Category: Preparing for Death

Posted on

Psychedelics Could Be New Frontier in End-of-Life Care

By Jim Parker

Psychedelic medicines may represent a new frontier for end-of-life care, as well as psychiatric treatment. While these substances — including LSD, MDMA, psilocybin and ketamine, among others — remain illegal, grass roots support for decriminalization or medical use is growing. Meanwhile, venture capitalists and other investors are spending billions to get on the ground floor of what could become a new health care industry. 

Much of the research and discussion on medical use of psychedelics has focused on care at the end of life. Interest in the potential medical benefits of these substances became widespread during the 1960s, but research all but stopped after they were criminalized through federal legislation in 1970. The first inklings of a resurgence began in the late 1990s, and momentum has picked up during the last decade.

“The evidence is just so compelling, and we have very little in terms of tools in our medical bag to be able to help people who are suffering from existential distress, anxiety and depression related to a serious illness diagnosis,” Shoshana Ungerleider, M.D., internist at Crossover Health in San Francisco, founder of the organization End Well, said. “We want people to be able to live fully until they die. If psychedelics given in a controlled therapeutic environment with trained clinicians who can help them do that, then these medicines should be more widely available.”

End Well recently produced a conference on the subject of psychedelic medicine for dying patients.

The body of scientific literature on psychedelics for dying patients continues to advance. Johns Hopkins Medicine in 2019 established a Center for Psychedelic and Consciousness Research backed by $17 million in grants.

Researchers have identified a number of clinical benefits, including reduction of anxiety, depression and improved acceptance of mortality, according to a 2019 literature review in the journal Current Oncology. The paper cited studies indicating that the most commonly used psychedelic drugs have no tissue toxicity, do not interfere with liver function, have few interactions with other medications and carry no long-term physical effects. Common side effects tend to be short in duration, such as nausea and vomiting or disruption of visual or spatial orientation.

Patients who use psychedelic medicines often report what researchers commonly describe as a “mystical experience,” involving a feeling of unity, sacredness, deeply-felt positive mood, transcendence of space and time, and other effects that study participants found difficult to verbalize, according to the Current Oncology paper. 

“This can be transformative for people with anyone who is wracked with trauma, grief, loss or extreme states of suffering,” Sunil Aggarwal, M.D., co-founder, co-director and practitioner at the Advanced Integrative Medical Science (AIMS) Institute in Seattle, told Hospice News. “There’s also evidence that these substances can also reduce physical pain.”

Aggarwal is a board-certified hospice and palliative care physician and a past chair of the American Academy of Hospice and Palliative Medicine (AAHPM).

All psychedelics are illegal at the federal level and in most states. Oregon in 2020 became the first in the union to remove criminal penalties for all illegal drugs and is now in the process of establishing the nation’s first state-licensed psilocybin-assisted therapy system.

More action has been happening at the local level, with communities such as Washington, D.C., Denver, Ann Arbor, Mich., three Massachusetts cities, and Santa Cruz and Oakland in California voting to decriminalize some psychedelics and permit medical use. Some of these regions are now considering statewide decriminalization.

Connecticut and Texas each have laws on the books that created work groups to study the medical use of psilocybin, MDMA and ketamine. Legislatures in Hawaii, Iowa, Maine, Missouri, Vermont and New York state are currently mulling decriminalization or medical use bills.

In late July, Rep. Alexandria Ocasio-Cortez (D-N.Y.) reintroduced an amendment to remove federal barriers to research the therapeutic potential of psychedelic substances. The U.S. House of Representatives quickly shot down the legislation, though it garnered more support this round than the previous time it was introduced.

“We quite a few years off from having enough trained therapists and a policy pathway for which these can be made more widely available in a controlled therapeutic setting,” Ungerleider said. “There’s just so much interest right now among patients and among family members to learn more about this. All health care professionals need to have an understanding of where we’re at with psychedelics.”

Interest in psychedelics has transcended the research space and entered the business world. The familiar adage, “follow the money,” frequently provides good indicators of which way the wind is blowing.

The psychedelics industry is expected to bring in more than $6.85 billion by 2027, Forbes reported. Many of these investors are seeking to reproduce the lucrative results of the cannabis industry that emerged in the wake of legalization among a number of states. A recent report indicated that 36 states and four territories allow use of medical cannabis products, according to the National Conference of State Legislatures.

