How Psychedelics Can Transform End-of-Life Care

By Shoshana Ungerleider and Barbara Hansen

If you’re on TikTok or Instagram, you may have encountered one of nurse Julie McFadden’s viral videos about all things death and dying. Hospice Nurse Julie, as she’s known, shares just how beautiful and difficult dying can be, and has a thing or two to say about how we can make things better for the many people who suffer unnecessarily at the end of life.

“Sometimes no matter what we do, it’s not enough. Despite how hard we try to control symptoms for patients so they can have a good quality of life toward the end of their lives, they and their families still suffer,” McFadden said when we reached out to her recently. “We don’t always know why the medicine we give patients for pain, anxiety, or agitation isn’t working. If there could be a better way to treat people where they can still enjoy their loved ones at the end of life, then why not use it?” McFadden asks.

One of us is a nurse and one of us is a physician, so we know the terror and pain those at end of life can face. We’ve come to believe that the careful administration of psychedelic treatments can make a huge difference in a person’s end-of-life experience. Dying well may not be on the minds of voters in Colorado right now, but it should be on Tuesday, when the state will vote on a ballot initiative determining whether to legalize psychedelic mushrooms.

More than two dozen other states and the U.S. House of Representatives are also grappling with their own versions of psychedelic legislation. Colorado may end up following in the footsteps of Oregon. In 2020, Oregon voters approved Ballot Measure 109 and became the first state in the country to allow the use of psilocybin to treat chronic mental health issues like PTSD and depression. Measure 109 is the country’s first chance to create a model for psychedelic treatment for a variety of mental health conditions. Oregon will launch its state-licensed psilocybin services program in 2023, and the way it addresses access, equity, and safety will inform what happens next in other states and countries. (One of us, Barbara, is a member of the Oregon Psilocybin Services Advisory Board.) While Measure 109 doesn’t limit itself by specifying conditions that can be treated with psilocybin, therapists and health care providers plan to recommend its use to treat depression, PTSD, and anxiety, and to help people kick addictions.

They also plan to use it to reduce anxiety for patients at the end of life. From the start, researchers have been curious about how psychedelics might affect people who are dying. An early study on psychedelics in the 1970s at Johns Hopkins University, inspired by a terminal illness diagnosis received by one of the staff nurses, focused on the potential to use LSD to treat psychological and existential distress in cancer patients. Several other studies on psychedelics in end-of-life care followed, and the research has resumed in the last decade or so—all to good effect.

We have both worked with patients who struggle with deep existential, spiritual, and practical questions about their deaths: When will it happen? How much pain will there be? What happens after I die? How will my loved ones bear my being gone? Some find peace toward the end, but others experience mental and physical symptoms of profound anxiety, depression, agitation, and more. To treat these symptoms, we have only a handful of tools—opiates, antidepressants, and sometimes, unfortunately, palliative sedation.

“When we’ve tried everything and we can’t get the person comfortable, when we are not expecting them to be comfortable and awake, our last resort is palliative sedation. But they don’t have any quality of life with that. … The goal for hospice is not to put someone to sleep until they die,” said McFadden.

The human body and brain undergo a series of profound changes over the course of dying. Some of these, like elevated anxiety and agitation, can be difficult for the patient, family members, and caregivers. In the most extreme cases, our only recourse as health care providers is palliative sedation, which, as McFadden described, is essentially putting a person into an induced coma through to their death. This option can be a heartbreaking loss for the patient and family members who are deprived of any more meaningful interaction and can also cause tremendous moral distress for the clinicians involved. Having more therapeutic options available that can significantly reduce end-of-life distress without numbing or sedating the patient would be absolutely transformative for the field of medicine.

By contrast, based on several recent clinical trials, there is evidence that a single treatment with psilocybin produces lasting and significant reduction in anxiety and depression for people with a terminal diagnosis. The data to date show that using psilocybin in a controlled therapeutic environment decreases death anxiety and increases optimism and quality of life for people near the end of life.

The end of life is not only a universal experience, we also know it’s one where psychedelic medicines can spur a massive paradigm shift in how we provide care.

