‘The End In Mind’ Conference Answers Questions About Psychedelics For End-Of-Life Patients

By Benjamin Adams

As they say, “memento mori.” The end is inevitable to all of us, but we have tools available to provide comfort—even in death. With psychedelics’ growing promise in therapies for trauma and grief, there are endless questions. Take the similarities between near death experiences and psychedelics, for instance.

End Well recently announced it will host “The End in Mind,” the largest-to-date annual virtual conference dedicated to the future of psychedelic medicines in care for people facing serious illness or end-of-life situations, taking place on October 14.

The conference will include panelists such as Melissa Etheridge as well as Dream Corps founder and political commentator Van Jones, along with a roster of healthcare, policy, culture, business and psychedelic leaders.

Conference tracks will cover psychedelic medicines and their uses—from Indigenous practices to recent clinical trials—and the current and future role of psychedelics in care for serious illness, grief and end of life. The science behind psychedelic drug development will also be pored over in detail.

End Well Founder Dr. Shoshana Ungerleider, MD, said that psychedelics could be a “paradigm shift in modern medicine,” creating new possibilities for end-of-life patients.

The event is sponsored by Palo Santo, a U.S.-based psychedelic investment fund that recently launched with $35 million in capital raised and an active portfolio of 20+ companies. Daniel Goldberg, cofounder of Palo Santo will be among the panelists, discussing the opportunities and concerns about the future of psychedelic medicine for people seeking to improve the quality of life at the end. Goldberg founded the diversified venture fund last year with Tim Schlidt and Tony Eisenberg. He noted the variety of voices that are expected this year.

“Our panel at this year’s End Well annual symposium is made up of an interdisciplinary group of professionals that are all psychedelic medicine advocates but with very different perspectives: Dr. Jerry Rosenbaum, Director of Harvard Mass General’s new Center for the Neuroscience of Psychedelics; Dr. Julie Holland, a renowned psychiatrist and psychopharmacologist who has been an advocate in the space for decades; and Shelby Hartman, a talented journalist who founded DoubleBlind, a media business focused on psychedelics,” says Goldberg.

The conference will provide interactive breakout sessions to answer questions and provide a deep-dive into the cultural, regulatory and industry shifts. “The four of us have very different vantage points yet all of us have unique exposure to the psychedelic private sector,” Goldberg says. “We will be exploring the rapid pace of innovation happening in psychedelics and what we are most excited about (and concerned about).”

Also on the panel will be Rick Doblin, Ph.D., American drug reformist, advocate and the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS) as well as Ira Byock, MD, a leading palliative care physician; and Patricia James, Cheyenne pipe carrier, among others.

The conference will also investigate the stigma attached to psychedelics. “Finally, we seem to be moving past the stigma around plant medicines,” said Etheridge, who tackled tragedy and cancer, “and into a whole new era of understanding that will hopefully enable more of us to experience the benefits of these powerful medicines—especially in the most dire times of need when we are confronting illness, grief, mortality, existential fear and death.”

The conference is also sponsored by Reset Pharma, biotechnology company Cybin, the first psychedelics company to be listed on the New York Stock Exchange; atai Life Sciences, a biopharmaceutical company aiming to transform the treatment of mental health disorders; and Microdose, a psychedelic-focused media platform.

“I’m also excited to share a bit about why our Psychedelic VC fund made a huge bet on Reset Pharma, which is developing and commercializing a novel psilocybin-based therapy to address mental health in patients with cancer and other life-threatening diseases,” Goldberg shares. “For its lead asset, the company is using the licensed research of Dr. Stephen Ross’ (NYU) seminal 2016 phase 2 clinical trial data. We believe this could help pave the way to change how we address end-of-life care as a society.”

Psychedelic medicines continue to evolve at a rapid pace. As a fund manager, Goldberg says he’s concerned when he sees valuations get bid up for certain early-stage psychedelic businesses that are based on hype. His fund, for instance, passed up on more than a few deals in the event that his scientific advisory board couldn’t get comfortable with the science—or lack of—behind some deals in the marketplace.

“We stay very focused on due diligence in order to assess a company’s ability to navigate the regulatory path and ultimately the likelihood of successful commercialization,” Goldberg says.

Based on Goldberg’s experience, not all of these psychedelic pharma startups are going to make it, regardless of the positive press they receive or the names on their board. “Clinical trials are incredibly expensive and while it might be easy for start-ups to raise $10-50 million, it’s tougher to come up with $100-300 million for trials unless you have the right product and team, as well as validating investors that have access to downstream capital,” he says.

Given that psychedelics were stigmatized for so many decades, Goldberg stressed the need for a focus on the science.

“Unless we can continue to prove safety and efficacy, doctors will be slow to move patients off of SSRI’s and give these new treatments a go,” Goldberg said. “Ultimately, we hope that patients will be able to try psychedelic therapy before being put on SSRI’s, which are hard to get off of and often have nasty side effects. Currently, psychedelics are still often viewed as a “last resort” but I believe eventually they will become the standard of care for many indications. We need that to be the case in order for insurers to get on board, which is critical as it relates to affordability.”

If we truly want to make these new drugs and treatments accessible to more people, developers need to jump through the regulatory hoops. That process has already been put into motion, for some substances. “The good news is that, even though psychedelics might have a colorful history and backstory, the FDA doesn’t really see psilocybin and MDMA any differently than amoxicillin or penicillin, in the sense that they are just drugs that have to go through the same arduous process to get approved,” Goldberg says. “In fact, because some of the ‘generic’ psychedelics, like psilocybin, have been around so long and have been proven to be safe, they have been granted ‘breakthrough therapy’ designation, which speeds up the process.”

Currently, the Palo Santo fund is invested in more than 20 businesses across the psychedelic ecosystem—with a focus on biotech and drug development. Given the range of early-stage investment, Palo Santo will have the ability to lean into the most promising companies in our portfolio and support them with downstream capital as they progress. “We are also in tech and service businesses related to the space, and we see quite a bit of cross pollination within our portfolio,” Goldberg says.

“We have a very exciting pipeline of opportunities centered around ‘2nd and 3rd generation’ psychedelic compounds,” he adds. “The innovation, accelerated by the incredible scientific talent jumping into psychedelics, is astounding. We see ample room for improvement in psychedelics and do not subscribe to the point of view that innovation is at odds with the broader psychedelics movement.”

Goldberg says it’s possible to respect the rich history of plant medicine while also supporting legalization measures at the same time. By investing heavily in the private sector, it’s possible to achieve improved versions of MDMA, LSD and create new chemical entities.