The largest investors in psychedelics include the venture capital firms Conscious Fund, Explorer Equity Group and Pala Santo. Earlier this year, Florida-based cannabis and psychedelics attorney Dustin Robinson co-founded Iter Investments, a new venture capital group focused on that sector.

A United Kingdom-based psychedelics-focused pharmaceutical company, Compass Pathways (NASDAQ: CMPS), went public in Sept. 2020 and is now worth an estimated $1.2 billion.

“There’s a unique opportunity to be able to go ahead and develop and commercialize [psychedelics] to a much larger patient population,” health care investor and venture capitalist Andrew Lee told Hospice News. “It’ll be interesting to see how natural pharmaceuticals might work. There’s the nonprofit, sacred path, the pharma path and the botanical drug sort of path. The most important thing is that this is another tool in the toolbox for treating a number of conditions.”

Complete Article ↪HERE↩!

Posted on

They watched their family members die.

Now they support medical aid in dying.

“It’s not just the pain, it’s the sense of isolation and aloneness and so on, which really can’t be assuaged by hospice.”

By Arianna MacNeill

When Mark Peterson thinks about his mother, Rhea, he thinks of the petite woman who loved to play golf, and enjoyed sitting down with a good book.

But another thing that Peterson recalls about his mother is her courage at the time of her death.

Because of the suffering and pain his mother endured, Peterson has become a vocal proponent for medical aid in dying, a way for terminally ill patients to choose to end their lives on their own terms.

State lawmakers are currently debating a bill that would legalize medical aid in dying in Massachusetts. The bill includes a variety of protections, including that the person must have a prognosis of six months or less to live, and go through a 15-day waiting period.

The initiative is already legal in a handful of states, including neighboring Vermont and Maine.

There are strong opinions both for and against the issue. Those in favor say laws in other states have worked the way they were intended. However, opponents are concerned that this will further burden the healthcare system, already taxed by the pandemic.

But behind the intellectual arguments for and against the issue are real people, like Peterson, who’ve faced the decline of a loved one and formed their opinion based on that sad reality. These are some of their stories.

A mother’s difficult choice

Rhea Peterson, who was born in 1907, began smoking cigarettes as a teenager – doctors at the time encouraged her to, she said. 

Throughout her life, Rhea had been hardworking. She became a copywriter, and she won awards, her son said. She raised four boys. She also wrote books for adults and children.

Rhea also beat breast cancer — she underwent a double mastectomy in the 1940s.

But at the end of her life, Rhea was robbed of the activities she loved.

At 75, she was diagnosed with chronic obstructive pulmonary disease, or COPD. 

Rhea quit smoking, her son said, “but COPD had its way with her, and basically she was no longer able to golf, and she got progressively weaker; she had to have what’s called an oxygen concentrator,” Peterson said. Using the concentrator meant she had to wear a nasal tube.

Rhea’s health continued to decline. Her vision started to go, and she began forgetting her medication. She also started becoming incontinent. 

She didn’t want to go into a nursing home, Peterson said.

“She couldn’t play golf, she couldn’t read as much, she couldn’t get out and get around, and she realized she was losing some of her memory,” her son said.

“In 1985, she said, ‘I want to die,’ and the brothers all kind of freaked out,” Peterson said. “We had no idea what to do with that.”

No state had medical aid in dying at the time — Oregon eventually became the first, in the mid-1990s — and end-of-life care hadn’t yet progressed to what it is today. The options for Rhea were limited, and in early 1986, she declared she was stopping all treatments. She had decided she would try to live into that year because she was told it would be better in terms of taxes on the inheritance.

The five days between when Rhea stopped her medications to when she passed were anything but peaceful. She struggled to breathe. There weren’t any painkillers.

“It was excruciating and gruesome,” Peterson recalled. Rhea was 78 when she passed.

For the past 11 years, Peterson, a retired psychologist, has dedicated his life to researching and teaching people about end-of-life options. He has also testified before the Legislature’s Joint Committee on Public Health regarding the state’s proposed medical aid in dying bill.