Oregon’s Measure 109 gave us a start. But some counties and cities in Oregon have put psychedelics back on the ballot this Election Day, pointing to a need for more public education about the benefits of psychedelic-assisted therapy, and more clarity on how these programs will work. Colorado’s ballot measure has the potential to move things much further. We hope that future legislation might more directly address the unique needs of those at the end of life. Some patients may not be able to travel to a service center or may have health care providers who are afraid to recommend the use of psilocybin. Others may not be able to afford to pay for psilocybin sessions out of pocket, since insurance coverage is still unknown. These details matter—pushing to get them included in legislation up front will speed up the ability of clinicians and therapists to provide psychedelic-assisted care for those at the end of life upon the adoption of new laws.

We’re on the verge of a transformation in end-of-life care that will touch us all, in some way, and voters in Colorado have a unique opportunity to help shape the future. From legislation to implementation and public conversation, it’s time to take a serious look at how psychedelic medicines can reframe our relationship with living and dying. Of course, it’s also time to vote.

Complete Article HERE!

Psychedelic trips and near-death experiences result in strikingly similar attitude shifts

The two experiences alter a person’s core beliefs in a comparable way and scientists want to understand why.

By Katie MacBride

In 2014, Tracy Morgan was in a car accident that nearly took his life. The former Saturday Night Live and 30 Rock cast member suffered near paralyzing injuries in the accident that killed his friend James McNair. In 2019, he told Oprah Winfrey how the crash fundamentally changed his attitude.

“The way I am with people, something’s just different. I find myself saying, ‘I love you’ 200 times a day to strangers.”

Such shifts in attitude about life and death are common among people who have had near-death experiences. Studies have found that those who describe themselves as having experienced near-death events have lower ratings in metrics assessing fear of death and higher ratings for belief in a happy afterlife.

Similar changes in attitude are often described by people who have psychedelic drug experiences. For example, a pivotal 2016 study that looked at the effect of psilocybin treatments in terminal cancer patients found that patients who took the drug had dramatic “increases in quality of life, life meaning, and optimism, and decreases in death anxiety.”

But what do near-death events and psychedelic experiences have in common? That’s what Johns Hopkins University School of Medicine researchers sought to parse. Their results, published Wednesday in the journal PLOS One, raise intriguing questions about what shifts our attitude toward life and death.

Here’s the background — Roland Griffiths is the director of the Center for Psychedelic and Consciousness Research at Johns Hopkins University School of Medicine. He was the first author on the 2016 psilocybin cancer patient study and has long been interested in attitude shifts resulting from psychedelic experiences.

What that study showed, Griffiths tells Inverse, is that “a single dose of psilocybin produced remarkable decreases in anxiety and depression that endured.”

What predicted these positive outcomes, he explains, was “a constellation of features of the experience.” These are classically defined as mystical experiences, though Griffiths cautions that some people may misunderstand what that means. “It’s not a supernatural thing; these have certain features that we can define empirically.”

Those features include “Sacredness, deeply felt peace and joy, transcendence of time and space,” and “internal unity and external unity.” The cliche but accurate way to describe that unity is feeling “one with the universe.” A psychedelic experience with those qualities is predictive of decreased anxiety and depression, as well as shifts in attitude about death and dying.

“If you look at the phenomenological features of near-death experiences, there’s something called a near-death experience questionnaire, it looks again suspiciously like the mystical experiences, there are so many features in common,” Griffiths says. “So that prompted us to wonder, ‘do we have a model [with psychedelics] that is very similar — in terms of brain mechanisms or psychological changes — to experiences that occur naturally.”

Griffiths and his colleagues decided to hone in on that question by directly comparing a group of people who claim to have had a near-death or “non-ordinary” experience that altered their attitudes about death and dying with a group who reported similar changes after taking a psychedelic drug.

What the researchers did — Researchers administered a survey to 3192 people. There were 900 in the near-death or other non-ordinary experience group; the remaining participants were sorted into groups based on the drug responsible for the experience in question: LSD, DMT, psilocybin, or ayahuasca — a psychoactive brew derived from specific shrubs that have traditionally been used in spiritual ceremonies by indigenous peoples in the Amazon basin.

