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Swiss LSD study yields incredible results for terminally ill patients

by Victoria Kim | MIC | 5 Mar 2014

The Journal of Nervous and Mental Disease published the results of an innovative study measuring LSD's effects on end-of-life anxiety. The study marks the first controlled trial of LSD in over 40 years. It tested the use of LSD as a complement to talk therapy for a group of 12 people nearing the end of life.

After about two months of weekly therapy, the eight participants who received full doses of LSD improved by about 20% on standard measures of anxiety. The four subjects who took a much weaker dose got worse. Overall, after following up with the group a year after the trial's conclusion, Dr. Peter Gasser, who conducted the therapy, said the patients anxiety went down and stayed down.

The drug caused no serious side effects other than temporary and therapeutically valuable times of distress. One of the subjects, a 50-year-old Austrian social worker named Peter, told the New York Times that he was worried about having a bad trip, but ended up having a mystical experience. "I had what you would call a mystical experience, I guess, lasting for some time, and the major part was pure distress at all these memories I had successfully forgotten for decades," he said. "These painful feelings, regrets, this fear of death. I remember feeling very cold for a long time. I was shivering, even though I was sweating. It was a mental coldness, I think, a memory of neglect."

One 67-year-old patient said he met his dead, estranged father somewhere out in the cosmos, who nodded to him in approval.

Switzerland is known for their progressive, harm reduction approach to drug policy. Their national heroin treatment program, for example, provides drug addicts with free methadone and clean needles. This policy has seen reduced deaths and crime rates, which is a marked turnaround from what was once the site of Zurich's infamous Platzspitz park, dubbed needle park in the 1980s.

It's been just over 70 years since Swiss chemist Albert Hofmann discovered LSD's mind-altering qualities when he absorbed some through his fingertips. But research about the drugs therapeutic qualities are just making a resurgence, along with mushrooms and ecstasy. Since the Controlled Substances Act of 1970 (CSA) came into effect 44 years ago, these psychedelics were labeled as Schedule I drugs, which are defined as having no medical benefit and a high potential for abuse, making them more difficult to conduct studies with. Marijuana is also considered a Schedule I drug.

Before the CSA, close to 700 studies took place, and the research suggested that psychedelics offered significant benefits in treating alcoholism, easing end-of-life anxiety and treating many complex psychiatric illness such as obsessive-compulsive disorder.

The scientific community has researched psychedelics for the treatment of PTSD, alcoholism and drug addictions, and their findings have been promising. The Johns Hopkins School of Medicine, for example, found that psilocybin, an active component of magic mushrooms that trigger transformative spiritual states, may have lasting medical and spiritual benefits when taken in the right dosage. The study researchers were able to reliably induce transcendental experiences in subjects. These experiences offered long-lasting psychological growth and helped people find peace in their lives without negative side effects.

With Switzerlands progressive approach to drug policy, scientists are able to conduct studies with drugs that are still very controversial in the U.S. While countries like Switzerland and Israel are ahead of the game in propelling research of the medical benefits of psychedelics, the U.S. is falling behind by limiting research of these substances.

https://mic.com/articles/84383/swis...esults-for-terminally-ill-patients#.5Ex7THR9S
 
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Psilocybin helps cancer patient overcome anxiety

by Robin Marantz Henig

Carol Vincent was having a psychedelic experience, taking part in a study just published that looks at whether cancer patients like her could overcome their death-related anxiety and depression with a single dose of psilocybin.

By the time she found her way to Hopkins in 2014, Vincent, now 61, had been living for six years with a time bomb of a diagnosis: Follicular Non-Hodgkins Lymphoma, which she was told was incurable. It was asymptomatic at the time except for a few enlarged lymph nodes, but was expected to start growing at some undefined future date; when it did, Vincent would have to start chemotherapy just to keep it in check. By 2014, still symptom-free, Vincent had grown moderately anxious, depressed, and wary, on continual high alert for signs that the cancer growth had finally begun.

"The anvil over your head, the constant surveillance of your health — it takes a toll," says Vincent, who owns an advertising agency in Victoria, British Columbia. She found herself thinking, "What's the point of this? All I'm doing is waiting for the lymphoma." There was no sense of being able to look forward to something. When she wasn't worrying about her cancer, she was worrying about her son, then in his mid-20s and going through a difficult time. What would happen to him if she died?

Participating in the psilocybin study, she says, was the first thing she'd looked forward to in years.

The experiment involved two treatments with psilocybin, roughly one month apart — one at a dose high enough to bring on a markedly altered state of consciousness, the other at a very low dose to serve as a control. It's difficult to design an experiment like this to compare treatment with an actual placebo, since it's obvious to everyone when a psychedelic experience is underway.

The NYU study used a design similar to Hopkins' but with an active placebo, the B vitamin niacin, instead of very-low-dose psilocybin as the control. Niacin speeds up heart rate but doesn't have any psychedelic effect. In both studies it was random whether a volunteer got the dose or the control first, but everyone got both, and the order seemed to make no difference in the outcome.

Vincent had to travel from her home in Victoria to Baltimore for the sessions; her travel costs were covered by the Heffter Research Institute, the New Mexico nonprofit that funded both studies. She spent the day before each treatment with the two Hopkins staffers who would be her guides during the psilocybin trip. They helped her anticipate some of the emotional issues — the kind of baggage everyone has — that might come to the fore during the experience.

The guides told Vincent that she might encounter some hallucinations that were frightening, and that she shouldn't try to run away from them. "If you see scary stuff," they told her, just open up and walk right in."

They repeated that line the following day—just open up and walk right in—when Vincent returned to Hopkins at 9 a.m., having eaten a light breakfast. The treatment took place in a hospital room designed to feel as homey as possible. It felt like your first apartment after college, circa 1970, she says, with a beige couch, a couple of armchairs and some abstract art on the wall.

Vincent was given the pill in a ceramic chalice, and in about 20 minutes she started to feel woozy. She lay down on the couch, put on some eye shades and headphones to block out exterior sights and sounds, and focused on what was happening inside her head. The headphones delivered a carefully-chosen playlist of Western classical music, from Bach and Beethoven to Barber's "Adagio for Strings," interspersed with some sitar music and Buddhist chants. Vincent recalled the music as mostly soothing or uplifting, though occasionally there were some brooding pieces in a minor key that led her images to a darker place.

With the music as background, Vincent started to experience a sequence of vivid hallucinations that took her from the deep sea to vast outer space. Listening to her describe it is like listening to anyone describe a dream — it's a disjointed series of scenes, for which the intensity and meaning can be hard to convey.

She remembered seeing neon geometric shapes, a gold shield spelling out the name Jesus, a whole series of cartoon characters—a fish, a rabbit, a horse, a pirate ship, a castle, a crab, a superhero in a cape—and at some point she entered a crystal cave encrusted with prisms. "It was crazy how overwhelmed by the beauty I was," she says, sometimes to the point of weeping. "Everything I was looking at was so spectacular."

At one point she heard herself laughing in her sons voice, in her brother's voice, and in the voices of other family members. The cartoon characters kept appearing in the midst of all that spectacular beauty, especially the comical crab that emerged two more times. She saw a frightening black vault, which she thought might contain something terrifying. But remembering her guides' advice "to just open up and walk right in," she investigated, and found that the only thing inside it was herself.

When the experience was over, about six hours after it began, the guides sent Vincent back to the hotel with her son, who had accompanied her to Baltimore, and asked her to write down what she'd visualized and what she thought about it.