When faced with end-of-life options, loved ones often panic, and sometimes get confused about what their family member would want, Peterson said.

“The decision-making can sometimes end up being distorted and cause great pain,” Peterson said. “Probably the biggest single example of that is when a child says, ‘I’ll do anything to save mom,’ and at times mom is subjected to very intrusive, aggressive efforts to save her life.” 

End-of-life care and medical aid in dying

Thinking about today’s end-of-life care compared to what existed during the mid-1980s, Peterson agreed that it has improved, but sometimes palliative care needs to be about more than just treating pain.

“It’s not just the pain, it’s the sense of isolation and aloneness and so on, which really can’t be assuaged by hospice,” Peterson said. “People who get to the point where they’re sick of being sick and the indignities of not being able to wipe themselves, and endless pills, there’s so many ways that people get to the point and … they say, ‘I’m done.’”

Long before she passed away, Susan Lichwala’s mother made her promise that if she was ever in a state where she could no longer take care of herself and was being kept alive artificially, that Susan would request her mother be taken off life support.

Yet, in 2016, her mother, Lynne, was diagnosed with lung cancer — she had smoked throughout her life, Lichwala said. She started chemo, but with atrial fibrillation, or AFib, her heart wasn’t strong enough to tolerate it. She received radiation therapy, but it wasn’t enough to stop the cancer’s progress.

Toward the end of her life, Lichwala said she was clinging to being alive, but was no longer living. She died after a couple of weeks. Lynne’s care through hospice was excellent, Lichwala said, but being alive in that condition isn’t what she would’ve wanted.

“I know my mother would never have wanted to have been like that, yet there was nothing we could do about it,” Lichwala said, since the law didn’t allow for medical aid in dying. This despite the fact that, “There was absolutely no chance [that] my mother was going to live.”

Thoughts on the current bill before state lawmakers

Peterson noted that medical aid in dying shouldn’t be called suicide, saying that it’s a “very loaded negative term that’s used by people who oppose someone having the opportunity to end their life the way they would.” There’s also the stigma attached.

He does say, though, that the current bill covers things like preventing those who are depressed or suicidal from ending their lives.

Since both his parents have passed, Peterson said he’s dreamed about his dad, who died of a stroke when he wasn’t present; he wasn’t able to say anything to him before his passing.

Complete Article ↪HERE↩!

Posted on

Serving neighbors, supporting families, standing witness

Hospice volunteer reflects on his work

by

Many people are uncomfortable talking about death. Juneau resident and retired biologist Carl Schrader isn’t one of them.

For the better part of the last decade, Schrader has supported people as they live out their final days in comfort as a hospice volunteer with Catholic Community Service. As a long-time volunteer, he stands at the ready to help patients and their families through the complex death and dying process.

Earlier this month, he was honored for his work as one of seven recipients of the Volunteer of the Year award given each year by the first lady of Alaska.

“I could really see a need out there. Not everybody is attracted to this type of work,” he said in a recent phone interview.

Schrader does many different things as part of his work, from delivering hospital beds to supporting caregivers, talking with people in their last days, and offering support to grieving family members.

“In our culture we tend to avoid thinking about death and dying. Most everyone likes seeing babies and kids, but the elderly and dying tend to be invisible. Our death is inevitable, but we all try to deny or at least ignore it,” he said.

Schrader said his Buddhist faith makes it easier for him to approach the idea of death and work as a hospice volunteer.

“My approach is to really face it. Don’t deny it. Don’t run away from it. As a Buddhist, you go to those places that scare you. The more you run away the more it chases you,” he said.

Serving neighbors

Schrader, who moved to Juneau from Seattle about 30 years ago, said that the work allows him to serve and care for his neighbors.

“One of the things that attracted me to Juneau is that it’s a community. I know my neighbors. Just by Juneau being semi-isolated, you get a sense of community here. I really feel it, and my volunteer work with hospice really encourages me. We take care of each other. We take care of each other because we are a community,” he said.

Schrader said that being around sick and dying people is difficult for many people, but that he has a greater level of comfort, and he’s learned to be comfortable with being uncomfortable.

“When I make a house visit, I take a few really deep breaths. Often you don’t know what you are getting into. I’m just there to be a caring human being,” he said.