Participants were given a series of questionnaires designed to parse different aspects of their experience and the enduring effects. To quantify the “cognitive, affective, paranormal, and transcendental” aspects of their experience, participants were given the Greyson Near-Death Experience Scale. These questions revolved around the thoughts, perceptions, and feelings that defined the person’s experience. The subjective aspects of the experience, as well as the attitude shifts following it, were evaluated using several other surveys.

What they found — One of the most striking findings is how similar the two groups were to each other.

“Almost 90 percent of both groups reported decreased fear of death following the experiences,” Griffiths says. “Both groups rated the experience very high for personal meaning and spiritual significance, and both groups reported persistent positive changes in personal well-being, life satisfaction, life purpose, and life meaning.”

Slight deviations occurred between the two groups; for example, those in the near-death experience group were more likely to report the experience as the single most meaningful of their life. The one exception was the ayahuasca subgroup, those participants rated the experience more closely to the near-death group: as the most meaningful of their life.

Interestingly, the psychedelic drug group rated the experience higher on the mystical and near-death experience questions than the participants in the actual near-death experience group.

Digging into the details — The reasons behind some of the slight discrepancies between the near-death and psychedelic groups were fairly obvious. For example, the near-death group was more likely to believe their life was in danger during the experience because, as Griffiths says, “they clinically were.”

Other differences, especially those among the psychedelic drug subgroups are less clear, though Griffiths offers some possible factors.

The ayahuasca subgroup being so similar to the near-death experience group on the singular meaningful experience metric may be the result of different demographics, or different contexts.

“The Ayahuasca group tended to be older, more affluent, and female,” Griffiths says. “And ayahuasca is more likely to be taken in a ceremonial setting. So there’s a set and setting difference there that’s distinct from psilocybin or LSD.”

While he can’t say for sure those account for the differences, they “may be very important to how those effects are interpreted.”

The answers likely won’t elude the researchers at the Center for Psychedelic and Consciousness Research for too long. They’re studying many different aspects of psychedelic-assisted therapy.

“We’re looking at different therapeutic indications for these drugs. We have studies on alcohol use disorder, OCD, anorexia, Alzheimer’s, Lyme disease, and PTSD,” Griffiths says. “We’re also looking at the brain mechanisms involved in psychedelic experiences. We have a whole line of investigation in healthy volunteers aimed at more fully understanding the longer term implications of some of these profound experiences.”

Complete Article HERE!

The psychedelic drug that could explain our belief in life after death

Scientists have discovered DMT, the Class A hallucinogenic, naturally occurs in the body, and may contain a clue to what happens when we die and why people see fairies

By Caroline Christie

DMT (Dimethyltryptamine) is the most powerful hallucinogenic drug around. The class A psychedelic is so potent that under the 1971 UN Convention on Psychotropic Substances its manufacture is strictly for scientific research and medical use and any international trade is very closely monitored. But it also naturally occurs in the human body. Now a Senior Psychologist at Greenwich University, Dr. David Luke, is trying to undercover a link between DMT and ‘near death experiences’ to explain elves, tunnels of light and centuries old folklore. On July 8th he’ll talk about his research at an event in conjunction with SciArt collaboration Art Necro at The Book Club in London.

Tell me about yourself

I am a psychologist at the University of Greenwich and I teach a course on the psychology on the exceptional human experience, which looks at extraordinary phenomenon of human beings. It’s all about mythical experiences, psychedelic experiences, personal paranormal experiences, mysticism, spiritual experiences, those sorts of things.

I do research on altered states of consciousness and exceptional human experiences, including psychedelics, medication, hypnosis as altered states and the experiences people have in the states such as out of body experiences, possession, telepathy, and clairvoyance – all your usual stuff.

How did you end up focusing on DMT?

I’m interested in DMT is because of my interest in psychedelics and the phenomenology of psychedelic use. DMT is of particular interest because it’s an extremely powerful psychedelic substance. But what’s more interesting than that, is that DMT naturally occurs in many plants, animals and in humans. It’s endogenous, meaning it’s made within the human body. So it’s more than just a natural plant psychedelic – it’s in us. That makes it extremely curious.

Wait – we naturally produce DMT? Why?