Three years after her trip, Carol Vincent is still symptom-free, and she's no longer waiting in dread for the cancer to show itself. I didn't get answers to questions like, "Where are you, God?" or "Why did I get cancer?" she says. What she got instead, she says, was the realization that all her fears and worries turn out to be "really insignificant" in the big picture of the universe.​
 
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Psilocybin for end-of-life anxiety

by Marlene Rupp

"It’s almost as if when you take psilocybin, it’s like taking onboard your own psychotherapist," said one participant about his psychedelic experience. A widespread belief about psychedelic drugs is that they can turn users mentally ill; what the data shows, however, is that psychedelics can achieve quite the opposite effect: they afford patients a relief of symptoms. Indeed, a growing body of evidence supports that psychedelic drugs may be extraordinarily effective in treating mood disorder and addiction.

Not surprisingly, facing one’s own mortality can unleash strong emotions. Up to 40 percent of cancer patients develop a mood disorder which in turn interferes with their chances of recovery. Psychedelic drugs certainly can’t heal cancer, but it appears they can mitigate the accompanying psychological distress.

Lead researcher Roland Griffiths and his team at Johns Hopkins University School of Medicine tested this hypothesis with 51 cancer patients. One group received a high dose of psilocybin, whereas the control group received an active placebo, which in this case was a very low dose of psilocybin that had no detectable behavioral effects. In this way, all participants were told they were taking psilocybin.

5 weeks after treatment with high-dose psilocybin, 92 percent of depressed patients and 76 percent of anxious patients showed significant improvements in symptoms. These positive results were not only immediate, but also long-lasting. Six months after their psychedelic experience, the patients suffering from depression were still going strong, with improvement rates of 79 percent. Regarding end-of-life anxiety, the improvement rate further increased from 76 percent five weeks after the treatment to 83 percent six months after the treatment. What’s more, half a year after the psilocybin session, over 80 percent of all participants stated that the experience had increased their well-being and/or life satisfaction.

"Such a substantial and enduring effect after a single dose is unprecedented in the field of psychiatry," said Roland Griffiths, Professor of Neuroscience and Psychiatry at Johns Hopkins.

"We are looking at a new paradigm for the way mental disorders can be treated,"
said Pharmacologist Dr. David Nichols, President and co-founder of the Heffter Research Institute.​
 
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Ketamine infusion therapies for end-of-life care

by Dr. Allison Wells

For a terminal illness ketamine may be a great treatment option. Psychedelic drugs and their derivatives, such as ketamine, help patients cope with existential concerns, and can reduce anxiety leading up to death. Ketamine infusion therapies can offer end-of-life patients peace of mind.

Patients who have access to psychedelic medications as part of treatment for their terminal illness have found that they werent scared of death anymore. They frequently say that the treatment was one of the most meaningful experiences theyve had, ever. They talk about gaining a sense of peace with the universe, and having a sense of universal oneness and serenity. Their anxiety typically decreases significantly.

Palliative and hospice care professionals, as well as all of the individuals who care for their loved ones, do an exceptional job caring for those in the various stages of dying. But often the depression, anxiety, and melancholy that come with having a terminal diagnosis go untreated. Ketamine infusions may be one good option for addressing this part of end-of-life care. In most cases, ketamine works instantly and helps to treat those often-overlooked symptoms in a way that few if any treatments beyond psychedelics can.

An appropriate treatment regime may involve a series of outpatient infusion therapies followed by maintenance treatments from time to time as needed by the patient.

The opportunity to provide some relief from depression, anxiety and fear may be a great gift for many facing death. And for those who are particularly struggling it may be especially welcome.​
 
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LSD found to markedly reduce anxiety in terminal patients

by Nancy Wride

A small trial conducted in 2014 in Switzerland demonstrated the potential for LSD-assisted psychotherapy to reduce anxiety stemming from terminal illness. At 2-month follow-up, participants who were randomly assigned to treatment with LSD showed significant reductions in state anxiety. At one-year follow-up, participants in the LSD group demonstrated sustained therapeutic benefit with no acute or chronic adverse affects.

The first research in 40 years testing lysergic acid diethylamide (LSD) has found that it markedly reduces anxiety in patients facing life-threatening diseases. The results of the study of LSD use as a supplement to psychotherapy were published this month online in the peer-reviewed Journal of Nervous and Mental Disease.

The double-blind, placebo-controlled pilot study in 12 subjects found statistically significant reductions in anxiety associated with advanced stage illness following two LSD-assisted psychotherapy sessions, announced MAPS, which sponsored the study. The results also indicate that LSD-assisted psychotherapy can be safely administered in these subjects.
 
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Psychedelics and end-of-life anxiety

Few things are as frightening as facing ones own mortality, and the challenges of grappling with the existential make the everyday problems of sickness and pain even more challenging. Terminally ill patients with advanced cancer or other diseases are understandably prone to depression and anxiety, which makes difficult circumstances considerably more difficult for them and their families. To ease this end of life transition, doctors have been researching the therapeutic value of psychedelics as a catalyst for emotional catharsis and acceptance that can allow patients to better come to peace with their situation. Such research gives us a chance at a major and meaningful breakthrough.

This research first started in the 60s with psychiatrist and psychedelic therapy pioneer Stanislav Grof who found very promising results before the cultural backlash against psychedelics made further study impossible. Today, this research is continuing under the guidance of leading edge Swiss and US researchers who are using psilocybin and LSD in clinical trials with terminally ill patients.

Psilocybin

Dr. Charles Grob, a researcher and psychiatrist at the UCLA Medical Center, studied the effects of psilocybin or magic mushrooms in end of life treatment for terminal cancer patients. The study involved 12 subjects who were dying of end-stage cancer. Grobs process involved the double-blind administration of either the psilocybin or a placebo, and gave the patients 7 hours to go on an inward journey in a safe environment with regular checkups by trained staff. After the session, patients were asked to describe their experiences and their levels of anxiety were measured.

The results of Grobs study were highly encouraging. While many of the patients underwent challenging moments during their psychedelic journey, they were cathartic and therapeutically valuable parts of the experience. Grob concluded that psilocybin was safe to administer in such an environment, and that it lead to a significant reduction in anxiety at 1 and 3 months after treatment. He further asserted that the results support the need for more research in this long-neglected field.

LSD

Another psychedelic being studied for end of life care is LSD. Swiss scientist Dr. Peter Gasser recently completed the first controlled trial of LSD in over 40 years, and it too produced very encouraging results. Like the psilocybin study, Dr. Gassers LSD study involved 12 terminally-ill patients who underwent psychedelic journeys in a controlled and safe environment. Gassers patients described emotional rollercoasters and mystical experiences that put their end of life transition in a new light. For those patients who received full doses of LSD, their anxiety went down and stayed down for a year or more after treatment.

New hope for the hopeless

Gasser and Grobs research on psilocybin and LSD should be a wake up call for doctors, caregivers, and families that are dealing with terminal illness. Their studies illustrate that these psychedelics are safe to administer in a proper environment, and they offer highly valuable introspective journeys that lead to measurable positive benefits, such as anxiety reduction.

Caring for those who are facing the end of their life and easing their stress is incredibly important both for the individual and their family. It is universal, and every culture has worked to ease this transition and to make it more understandable. End of life therapy is potentially entering an exciting new stage. It is wonderful news that we are once again studying and embracing psychedelics as important healing tools in these scenarios.

https://psychedelictimes.com/psyched...-life-therapy/
 
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A dose of magic mushroom, and then lasting peace


On a summer morning in 2013, Octavian Mihai entered a softly lit room furnished with a small statue of Buddha, a box of tissues and a single red rose. From an earthenware chalice, he swallowed a capsule of psilocybin, an ingredient found in psychedelic mushrooms.

Then he put on an eye mask and headphones and lay down on a couch. Soon, images flew by like shooting stars: a spinning world that looked like a blue-green chessboard; himself on a stretcher in front of a hospital; his parents, gazing at him with aching sadness as he reached out to them with childlike love.