Schrader said the process is liberating because it relieves him from worrying about himself or focusing on his nerves or feelings.

“I realize that I’m capable of being there for someone, just as a human being. I’m not put off by the apparent ugliness of the dying process. It’s an opportunity for me to practice compassion and support my neighbors in Juneau,” he said.

Though, he admits the work can be draining.

“It’s a very heavy time and can be very emotionally taxing sometimes to be in the presence of a dying person,” he said,

He credits a strong personal meditation practice and walks with his dog, Luna, with helping him to restore his emotional energy.

Supporting families

Schrader said that as he meets families during these stressful times, he’s witness to the best in people.

“People show their true compassion and it’s really beautiful,” he said.

Often, he answers questions about the process of dying.

“I explain that the body is shutting down and help people understand the stages of what’s happening,” he said.

Schrader said that explaining the death process to friends and family members makes it less upsetting for them.

“It really helps people,” he said.

Sometimes he helps family members process their stress about the situation. In other cases, he helps people deal with feelings about complicated family relationships.

Helping caregivers

Schrader said that a lot of his work goes to support caregivers.

“This is something that really surprised me when I got into this work,” he said.

Schrader explained that when a person is sent to hospice care, family members and close friends step in to help with day-to-day care with support from a team.

“It’s often a 24-hour a day job,” he said. “It’s one of the more challenging things.”

He said he helps by showing family members how to deal with straightforward, daily things like getting the patient to the bathroom or keeping their loved one clean. He also helps set up equipment and provides training to help families use it.

“Much of what I do as a volunteer is to support the caregiver. Being a caregiver is incredibly demanding both physically and emotionally. Often the caregiver is also elderly and may have physical limitations,” he said. “I look for anything I can do to be helpful. It’s often just simple things like changing light bulbs, taking out the trash, picking up medications, maybe walking the dog.”

Schrader said that he often offers to stay with the patient so family members can take a break and recharge.

“That’s when I get to spend quality time with people and get to know them. I get people to talk about their lives. I’m amazed at how amazing people are,” he said.

Standing witness

Schrader said that hospice patients often feel better after returning home.

“They are often quite perky and happy to be back at home. They get a lot better as soon as they come home,” he said.

He said the process of dying unleashes a wide range of emotions that can include fear and anger. He said that he’s there to stand as a witness and validate their feelings.

Some patients are eager to talk about their lives. Others have spiritual questions, he said.

“It’s really good to get them to talk about it. Some are very afraid of dying and it’s good to be as reassuring as possible,” Schrader said, noting that he listens and encourages people to share their religious perspectives with him.

Perspective on living

Schrader said that his hospice works give him a new appreciation for his life and helps him face his mortality, as he grows older.

“It makes me more appreciative of my life and what I have,” he said. “Someday, someone will deliver a hospital bed to my house,” he said.

He said that knowledge compels him and his wife, Sue, to live life fully.

“We better do what we can,” he said, adding that he enjoys being active outdoors.

“My end is not so theoretical anymore,” he said.

The team

Schrader said that the people at Catholic Community Service make his work possible.

“It’s a real team with great staff, he said. “The entire team is just wonderful, and people are just incredibly caring people. People are so thankful and so grateful.”

Jessica Kinville, Catholic Community Service volunteer coordinator, said that Schrader is an important part of the team.

“Carl is a great person. He approaches his work with a sort of gentleness and is always an active, sympathetic listener,” she told the Empire in a phone interview Friday afternoon.

“A lot of people have felt very supported by him. He’s someone I can always count on. He always puts his heart into his work,” she added.

Schrader said that Catholic Community Service offers many senior services, and they are always looking for more volunteers.

“Here I am as a Buddhist, working for the Catholics,” he laughed.

“They have the organization and offer a lot of wonderful senior services,” he said. “We are all part of a compassionate team. We want to do what we can for people.”

Volunteer of the Year

According to the governor’s office, the First Lady of Alaska Rose Dunleavy chose Schrader as a recipient of the Volunteer of the Year award.