Psychedelic experiences vary widely, especially when used improperly. There is a vast range of intentions. “I want everyone who wants to go on an expensive ayahuasca retreat to Peru to do so, but I also want safe, prescription drugs—that are reimbursed by insurers—available to those who are more comfortable with that route. We need to meet people where they are with all of this,” Goldberg says.

The End in Mind will take place on October 14, from 11:45am to 5:00pm EDT/8:45am to 2:00pm PDT. Registration is free until September 26. It’s free and open to the public.

Complete Article HERE!

Mushrooms are having a moment, most notably in the treatment of mental-health disorders and PTSD

Canada’s federal health minister has recently granted patients, therapists and doctors with exemptions to use psilocybin mushrooms for therapeutic purposes

By

Rebecca Crewe had mixed emotions the day she dropped her partner Tony White off at the ATMA Urban Journey Clinic in Calgary to undergo a psychedelic treatment that uses psilocybin, the “magical” ingredient found in some species of mushrooms.

She was nervous and more than a bit skeptical. Little was known about the experimental treatment that has only recently been made available to patients in Canada with terminal illnesses. But White, who was dying of Stage 4 cancer, was adamant. He was so doped up on pharmaceuticals (including fentanyl, oxycontin, hydromorphine, medicinal cannabis) that his quality of life was non-existent. Even with all the drugs he could still barely walk. “Tony felt he had nothing to lose,” Crewe says.

When she returned to pick him up after his five-hour treatment the changes she saw left her stunned. White was smiling, joking with his psychiatrist and staff. And, most shocking, he was bending down, walking around and moving with a fluidity she had not seen in months.

“He told me he couldn’t really describe what happened,” Crewe says. “All he knew was that he worked some things out and felt at peace. I wish some doctor could explain it.”

For the past few years, researchers at academic institutions such as Johns Hopkins University in Baltimore, Md., Imperial College London and New York University have been trying to do exactly that. They have been studying how psilocybin – a hallucinogen that works by activating serotonin receptors in the brain – affects mood, cognition and perception. So far, it shows promise in helping to alleviate a number of serious mental-health disorders, including acute depression, anxiety, post-traumatic stress disorder (PTSD) and substance abuse.

“It’s still very early stages, but we believe psilocybin treatments can truly be an aid in helping society cope with the mental-health crisis,” says David Harder, chief executive officer of ATMA Journey Centers. “The medicine is not a panacea that will magically heal humanity, but in the right settings, these molecules can open our minds to changing our perspective on those things that hold us back.

“They can help us see our own self-limiting beliefs, trauma-related mental-health struggles, and relational tensions that bring us pain,” Harder says. “They truly are a paradigm shift in treatment, where rather than a pill you take for the rest of your life, it is a shift in perspective through one or two treatments that can change our view of reality, and bring about a life of purpose and joy.”

Within the past five years, the Food and Drug Administration in the United States has steadily granted breakthrough therapy status to drugs that were banned in the 1970s and 1980s, including MDMA (also known as ecstasy and molly), ketamine and psilocybin. In November, Oregon became the first state to decriminalize psilocybin mushrooms, following in the footsteps of cities such as Denver, and California’s Oakland and Santa Cruz.

Currently, Health Canada has only approved psilocybin treatment for people in palliative care. However, a growing number of private companies (startups such as Numinus Wellness, Doseology Sciences and HAVN Life Sciences, all in British Columbia) and academic institutions (University of Toronto and University of British Columbia) are trying to convince government regulators that more money and time should be invested in researching how psilocybin-assisted psychotherapy might be used to unlock some of the mysteries of the human brain.

Dr. Evan Wood, chief medical officer at Numinus on Vancouver Island, says the societal costs of mental illness, addiction and trauma are much too high to ignore the potential breakthroughs that might be possible with psychedelic treatments. “With one in five Canadians currently grappling with debilitating mental-health conditions, we can’t afford not to look at psilocybin seriously,” Wood says, adding that mental illness is projected to cost the global economy US$16-trillion by 2030, according to a recent Lancet Commission report.

At Numinus, where they extract psychoactive compounds from plants and fungi, Wood says they are working toward a psilocybin-assisted therapy trial for patients with substance abuse disorders, as well as depression, anxiety and PTSD.

“There is a part of our brain called the default mode network that essentially enables us to function in our environment by decluttering the stimuli around us and quieting all the information coming into our senses. In depressed patients, and those with PTSD or substance abuse disorders, the default mode network is more active,” says Wood, a professor of medicine at UBC where he helps lead the university’s efforts in the area of addiction prevention and treatment.

“A session with psilocybin seems to disrupt this network, reset it and decrease its activity, thus alleviating the symptoms. The changes it appears to be bringing about with people are really profound. It gets at the root of what’s driving people to these mental disorders. Instead of giving them chemicals that numb those feelings, these treatments help you put that trauma behind you.”

Ronan Levy, co-founder of Field Trip Health, which operates eight psychedelic therapy centres in the world including two in Canada (Toronto and Fredericton; a third will open in Vancouver by the end of 2021) says demand in the last year has been robust. While in Canada they can only provide ketamine therapies at present, he expects both the Federal Drug Administration and Health Canada will approve psilocybin therapies in the next few years.

“I anticipate psychedelic-assisted therapies will rapidly become one of the most important treatment options for most commonly diagnosed mental-health conditions,” Levy says. “The evidence to their efficacy and safety is profound.”

This work is going on while all things fungi are experiencing a curious renaissance. The global mushroom market, excluding psilocybin mushrooms, is expected to be worth more than US$50-billion by 2025, according to the San Francisco-based market research firm Grand View Research. Mushrooms are showing up everywhere in the wellness sector, in coffees, teas, face serums, body lotions and supplements that claim to boost immunity, ease inflammation, improve cognition and relieve stress.

Dr. David Mokler, professor emeritus of pharmacology at the University of New England and an adviser to HAVN Life, says public demand for plant-based medicines is the catalyst driving some governments to slowly start lifting restrictions on psilocybin-based treatments.

“Depression is a life-threatening disorder. PTSD as well. Anxiety causes huge disruptions in people’s lives,” says Mokler, a specialist in neuropharmacology. “Drugs only benefit 40 to 60 per cent of patients with these disorders and there are still a significant portion of patients they have no impact on at all. If we can give them a drug safely like psilocybin, and it eases their suffering, which we’ve seen in many studies, then I am very excited about that. However, there is still so much we don’t know so it’s prudent to move forward with caution.”

Canada is taking baby steps toward allowing even limited use of psychedelic mushrooms – an approach that Dr. Pierre Blier, director of mood disorder research at the University of Ottawa, believes is wise. “The research done to date – by very reputable people in a very serious manner – is, however, still in very early stages.”

