Tag: Psilocybin

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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↩!

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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↩!

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Dying without fear

— How psychedelics can ease the anxiety of terminal illness

A palliative care physician on keeping ‘1 foot in the medical world and 1 foot in the psycho-spiritual world’

By Anne Strainchamps

When Lou Lukas meets a new patient, she knows two things right away. First, that her patient has been diagnosed with a terminal illness; and second, that they’re terrified.

For Lukas, who teaches palliative medicine at the University of Nebraska Medical School, guiding patients through that fear and anxiety is just as important as treating their disease, because it’s what will determine how they live during the time they have left.

“What happens to most people is that they’re so frightened, they start to shut down,” Lukas says. “They become depressed and anxious. Meanwhile, we start scheduling them for medical treatments that may or may not work. But we haven’t questioned whether we can stop treatment because they’re too terrified to think about the possibility. So we get stuck in this cycle of clinging to life, even if it means I’m spending three days a week going through treatment and not spending time with my family. And in the end, nobody gets out of here alive, right?”

Lukas believes psychedelics have the potential to transform life after a terminal diagnosis by easing the grip of fear. Like many palliative medicine physicians, she pays close attention to the growing body of clinical trials for psychedelic-assisted therapy.

“It’s phenomenal,” she says. “Somewhere between 60 and 80 percent of people have profound experiences that dramatically change their life and their perception of their illness, which is remarkable because nothing else works like this.”

Wanting to know more about the future of psychedelics in end-of-life care, Anne Strainchamps of “To The Best Of Our Knowledge” got in touch with Lukas.

This conversation has been edited for clarity and length.

Anne Strainchamps: The FDA has not yet approved psilocybin for medical use. But clinical trials are underway in medical centers around the country. Tell me about yours.

Lou Lukas: I’m doing a trial of a psilocybin protocol for people who have pancreas cancer, which as you know is one of the most lethal of the solid organ cancers. Most people are diagnosed very far along and we can give them a couple of months usually, but not a whole lot longer than that. Some people might live a year, a year and a half. So you can imagine being told this.

AS: It’s a terrifying diagnosis.

LL: It is. And so people who are at our cancer center being treated for their pancreas cancer will be offered admission into this study, which will take them through six to eight hours of preparatory counseling, a day-long dosing session, and then several sessions of integration afterwards.

AS: What is it like to take psilocybin, for someone who has a terminal illness? How do they feel the day after? What’s different?

LL: It isn’t even the day after! When the dosing session is finished, when they come back into consensus reality, they just look at you like — “that was amazing.”

I witnessed one patient say, “All that anxiety I felt? It’s just stories. And I can get a different story. Yeah, I’ve got cancer, but I don’t need to be that worried about it.”

Underneath it all, people report a sense of being in the presence of love. You know, we put up a lot of defenses to get through our world, to keep ourselves physically and emotionally safe. And if we were able to let some of those defenses down, maybe we would have more access to love. And if you have that, then you can really accept a lot of things.

AS: What opens up for patients and their families, when they’re less frightened of the prospect of dying, when that anxiety eases?

LL: Then it becomes possible to think about going out with some joy and some curiosity and really full of life. Like: “What gifts do I need to leave to my family? How do I pass on some of my wisdom?”

We’ve all got a deadline in life.

There are some people who even talk about the ecstatic grief of knowing that this life we’re living is so precious and so sacred. But it’s only when there’s not that much of it left that you really feel the beauty and magnificence of it. So if you can help to convey that to people, if you can say, “Wow, look at this gift we’re sharing. Look at the intimacy we’re able to have now because I don’t have that much more time to hold your hand,” then you can really help people grow from generation to generation.

AS: You must be a very unusual palliative physician, because honestly, I think most would be more like, “Maybe we should add some more morphine.”

LL: I think given the opportunity, most palliative doctors would go into similar territory. I teach residents and fellows, and I tell them, “If you don’t talk to people about this, who will?” Because even if a patient has a trusted spiritual advisor, their pastor may not have any idea how sick they are. And if you don’t initiate those conversations about making meaning out of their life, they’re never going to connect with their pastor in a different way.

Our ability to reclaim some of the shamanic origins of medicine means learning how to bridge this gap. We need more physicians who feel called to edge-walking — one foot in the medical world and one foot in the psycho-spiritual world.

AS: I imagine some of these terminally ill patients must say, “If only I’d had this revelation 30, 40 years ago, I might have lived differently.” It does raise the question — why should people have to wait until they’re dying to have psychedelic therapy?

LL: Well, exactly. I’ve been thinking that it could be used like a sacrament, or rite of passage. Maybe when you come into adulthood, and then perhaps when you get married or have a child, or perhaps every decade, you just touch back down and remember that you’re connected to everything.

Almost like a ritual bath, a mikvah in Judaism — perhaps there’s this time when I take a psychedelic bath, when I think, “I’m going to wash myself in the universe. I’m going to immerse myself in the unconscious mind. I’m going to feel that expanse of consciousness and realize that I’m part of everything.”

And then come back and do the laundry and change the diapers.

Complete Article ↪HERE↩!

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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↩!