“Carl embodies the true Alaskan spirit and shares it through his camaraderie and passion,” the release said. “Carl is a compassionate ear for those in physical and spiritual pain, a warm presence for grieving families, and always on standby to set up a hospital bed in a living room. Carl has maintained consistent availability day-after-day, year-after-year; he is calm and patient in work that is unpredictable and emotionally taxing.”

Schrader is humble about receiving the Volunteer of the Year Award.

“I’m really accepting on behalf of the hospice team. It really felt like a shout-out to the nursing staff. I’m privileged to be a part of the team. The award really acknowledges the entire program,” he said.

Schrader was honored for his work at a ceremonial luncheon in Anchorage earlier this month.

“The reception was really good,” Schrader said. “It was nice to drop all the politics and just be there as people. We are all just people.”

Volunteers welcome

Schrader said several volunteer opportunities are available through Catholic Community Service, including Friends of Seniors, which helps senior citizens with basic needs like shopping and dog walking.

Posted on

What the death rattle and capital punishment have in common

By Joel B. Zivot and Ira Bedzow

Death rattle. That’s the sound some dying people make, caused by a buildup of mucus and other secretions in the throat as the body begins to slowly lose its life force. It can sound wet and crackling, or like a soft moan or snoring or gargling.

No one knows if a dying person finds the death rattle disturbing or distressing, as no one can pretend to know with certainty the inner subjective experience of anyone too ill to express it. The common medical assumption, though, is that they are not distressed by it. But the death rattle is disturbing to family members and loved ones who are with their loved ones as they are dying. They typically interpret the sounds as indicative of pain and the absence of a “good death.”

A team of researchers in the Netherlands conducted what they call the SILENCE clinical trial to see if an injection of scopolamine butylbromide, an antispasmodic drug, could stop, or at least reduce, the death rattle. It did.

In an accompanying editorial, two U.S. physicians make the case that administering a drug to reduce the death rattle is justified, even when one cannot know the inner experience of a dying patient. They claim that “when in doubt regarding comfort, it is best to try treatment.” They also write that it can relieve the distress not of the patient but of those bearing witness to the death.

The first reason reveals a technological imperative that is permeating health care delivery. The technological imperative says, “If it’s possible, it should be done.” While moral philosophers since Immanuel Kant have held that “ought implies can” — meaning that having a moral duty entails that one is able to fulfill it — the premise doesn’t work both ways. Shooting first (in this case a subcutaneous injection of scopolamine butylbromide) and asking questions later is not the best approach. Of course, it may become best practice to reduce the death rattle, but the medical profession should at least consider why before deeming it so.

The second reason — to alleviate the discomfort of those bearing witness — speaks to the current debate over the legality and morality of capital punishment, especially now when the Biden administration wants to reinstate the death penalty for Boston Marathon bomber Dzhokhar Tsarnaev, even though earlier this year the U.S. attorney general ordered a moratorium on federal executions.

Death by execution and death in the setting of end-of-life care have something in common. Both involve the presence and witness of interested parties. And what is witnessed — rather than what is occurring to the dying individual — matters a great deal.

The law stipulates that punishment cannot be cruel and unusual. The experience of execution also confronts society’s aversion to see itself as inhumane. But the absence of cruelty does not create humaneness. Punishment must not be tortuous or deliberately degrading and should not exceed the severity of the crime committed.

The Biden administration may see execution fitting for the crime of the Boston Marathon bombing. That decision will rest with the court. Whether or not execution on its face is inhumane, it is certainly extreme and should be used judiciously — not politically.

The idea that execution may be a form of torture is one of the primary reasons for its medicalization. The American Society of Anesthesiologists strongly discourages anesthesiologists from participating in executions, and says that legal execution “should not necessitate participation by an anesthesiologist or any other physician.”

Execution wrongly impersonates a medical act and the impersonation is so convincing that even doctors and the public are fooled. In the United States, no method of execution has ever been set aside as unconstitutional, though methods of execution have come and gone — think hanging, firing squad, and electric chair (though this last one may be coming back) — based on public perception of the outward appearance of death by execution.

Administering paralytics and other drugs may make lethal injection look more humane, even peaceful. Yet autopsies performed on individuals executed by lethal injection have shown that they suffered from pulmonary edema — their lungs were drenched with body fluids. In a self-aware person, such lung congestion would be akin to death by drowning.