He warns that people need to be cautious. “Phase 3 trials are under way, but until we have blind proof of efficacy I would not recommend these treatments to my patients,” Blier says. “The danger is that people hear about these treatments and go buy mushrooms from illicit sources. Some mushrooms are toxic and I fear for their safety.”

For some people suffering from debilitating physical and mental illnesses, waiting is no longer an option. At the ATMA Urban Journey Centre, which opened last January, they have treated three clients so far, with three more in pretreatment psychotherapy.

White died 19 days after his appointment on Jan. 20, 2021, at the age of 46. However, the quality of life he enjoyed in his final days was a gift that Crewe believes all palliative patients should have access to.

“You have to understand how sick he was,” she says. “The day before Tony went into the centre he had a 50 milligram fentanyl patch on his arm and had to take eight bumps of the opioid to keep the pain at bay. After taking the mushroom, Tony’s patch was reduced to 12 mg and he never took another bump again.”

In the last few weeks of his life, Crewe says White found peace – he was happy. “The thing I find amazing is we had to get special permission to try this experimental treatment but we could get fentanyl, morphine and other highly addictive drugs without blinking an eye.

“To me this alternative treatment should be treated the same as medically assisted dying,” Crewe says. “It should be made available to anyone who wants it.”

Complete Article HERE!

Can Psychedelics Help Make Dying Easier?

“I need to be in a space where I am not hopeless,” says one terminal cancer patient who is suing the Justice Department and the DEA for her right to use psilocybin

By &

Erinn Baldeschwiler had already been having a rough go of it. A mother of two teens, she was going through a divorce, moving out of her house, and splitting from her business partner all as the severity of the Covid-19 pandemic was becoming a reality. Amid it all, she was diagnosed with stage four, triple-negative metastatic breast cancer. The doctors told her that even with chemotherapy every week — something which she knew would severely impact her quality of life — and immunotherapy every two weeks, she likely had about two years to live.

“It was devastating,” says Baldeschwiler, 49. “I thought, what if I’m not going to be here for my kids? A dear friend passed very suddenly, unexpectedly from cancer a few years back and I just know the pain that it leaves behind. It was really, really heavy.”

Now Baldeschwiler, along with Michal Bloom, another cancer patient diagnosed with stage 3 ovarian cancer in 2017, their palliative care physician, Dr. Sunil Aggarwal, and his clinic, AIMS Institute, are suing the Department of Justice and the Drug Enforcement Administration. Baldeschwiler and Bloom want to try psilocybin, the psychoactive component in psychedelic mushrooms, in a therapeutic context for what’s sometimes called “end-of-life distress,” depression, anxiety, and other mental health challenges that can come along with a terminal diagnosis. 

Kathryn Tucker, one of seven attorneys on the case, says Baldeschwiler and Bloom have the right to access psilocybin under Washington state’s Right to Try law, a law which permits patients with a terminal illness to access drugs that are currently being researched, but not yet approved. The federal government, she says, is wrongfully interfering with that right.

According to Tucker, who has devoted much of her career to helping pass and reform legislation meant to ease the suffering of those at the end of their lives, states are the primary authority for the regulation of medicine. And yet, in January, Tucker says, when she wrote to the Drug Enforcement Administration, on behalf of  Aggarwal, Baldeschwiler, and Bloom, asking them how they should go about accessing psilocybin, the administration wrote back saying they couldn’t because psilocybin is a Schedule I drug on the Controlled Substances Act, the most restrictive category defined as drugs with “no medical use” and a “high potential for abuse.” (Typically, physicians with terminal patients would go straight to a manufacturer to get access to a drug under a state’s Right to Try law, but they needed to write to the Drug Enforcement Administration about the process for access since psilocybin is federally illegal.)

In addition to Washington state, 40 states have Right to Try laws, although they’re all worded slightly differently. (Some use language like “terminally ill” while others say “life threatening,” which could change who qualifies.) Overlaid on top of these state Right to Try laws is a federal Right to Try law, which President Trump signed in 2018. In this case, Tucker and the fellow attorneys are primarily focused on patients’ rights under Washington’s Right to Try law, but are using the federal Right to Try law to bolster their argument.

Both the Washington law and the federal law state that terminal patients can access drugs that are not yet approved by the Food and Drug Administration so long as they’ve successfully made it through the first phase of an FDA-approved clinical trial and are currently being investigated. Psilocybin is currently in the final phase of research before FDA approval, and has shown so much promise for treatment-resistant depression and major depressive disorder that it’s been granted “breakthrough therapy” status by the FDA.

“The DEA just did not know about or did not understand Right to Try and this lawsuit is something of an educational vehicle,” Tucker says. Yes, she says, psilocybin is on the Controlled Substances Act, but in the hierarchy of legislation, The Federal Food, Drug, and Cosmetic Act, which Right to Try falls under, trumps the Controlled Substances Act. Tucker says DEA officials just don’t understand that or are behaving as though they don’t. (The Department of Justice declined to comment for this story.)

“I don’t want my diagnosis to be upsetting and dark and hopeless for my kids,” says Baldeschwiler. “So I need to be in a space where I am not hopeless and there is peace. I know for certain if I’m negative and ‘woe is me,’ and desperate and have feelings of like ‘I just want to check out,’ that’s going to make it a hundred times worse.”

Baldeschwiler first got the idea to do psychedelic-assisted psychotherapy from Aggarwal, who she’d found after looking around for more holistic treatment plans in the Seattle, Washington area. Aggarwal discovered what he says is the extraordinary potential of psilocybin to help cancer patients when working with the psilocybin research group at New York University.

Researchers, going back to the late 1950s, found psychedelics such as psilocybin and LSD showed promise for end-of-life distress as well as a host of other mental health conditions, from alcoholism to trauma. Much of this research, however, is not considered valid by the Food and Drug Administration because it did not follow their current protocols.

After Richard Nixon signed the Controlled Substances Act into law in 1970, there was essentially a decades-long ban on psychedelic research. It was a landmark study, published in the Journal of Psychopharmacology, in 2006 — showing psilocybin holds promise for end-of-life distress in cancer patients — that largely jumpstarted what’s now known as the “Psychedelic Renaissance,” the second wave of psychedelic research in the U.S. since the 60s. The study found that after two or three psilocybin sessions, a majority of participants had significant and positive changes in their mood, while 33 percent rated the experience as the most spiritually significant experience of their life, comparable to the birth of a first child or the death of a parent. Since then, this research has continued with the same results in trials at Johns Hopkins and New York University.

