Psilocybin therapy: an option for palliative care

(Christine is a member of the Dying Well Initiation/Global Wellness Institute and former owner of a 250-client home health agency. She holds a certificate from Psychedelics Today Vital Therapies and Integration Training Program and is the Founder and Executive Director for the nonprofit End of Life Psychedelic Care. This article, used with permission, is a portion of the original at https://eolpc.org/psilocybin-and-ketamine-an-option-for-palliative-carepicture/.)

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Psychedelics have gained mainstream attention because of media’s reporting on promising research and Michael Pollan’s recent documentary on Netflix, How to Change Your Mind. The promise to reduce symptoms related to mental illness, and an ever-growing list of other conditions – such as neurodegenerative diseases, anorexia, cluster headaches, autism, substance use disorders, and more – is too good for people to ignore.

Many of the studies show promising results, with none more compelling than those using psilocybin with adjunct psychotherapy to reduce psychological and existential distress in those with life-threatening illnesses. For two decades, prestigious universities such as Johns Hopkins, NYU, and UCLA have consistently shown that the use of psilocybin-assisted therapy reduces anxiety and depression in participants with advanced-stage cancer. Not only that, but participants also confronted their fear of dying, found meaning in their lives, and felt at peace with their death and dying.

The JHU researchers found that six months after two psilocybin dosing sessions alongside psychotherapy, 79% and 83% of participants significantly reduced depression and anxiety, respectively, and more than 80% reported increased feelings of well-being. Similarly, in a study conducted at the New York University Langone Medical Center, research showed that eight months following a single psilocybin dose, 83% and 58% of participants were in remission for depression and anxiety, respectively.

Even more compelling are the results from a follow-up study to measure reductions in depression 18 months after a single dose of psilocybin. Fully 67% of the participants reported significant reductions and 57% were in remission.

The field of study has exploded as researchers seek to prove the benefits of psilocybin therapy to this vulnerable population. There are no less than 10 studies being planned or underway. [You can find them by going to clinicaltrials.gov and using keywords such as psilocybin, cancer, anxiety, or depressions.]

From these studies and others, participants commonly report a feeling of oneness and a reduction in the fear of dying, the latter considered one of the major reasons for increased anxiety and depression in palliative care patients. JHU published a study on August 24, 2022, to compare people who have used psychedelics to people who have experienced near-death or similar experiences (NDEs). They surveyed 3,192 participants, 933 of them were non-psychedelics users but had NDEs; the remaining participants had used a variety of psychedelics, including psilocybin and LSD.

One similarity between the groups found that 88% of the non-psychedelic users and 89% of the psychedelic users, experienced a reduction in their fear of dying. In general, they also found that scores on the mystical and near-death experience questionnaires were significantly higher in the Psychedelic Group than those in the Non-Psychedelic Group.

This leaves those of us wanting to ease the suffering for those at end of life in a tremendous quandary. One option is to travel out of country to places such as the Netherlands, Jamaica, Spain, or Portugal where psilocybin is permitted by law. The reality, though, is that people with life-threatening illnesses are reluctant to travel overseas and leave the safety net of their medical team.

In the US, one option is emerging in states like Oregon and Colorado. Oregon allows for psilocybin care under state law through Licensed Psilocybin Service Centers. Although there is no program designed specifically to address the needs of someone with an advanced illness, palliative care patients have participated in sessions at Licensed Service Centers. Colorado anticipates launching similar services in 2025 and, unlike Oregon, psilocybin care will be able to be administered within a palliative care setting or even in one’s home.

In Canada, those with a life-threatening illness may be able to apply and be accepted into Canada Health’s Special Access Program, which allows them access to psilocybin therapy with a trained facilitator or in-group programs like Roots to Thrive (RTT). Based in Vancouver, British Columbia, RTT developed what they call a “practice in community” therapy program, offering eight weeks of preparation and integration around a psilocybin experience.

Building community is an important part of the program. Participants traverse the program in cohorts and forge deep bonds as they prepare, journey, and discuss experiences together. As Dr. Pamela Kryskow, Head of Psychedelic Medicine likes to say, the participants “come for the psychedelics but stay for the community.”

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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.

Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.

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