Society’s opinion about what it finds to be cruel continues to evolve. But it should primarily take into account the sufferer, not those who are watching.

At the bedside of someone who is dying, families and friends are increasingly welcomed to be present, to accompany a loved one in their last moments. This is a good thing, as it returns death and dying to the realm of the home and community so people do not have to die alone. It also helps drive home that death is part of life and not something to hide away or ignore.

The danger that the SILENCE trial presents is the risk that hospitals will curate the dying experience for the sake of loved ones, just as lethal injection curates a medicalized execution for the sake of the witnesses.

If the death rattle is not painful, instead of muting it — and instead of simply paralyzing the executed — it may be better to recognize the bright line that separates the living from the dead. Mollification of observers’ experiences in both instances may anesthetize feelings regarding natural death or killing. It may also lower the bar for what constitutes facilitating death or moral killing.

As a society, we must be sure to uphold our collective humanity and alleviate suffering. But we should be focused on the suffering of the dying and not those who are watching.

Complete Article ↪HERE↩!

Posted on

Hospice staff help dying animal lover see her dogs and horse for one last time

Jan Holman, 68, had been away from her beloved pet dogs and horse for six weeks and was missing them all until she received a special visit – facilitated by her hospice

Jan was happy to be reunited with her dogs Monty and Rowley

By Millie Reeves

A terminally ill woman has had the chance to say goodbye to her two dogs and horse thanks to hospice staff.

Jan Holman, 68, was admitted to hospital six weeks ago and is now a patient at the Hospice of the Good Shepherd in Chester.

Her quick referral to the hospice meant she hadn’t had a chance to say goodbye to her dogs, Monty and Rowley, or Bob, her horse of 10 years.

Due to the pandemic Jan was unable to have any visitors at the hospital, and her husband of 46 years, Dennis, said she found having no visitors or personal contact difficult.

After four weeks, Jan was moved to the hospice to receive end-of-life care.

Knowing Jan was also missing her animals, the hospice arranged for a visit from her two Cavalier King Charles Spaniels, Monty and Rowley, as well as her horse, Bob.

Even though she was unable to get out of bed, Jan was excited to have the chance to see the gang one more time.

Dennis said: “It was just such a relief once Jan was moved from the hospital to the hospice in Chester and we were able to have named visitors who could come and see Jan regularly, however we never imagined that we would be able to include Monty, Rowley and Bob on the visiting list.”

Staff brought in Jan's two Cavalier King Charles Spaniels Monty and Rowley
Staff brought in Jan’s two Cavalier King Charles Spaniels Monty and Rowley

He continued: “All the staff here have been wonderful. Jan has been so well cared for, nothing is too much trouble even down to the chef coming every day to see what he can tempt Jan to eat.

“Nothing is too much trouble, including arranging for a horse to visit!”

Before her illness Jan, who has lived in Chester all of her life, could be seen dressed as Chester’s Tudor Lady delivering tours of the city where she has been a Blue Badge Tour Guide for 37 years.

Jan said: “I just can’t believe what the staff here at the hospice have done for me. Until a few weeks ago I was still riding Bob every day and he is such an important part of my life, and I have missed him so much.

“I knew that arranging for my dogs to visit was possible as we had a neighbour who was a patient at the hospice a few years ago and we were allowed to bring the dogs to visit her, but I just didn’t expect that they would ever be able to give me the chance to see Bob one more time.”

Horse Bob came to visit through the patio door
Horse Bob came to visit through the patio door

Louise Saville King, deputy ward manager at the hospice, said: “It was obvious when Jan first came to us that she is passionate about her animals and that horses have played a large part in her life for many years.

“The ethos of hospice care is not just about caring for the clinical needs of our patients but also looking after their emotional and spiritual needs as well.

“It’s about making a difference to our patients and their families in whatever way we can.

“We know that sometimes people are scared at the thought of coming to the hospice, but it’s a positive place where people are supported and well cared for.

“The work of the hospice really does make a difference to people’s lives.“

Complete Article ↪HERE↩!

Posted on

Death and psychedelics

— How science is reviving this ancient connection

By

In November 1963, the writer and psychedelic explorer Aldous Huxley laid in bed, unable to speak. He was dying of cancer. One of his final acts was to pass a handwritten note to his wife Laura. 