“Many, many patients come to me wanting this,” says Aggarwal of psilocybin-assisted psychotherapy. “They read about it in the news or in Michael Pollan’s book.” He says it’s hard to predict, but there’s surely millions of terminally ill patients who could benefit from psilocybin therapy. In 2021 alone, an estimated 1.9 million Americans will be diagnosed with cancer, according to the National Cancer Institute. That doesn’t even take into account, says Aggarwal, all the other terminally ill patients, such as those with Lou Gehrig’s disease, whom he also works with.

Susan Patz, a 62-year-old woman with Lou Gehrig’s disease, filed an Amicus brief, a statement which can be filed to the court by someone in favor of a particular side of a case, for this lawsuit. Patz lives in the town of Monroe, Washington, where her husband John is now her caretaker as she slowly loses agency over her body and even her ability to breathe and swallow. 

“Because of the ALS, I have had to give up a lot of the activities I was passionate about,” she wrote to the court in a brief filed on May 24th. “I loved gardening, and I used to delight in driving the tractor around our property. I loved to swim at the YMCA five days a week. I loved cooking and trying new recipes. I can no longer do any of those things.” She often stays up until 3 or 4 in the morning, because she can’t sleep; she used to be “foodie,” but now doesn’t want to eat or even see friends for fear that they’ll see her as a “sick person.”

“I am desperate to try something that will work, something that will enable me to experience joy and pleasure again,” she wrote to the court. “If the Right-to-Try laws don’t allow someone like me the chance to try something that may help alleviate my suffering, then what good are they?”

On June 21st, the Department of Justice will file a brief on behalf of the Drug Enforcement Administration. On July 12, the petitioners — Aggarwal and his patients — will be given the opportunity to reply. And then, likely in September, the oral argument will take place in which, Tucker says, they may get their first insights into where the court stands on the case. She’s hopeful that perhaps they won’t even get that far, though, because the Drug Enforcement Administration will reach out with the intention of finding a resolution.

Either way, Tucker says, if the case passes, the next doctor and patient who want access to psilocybin for end-of-life distress shouldn’t need to take it to court again. If they succeed in Washington, then, she says, doctors and patients in states with Right to Try laws should be able to access psilocybin.

There’s many unknowns, however, about how doctors and patients would go about notifying the DEA when they’re going to conduct psilocybin therapy — and how they would access the psilocybin itself. Currently, under Right to Try laws, doctors don’t need government approval at all — they can go straight to manufacturers to request access to a drug that’s under investigation for their patient. But the process might be different for psilocybin and a host of practical issues exist, too, such as that it’s difficult to find federally-licensed labs making synthetic psilocybin as there’s no publicly available directory. At this point, Tucker says, they’re just focused on taking things in “small bites.”

“It kind of kills me that I have to be dying to even possibly have access to this medicine when I think it could be incredibly helpful for so many people that maybe don’t fall into that category,” says Baldeschwiler. “I truly, truly am hoping that we have some open minds and open hearts with regards to the DEA and that they honor the intent and the letter of the law because we fall within it.”

Complete Article HERE!

Why Canada Could Be Next To Allow Psychedelic Therapy

(And How It’s Already Changing Lives)

Canada’s federal health minister has recently granted patients, therapists and doctors with exemptions to use psilocybin mushrooms for therapeutic purposes

by Amanda Siebert

Canada has an international reputation for progressive health policies, take for example its publicly funded healthcare program and its assisted dying laws. It also led the way in drug reform when it became the first G7 country to legalize cannabis in 2018.

But in the face of a worldwide pandemic, a national overdose crisis, and mounting evidence to show that greater access to both psychedelic and other restricted drugs could have positive public health outcomes, it’s fair to say some of the country’s regulations around restricted substances are outdated.

Now, as a handful of patients and more recently doctors and therapists have been granted exemptions to use psilocybin, the nation’s federal health agency is considering making changes to existing policies that could open the door to much more than magic mushrooms.

In 2020, a handful of firms including non-profit organizations and publicly traded companies have worked with Health Canada to encourage greater access to psilocybin and other psychedelic therapies. While one has gone the route of using existing legislation to help individuals apply for exemptions, another is encouraging policy changes that would allow doctors to seek access to restricted drugs for their patients.

‘The Unknown Of What Can Happen After You Die Doesn’t Feel So Unknown To Me Anymore’

One of the earliest studies to come out of the so-called psychedelic renaissance was conducted at Johns Hopkins University in 2016, and sought to examine how psilocybin would affect depression and anxiety in patients suffering from life-threatening cancers. It found that just a single dose of psilocybin left subjects with longstanding relief, with 78% experiencing lower rates of depression and 83% experiencing lower rates of anxiety six months after receiving the treatment.

When Thomas Hartle, a 52-year-old Saskatoon resident with stage four colon cancer read the results of the study, he says he “felt like they were too good to be true.”

“But when you suffer from anxiety, you really look for whatever sources of relief you can get,” he says. Hartle enlisted the help of TheraPsil, a non-profit organization based in Victoria, B.C., to try and access psilocybin therapy for himself. Using a subsection of the Controlled Drugs and Substances Act that allows the health minister to grant an exemption for medical or scientific purposes, TheraPsil has so far assisted dozens of Canadians, including terminally ill and clinically depressed patients, as well as doctors and therapists, in the application process.

In August 2020, Health Minister Patty Hajdu granted the first exemptions to four Canadians suffering from end-of-life anxiety. One of them was Hartle.

The father, husband, and IT technician says his anxiety is “specialized to the existential kind and doesn’t extend to public speaking,” so he’s more than happy to share his experiences with psilocybin. Before his first treatment, he prepared extensively with a therapist, and has since undergone a subsequent session. Without hesitation, he says the experiences have changed his perspective on death and dying.

“What it’s changed the most for me, is that the unknown of what can happen after you die doesn’t feel so unknown to me anymore. Most of how we define ourselves is our experiences and memories and things like that. In the psilocybin experience, my consciousness existed in ways that had absolutely nothing to do with anything in this life,” he says.

“To exist in another state that has nothing to do with my identity here, and to feel comfortable and serene in that state tells me that it’s possible to have some sort of continuation of consciousness that goes beyond our experience here.”

Hartle adds he feels more empathy towards other people since his initial treatment, and says his family has noticed he uses more emotional words in his speech. As a naturally analytical thinker, he says he’s also welcomed a shift to a more creative mindset.

Beyond the positive mental benefits he’s experienced, Hartle says psilocybin also helps to relieve pain associated with migraines, which he’s suffered from since he was a child. “When I compare it to most of the other treatments that I have gone through over the last few years, psilocybin is like the opposite of side effects,” he says, laughing.