We don’t really know. It was first isolated as a chemical about 100 years ago in various plants. For example in ayahuasca, (a hallucinogenic brew from South America) the other chemicals that were isolated in a plant were named telepathine because users reported telepathic experiences. DMT was later found to be naturally occurring in the human body, found in large quantities in the cerebral spinal fluid. It’s thought to be produced in the lungs and in the eye. It’s also speculated, but not proven, that it’s made in the pineal gland.

What’s the pineal gland?

The pineal gland is a weird organ. During the daytime it produces serotonin, which we know keeps us happy and buoyant, and at night the serotonin gets converted into melatonin. It’s also thought that the gland produces DMT, which is converted from serotonin because they’re similar, it just an enzyme that converts it. The gland is part of the brain’s structure, situated just outside in the spinal fluid in a cavity. It’s really interesting. Why would we have an extremely strong psychedelic substance being produced in our brains? What is its ordinary function in humans? It’s not very well understood, largely because there’s not much done into it. The initial speculation thought that it was perhaps responsible for psychosis, in that people with schizophrenia may have an overproduction of DMT. There was some research conducted into it in the 1960s, but that didn’t get any consistent findings. So that idea was abandoned. Shortly after that, the research with humans stopped because psychedelics became illegal. It didn’t really stop people from taking them, but it did stop researchers from reaching the affect in humans.

Recently, research has begun again. A pioneering medical doctor in the 1990’s called Rick Strassman , started injecting people with DMT as part of a medical research project. About 50 to 60 participants were given high doses and they reported some extremely bizarre phenomena. Approximately half of the participants on a high dose reported being in other worlds and encountering sentient entities, i.e. beings of an intelligent nature which appeared to be other than themselves. The experience was so powerful that participants were convinced of the reality of experience with these other beings. It poses some very interesting questions.

What do these beings look like?

The beings themselves took on various forms. Sometimes they took on the form of little elves or imps or dwarves, sometimes they’re omniscient deities, other times they’re angelic beings. But they’re specifically not humans. Rick Strassman also speculated that the DMT experience had a lot of similarities with what we know about the near death experience.

How is being on DMT similar to having a near death experience?

The near death experience is a type of experience syndrome, whereby people perceive themselves to be near death or in danger of dying. Typical experiences include the sensation of leaving the body, entering into a tunnel of light and flashbacks of their lives. People typically meet some kind of being, sometimes a deceased relative or a powerful other, like an angelic being. The being will tell them it’s not their time to die and that they should return. Then the person who’s having the experience will return back to their body. Sometimes it coincides with them being resuscitated if they are having a genuine near death experience, like a cardiac arrest.

Research has suggested that there is an overlap between that experience and the experience people have when on DMT. In that there’s often encounters with beings, out of body experience, life changing experience, which is often said of near death experiences. But there are dissimilarities as well.

Why are these experiences particular to DMT?

That’s a five and half million dollar question. It’s not well understood. Why do people have this reoccurring theme of apparently sentient entities? It could be that it’s a hallucinatory experience, and for some reason DMT triggers the sense of encountering another being. Or perhaps it’s a misfiring of the brain’s neural network that’s reasonable for those kinds of experiences ordinary.

But it’s curious that the experience occurs in the absence of any kind of objective sentient being in the presence of the person. The other thing is that people quite adamantly testify to the reality of the experience. They say it’s more real than this world. Although we can explain it as a neurochemical misfiring, people who have the experience typically feel dissatisfied with that explanation because it feels so real. But to say it’s a hallucination isn’t satisfactory either.

Hallucination is a bit of a waste basket term for odd experiences we don’t really understand or can’t explain. It’s just a label really.

What’s even more baffling is that people seemingly independently have similar types of encounters. They may not know about other people’s experiences of little people, elves, gnomes or dwarves.

We’ve found reports of them right back to the very first DMT experiments conducted by a psychiatrist in Hungary during the 1950’s. He first tested it on himself and then gave it to his colleague.They all reported the same thing.

My colleagues and I think these experiences aren’t culturally mediated. This is when people are primed to expect something i.e. elves and dwarves and so on, because they’ve heard about it. We think people have been having these experiences on DMT naively, ever since it was first isolated and taken by humans. There’s something about DMT itself which cultivates these experiences. We’re just not sure how or why.