His famous last words: “LSD, 100 µg, intramuscular.”

It was Huxley’s dying wish: a large dose of acid, please. Laura Huxley fulfilled the request twice during her husband’s final hours.

First synthesized 25 years before Huxley’s death, LSD was still legal in 1963. Scientists were studying it as a potential treatment for alcoholism and other ailments, as well as investigating its similarity to other psychedelics. It wasn’t until 1968 that the federal government outlawed these drugs due to their association with the cultural turbulence of the 1960s.

Today, several decades later, terminal cancer patients are once again taking psychedelics. This time around the drugs are being administered by doctors and scientists in controlled settings—and they are not microdoses. The results of this research have been nothing short of remarkable.

Laura Archera Huxley, 40-year-old musician and filmmaker, and husband Aldous Huxley, 61-year-old British novelist, pictured at their Hollywood home in Hollywood in 1956. On his deathbed seven years later, Huxley asked his wife for a massive dose of LSD.

Alleviating anxiety and despair

Terminal patients often suffer from feelings of intense anxiety and despair after receiving their diagnoses. For many, this is just too much to bear. The overall suicide risk for these patients is double or more compared to the general population, with suicide typically occurring in the first year after diagnosis.

Terminal patients have twice the suicide risk of the general public. Psychedelics may help reduce their fear and suffering.

That’s where psychedelic therapy may help. After a single large dose of psilocybin, taken in a curated space and supervised by a pair of doctors, many patients report feeling reborn. It’s not that the underlying physical disease has been cured. Rather, the drug prompts a shift in the theme of their emotional self-narrative—from anxiety and despair to acceptance and gratitude.

It may seem curious to think about psychedelic drugs, often associated with hippies and the Grateful Dead, as clinical-grade tools for overcoming our primordial aversion to death. But maybe it shouldn’t be. Maybe this is only surprising if your window of historical perspective is too narrow. Maybe these “novel findings” are, in a sense, a return to somewhere we’ve been before.

Psychedelics at the dawn of civilization

In late 2020 I spoke to Brian Muraresku, author of The Immortality Key: The Secret History of the Religion With No Name, about the use of psychoactive plant medicine throughout antiquity. Our podcast conversation covers this history in more detail, but it’s clear that humanity’s relationship with psychoactive plants extends back at least to ancient Greece—if not further. It’s hard to look at prehistoric cave paintings like the Tassili mushroom figure and not wonder if psychedelics played a part in their creation.

Western philosophy may have developed with help from psychedelics as well. In Plato’s well-known allegory of the cave, a group of prisoners live chained to a cave wall, seeing nothing but the shadows of objects projected onto it by fire. The shadows are their reality; they know nothing outside of it. Philosophers, Plato states, are like prisoners freed from the cave. They know the shadows are mere reflections, and they aim to understand deeper levels of reality.

Plato’s philosophical ideas might have been influenced by psychedelic experiences.

Was Plato tripping?

If that sounds like someone who’s explored those deeper levels with psychedelic assistance…well, maybe it was. In his book, Brian Muraresku explores the significance of the Eleusinian Mysteries, secret ceremonies that involved death and rebirth. For centuries, philosophers and mystics traveled to the Greek town of Eleusis to partake in a ritual that involved an elixir known as pharmakon athanasias, “the drug of immortality.”

“Within the toolkit of the archaic techniques of ecstasy–plant medicine just being one among many–something you find again and again, in Ancient Greece and other traditional societies, is this sense that to ‘die’ in this lifetime, or achieve a sense of timelessness in the here and now, is the real trick.” -Brian Muraresku

Contemporary archaeologists, digging outside Eleusis, have unearthed ancient chalices containing a residue of beer and Ergotized grain. Ergot is a fungus that grows on grain. It produces alkaloids similar to LSD. It’s possible, then, that influential thinkers like Plato were inspired by genuine psychedelic experiences.

This connection between psychedelics and death didn’t end with Eleusis. It survived, often repressed and hidden from view, right through the time of Aldous Huxley.