Doctors Can Access Psilocybin, Too

Dr. Emma Hapke is TheraPsil’s co-chair of research and one of 16 doctors, nurses, therapists and social workers recently granted exemptions to take psilocybin in preparation for work with patients. She is part of a committee at TheraPsil developing a training program for psychedelic assisted psychotherapy, which she hopes to kick off in 2021.

“We feel that it’s essential that therapists themselves have their own experiences in a non-ordinary state of consciousness, to be on the receiving end of that type of therapy so they can then guide others to do the same,” she says.

She emphasizes that while psychedelic substances have been shown to provide benefit for people suffering from an array of mental health conditions, it’s imperative that any psychedelic experience be paired with therapy for maximum and longstanding relief.

“The molecule in and of itself isn’t what’s healing—it’s the whole package of being in a healing relationship with a therapist and going into the non-ordinary state with psilocybin to access different parts of the psyche,” she says. “If the experience is not integrated, it’s hard for it to lead to lasting change, and so it’s really important that we’re not just talking about a psychedelic. We’re talking about psychedelic-assisted therapy.”

Spencer Hawkswell, TheraPsil’s CEO, says before August 4, seeking exemptions for terminally ill patients felt like an uphill battle. Today the mood has changed, and there is a greater sense of optimism among his team.

“I never thought I’d say that it was easy, or that Health Canada has been incredibly cooperative,” he says. “These [patients] are empowered Canadians, and we do have rights and systems that work for them. Just to have that affirmation is pretty amazing.”

Recognizing the utilitarian nature of Canada’s approach to mental healthcare and drug policy, Hawkswell says that while the current system tries to meet the needs of most, it falls short. “What TheraPsil is doing is showing that there are options beyond the current policy regulations and the norm of healthcare in Canada.”

Numinus Advocates For Special Access Program Reform

Health Canada’s Special Access Program (SAP) allows healthcare professionals to request restricted or otherwise unavailable drugs for patients who have tried existing treatments and found them to be unsuccessful. In theory, the SAP should allow doctors to request access to drugs like psilocybin, MDMA, and LSD. That changed in 2013, when under Conservative Prime Minister Stephen Harper, accessing restricted drugs through the SAP was prohibited. Since then, the only way for patients to access such substances is through clinical trials.

On December 12, Health Canada announced its intention to reverse the regulatory changes made in 2013, and initiated a 60-day comment period seeking public feedback. Dr. Evan Wood, chief medical officer at Numinus, has been advocating for changes to the program since early 2019.

Wood says by amending the SAP provision on restricted drugs, Health Canada will better align itself with the Helsinki Declaration, a set of international ethical guidelines that suggest (among other things) if a patient accesses a restricted drug through a clinical trial and finds it to be beneficial, they should be entitled to receive ongoing therapy. Currently, if a Canadian were to access a psychedelic substance or another restricted drug though a clinical trial, even with the support of a physician, they would not be able to continue to access it.

“In my view, it’s really just about stigma and the cultural baggage associated with these molecules,” Wood says. “This is bringing Canada in compliance with those international ethical guidelines, and kicking the door open a crack for Canada to be a real world leader in this area.”

While Wood acknowledges that the Covid-19 pandemic has rightfully taken the majority of Health Canada’s attention in 2020, he’s glad to see that psychedelic-assisted psychotherapy has risen to an area of needed focus, and gives full credit to the agency for proposing the regulatory reversal.

If the change to the SAP is made, Wood says access to novel psychedelic treatment has the potential to increase significantly, as interested patients would simply need to find a doctor willing to apply for access to the drug on their behalf. Applications would then be judged on an individual basis, but would be less arduous than applying for an individual Section 56 exemption, and perhaps even eliminate the need for that process entirely.

For companies like Numinus, Wood says the changes would enable them to better establish the physical infrastructure of their businesses, to train staff, and “to do all of the things that are necessary to do this kind of work safely.”

“When you put the known risks alongside the known safety of these substances, it’s a bit of a no brainer,” he says. “It’s not going to be a cure for everybody, but even to be talking about a ‘cure’ in the context of mental health challenges is a total paradigm shift.”

Some might argue that decriminalization is the obvious next step, however Health Canada isn’t alluding to that just yet. In an email, a spokesperson for Minister Hajdu said the agency “thoroughly reviews all requests for exemption and makes decisions after taking into account the risks and benefits.”

“We still have much to learn about the risks, which is why the sale and possession of psilocybin is still illegal. Until there is a sufficient evidence base, Health Canada will review each request for an exemption on a case-by-case basis.”

Complete Article HERE!

Research shows psilocybin — a Schedule I narcotic — to be of great help to patients with end-of-life problems


Guided LSD session at Johns Hopkins University.

“People in this country don’t talk about death. When I would talk about it sometimes with people they would say, ‘Oh be optimistic! Don’t talk that way. You’re gonna be fine.’ You really need to look at it (death) and this is the perfect way to do it.”
Ann Levy – psilocybin-assisted psychotherapy study participant

I remember the ride home being really quiet. Typically, my mom would be driving me nuts, loudly singing old Methodist hymns, rather than letting us listen to music on the radio. But this time she just drove silently as my grandmother, Lillian Brustad, stared out the window of our well-traveled station wagon. We had just left my grandmother’s oncology appointment in Rochester, New York and we were heading back to her home in Hamilton. There was no discussion about the appointment, no talk about any diagnosis, no ‘next steps’ and no ‘why me’s?’ What was said was said in a meeting with my mother, my grandmother and her doctors.

I’d break the silence with my repetitive pre-teen complaints as to why we should have stopped in Rochester, rather than waiting until Syracuse to pull into a Friendly’s restaurant for a Jim Dandy sundae. I’d debate from the back seat that stopping in Rochester would have made me full and happy. Stopping would have better allowed me to finish this book report on Mickey Mantle that I was putting off.

When I wasn’t complaining; there was silence…

We made many more trips to Rochester over the next few years. My grandmother remained stoic in her battle against cancer, despite it wreaking havoc on her physical body, eventually taking her life.

The final months of life are often marked by increasing physical and emotional suffering. As one approaches death, we often experience varying degrees of depression, hopelessness, anxiety, and a desire to hasten death. The prospect of our loved one’s looming death can lead to feelings of defeat, helplessness, and despair in family members and within the patient’s medical team.

How do you want to die? Most people hope to die at home, with their loved ones, but sadly an overwhelming majority of us die in a hospital or extended care home surrounded by beeping equipment.