So why do you think DMT is present in the human body?

Rick Strassman tried to use it as a way of explaining the near death experience. He suggested that what happens when you have a near death experience is that your brain releases its store of DMT into the brain and it’s this chemical release that gives the experience.

No one has done a particularly thorough job of mapping the classic near death experience to the classic DMT experience. People have attempted crude compassions but no one has looked at it closely. When you do there are some overlaps but there are a lot of differences.

Although the DMT experience broadly contains all the elements of a near death experience, near death experiences are not like DMT ones. You have the experience of being out of the body or a tunnel of light, like you have with DMT, but there are things we find in the DMT experience that we don’t find in the near death one, such as geometric patterns and alien and bizarre experiences, whereas near death ones are typically very earthly.

What’s more Interesting is if you look at the folklore in literature around 100 years ago. People documented verbal accounts of people who had experiences with pixies. Typically in the folklore literature there were most often associated with spirits of the dead, which has some alliances with the idea of DMT being related to near death experiences. How and why that is, that’s anyone’s guess really.

Are we close to finding any answers?

Scientifically it’s somewhat tricky. I’ve been researching in this area for about 10 or 15 years. DMT struck me as being extremely curious because there’s no other psychedelic we know of that naturally occurs in the human body. I mean the human neural system has endocannabinoids which are related to cannabis THC, but there’s a big difference between that and the presence of DMT.

What’s the role of DMT in the body and why do people have such extraordinary intense and bizarre experiences when they take it? Strassman’s theory is that the purpose of DMT is to help people transition from a living state to a post-death state, whatever that might be. That’s a quite ambitious speculation from a scientific perspective. Because you can’t really know what happens after death.

Strassman’s theory is that the purpose of DMT is to help people transition from a living state to a post-death state, whatever that might be.

Current mainstream scientific thinking is that the brain dies and consciousness ceases. New research and evidence is beginning to challenge that. If you’re looking at the near death experience research that’s going on, people are reporting having experiences of conciseness and conscious awareness even when there’s no apparent brain activity. When the heart stops beating for about 20-30 seconds, all brain activity that we can detect stops because the brain is starved of oxygen.

In theatre operations when people have had their heart stopped and the blood drained from their brain have reported conscious experience throughout the whole procedure, sometimes lasting an hour or more, during which there is no brain activity that we can detect. This challenges the notion that you can have no consciousness experience without brain activity. Now we can’t be certain that they’re actually having a consciousness experience, because we can’t be sure it’s taking place at the same time as their stops working. They could just conflate the experience when they recover brain activity. Or it could be that there are some parts of the brain that we can’t detect, which still remain active. But there’s no evidence for that. So we’re in peculiar territory here, scientifically speaking.

Do you think we’ll ever be able to test for signs of consciousness after death?

We always like to think we’ll have a better understating in the future and science does tend to progress but it’s quite a tricky area. Experimentally it’s very difficult. We’re not in a position to experimentally put people into a death state and see what happens. Although we can take note of people who have surgical procedure and are put into a state of clinical death.

We don’t even know if DMT exists in the pineal glands. We have discovered it in the pineal glands of rats, which are anatomically similar to humans. So there is possibility but we have yet to discover what the pineal glands’ actually function is. It seems to be important as a neurological transmitter on certain, little understood, nerotransmitter sites in the brain. It also seems to have important indications in the immune system. But the question remains why we have an extremely potent psychedelic chemical floating around in the human body. Can this account for spontaneous mythical and spiritual experiences?

Complete Article HERE!

Terminally ill patients the first in B.C. to consume legal supply of magic mushrooms

“Having this approval, I feel like the luckiest person. I know a number of people with cancer who have died waiting for one.” — Thomas Hartle

Saskatchewan’s Thomas Hartle, 54, is one of five terminal cancer patients who will begin psychedelic therapy on Sunday, April 3, 2022, in Nanaimo. Hartle will use psilocybin to help cope with the anxiety surrounding his diagnosis.

