.

Dr. Michael Bierer, whose clinical practice focuses on addiction, also expressed concern about over-interpreting the benefits seen in these studies.

“In the context of bipartisan fatigue with the war on drugs, it’s now PC to entertain mind-bending drugs’ therapeutic potential,” he wrote to me after reviewing the LA Times story. “I worry, as with cannabis, that the public and patients are too hungry to credit these substances and others with healing powers. I do believe there is a real signal there–and the psilocybin papers are convincing– but the application of these drugs might need to be specific to be efficacious. For instance, the role of the guide/therapist in the use of psilocybin may be critically important.”

Bierer said there were similar questions swirling around cannabis, and whether, for example, the ratio of cannabidiol to THC needs to be within a certain narrow band for the therapeutic effect to be robust — as in high-quality randomized controlled trials of multiple sclerosis spasm.

“Once approved,” he warned, “drugs get used off-label and in doses or frequency that increase the probability of harm rather than benefit. And if made OTC (is that a way to characterize cannabis’ decriminalization?) the risks rise more.”

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