What would a good death look like? Anthony Bocelli, PhD, is a palliative care psychologist and investigator in a study conducted at the NYU School of Medicine on the use of psilocybin-assisted psychotherapy to help patients and families deal better with end-of-life distress.

“Death needs to be humanized,” he says. “Although the end-of-life can be profoundly difficult, it can also trigger a search for meaning and an openness for the sacred.”

Maria Sabina called psilocybin mushrooms her ‘saint children.’ Sabina was the Mazatec curandera/healer that banker Gordon Wasson sought out to learn the secrets of ‘magic mushrooms.’ Sabina introduced Wasson and his wife Valentina to teonanácatl; the Psilocybe mushroom. ‘nti-ši-tho in Mazatec, meaning the ‘Little-One-Who-Springs-Forth’.

Wasson went on to famously detail his psychedelic experience in Life Magazine, introducing these sacred mushrooms to the Western world. Albert Hofmann, discoverer of LSD and chemist at the Swiss Sandoz Laboratories, isolated psilocybin in 1957 from mushrooms collected by Wasson’s team on their second trip to Oaxaca.

These sacred mushrooms have been used for millennia by indigenous cultures around the globe for healing and insight. Psilocybin-assisted psychotherapy melds this ancient sacred wisdom with modern day scientific technology. I am not talking here about eating a bag of ‘shrooms and tripping at a rock concert; this is about the therapeutic use of this valuable tool in a controlled setting under supervision by trained guides to help combat depression, addiction, and existential distress.

So why psilocybin mushrooms and why now? It has been said that psychedelics could be to psychiatry, what the microscope is to biology or the telescope was to astronomy. Bear in mind that telescopic science was prohibited in 1616 for over 100 years, in fear that people may discover that planet Earth was not the center of the universe.

Alicia Danforth, Ph.D, served as investigator on a psychedelic research study at Harbor-UCLA Medical Center examining the safety and efficacy of psilocybin as a treatment for advanced-cancer anxiety. She remarked, “It’s very important not to lose sight of the fact that research with psychedelic medicines has been going on for thousands and thousands of years. As long as there has been humans really. What’s new is when you get into the Western medical model.”

Dr. Danforth worked with Dr. Charles Grob on an important pilot study at Harbor-UCLA Medical Center on 12 patients who were facing end-of-life from advanced stages of cancer. Subjects were administered a placebo (niacin) during one session and the other session they received psilocybin.

I had the pleasure of discussing the study and their findings with Dr. Danforth. “Our participants were really near death. Some did not survive the six-month follow-up period,” she said.

Dr. Danforth detailed that they administered “one session at a low-to-moderate dose because we were the first cancer-treatment study in a new wave of psychedelic-assisted therapy and the FDA was really conservative. The main purpose for these little pilot studies is to establish that they are safe and is it even achievable. Does it work?”

The other studies that I will cite in this article worked with higher doses of psilocybin. However, Danforth stated that, ‘even with one session of preparatory psychotherapy session before (treatment day), then a really supported session on the day of treatment, then therapy afterwards, our study found a reduction in anxiety and a trend toward a reduction in depression.” She continued, “It’s more important to look at the trending that leads to larger studies so you can make stronger claims. We saw positive trends and there was a significant difference in the anxiety scores. The qualitative outcomes were good; the safety data were good. We didn’t have any serious adverse events and everything was green light go for the larger studies.”

As Danforth mentioned, humans have been conducting research for thousands of years on psychedelics. Prior to prohibition of these substances in the late sixties, there were more than a thousand studies conducted with more than 40,000 subjects and many showed positive trends.

During the 1960’s, Dr. Eric Kast, from the Chicago Medical School utilized LSD for a series of studies working with cancer patients encountering death. Several hundred advanced-stage cancer patients were administered LSD. Findings showed trends toward pain reduction for several weeks, relief of depression, improved sleep, and a lessened fear of death. Dr. Kast noted that some of these individuals showed a striking disregard for the gravity of their personal situations. They frequently talked about their impending death with an emotional attitude that would be considered atypical in our culture.

Another important study by William Pahnke from the Maryland Psychiatric Research Center, in Baltimore conducted a study that was published in the Harvard Theological Review in 1969. His work examined the psychedelic mystical experience in the human encounter with death. He found, “The most dramatic effects came in the wake of a mystical experience.” He reported a decrease in fear, anxiety, worry and depression. Often the need for pain medications was lessened, because the patient was able to tolerate pain more easily. There was a profound increase in serenity, peace, and calmness, with a marked decrease in the fear of death.

Roland Griffiths, Ph.D., is a Professor in the Departments of Psychiatry and Neurosciences at the Johns Hopkins University School of Medicine. He is the principal investigator of the Johns Hopkins Psilocybin Project. He and his team have been studying the effects of psilocybin and its ability to bring about mystical experiences. Their team conducted the largest and most rigorous study in this new wave of psychedelic research involving fifty-one patients who had received a potentially life-threatening cancer diagnosis.

“We found that the response was dose-specific,” Dr. Griffiths said. “The larger dose created a much larger response than the lower dose. We also found that the occurrence of mystical-type experiences is positively correlated with positive outcomes. Those who underwent them were more likely to have enduring, large-magnitude changes in depression and anxiety.”

The Johns Hopkins group reported that psilocybin decreased both clinician and patient-rated depressed mood, anxiety, and death anxiety. The results showed increased quality of life, sense of connectedness, and optimism. Participants expressed an increased belief that death is not an ending, but rather a transition to something even greater than this life. About 70% reported the experience as one of their top five spiritually significant lifetime events, including the birth of a child or death of a loved one.”

He continued, “There are potential risks associated with these compounds. We can protect against a lot of those risks through the screening and preparation procedure in our medical setting. About 30 percent of our people reported some fear or discomfort arising sometime during the experience. If individuals are anxious, then we might say a few words, or hold their hand. It is really just grounding them in consensual reality, reminding them that they have taken psilocybin, that everything is going to be alright. Very often these short-lived experiences of psychological challenge can be cathartic and serve as doorways into personal meaning and transcendence.”

Dr Charles Grob, the principal investigator on the UCLA study reported similar results, “Psilocybin facilitates a greater likelihood of achieving a psycho-spiritual state of consciousness — a mystical kind of experience. The old research literature from the 50’s and 60’s very strongly indicated that individuals in psychedelic research studies, who experienced a spiritual epiphany during the course of their many hour treatment sessions, were more likely to have a long-term positive therapeutic outcome.”

Why does psilocybin appear to efficacious, while modern pharmaceutical efforts are largely ineffective?