Psilocybin has been illegal in the United States for more than 40 years. But Mr. Mihai, who had just finished treatment for Stage 3 Hodgkins lymphoma, was participating in a study looking at whether the drug can reduce anxiety and depression in cancer patients. Throughout that eight-hour session, a psychiatrist and a social worker from NYU Langone Medical Center stayed by his side.

The results from that study, and a similar small, controlled trial, were striking. About 80 percent of cancer patients showed clinically significant reductions in both psychological disorders, a response sustained some seven months after the single dose. Side effects were minimal.

In both trials, the intensity of the mystical experience described by patients correlated with the degree to which their depression and anxiety decreased.

The studies, by researchers at New York University, with 29 patients, and at Johns Hopkins University, with 51, were released concurrently in The Journal of Psychopharmacology. They proceeded after arduous review by regulators and are the largest and most meticulous among a handful of trials to explore the possible therapeutic benefit of psilocybin.

Dr. Jeffrey Lieberman, a past president of the American Psychiatric Association, and Dr. Daniel Shalev of the New York State Psychiatric Institute are among leaders in psychiatry, addiction medicine and palliative care who endorsed the work. "The studies," they wrote, "are a model for revisiting criminalized compounds of interest in a safe, ethical way."

"If research restrictions could be eased,"
they continued, "there is much potential for new scientific insights and clinical applications."

Although cancer patients will not have access to therapeutically administered psilocybin anytime soon, the findings add vigor to applications to expand research in a multicenter trial with hundreds of participants.

Some medical professionals held the studies at arms length. Dr. William Breitbart, chairman of the psychiatry department at Memorial Sloan-Kettering Cancer Center, questioned this use of cancer patients. "Medical marijuana got its foot in the door by making the appeal that, cancer patients are suffering, they're near death, so for compassionate purposes, let's make it available, he said. And then you are able to extend this drug to other purposes."

Psilocybin trials are underway in the United States and Europe for alcoholism, tobacco addiction and treatment-resistant depression. Other psychedelics are also being studied for clinical application. This week, the Food and Drug Administration approved a large-scale trial investigating MDMA, the illegal party drug better known as Ecstasy, for post-traumatic stress disorder.

Cancer-related psychological distress, which afflicts up to 40 percent of patients, can be resistant to conventional therapy. Mr. Mihais anxiety began when doctors finally told him he was in remission.

He would keep touching the nodules on his neck, where the cancer had announced itself. He flew to Europe to celebrate the end of treatment and his graduation from college, but abruptly returned to New York, terrified to be away from oncologists. He began drinking daily, hard, jeopardizing his fragile health.

Alarmed, doctors suggested the psilocybin study.

He took the capsule and began tripping. After seeing himself on a hospital stretcher, he recalled: "I had an epiphany."

"Why are you letting yourself be terrorized by cancer coming back? This is dumb. Its in your power to get rid of the fear,"
he told himself. "That's when I saw black smoke rising from my body. And it felt great."

Three years later, Mr. Mihai, now 25 and a physician assistant in Las Vegas, said, "I'm not anxious about cancer anymore. I'm not anxious about dying. The session," he added, has made my life richer."

In the 1940s and 1950s, psychedelics were studied in hundreds of trials. But by 1970, when those drugs were placed in the most restricted regulatory category, research ground to a near halt.

Since about 2000, investigators have begun studying them, mostly with private funding. These two studies built on a 2011 UCLA psilocybin pilot project with 12 cancer patients.

Both share similarities. All volunteers had diagnoses of cancer-related anxiety or depression. Patients were randomly given a placebo or synthetic psilocybin, and not told which. Within seven weeks, they were given the other sample.

All patients were educated about the drug, monitored by two people throughout the placebo and psilocybin sessions, and seen for follow-up evaluation.

Researchers created seven-hour music playlists, paced to the anticipated rhythms of the drug reaction. N.Y.U. leaned toward New Age and world music, Brian Eno; sitars; didgeridoos. Johns Hopkins favored Western classical.

At N.Y.U., psychotherapists tried to layer the session into patients memories by asking them to write about their visions in a journal and discuss the experience in meetings. The Johns Hopkins study, led by Roland R. Griffiths, a psychopharmacologist, had monitors who urged participants to trust, let go and be open.

The N.Y.U. researchers assessed patients the next day and found the effects to be immediate in most of them.

Dr. Stephen Ross, the lead investigator and chief of addiction psychiatry at N.Y.U., pointed out that antidepressants, by contrast, can take weeks to show benefit.

"Cancer patients with anxiety and depression need help immediately," he said, "especially if you consider that they are at elevated risk for completed suicide."

Some experts questioned the reliability of the results. Dr. Breitbart said that because diagnoses ranged from early-stage cancer to imminent terminal illness, it was impossible to know which patients might have come through their psychological ordeal without psilocybin, whether some might have adapted to the new norms of their disease; felt stronger once chemotherapy side effects, including depression, had abated; or even experienced an improvement in health.

None of those possibilities fit Kevin, who had a bone-marrow transplant for acute myeloid leukemia. It sent his cancer into remission, but left him with graft-versus-host disease.

Suffering from chronic pain and fatigue, Kevin, 57, who lives in central Michigan and asked that his last name be withheld because he had been in law enforcement, had to retire. Four years after the transplant, he despaired.

"Going through a near-death illness is similar to returning from combat," he said. "It damages who you are, to the core of what it is to be human."

"I was hoping to get out of this funk of waiting for the other shoe to drop,"
he added. "You are looking up to the heavens, saying, What else can I try?"

In 2013, Kevin entered the Johns Hopkins trial. During his session, he saw spirals of iridescent spheres that folded in on themselves.

"The experience didn't restore me to my former life," he said, "but I have a greater sense of peace of what might come. I am very grateful, beyond words, for this trial. But you have to approach the session with the right intentions of why you are doing it. Because you are going to meet yourself."

Researchers do not know why psilocybin has worked in these settings. Neuroimaging scans of healthy volunteers show areas of the brain lighting up or resting during dosing. Psychedelics activate a serotonin receptor that can lead to the alterations of consciousness reported routinely.

One theory is that psilocybin interrupts the circuitry of self-absorbed thinking that is so pronounced in depressed people, making way for a mystical experience of selfless unity.

The studies received funding from the Heffter Research Institute, an alliance of scientists interested in the medical study of psychedelics. Dr. George Greer, the co-founder of Heffter, does not see a commercial future for psilocybin, even if it is eventually approved for therapeutic use, because these patients needed only one dose.

Instead, he envisions a nonprofit manufacturer, with distribution restricted to specialized clinics.

Researchers were emphatic that these results should not be interpreted as condoning psychedelic mushrooms for self-treatment. Dr. Griffiths noted that patients received extensive support, which may have deepened and secured their life-affirming transformations.

"People will take psilocybin at a rave or at Burning Man, the art and performance desert festival, but the effect," he said, "evaporates like water running through their hands."

https://www.nytimes.com/2016/12/01/h...epression.html
 
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Psychedelics help cancer patients let go


by Jesse Hicks | VICE

It was only a few months ago that researchers showed that combining psychotherapy with psilocybin, the psychedelic compound found in "magic" mushrooms, could relieve anxiety and depression in patients with advanced cancer. But many of the effects of psychedelics remain poorly understood, and why patients felt better was an open question.

For a recent paper, the same researchers from New York University interviewed patients about their experience of psilocybin-assisted therapy. They described transformed relationships with their loved ones, finding themselves able to let go of resentments and offer forgiveness. The psychedelic experience sparked emotional catharsis for all the participants, and many felt a greater sense of connectedness with the rest of the world. Their experiences, in other words, sound very much like your typical psilocybin trip.