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“Microdosing helped me come to terms with my own death”

Doctors don’t understand why I’m still here. I think the peace of mind psilocybin has given me is a huge part of it

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Who: Andrea Bird, a 60-year-old artist and former art educator based in Caledon

Treatment: Psilocybin microdoses, one to three times a year

My husband, Daniel, and I ran an art school for years at the Alton Mill Arts Centre in Caledon. In 2012, I went for my first mammogram, and they found a large tumour in my right breast. I was diagnosed with Stage 2 cancer. I felt shocked and confused. I had surgery, followed by chemo, followed by radiation. That took about a year, and then I was told, “You’re cancer free. Go live your life.” And so I did.

About four years later, my cancer had metastasized to my bones and lungs, and last summer, it spread to my brain as well. I was diagnosed with Stage 4, which is terminal. My doctors and I were now talking about end-of-life plans. The estimated timeline is about two years, according to my husband’s research. I was not so keen to have a date floating around, so I left that part of the process to him. It was really challenging for me to wrap my brain around mortality, and I tried antidepressants but they didn’t help much. I had all this internal turmoil, thinking, How do I want to spend this time? I wanted my days with the people I love, in ways that were nourishing for all of us.

At the time, Daniel was reading Michael Pollan’s book, How to Change Your Mind, which is about how psychedelics can be used in therapeutic treatments for PTSD, addiction, trauma and end of life. I read the chapter on psilocybin and told my husband I wanted to try it. I had never done anything like this before and was always very cautious about those kinds of things, but I thought it might be helpful. Dying had pushed me to the edge of my capacity to cope.

I mentioned psilocybin to a friend, and they told me they knew someone who could help—a guide of sorts. It felt like the universe was aligning because I had no idea how to do it or how to access the drug. Everything fell into place extremely easily and I thought, Andrea, life is giving you the opportunity to try this. Do you have the courage to do it?

I had a lot of conversations about what to expect with my guide. They’re not a doctor, but they’ve researched psychedelic medicine and are extremely knowledgeable. I quickly realized that I was in good hands. They asked me, “What do you want to get out of this? What are your fears?” I hoped to come to terms with death and dying. I also wanted to know what I could let go of. Like preparing to climb a mountain, I wanted to lighten my load and only take what was essential.

I had my first trip in December of 2018. My guide boiled three and a half grams of mushrooms in hot water with lemon and ginger. I was sitting at home, and Daniel went out with our pets. The guide had Daniel’s phone number if they needed him. I sat in a reclining chair with eye shades and headphones, playing a psilocybin playlist on Spotify made by the team at Johns Hopkins University, a leader in psychedelic therapy research.

I started to feel the effects in half an hour, a full spectrum of emotions: gratitude toward Daniel, then sadness that I was dying, and then a deep realization of how fortunate I had been. It helped me to come to terms with my reality. I recognized that being sad and grieving for my life was not a problem. Because if I didn’t love life so much, then there wouldn’t be that sadness.

It also helped me to understand that life is a gift that we get to have for a little while, and then we have to give it back. On my first trip, my death showed up as a physical form in my mind’s eye. You know when you’re running a relay race and you’re carrying the baton, and your friend up ahead is waiting for you to pass the baton into their hand? Their hand is in the ready position, they’re crouched over with their arm outstretched behind them. That’s what death looked like. Death was the hand waiting for me to pass the baton to it, and the baton was my life. And death wasn’t in any hurry. But it was there. And it’s there for everybody. At some point, everybody has to part with their life. I don’t want to die. I don’t want to give up this beautiful life. I don’t want the people I love to have to grieve for me and all of that. But that’s just the nature of life. It’s not personal. This is how it is.

I did another trip a year later to see if there was anything else I needed to understand and I got this resounding message: You’ve got this. You’re as okay as you can be in this situation. The second trip confirmed the realization I was edging towards: death is not separate from life, deep despair and grief are not separate from wholehearted love and joy.

Since then I have microdosed off and on, under my guide’s advice. I would take tiny amounts, like one tenth of a gram, grind up the mushrooms, and put it on toast. There was no psychedelic effect at all. Rather, microdosing upped my capacity to deal with the emotional waves that were hitting me at that time.

Last summer, through TheraPsil, a Victoria-based advocacy group, I got an exemption from the federal government to take psilocybin legally. When I got the exemption, I felt such a relief. I know psychedelic therapy is all relatively new, but it feels like it’s overdue because it’s so effective. I haven’t microdosed for months now but it’s good to know it’s an option.

I want to help de-stigmatize and demystify some of the concern that comes with this drug and advocate for legalization. It’s possible to get an exemption, but why should dying people have to deal with yet another obstacle during this time when they’re doing everything they can to wrap their brain around dying? People should be made aware that psilocybin is an option, whether they choose to take it or not. And if they choose to, the process should be effortless for them.

Taking psilocybin was the most helpful thing I did in the last four years in coming to terms with my own death. I’m currently on a cancer regimen that involves a monthly injection, morphine for pain and all kinds of other drugs to treat the side effects of opiates. But I mostly feel like myself. I’m still in pain and get tired easily, but with the energy I have, I am painting, reading poetry, listening to music, dancing and visiting with dear friends. The doctors don’t understand why, four and a half years later, I’m still here, feeling as well as I do. Clearly the treatment plan I’m on is working. That’s part of it, but I think the peace of mind psilocybin has given me has been huge.

Complete Article ↪HERE↩!

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

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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.”

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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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