The connection re-emerges in the 1960s

In the 1960s, Timothy Leary co-wrote a book called The Psychedelic Experience: A manual based on the Tibetan Book of the Dead. Leary, the exiled Harvard professor and psychedelic guru, dedicated the book, “with profound admiration and gratitude,” to Aldous Huxley. It opens with a passage from The Doors of Perception, Huxley’s essay on the psychedelic experience. Huxley is asked if he can fix his attention on what the Tibetan Book of the Dead calls the Clear Light. He answers yes, “but only if there were somebody there to tell me about the Clear Light.”

It couldn’t be done alone. That’s the point of the Tibetan ritual, he says: You need “somebody sitting there all the time telling you what’s what.”

Huxley was describing a trip sitter, someone who guides a person along their psychedelic journey. Sometimes it’s an ayauasquero in the heart of the Amazon. Sometimes it’s a doctor holding your hand in a hospital.

Timothy Leary, shown at home in California in 1979, was deeply influenced by Huxley’s work.

Seeking rebirth within the mind

In his book, Leary grounded Eastern spiritual concepts in the understanding of neurology we had at the time. The states of consciousness achieved by meditation masters and those induced by three hits of Orange Sunshine, he wrote, may actually be the same. Both involve dissolving the ego (“death”) and allowing it to recrystallize as the default mode of consciousness returns (“rebirth”). 

Leary wasn’t talking about magic. Scientists know these as “non-ordinary brain states,” inducible by rigorous attentional practice (meditation), pharmacological intervention (psychedelics), and organic decay (dying).

The ability of psychedelics to induce these remarkable brain states may also be why they’re showing such promise in alleviating the very ordinary fear of death.

Today’s psychedelic treatments: Coping with death

So what, exactly, has recent research on psilocybin as an end-of-life anxiety treatment involved?

A few small studies have seen psilocybin administered to dozens of cancer patients. They’ve been conducted in a randomized, double-blind, placebo-controlled fashion. In general, a large majority of patients showed sustained, clinically significant reductions in measures of psychosocial stress and increased levels of overall well-being.

For example, in one study, 80% of the patients found that a single dose of psilocybin quickly relieved their distress. Remarkably, in some patients that positive effect lasted for more than six months.

Sprouting new physical connections

What’s going on at the neuronal level to produce those changes? We don’t know for sure, but some preclinical research has given us a hint. Both psilocybin and LSD have been shown to induce rapid and lasting antidepressant effects in lab animals.

Early studies hint at how psychedelics may produce positive changes in the brain.

Early indications are that psychedelics may allow brain circuits to rapidly sprout new physical connections. This is exciting, but again: These are non-human studies, and it’s early.

It’s gratifying to see any of these studies happening, frankly. This is research that’s been stalled by the Schedule I status of psychedelics for half a century. Much of this work requires obtaining a special federal waiver to study banned substances, which slows progress.

Potential help for end-of-life patients

Fortunately, the FDA recently designated psilocybin therapy as a “breakthrough therapy” and the DEA has proposed increasing the supply of psilocybin for research. This should speed up the rate at which we understand the clinical efficacy of psilocybin and related psychedelics.

Here’s more good news: In terms of psilocybin’s efficacy as a treatment for end-of-life anxiety, larger human trials are already underway.

Dr. Stephen Ross, one of the field’s leading researchers, has described the significance of this work: “If larger clinical trials prove successful, then we could ultimately have available a safe, effective, and inexpensive medication—dispensed under strict control—to alleviate the distress that increases suicide rates among cancer patients.”

Huxley: Ahead of his time

In one sense, Aldous Huxley was ahead of his time. More than a half-century before today’s renaissance in psychedelic research, his own experiences had evidently brought him to the conclusion that the best way to experience death was in a psychedelic trance.

In another sense, though, Huxley was one in a long line of creators stretching back to ancient Greek philosophers and perhaps even to prehistoric cave artists. They may all have used psychedelics to catalyze their outward creativity and comfort their inner distress.

Huxley titled his famous introspective essay, The Doors of Perception, after a quote from the English poet, William Blake: “If the doors of perception were cleansed everything would appear to [us] as it is, infinite.”

We will never know what he experienced in the final hours before his death, after handing that note to his wife. I like to think that for him, the last breath seemed to last forever.

Complete Article ↪HERE↩!