Dr. Griffiths explains, “Psilocybin acts very selectively at serotonin-2A receptors, which are a neurotransmitter that promotes positive feelings. Acting like a ‘lock and key’, so psilocybin can click in to this receptor site and activate a variety of processes.” With all of the classical psychedelics; LSD, psilocybin, mescaline; the thing that they have in common is that they activate serotonin-2A receptors.

Dr. Danforth added, “Sometimes when we are in a challenging situation in life, our thoughts can get stuck in a loop. Negative thoughts just continue and continue and continue and psilocybin in a therapeutic setting can function like a big hand coming in and jiggling the needle on a skipping record, so that a tune can resume.”

Yet another study — this one conducted by NYU Langone Psilocybin Research Project — examined the effects of psilocybin on the psychosocial distress with patients with advanced cancer. This trial was led by Stephen Ross, M.D. and Anthony Bossis, Ph.D. Their study included 29 patients facing end-of-life. In their sessions, subjects were either given either a moderate dose of psilocybin or a placebo (niacin), cross-switching to the other after about seven weeks after the first session. Findings were very similar to the studies at UCLA and Johns Hopkins. They found that psilocybin produced immediate, substantial, and sustained improvements in anxiety and depression leading to decreases in cancer-related demoralization and hopelessness, improved spiritual well being, and an increased quality of life. At the six-month follow-up, psilocybin was associated with enduring anxiolytic and antidepressant effects.

The NYU researchers further reported sustained benefits in existential distress and quality of life, as well as improved attitudes towards death.

There is growing anticipation that psilocybin could be rescheduled and open up further opportunities for psychedelic research. Decriminalization of psilocybin is going to the voters in the city of Denver on May 7.

“I look forward to a day, that if it were clinically indicated to be able to offer that service to certain clients,” Dr. Danforth said. “Expanded access is not available yet; no one in the United States is able to legally work with Schedule I substances in a clinical setting,”

She continued, “It’s possible in the near future that some in the MDMA (ecstasy) world we will have expanded access for PTSD therapy. It’s hard to anticipate what’s going to happen with MDMA and psilocybin, but I don’t think it’s going to happen overnight. Everybody’s kind of waiting to see what happens in Denver and what that’ll mean… There are a ton of opportunists rushing in trying to make a buck, but in terms of real clinical work, that process moves at a snail’s pace, as it should.”

I asked Dr. Danforth on additional prospects for psychedelic-assisted psychotherapy. “My private practice is almost exclusively adults on the autism spectrum and some of them have very severe social anxiety and MDMA would be a real powerful clinical tool.”

She continued, “Others are very interested at looking at psychedelics for the betterment of well people. Two streams of effort working here — treating people that are unwell or providing guidance for those that are well, like we have been doing for thousands of years. They may have spiritual reasons for altering consciousness. It’s not all about getting a competitive edge in Silicon Valley, but it’s about how do we make our community healthy. For me it just happens to be the healing aspect. For people that are really suffering is where my interests lie.”

So what are the most promising areas in psilocybin research?

“Two of the most promising areas are Palliative Care; reducing the stress near the end of life and addiction studies,” Danforth replied. “I’ve always been really fascinated with the smoking cessation studies at John Hopkins and with Michael Bogenschutz M.D. (NYU) studies on alcoholism. I think that was one of the most promising areas of study from the first wave of psychedelic research in the sixties. I’d like to see more funding and research around treating addiction.”

Danforth said it’s frustrating not being able to use all the tools she’d like when treating patients. “I feel a bit like a firefighter who’s still allowed to fight fires, but I just can’t bring my hose,” she said. “The answer isn’t, ‘well let’s just give everybody fire hoses,’ because a lot of people could be hurt in an uncontrolled setting. I hope that we can find a middle ground.”

Dr. Danforth advises, “Psilocybin was used as a sacrament for sacred rituals, with a lot of reverence, wisdom, tradition, and mentoring. I’m not sure we are grown up enough as a culture to just have widespread access.”

Dr Danforth’s associate on the UCLA study, Gurpreet S. Chopra, emphasized, “I think it’s kind of ridiculous to be a scientist and a doctor and not investigate and try to understand how we can use these tools in a Western Culture safely.”

I posed a similar thought to local clinical psychologist and founder of the Alaska Psilocybin Society, Dr. William Kerst. Dr. Kerst finds that psilocybin being a Schedule I substance to be ridiculous. “It clearly has potential medical benefit as demonstrated by the studies that are ongoing and not only is it not necessarily addictive, but it tends to be anti-addictive.”

“Working with the Alaska Psychedelic Society, I have had several patients that are struggling with end-of-life anxiety, which is one of the primary uses of psilocybin in some of these studies and they don’t have time for legalization efforts to get pushed through. They need relief and it looks like these substances may be able to do that, and right now we have to say, ‘no’ to these patients and that’s terrible. It’s heart-wrenching, honestly.”

Should you have further interest in investigating psychedelic substances, the Alaska Psychedelic Society is holding their monthly meeting on Saturday, April 27 from 2 to 4 pm at Uncle Leroy’s Coffee, located at 701 West 36th Avenue in Anchorage. Also visit the Society’s Facebook page to keep updated on future meetings as well as recent studies and articles regarding psychedelics.

Complete Article HERE!

Patients in end-of-life care to be treated with magic mushrooms

A spokeswoman for Palliative Care Australia said anxiety is a common and distressing symptom for those entering the final stage of their life.

By Benjamin Ansell

Palliative care patients will be treated with the psychoactive ingredient in magic mushrooms in a bid to reduce their anxiety during end of life care.

The first of 30 patients in Melbourne’s St Vincent’s Hospital trial will be treated with psilocybin in April after a year-long battle to have the study approved by the ethics committee, as well as state and federal authorities.

Patients will be given a single dose of the psychedelic drug, which stimulates feelings of euphoria and is believed to be able to ease anxiety, fear and depression for up to six months.

Applicants will be screened, requiring a state government permit to take the medication, and will be closely monitored by two clinicians on the ‘dose day’ while the initial high wears-off.

“With therapists in the room providing therapy it will allow people to have a heightened awareness of their situation, see the problem and work through it,” Mark Bowie, director of Palliative Medicine at St Vincent Hospital, said.

St Vincent’s clinical psychologist Dr Margaret Ross said patients in the study will be given a single dose of the drug in capsule form.

A similar trial conducted at New York University found 70 per cent of patients later reflected on the psilocybin experience as one of the top five most spiritually significant experiences of their entire lives, while 87 per cent reported increased life satisfaction overall.