But the study's authors point out that this may be the first qualitative analysis of patients in psychedelic therapy. Recent research has shown psychedelics may reduce suicide risk, help treat addiction, and even alleviate post-traumatic stress disorder. Quantitative studies that measure treatment effects, the researchers note, are valuable for testing hypotheses, but they don't help us generate hypotheses. In a field that's barely been explored, qualitative accounts can challenge preconceptions and reveal new information. What we need, the paper suggests, is new and more nuanced ways of understanding the subjective psychedelic experience.

To add to that understanding, researchers interviewed 13 adults aged 22 to 69 who participated in a previous NYU study which served as a phase II clinical trial for psilocybin-assisted therapy. They all had anxiety related to a cancer diagnosis at the start of the trial, and received a moderate dose of psilocybin in conjunction with psychotherapy sessions. More than half had never taken psychedelics before.

The earlier study showed impressive and enduring benefits, with both anxiety and depression decreasing dramatically. For the qualitative follow-up, researchers conducted semi-structured interviews, asking participants to talk about the before, during, and after of their experience. They didn't specifically ask people about their relationships, but everyone said the treatment resulted in them seeing their loved ones in a new way. Researchers coded and compiled their responses, finding those broad themes of emotional catharsis and improved relationships.

"I felt like I let go of a lot of anger and resentment towards my parents," one participant said. "I mean, I thought I had already done that, but I really hadn't, and I kind of saw them more as, like, these flawed human beings who did the best they could." Another described seeing his daughters in a new light: "Bit by bit, my daughters were turning into these radiant beings, cleansed of all these fears. It was incredibly emotional, because it was something I have, as their father, long known, but it's a very great pain when you see your children being victimized by fears … to see these beautiful beings not realizing their essence."

Others said the treatment helped them shift their priorities. One person said: "We forget what's really important; we get carried away with work and making our money and paying our bills, and this is just not what life is about."

But not everything was sweetness and light. Many participants reported feeling challenged by their experience—nine out of 13 described losing their sense of self. (Another not uncommon occurrence.) They felt disorientingly unmoored from themselves before passing through self-doubt into a greater understanding and acceptance of themselves, a process the researchers suggest may be a necessary part of the experience.

Again, so far, so familiar. But while the study may read like a collection of typical (if affecting) trip reports, understanding how psychedelics work on the individual mind may prove as important as measuring their outward effects. Psychedelic therapy is an emerging field, and studies like this push forward the frontier.

https://tonic.vice.com/en_us/article/zmma3y/psychedelics-help-cancer-patients-let-go-of-distress
 
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The History of Psychedelic Therapy with the Dying

by Stanislav Grof & Joan Halifax

Our experience with persons dying of incurable diseases has been closely associated with the development of psychedelic therapy, a comprehensive program of brief psychotherapy utilizing mind-altering substances such as lysergic acid diethylamide (LSD) and dipropyltryptamine (DPT). Although this treatment is a direct outgrowth of modern pharmacological and clinical research, it has close parallels in various contemporary non-Western cultures and its roots reach back to prehistory and the shamanic rituals and healing ceremonies of many ancient civilizations.

The first suggestion that psychedelic substances could be useful in the therapy of individuals dying of incurable diseases came from pediatrician Valentina Pavlovna Wasson. After many years of intensive ethnomycological studies, she and her husband, Gordon Wasson, became interested in the use of psychedelic mushrooms in pre-Columbian cultures and in contemporary Central America. They made several field trips to Mexico to explore this issue, and finally in June 1955 they became the first Westerners to be admitted to a sacred ritual conducted by the Mazatec curandera, or medicine woman, Maria Sabina. The Wassons were deeply impressed by the powerful effect of the mushrooms that they ingested in this ceremony. Roger Heim, the French mycologist whose aid the Wassons sought, identified the mushrooms botanically as Psilocybe mexicana and its congeners; he then sent samples to the laboratories of the Swiss pharmaceutical company, Sandoz, for chemical analysis. In 1957 Valentina Pavlovna Wasson gave an interview in This Week magazine about the history of this discovery and her own experience after the ingestion of the Mexican sacred mushrooms. She expressed the opinion that if the active agent could be isolated and a sufficient supply assured, it might become a vital tool in the study of psychic processes. She also stated that as the drug would become better known, medical uses would be found for it, perhaps in the treatment of alcoholism, narcotic addiction, mental disorders, and terminal diseases associated with severe pain. Several years later a team of researchers working in Baltimore independently tested the validity of her unusual vision. A group of psychiatrists and psychologists at the Maryland Psychiatric Research Center who were not familiar with the article in This Week conducted systematic studies of psychedelic therapy with LSD, a drug closely related to psilocybin, for exactly the same indications that Valentina Wasson predicted. We ourselves were surprised to discover the newspaper clipping in Gordon Wasson's library during a 1974 visit to his home.

The next stimulus for the use of psychedelics with dying individuals did not come from a physician or behavioral scientist but from the writer and philosopher, Aldous Huxley. He was profoundly interested both in the phenomenon of dying and in the religious and mystical experiences induced by psychedelic drugs. With unusual sensitivity and insight he assisted his first wife, Maria, when in 1955 she was dying of cancer. During her final hours he used a hypnotic technique to bring her into touch with the memory of ecstatic experiences that had occurred spontaneously on several occasions during her life. The explicit goal was to facilitate her experience of dying by guiding her toward these mystical states of consciousness as death was approaching. This deep personal experience has its parallel in Huxley's novel Island, where the character Lakshmi is dying under very similar circumstances. In a letter to Humphry Osmond, a psychiatrist and pioneer in psychedelic research who introduced him to LSD and mescaline, Huxley wrote:​

My own experience with Maria convinced me that the living can do a great deal to make the passage easier for the dying, to raise the most purely physiological act of human existence to the level of consciousness and perhaps even of spirituality.

To those who are familiar with the effects of hallucinogenic drugs and with Huxley's personal history, there is no doubt that the "soma" in Brave New World and the ''moksha medicine'' in Island are psychedelic substances similar in their effects to LSD, mescaline, and psilocybin. In Huxley's vision "moksha medicine'' gives inhabitants of the island mystical insights that free them from the fear of death and enable them to live more fully. In another letter to Humphry Osmond written as early as February 1958, Huxley was quite explicit about his idea of seriously considering the use of LSD with dying individuals:​

... yet another project--the administration of LSD to terminal cancer cases, in the hope that it would make dying more spiritual, less strictly physiological process.

According to his second wife, Laura, Aldous mentioned on several occasions that ''the last rites should make one more conscious rather than less conscious, more human rather than less human.'' In 1963, when he was himself dying of cancer, Huxley demonstrated the seriousness of his vision. Several hours before his death he asked Laura to give him 100 micrograms of LSD to facilitate his own dying. This moving experience was later described in Laura Huxley's book, This Timeless Moment.

Aldous Huxley's suggestion, although reinforced by his unique personal example, for several years had no influence on medical researchers. The next contribution to this area came from a rather unexpected source and was unrelated to Huxley's thinking and efforts. In the early 1960s Eric Kast of the Chicago Medical School studied the effects of various drugs on the experience of pain in the quest for a good and reliable analgesic. He became interested in LSD as a possible candidate for such a substance because of certain peculiarities of its effect on humans. He learned that LSD tends to produce a marked distortion of the body image and alterations of body boundaries; furthermore, it seemed to interfere with the ability to concentrate and maintain selective attention on a particular physiological sensation. Thus, in individuals who are under the influence of LSD, simple visual impressions may take precedence over sensations of pain or concerns related to survival. Both the effect of LSD on the body image and its interference with selective focus on significant input seemed to be worth exploring in terms of their potential for altering the perception of physical pain.

