Psychedelics for End-of-Life Patients

— What the Research Says

Psychedelics drugs may help dying patients face death. However, practitioners and researchers advise caution. End-of-life is a unique time with a distinct set of risks requiring specialized care. Using psychedelics for patients facing death has yet to be thoroughly tested.

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  • Psychedelic drugs may help end-of-life patients by opening floodgates of new brain connections, reducing anxiety and feelings of isolation.
  • Research suggests side effects and risks of psychedelics for therapy are low in medically stable subjects.
  • End of life patients, however, face unique circumstance and are not medically stable.
  • Hope surrounds the promise of psychedelic-assisted therapy, but more research with terminally ill patients is needed.
  • In the meantime, there are other ways end-of-life patients can find connection, peace, and meaning.

Using psychedelic drugs (psilocybin, DMT/Ayahuasca, ketamine, MDMA, and LSD) for mental health treatment is a hot topic in current research.

America’s mental health crisis has not abetted, showing a need for innovative treatment. Evidence and confidence are growing around psychedelic use paired with talk therapy.

Mental anguish is common among people with terminal illnesses. As therapy with psychedelics continues to demonstrate emotional healing, more practitioners are eager to use the tool for end-of-life patients.

A powerful therapeutic tool

Psychedelic drugs, also known as magic mushrooms and hallucinogens, affect mood, energy levels, cognition, and perception. For many people, they stimulate profound spiritual experiences, dissolving the feeling of disconnection from self, the world, the universe, and a higher power.

People around the world have used psychedelics for centuries as a cultural and spiritual practice. Today psychedelics in both plant-based and synthetic forms are used recreationally and in scientific studies.

Many therapists, psychologists, and psychiatrists cite dramatic improvements in conditions like anxiety, depression, and post-traumatic stress disorder, lasting for weeks to months.

Science isn’t sure how psychedelics work, but they briefly quiet some parts of the brain and open others, causing a floodgate of new connections. This floodgate releases people from entrenched thought patterns and builds new neurological connections, something known as neuroplasticity.

As a result, many people change their minds and their lives.

These life-changing revelations can arise from disturbing psychedelic trips. Still, many who endure a gut-wrenching hallucinogenic journey say it was one of the top five most important events in their lives – worth the anguish for the rich healing.

Research suggests the best outcomes – long-lasting and life-changing – happen with intense therapy before and after taking a psychedelic drug.

Perhaps the most powerful outcome of using psychedelics for therapy is an increased sense of belonging. Connectedness is a deep, human need regardless of race, ethnicity, and culture. Feeling disconnected causes internal turmoil that can lead to chronic health problems.

Psychedelics for end-of-life care

In the last weeks and months of their lives, people face an intense rollercoaster of emotions, including fear, anxiety, and sadness.

Research has shown that psychedelic therapy can reduce death anxiety and increase a sense of connection and meaning for end-of-life (EOL) patients.

An academic book published in 2022 called Disruptive Psychopharmacology discusses the current science of psychedelic use for therapy and its safety and implementation. Psychiatrists and neuroscientists from John Hopkins and the University of California, San Francisco, collaborated on an end-of-life and palliative care chapter. They reviewed the research on psychedelics for patients facing the last stage of a terminal illness, often cancer.

As the authors noted, research with psychedelics for terminally ill patients started in the 1960s. Since then, research with dying patients continues to be promising – although narrow in scope – for improving depression, fear of death, discouragement, and connectedness.

Relief from fear and isolation are two serious emotional challenges for EOL patients. They seek peace and connection to their loved ones. Psychedelics coupled with therapy could achieve more comfort.

The risks of psychedelics for EOL

However, the psychology community advises caution in using psychedelics for end-of-life patients.

According to Dr. David B. Yaden and his team of researchers who wrote the EOL chapter in Disruptive Psychopharmacology, most researchers have studied psychedelic use with medically stable patients, even if they have a mental illness.

EOL patients are not medically stable and can be highly stressed. Psychedelics may worsen symptoms like insomnia, confusion, delirium, shortness of breath, and diarrhea.

They could also cause patients to question long-held spiritual beliefs, possibly adding more stress to the patient and loved ones.

The authors also said we know too little about whether psychedelics interact safely with medications commonly given to EOL patients.

Furthermore, there are no dosing and treatment protocols, certification processes, or professional organizations to oversee the safe use of psychedelic therapy.

Even worse, there are too many reports of sexual abuse by psychedelic-assisted therapists. Thorough training and vetting of therapists are needed because assisting psychedelic trips is very specialized and challenging for therapists.

In a 2022 Medium article, Dr. Rosalind Watts, a leading researcher on the therapeutic use of psychedelics, wrote that real healing is possible when psychedelics are “interwoven into very intentional therapy…The drug was a catalyst to the therapeutic process, not the therapeutic process itself.” She worries we focus on the drug and not the expertise of therapists.

Palliative care specialists say there are many natural wonders – spiritual and physical – in the dying process. They worry that psychedelics may negatively interrupt a naturally beautiful process that, by itself, can create positive transformation.

Obtaining psychedelics for EOL therapy

Psychedelics are only legally available for research studies, but in the coming years, that will change.

Oregon and Colorado legalized psychedelics for therapeutic use in the United States, while several other states have decriminalized them. Once a drug is legalized or authorized by the FDA, however, implementing their use can still take a few – sometimes several – years.

Other ways to open your mind

Music triggers the brain’s pleasure center and a broad, highly diverse network of brain neurons.

Studies suggest spirituality – like psychedelics – hushes the self-focused parts of the brain. This effect happens in the deepest states of prayer and worship, causing “me” to meld seamlessly into connectedness with others, the universe, and a higher power.

Various forms of meditation also open neurological pathways in transforming ways.

Many studies show that healthy relationships and participation in a diverse community reduce stress and improve a sense of belonging.

If you or a loved one face the end of life, it’s essential to talk with a spiritual advisor or a palliative care specialist who can help you find what works for you to feel connected and unafraid.

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