Vice President of Australia’s Psychedelic Research In Science and Medicine Association Dr Stephen Bright told 9News that the study “sets a precedent” for more research into the medical application of psychoactive substances.

Patients will be treated with the psychoactive ingredient in magic mushrooms.

“I think it’s fantastic this study has been able to obtain the requisite approval, there have been multiple attempts to use psychedelics which have all been knocked back,” Dr Bright said.

“The fact that this has been able to secure approval is very encouraging.”

Dr Bright, also a senior lecturer at Edith Cowen university, is currently attempting to secure funding and ethics approval for another study on the potential of MDMA to be used in the treatment of Post-Traumatic Stress Disorder.

A spokeswoman for Palliative Care Australia told 9News.com.au anxiety is a common and distressing symptom for those entering the final stage of their life.

“This can be triggered by concerns and fears about how they will die, how their families and loved ones will cope as well as existential or spiritual concerns,” the spokeswoman said.

Complete Article HERE!

Going Out on a High: the Doctor Advocating LSD for Dying People

Everybody’s got to die. But not everyone’s got to be miserable doing it.

By

The good doctor is irked. In a very gentle way, but still.

“I think it was Confucius who said that the beginning of wisdom is to call things by their correct name,” says Dr. Ira Byock, 67, founder and chief medical director at the Providence St. Joseph Health Institute for Human Caring in Torrance, California. “So to be perfectly grammatically correct and to be absolutely legit, let’s focus on the adverbs and the adjectives, since what we’re really talking about is Dying Well.”

Which is exactly where throats start to get cleared and the death-phobic among us try to edge toward the exits. Because no matter the fact that each and every person alive to read this must one day perish, none of us wants to perish. Particularly not in misery and solitude. “I’ve had patients who have literally said to me that they’d rather be pushed down a flight of stairs,” intones Byock, “than have to face a future of crap care in some facility at the end of their lives.”

But Byock is not in the euthanasia camp — dying quicker doesn’t mean dying better. His pitch, instead: a menu of a few different things, the most compelling being “psychedelic-assisted therapies.”

Studies show about 25 percent of Medicare spending gets poured into caring for people in their last year of living — which would add up to $175 billion last year. That number is catching the eyes of cost-cutting politicians. All this penny-pinching has caused Byock to turn a jaundiced eye to the spate of now-legal physician-assisted death states: California, Colorado, the District of Columbia, Hawaii, Montana, Oregon, Vermont and Washington. “I call it Physician-Hastened Death,” says Byock. “And why the rush to hustle the old and the sick into the hereafter? Excuse me if it just seems a little too convenient to me.”

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Byock’s New Jersey roots, played through the betraying trace of an accent, are even more in evidence as he inveighs, not without flashes of humor, against dying badly and too soon. Working one of his first physician gigs after med school in a rural Montana emergency room for about 14 years, Byock created a clinical assessment tool that measured the quality of life for people who are suffering.

His prescriptions for the medical-industrial complex now include listening to patients, formulating care plans for disease and symptom treatments, helping them sleep, helping them move their bowels, addressing family needs and perhaps most importantly training doctors to do this early. So medical schools have to teach about caring for seriously ill or dying people up to and including the ethics of decision making, and should face financial penalties if they fail to do so. “Most med schools dedicate one month for pregnancy care even if the doctors in question won’t end up delivering babies,” Byock says. ”But 70 percent of physicians will be seeing sick or dying people.”

Byock talks about learning to listen, being sensitive to older patient needs — and then comes the needle-scratching-across-the record moment when he brings up psychedelics.

“I’m a child of the ’60s,” Byock laughs. “And there are legitimate medical uses of psychedelics when we’re talking about end-of-life wellbeing issues.” With an eye to easing pain and creating comfort, Byock turns to the early, legal uses of psychedelics as an adjunct to therapy, as well as the recent and well-publicized benefits of using psychedelics to mitigate PTSD.

Elizabeth Wong, a Northern California nurse and Byock fan who is training to be an end-of-life doula, points to controlled studies that show psychedelics having “lasting effects for up to six months on anxiety issues. It’s real science.” As legalization of medical and recreational marijuana has made clear, this is less of a traditional Democratic/Republican divide, says the committed progressive Byock, but more of which stakeholders win and which will lose.

Dr. Ira Byock, the doc from Jersey.

Losing? If the Dying Well’ers were to succeed, pharmaceutical companies and medical equip

ment manufacturers would take a hit. A contingent of pro-lifers under the aegis of the American Life League has blasted Byock’s work as “stealth euthanasia,” a charge Byock believes is risible. And winning? Nurses’ aides, nursing homes, hospices, long-term care facilities and pretty much anybody who expects to be dying.

“I think you’ll need more than a scorecard to get people to change their minds about this,” says senior care worker Josefine Nauckhoff. “Or at the very least America will have to take seriously those magical, mystical countries that have figured this out.”

Like? “Canada,” Byock says. “They’re taking this seriously,” with an emphasis on hospice centers, senior care facilities and addressing end-of-life issues as though they were both real and manageable.

Byock is pushing the U.S. to follow suit via his indefatigable advocacy in the wellness community, faith-based Catholic initiatives, books, conferences for reimagining the end of life and even the Death Over Dinner movement, where people bite the bullet, as well as biscuits, and talk seriously about death.

A movement is evident in the growing number of related books, death cafés, conferences, efforts at real legislative change and hospitals that are dealing on their own. In 2016, three-quarters of all U.S. hospitals had a palliative care team — focusing on improving quality of life for those with serious illnesses — up from one-quarter of hospitals in 2000, according to the Center to Advance Palliative Care.

“This is not just about avoiding suffering,” Byock said. “I’m in it for the joy. But, I mean, we’re all going to die. Best we do so the best ways we can.”

Byock and an ad hoc group of like-minded experts propose the following public policy planks to improve end-of-life care:

  • Raise training standards for physicians, nurses and allied clinicians in geriatrics, palliative care and related topics.
  • Establish minimum program standards for “palliative care” (disciplines, staffing, services, hours).
  • Require palliative care consultation before high-risk surgery or low-yield treatments for patients with advanced age or physiologic frailty.
  • Eliminate the requirement to forego disease treatments to receive hospice care for comfort, quality of life and family support.
  • Long-term care: Require adequate staffing of nurses and aides.
  • Long-term care: Require living wages and benefits for aide-level workers.
  • Annually revoke licenses of nursing homes in lowest 10 percent of quality and resident safety scores.
  • Award new licenses only to nursing homes qualifying as Greenhouse, Planetree or Beatitude-style models.

Complete Article HERE!