In a paper published in 1964 Kast and Collins described the results of a study in which the hypothetical analgesic properties of LSD were compared to those of two established and potent drugs, dihydromorphinone (Dilaudid) and meperidine (Demerol). In a group of fifty individuals suffering from severe physical pain were thirty-nine patients with various types and stages of cancer, ten patients with gangrenes of feet or legs, and one with severe herpes zoster (shingles). The outcome of the statistical analysis of this comparison indicated that the analgesic effect of LSD proved to be superior to both Dilaudid and Demerol. In addition to pain relief, Kast and Collins noticed 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; yet it was quite obvious that this new perspective was beneficial in view of the situation they were facing.

In a later study of 128 individuals with metastatic cancer, Kast explored in more detail some of his earlier findings. This time he was interested not only in the effects of LSD on pain but also on some additional parameters: emotional changes, sleep patterns, and attitudes toward illness and death. In view of the fact that there was no psycho therapeutic emphasis and the patients were not even informed that they were being given LSD, the results were quite remarkable. A precipitous drop in pain occurred in many individuals about two to three hours after the administration of 100 micrograms of LSD and lasted an average of twelve hours; pain intensity for the whole group (not necessarily for every patient) was decreased for a period of three weeks. For about ten days after the session, Kast observed improvement of sleep and a less concerned attitude toward illness and death.

In 1966 Kast published another paper in which he paid more explicit attention to the influence of LSD on the religious and philosophical experiences and ideas of the patients. The group he studied consisted of eighty persons suffering from terminal malignant disease, with estimated life expectancies of weeks or months, each of whom had been fully informed of the diagnosis. In contrast to earlier studies, the LSD sessions were terminated by an intramuscular injection of 100 milligrams of chlorpromazine upon the appearance of fear, panic, unpleasant imagery, or the desire to rest. The beneficial influence of a single administration of 100 micrograms of LSD on physical pain, mood, and sleep patterns was similar to the preceding studies. In addition, Kast described a variety of changes in the patients that made their situation more tolerable. He noticed improved communication both between the observer and the patients and among the patients themselves; this enhanced their morale and self-respect and created a sense of cohesion and community among them. Quite significant, also, was the occurrence of "happy, oceanic feelings" lasting up to twelve days following the administration of LSD. Kast stated explicitly that a certain change in philosophical and religious attitudes in relationship to dying took place that were not reflected in his numerical data and graphs.

In spite of what to an LSD therapist might at present appear as shortcomings in Kast's studies, the historical value of his pioneering effort is unquestionable. He not only discovered the analgesic value of LSD for some patients with intractable pain, but he also brought forth the first experimental evidence for Aldous Huxley's suggestion that the administration of LSD might ease the encounter with death in persons suffering from cancer. Kast concluded the last of his studies by stating that, according to his observations, LSD is capable not only of improving the lot of dying individuals by making them more responsive to their environment and family, but it also enhances their ability to appreciate the nuances and subtleties of everyday life. It gives them aesthetic satisfaction and "creates a new will to live and a zest for experience, which, against a background of dismal darkness and preoccupying fear, produces an exciting and promising outlook."

The encouraging results of Kast's studies inspired Sidney Cohen, a prominent Los Angeles psychiatrist, friend of Aldous Huxley, and one of the pioneers in LSD research, to start a program of psychedelic therapy for individuals dying of cancer. Unfortunately the results of his study and the details of his treatment procedure have never been published. In a 1965 article Cohen expressed his feelings about the potential of psychedelic therapy for the dying, based on his pilot experiments with a small group of patients. He stated that his own work confirmed Kast's findings about the beneficial effect of LSD on severe physical pain and suggested that LSD may one day provide a technique for altering the experience of dying. Cohen saw clearly the importance of this research endeavor: "Death must become a more human experience. To preserve the dignity of death and prevent the living from abandoning or distancing themselves from the dying is one of the great dilemmas of modern medicine."

Cohen's co-worker, Gary Fisher, later published a paper in which he discussed the personal and interpersonal problems of the dying. In this context he emphasized the significance of transcendental experiences--whether spontaneous, resulting from various spiritual practices, or induced by psychedelic drugs. As a result of such experiences the individual ceases to be concerned about his or her own physical demise and begins to see it as a natural phenomenon of the cycling of the life force. This acceptance drastically alters a person's life-style; the individual no longer reacts with panic, fear, pain, and dependency to the changes that are occurring. Rather, the patient is willing and eager to share this new knowledge with close family members and friends. Fisher discussed the use of LSD therapy within the framework of a research project where this drug was compared with an experimental analgesic and only one hour was allowed for preparing patients for the session. In spite of this limitation, he observed what he described as dramatic results in terms of pain reduction, psychological aftereffects, and adjustment of the patients to their impending deaths.

Another series of observations that was later integrated into the concept of psychedelic therapy for the dying originated in the Psychiatric Research Institute in Prague, Czechoslovakia. A research team of this institute headed by Stanislav Grof (coauthor of this book) conducted experiments in the early 1960s with psychiatric patients, exploring the potential of LSD for personality diagnostics and psychotherapy. These efforts finally resulted in treatment that involved intense psychological work and a series of therapeutic sessions with LSD. Although this approach was initially based in theory and practice on psychoanalysis, in the course of years it underwent substantial modifications and became an independent therapeutic procedure combining work on psychodynamic issues with a definite emphasis on transpersonal and transcendental experiences.

In the exploratory phase of this work, all psychiatric patients from various diagnostic categories undergoing serial LSD sessions sooner or later transcended the psychoanalytic framework and spontaneously moved into experiential realms that have been described through millennia as occurring in various schools of the mystical tradition, temple mysteries, and rites of passage in many ancient and pretechnological cultures of the world. The most common as well as the most important of these phenomena were experiences of death and rebirth, followed by feelings of cosmic unity. This profound encounter with one's own impermanence and mortality was very complex and had biological, emotional, intellectual, philosophical, and metaphysical dimensions. Experiences of this kind seemed to have had very beneficial consequences for these psychiatric patients; some very dramatic improvements of various psychopathological conditions were observed immediately following the death-rebirth phenomenon and, in particular, the experiences of oneness with the universe. This suggested the existence of a powerful therapeutic mechanism as yet unknown to Western psychiatry and psychology that appeared far superior to those used in conventional psychotherapy.

Many individuals who had the experience of death and rebirth sometimes accompanied by feelings of cosmic unity independently reported that their attitudes toward dying and their concepts of death underwent dramatic changes. Fear of their own physiological demise diminished, they became open to the possibility of consciousness existing after clinical death, and tended to view the process of dying as an adventure in consciousness rather than the ultimate biological disaster. Those of us conducting this research kept witnessing, to our great surprise, a process that bore a striking similarity to mystical initiation and involved experiential sequences that resembled those described in the Tibetan or Egyptian Book of the Dead.

The claims of changes in attitudes toward death were so frequent that it seemed important to test their practical relevance. It was obvious that a deep change of consciousness of that sort could be very beneficial for dying individuals, particularly those with chronic, incurable diseases. The first author (S.G.) then had an opportunity to work with several persons diagnosed with cancer. These pilot observations indicated that the alleviation of the fear of death earlier reported as a result of LSD therapy in psychiatric patients (most of whom were young and physically healthy) can occur also in those for whom the issue of death is of immediate relevance. At this point the Prague group began seriously discussing the possibility of working systematically with dying people, and Grof designed a research program using serial LSD sessions with individuals dying of cancer. These plans were interrupted by a fellowship granted to him by the Foundation's Fund for Research in Psychiatry in New Haven, Connecticut, that took him to the United States.