By Sarah Grochowski

Five terminal cancer patients have been granted Canada’s first legal, domestic supply of magic mushrooms to treat their end-of-life anxiety.

One of them, 54-year-old Thomas Hartle, arrived at Nanaimo airport Saturday morning from his home in Saskatoon to participate in psychedelic therapy using psilocybin, the active ingredient in magic mushrooms, which he hasn’t been able to legally do since August, when his one one-year exemption from the Controlled Drugs and Substances Act expired.

By that time, his Stage 4 colon cancer had returned.

“Having this approval, I feel like the luckiest person. I know a number of people with cancer who have died waiting for one,” said Hartle, a father of two girls, who will undergo psychedelic therapy by palliative care physicians with Nanaimo-based health care organization Roots To Thrive.

“I really didn’t think I was going to make it this long,” he said.

In January, Health Canada restored the ability of doctors to request access to psilocybin after excluding the non-market prescription from its Special Access Program (SAP). Now terminally-ill patients can access the drug if it is administered in a clinical setting.

Roots To Thrive doctors had their SAP requests for the patients approved last week and plan to distribute prescriptions from Calgary’s Psygen Labs to the group Sunday as individuals of the group set their intentions for their trip.

Saskatchewan’s Thomas Hartle, 54, is one of five terminal cancer patients who will begin psychedelic therapy on Sunday, April 3, 2022, in Nanaimo. Hartle will use psilocybin to help cope with the anxiety surrounding his diagnosis.
Saskatchewan’s Thomas Hartle, 54, is one of five terminal cancer patients who will begin psychedelic therapy on Sunday, April 3, 2022, in Nanaimo. Hartle will use psilocybin to help cope with the anxiety surrounding his diagnosis.

Hartle, who first underwent the treatment in Saskatchewan by ingesting magic mushrooms he grew himself, has a goal of coming to terms with dying.

“When you get a terminal cancer diagnosis, it instils a sense of panic in you, you can’t sleep. I was consumed with terror about who will be there for my daughters when I die. Worry took away my ability to function and live,” he said.

“Magic mushrooms allowed me to calm the worries in my head, allowing my body to use my energy for healing instead and process those fears in a supportive environment. The positive effects last six months.”Hartle’s main concern is that others battling terminal diagnoses will not be able to access a legal supply of psilocybin as easily.“When Health Canada first announced that doctors could request psilocybin they said the special access requests will have a quicker response rate, a matter of days for emergencies. However, it took three months for my doctors to get approval.”

As of Friday, Health Canada said it had received a total of 14 SAP applications for psilocybin — of those, six have been authorized, four are under review and four were withdrawn by the physician before a decision was rendered.

“Requests to the SAP involving new products or new indications typically take longer to process because verifications must take place with the manufacturer regarding product quality and their ability and willingness to provide the drug,” the agency said in an email.“However, once access to a specific product has been authorized by the SAP, ensuing requests for the same drug can be processed much more quickly.”Previous to the SAP allowance, patients were only able to access psilocybin-assisted psychotherapy through clinical trials or Sec. 56 exemptions.

“It took me 103 days to get my first exemption,” Hartle said. “Now, more than 200 days later, I’m still waiting to hear back about my renewal application.”

Spencer Hawkswell, CEO of TheraPsil, a Victoria group that helps Canadians get access to psychedelic therapy, said British Columbians approved for exemptions have been forced to source the drug by growing their own or purchasing it from an unlicensed dispensary.“Patients do not know what is inside the substances they are having to purchase. It’s not as safe as it should be,” Hawkswell said.Hartle, who plans to fly home Wednesday for his 70th round of chemotherapy, said time is of the essence for the terminally ill.

“It hurts my soul to know that so many people may not be getting the help they need as soon as they need it.”

Complete Article HERE!

Congressman Asks Colleagues To Demand DEA Allow Psilocybin Treatment For Terminal Patients

By

A congressman is asking his fellow lawmakers to join him in requesting that the Drug Enforcement Administration (DEA) allow terminally ill patients to use psilocybin as an investigational treatment without the fear of federal prosecution.