After his arrival in Baltimore in March 1967, he joined the team in the Research Unit of Spring Grove State Hospital, which later became the core of the Clinical Sciences Department of the newly built Maryland Psychiatric Research Center. Here he found, to his surprise, that some time prior to his arrival this group had been interested in exploring the potential of LSD psychotherapy for alleviating the emotional and physical suffering of cancer patients. The sequence of events that spurred the interest of the research team in this problem area, briefly described, is this: Since 1963 a group of psychiatrists, psychologists, and social workers at Spring Grove had been exploring the effects of a brief course of LSD-assisted psychotherapy on the drinking behavior, psychological condition, and social adjustment of alcoholics. In a parallel study the therapeutic potential of this new treatment was tested in a group of neurotic patients. During the assessment, based on clinical interviews as well as psychological testing, the symptoms particularly responsive to psychedelic therapy appeared to be depression and anxiety.

In 1965, when the studies with alcoholics and neurotics were well under way, the Spring Grove research team first focused its attention on the needs of dying cancer patients in an unforeseen and tragic manner. A professional member of the research team, Gloria, a woman in her early forties, developed a carcinoma of the breast. She had undergone a radical mastectomy; subsequent surgery had revealed inoperable metastases of the liver. Although still ambulatory, she was in severe physical and emotional distress. She was fully aware of her condition and her prognosis and shared her feelings of despair with staff members. On the basis of the relief of depression and anxiety frequently observed in psychiatric patients following LSD-assisted psychotherapy, Sidney Wolf, a psychologist and member of the therapeutic team, suggested that the psychedelic treatment procedure might prove helpful to his colleague. It seemed possible that her depression and anxiety, although reactive in nature and well substantiated by a painful life situation, might respond favorably to LSD therapy, as was the case in other conditions of a psychogenic nature.

After discussions with her husband, her physician, and with the approval of all concerned, a course of psychedelic therapy was initiated, with Sidney Wolf in the role of "sitter.'' In the treatment plan at Spring Grove the primary objective was to facilitate the occurrence of a psychedelic peak experience in the context of brief but intensive psychotherapy. The preparation for the session lasted somewhat over a week; the focus was on the issue of personal identity and on current interpersonal relationships. When most of the important areas involved were satisfactorily clarified, a 200-microgram LSD session was conducted under conditions quite similar to those used for psychiatric patients. The outcome of this pioneering experiment was quite remarkable: After careful preparation and several subsequent drug-free interviews a single LSD experience seemed to have changed the quality of Gloria's remaining days. Shortly after the LSD session she went on vacation with her husband and children. Upon her return, two weeks after the session, she completed the following retrospective report:

''The day prior to LSD, I was fearful and anxious. I would at that point have gratefully withdrawn. By the end of the preparatory session practically all anxiety was gone; the instructions were understood and the procedure clear. The night was spent quietly at home; close friends visited and we looked at photograph albums and remembered happy family times. Sleep was deep and peaceful. I awakened refreshed, and with practically no fear. I felt ready and eager. The morning was lovely, cool and with a freshness in the air. I arrived at the LSD building with the therapist. Members of the department were around to wish me well. It was a good feeling."

''In the treatment room was a beautiful happiness rosebud, deep red and dewy, but disappointingly not as fragrant as other varieties. A bowl of fruit, moist, succulent, also reposed on the table. I was immediately given the first dose and sat looking at pictures from my family album. Gradually, my movements became fuzzy and I felt awkward. I was made to recline with earphones and eyeshades. At some point the second LSD dose was given to me. This phase was generally associated with impatience. I had been given instructions lest there be pain, fear, or other difficulties. I was ready to try out my ability to face the unknown ahead of me and to triumph over my obstacles. I was ready, but except for the physical sensations of awkwardness and some drowsiness nothing was happening."

''At about this time, it seems, I fused with the music and was transported on it. So completely was I one with the sound that when the particular melody or record stopped, however momentarily, I was alive to the pause, eagerly awaiting the next lap of the journey. A delightful game was being played. What was coming next? Would it be powerful, tender, dancing, or somber? I felt at these times as though I were being teased, but so nicely, so gently. I wanted to laugh in sheer appreciation of these responses, regardless of where I had just been, how sad or awed. And as soon as the music began, I was off again. Nor do I remember all the explorations."

"Mainly I remember two experiences. I was alone in a timeless world with no boundaries. There was no atmosphere; there was no color, no imagery, but there may have been light. Suddenly I recognized that I was a moment in time, created by those before me and in turn the creator of others. This was my moment, and my major function had been completed. By being born, I had given meaning to my parents' existence."

"Again in the void, alone without the time-space boundaries. Life reduced itself over and over again to the least common denominator. I cannot remember the logic of the experience, but I became poignantly aware that the core of life is love. At this moment I felt that I was reaching out to the world--to all people--but especially to those closest to me. I wept long for the wasted years, the search for identity in false places, the neglected opportunities, the emotional energy lost in basically meaningless pursuits."

"Many times, after respites, I went back, but always to variations on the same themes. The music carried and sustained me. Occasionally, during rests, I was aware of the smell of peaches. The rose was nothing to the fruit. The fruit was nectar and ambrosia (life); the rose was only a beautiful flower. When I finally was given a nectarine it was the epitome of subtle, succulent flavor."

"As I began to emerge, I was taken to a fresh windswept world. Members of the department welcomed me and I felt not only joy for myself, but for having been able to use the experience these people who cared for me wanted me to have. I felt very close to a large group of people. Later, as members of my family came, there was a closeness that seemed new. That night, at home, my parents came, too. All noticed a change in me. I was radiant, and I seemed at peace, they said. I felt that way too. What has changed for me? I am living now, and being. I can take it as it comes. Some of my physical symptoms are gone. The excessive fatigue, some of the pains. I still get irritated occasionally and yell. I am still me, but more at peace. My family senses this and we are closer. All who know me well say that this has been a good experience."


Five weeks after the date of the session, Gloria suddenly developed ascites (accumulation of serous fluid in the abdominal cavity) and had to be rehospitalized; she died quietly three days later.

The result of Sidney Wolf's endeavor was so encouraging that the Spring Grove staff decided to explore further the potential of psychedelic therapy for alleviating the suffering of those dying of cancer. A group of open-minded surgeons at Baltimore's Sinai Hospital expressed interest in this procedure, offered their cooperation, and agreed to refer patients for LSD therapy. Three more persons were treated at this time by Sanford Unger, a psychologist who had played an important role in launching the Spring Grove studies of alcoholics and neurotics.

The next important step in this direction was made in late 1967, when Walter N. Pahnke joined the Spring Grove team. He was instrumental in changing the initial interest of the staff into a systematic pilot exploration and eventually a research project. Pahnke's background made him ideally suited for this type of work. He was a graduate of Harvard Medical School, and in addition had a doctoral degree in comparative religion and a degree in divinity.

It is hard to imagine a more useful way to combine medicine, psychology, and religion than psychedelic therapy with dying individuals. With unusual energy, enthusiasm, and devotion, Pahnke assumed the role of principal investigator in the cancer study. After pilot experimentation he was able to obtain financial support from the Mary Reynolds Babcock Foundation. He started a research program exploring the value of psychedelic therapy utilizing LSD. Later he initiated a similar project in which a short-acting psychedelic, dipropyltryptamine (DPT), was used in lieu of LSD.

Walter Pahnke's life and work were drastically terminated in a tragic accident on July 10, 1971. While vacationing in his summer cabin in Maine, he did not return from one of his scuba-diving expeditions. His body and diving equipment were never recovered and the nature of the accident has remained a mystery. Walter's demise was a great loss for the Spring Grove team, from the personal as well as professional point of view. After Walter's death the first author (S.G.) assumed medical responsibility for the cancer study as his primary research activity and interest. His objective was not only to complete the research projects and accumulate enough data but also to formulate a theoretical framework that would account for some of the dramatic changes occurring as a result of LSD therapy. It seemed important at this point to carefully analyze the data from LSD sessions of normal volunteers, psychiatric patients, and dying individuals, and to formulate a comprehensive theory of LSD therapy based on a new model of the unconscious.

A new dimension was added to these endeavors when in 1972, Joan Halifax, the second author, joined the team as co-therapist and anthropological consultant. We could now combine our backgrounds in experimental psychiatry and medical anthropology and view the data from a broad cross-cultural perspective. It was in this process of interdisciplinary cross-fertilization, when we were working as a therapeutic dyad, sharing observations and exchanging data, that the ideas expressed in this book started to crystallize into their present form.
Chapter 2 of The Human Encounter with Death
New York: E.P. Dutton 1977, ©Grof & Halifax
 
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Psychedelics and end-of-life care

The active ingredient in magic mushrooms was given to terminal cancer patients: 80% had immediate reductions in anxiety and depression which persisted for six months or longer. We think that's because psychedelics can change entrenched ways of thinking that people might otherwise not be able to tackle on their own.

Today, in a ground-breaking development in the field of psychiatry, 2 new studies were published in the Journal of Psychopharmacology showing that a single dose of psilocybin – a powerful, naturally occurring psychedelic compound found in “magic mushrooms” – can radically improve the well-being and positivity of terminally ill cancer patients.

The research, completed at NYU and Johns Hopkins, gave participants diagnosed with advanced cancer a moderate to high dose of psilocybin in a controlled environment with support from highly qualified guides. Results demonstrated immediate and marked reductions in their levels of anxiety and depression that, remarkably, still persisted 6 months later in 80 per cent of the participants.

Presently, end-of-life care consists of counseling and pharmaceutical treatments, such as antidepressants, to quell feelings of isolation, depression and anxiety commonly associated with a diagnosis of terminal illness. However, most medications can take months to start working and are not effective for all patients. Commonly prescribed drugs such as benzodiazepines may be addictive and can have other unpleasant side effects.

The approach highlighted today, known as “psychedelic-assisted psychotherapy” makes use of the “magic mushroom” ingredient psilocybin. Various studies using this approach over the last decade have shown that giving people psychedelics, with the support of psychotherapy, can provide fundamental and enduring changes much quicker than counselling alone. As a result, in recent years, psilocybin has received increasing attention in the clinical and scientific research communities.

Earlier this year, the Beckley/Imperial Psilocybin and Depression study showed that two low to medium doses of psilocybin reduced depressive symptoms in 67 per cent of participants, with 42 per cent remaining depression-free after three months. Participants in this study had all suffered from depression for at least 18 years and been completely unresponsive to any other forms of treatment. Next year, a larger, placebo-controlled study will be conducted to verify these findings.

And that’s not all. In addition to the focus of psychedelic-assisted therapy for depression and anxiety, the Johns Hopkins team also conducted a pilot study investigating smoking addiction treatment with psilocybin. Results showed 80 per cent of the smokers still hadn’t had a cigarette at the six month check-up.

Interestingly, the research showed that people were most likely to successfully stop smoking if they reported having mystical experiences on the days they were treated with psychedelics. These experiences were variously described by people as “mystical”, “spiritual”, “ego-dissolution” and “feelings of oneness”. It seems that when people reported these feelings, it correlated with a transformation of previously entrenched thoughts patterns that made them keep repeating the same negative habits.

It is possible that it is this aspect of the experience that enables cancer patients to alleviate the anguish associated with their diagnosis. “In some ways, I feel that I am better equipped to deal with what life throws at me, and to appreciate the good things. I'm grateful to be alive in a way that I didn’t know I could be,” said Eddie Marritz, a participant in the NYU study. “It’s a kind of gratitude that’s ineffable. I am much more focused on this moment.”

The research being done with terminal cancer patients adds to the growing collection of evidence of psychedelics’ therapeutic potential and indicates a significant development of an exciting new model of mental health treatment. Scientists are discovering that psychedelics change consciousness in a unique way that has the tremendous potential to revolutionise the field of psychiatry.

“The most interesting and remarkable finding is that a single dose of psilocybin produced enduring decreases in depression and anxiety symptoms, and this may represent a fascinating new model for treating some psychiatric conditions,” said Dr Roland Griffiths, lead investigator at Johns Hopkins.

As larger Phase III clinical trials are conducted, it is clear that this new model could help countless people worldwide who are seeking a long-term solution for their psychological suffering.

https://www.independent.co.uk/voices...-a7449331.html
 
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Dr. Ira Byock

The doctor advocating LSD for the dying

by Eugene Robinson

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.”

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.

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

 
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From an interview with Roland Griffiths, Ph.D.


by David Jay Brown with Louise Reitman

David: Have you seen anything in your sessions that influenced your understanding of, or perspective on, death?

Roland: The hallmark feature of the mystical experience, that we can now occasion with high probability, is this sense of the interconnectedness of all things, a sense of unity. That sense of unity is often accompanied by a sense of sacredness, of openheartedness or love, a noetic quality suggesting that this experience is more real than everyday waking consciousness. I believe that the experience of unity is of key importance to understanding the potential existential shifts that people can undergo after having these kinds of experiences.

Within the domain of the psychology of religion, scholars have described two variations of this experience of unity – something called “introverted mystical experience” and another called “extroverted mystical experience.” The extroverted version of this sense of unity was assessed by items in one of the spiritual questionnaires that we used, the Hood Mysticism Scale. I’ll read you a couple of items. One is, “An experience in which I felt that all things were alive.” Some of the others are: “An experience in which all things seem to be aware.” “Realized the oneness of myself with all things.” “An experience where all things seemed to be conscious.” “An experience where all things seemed to be unified into a single whole.” “An experience in which I felt nothing was really dead.”

So this feature of mystical experiences points toward the nature of consciousness, and an intuition that consciousness is alive and pervades everything. From there, it is not a great stretch to contemplate the possibility of the continuity of consciousness – or, more traditionally, immortal soul. Such an experience can break down a restrictive sense of being defined by your body, in a total materialistic framework. So I think that it’s these subtle and not-so-subtle perceptual shifts that could be at the core to rearranging someone’s attitude about death.

David: Is this why you think that psychedelics can be helpful in assisting people with the dying process?

Roland: It’s common for people who have profound mystical-type experiences to report very positive changes in attitudes about themselves, their lives, and their relationships with others. People report shifts in a core sense of self. Positive changes in mood are common, along with shifts toward altruism, like being more sensitive to the needs of others, and feeling a greater need to be of service to others. It is not difficult to imagine that such attitudinal shifts flow directly from the sense of unity and other features of the mystical experience – a profound sense of the interconnectedness of all things packaged in a benevolent framework of a sense of sacredness, deep reverence, openhearted love and a noetic quality of truth. So it’s quite plausible that the primary mystical experience not only underlies changes in attitude toward death specifically, but also changes attitudes about self, life, and other people in a way that’s dramatically uplifting.

David: What sort of promise do you see for the future of psilocybin research?

Roland: I’m trained as a scientist, so I’m very interested in all of the scientific questions that can be asked of this experience. I’m interested in the neuropharmacology of the experience. I’m interested in the psychological and physiological determinants of this kind of experience. And then I’m interested in the consequence of this kind of experience – not only for healthy volunteers, but also for distressed individuals who might have a therapeutic or clinical benefit. Now, whether or not unpacking those scientific questions will lead to approval of psilocybin as a therapeutic drug, I don’t know – and, in some ways, it’s not important one way or another.