A new Dear Colleague letter that’s being circulated by Rep. Earl Blumenauer (D-OR) notes that there are state and federal right-to-try (RTT) laws that should make it so certain patients can obtain the psychedelic given that it’s shown early potential in ongoing clinical trials.

Yet DEA has denied access, resulting in a lawsuit that was filed in March by a Washington State doctor who sought federal guidance to treat terminal patients with psilocybin mushrooms and was told there wasn’t a legal avenue for him to do so.

“There has been a growing body of evidence in recent years pointing to the safety and effectiveness of psilocybin assisted therapy as a potential method to provide care to individuals with treatment-resistant depression and/or anxiety,” Blumenauer wrote to fellow lawmakers.

“However, even with these promising advancements, the pace of regulatory approval has been far too slow for a naturally occurring substance that has evidence of having been safely used by humans for therapeutic uses for thousands of years,” the congressman said. “This is even more true when the quality of care and treatment for terminally ill individuals is resultingly limited and impacted.”

Congress and 41 states have adopted right-to-try laws, which allow patients with terminal conditions to try investigational medications that have not been approved for general use. The letter says DEA has “has failed to abide” by the law.

“I hope you will join me in urging that the DEA takes quick action to remediate these concerns and end their obstruction of access to end-of-life care,” Blumenauer said.

The lawsuit against DEA is currently before the U.S. Court of Appeals for the Ninth Circuit, which heard oral arguments in the case in September. Washington State’s attorney general’s office joined the plaintiffs in support of psilocybin access. DEA argued that the court should dismiss the suit because it lacked jurisdiction.

Blumenauer is asking his colleagues to sign onto a letter addressed to DEA Administrator Anne Milgram, who was appointed by President Joe Biden and confirmed by the Senate over the summer.

“We strongly believe that our constituents suffering such illnesses should have access to this investigational drug should they decide to pursue such a course of treatment and we urge you to take quick action to ensure that the DEA accommodates federal and state RTT laws and allows terminally ill patients to receive psilocybin for therapeutic use,” it says.

The lawsuit—which was brought by an oncology clinic, the Advanced Integrative Medical Science (AIMS) Institute—”can, and ought to be, quickly settled in a manner which addresses DEA’s legitimate concerns about ensuring adequate security to prevent diversion, while enabling dying cancer patients such as those in the AIMS case access to psilocybin,” the letter says.

“Urgent action is needed to ensure that patients currently suffering terminal illness can elect treatment involving psilocybin,” it concludes. “We urge you to take quick action to ensure that the DEA accommodates enacted RTT law and allows terminally ill patients to receive psilocybin for therapeutic use. We appreciate your attention to this urgent matter.”

Sunil Aggarwal, the AIMS doctor behind the lawsuit, told Marijuana Moment that he is “so heartened and grateful for Representative Blumenauer’s leadership here to help my patients who have advancing serious and life-threatening cancer to try psilocybin-assisted therapy, as is their right, to palliate and relieve suffering.”

“High quality clinical evidence has shown that psilocybin-assisted therapy can help generate awe, connection, and joy, and these can impact immune function, mood, demoralization, and potentially prognosis,” he said. “The time is now for all members of Congress in Washington State and beyond to sign onto this letter that implores the US DEA to respect and protect the right to try law’s promises for my patients and others like them. It is the right thing to do, and this is an urgent and time-sensitive matter.”

The Blumenauer-led letter to DEA closes for signatures on Friday. It’s not clear when it will be sent to the agency, but it’s currently dated for some time in December.

Blumenauer separately told Marijuana Moment on Thursday that he’s “excited” about advancements in psychedelics research, as well as the implementation of a psilocybin therapy program that’s being set up in his home state of Oregon, where voters approved the historic reform during last year’s election.

Oregon’s initiative is “a model about how to take advantage of the this therapy for people who desperately need it,” he said. “There are a number of opportunities to demonstrate the power of this therapy. And we are, in a very thoughtful and systematic way, implementing that in Oregon to show how it can result.”

“I think this discussion needs to take place on Capitol Hill—and it’s something that I would like to occur early in the new the new year,” Blumenauer said. “Let people understand the potential, using opportunities now for people in the late stages of life to be able to try this using federal legislation.”

Complete Article HERE!

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.”

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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.

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