For me, what’s most important is understanding the mechanisms that occasion these kinds of experiences. So I will not argue the future is with psilocybin per se. But it does appear to be an amazingly interesting tool for unlocking these mysteries of human consciousness. As we get a better understanding of the underlying neuropharmacology and neurophysiology, it may be that better compounds or nonpharmacological techniques can be developed that occasion these experiences with even higher probability than we can right now with psilocybin.

Frankly, I can’t think of anything more important to be studying. As I’ve said, the core feature of the mystical experience is this strong sense of the interconnectedness of all things, where there’s a rising sense of not only self-confidence and clarity, but of communal responsibility – of altruism and social justice – a felt sense of the Golden Rule: to do unto others as you would have them do unto you. And those kinds of sensibilities are at the core of all of the world’s religious, ethical, and spiritual traditions. Understanding the nature of these effects, and their consequences, may be key to the survival of our species.

David: That was precisely the point that I was trying to make when I edited the MAPS Bulletin about ecology and psychedelics. Psychedelics have played such an important role in inspiring people to become more ecological aware.

Roland: Yes, that follows from the altruistic sensibility that may flow from these types of experiences. Ecology can become a big deal with these experiences. If you really experience the interconnectedness of all things and the consciousness that pervades all things, then you have to take care of other people and the planet, right? And to bring this back around to death and dying, if everything is conscious, then death and dying may not be so frightening. There is a big and mysterious story here.

https://www.maps.org/news-letters/v2...0n1-22to25.pdf
 
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Harbor-UCLA Medical Center cancer anxiety research with psilocybin*

by David Jay Brown | Hospice News

Alicia Danforth worked on the cancer anxiety research study with psilocybin at the Harbor-UCLA Medical Center with psychiatric researcher Charles Grob, M.D.

David: Have you seen anything in your research that influenced your perspective on death and dying?

Alicia: One of our subjects had been living with cancer for awhile. She had been dealing with a cancer that had gradually become more severe. She was a very optimistic woman who had a lot of deep spiritual beliefs and practices. She hadn’t acknowledged to herself yet that this cancer would eventually take her life, probably sooner rather than later. She was able to talk freely about how that realization had come to her during the psilocybin session. It was really powerful to share that experience with her. She reconciled with the idea that she was going to die from her cancer, and she hadn’t previously come to that conclusion.

As advice to anybody who is going to be doing this kind of research, I suggest not assuming that you know what people will choose, and don’t assume that just because they have a diagnosis of stage-IV cancer that they have accepted the diagnosis as terminal. Journalists will do that sometimes. They’ll describe participants in a study as “terminal cancer patients” or as “cancer victims,” but the participants may not have accepted that prognosis yet. It’s always more appropriate to use the terms advanced-stage cancer or metastatic cancer. Not everyone who participated in the study had concluded that their cancer would be terminal.

This brings up an important point. I had to be mindful about clarifying the purpose of the experimental treatment. There were times—and it was always difficult to accept—when some individuals were unable to conceal harbored desires for a miracle cure for the cancer. I had to be diligent about confirming with them that this was a psychiatric study for anxiety and that we were not attempting to treat the cancer. Some participants would hear that disclaimer and, maybe rightfully so, say something like, “Yes, but if my mood improves I may be able to live a little bit longer. Or I might have a better quality of life that will make my body stronger, so that I can survive a little longer.” I didn’t try to suppress that perspective if someone already had it. Responsible researchers have to be very clear about what they are attempting to influence in experimental cancer anxiety studies with psychedelics.

The only thing that I can attest to is what some participants reported about improved quality of life for their remaining time. A few speculated with questions such as, “Did I outlive my prognosis? Did I live longer than the doctors expected me to because I did this?” We couldn’t draw any conclusions, but we did have participants talk about how the time they did have left was improved in a variety of ways.

Because it was my first time working with this population, I had naively assumed that everybody in the study was signing up because they were scared of dying and that concerns about mortality would be foremost. ...I learned...that we have a choice to make meaning as long as we’re alive, and that the moment of death can be a peaceful transition. I thought that people were afraid of the pain, or that they were afraid because they didn’t know what to expect after death. With people who had accepted that they were going to die, there often were more immediate concerns that they were seeking support for. One example would be improving the quality of their relationship with their significant other.

For some of our participants, the anxiety that they were experiencing with the cancer was having a detrimental effect on their relationships. Because they were so consumed with anxiety, they were tense and agitated all the time—which led to a lot of bickering and friction with their partners. Some subjects attributed improved relationships to the psilocybin experience. They said it helped them to let go of some of that anxiety that was overwhelming every aspect of their personal lives.

I’ve learned that it is possible to have a cancer diagnosis and not fear death. Fearing the dying process, the pain, the saying goodbye... of course, that’s natural. But it is possible to not fear death, at least for periods of time, after a cancer diagnosis. If you’re afraid to go to the dentist, then you’re going to be afraid of dying, but the quality of what is actually frightening when facing death, that perspective is what shifted for me. The insight I gained was that the time between receiving a diagnosis of a terminal illness and the moment of death can be much more than just waiting for death and enduring physical and emotional pain. It does not have to be wasted time. I learned that human beings are capable of finding meaning in their lives and extending love to others until they draw their last breath. That final period, the last chapter in a biography, can be profoundly transformational and have deep, deep meaning, if a person does the work. Or it can be a time full of terror, regret, and distancing from people you’re close to. What I learned was that we have a choice to make meaning as long as we’re alive and that the moment of death can be a peaceful transition. And psychedelics can play a supportive role in finding that deep meaning and sense of peace.

https://www.maps.org/news-letters/v20n1/v20n1-26to27.pdf
 
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The Flight of the Soul (1850) by Louis Janmot

The Ultimate Journey

by David Jay Brown

In 2008, Swiss psychiatrist Peter Gasser, M.D., became the first medical researcher in the world to obtain government approval to do therapeutic research with LSD. This was the first government-approved LSD study since Stanislav Grof was forced to shut down his research in 1972. Gasser’s LSD/end-of-life anxiety study was sponsored by MAPS.

David: Can you talk a little about how you started doing LSD research, and what it feels like to be the first researcher to receive government approval to do human studies with LSD in thirty-five years?

Peter: In January, 2006–around the time that we held the symposium for Albert Hofmann’s 100th birthday celebration–Rick Doblin and I were walking through the snowy Swiss mountains. While we were walking, Rick said that he thought that it would be great to do research with LSD again, as MAPS had just successfully launched studies with MDMA. After speaking with Rick, I began the process of gaining approval and meeting all the requirements. Getting a license to work with LSD felt like a great honor. It also filled me with a sense of hope, as this means the end of a thirty-five year Ice Age, where all therapeutic research with LSD was totally blocked.

David: What have you learned from Stanislav Grof’s work that helps you conduct your own research?

Peter: When some friends of mine discovered that I would be working with people who were seriously ill, or possibly dying, they gave me a warning. They told me that they thought that this would be too heavy of an emotional burden for me. However, one friend also recommended that I read Stan Grof’s book The Ultimate Journey, which I wasn’t familiar with at the time. Grof’s book taught me to have an open, natural, and interested attitude towards the patients in this study. At that time I had no special training in psycho-oncology [the psychological aspects of cancer], although I had had some experience over the years working with people suffering from life-threatening diseases.

From Grof’s book The Ultimate Journey, I learned that the issues that people faced in his studies were basically the same issues of our common human condition, only in a different intensity and priority. Grof’s book is a rich treasure chest, filled with cultural, historical, philosophical, and religious links that help us to understand the individual psychological process. Like Carl Gustav Jung, Grof is an author with an extremely broad background of knowledge about the history of mankind, in all it’s shapes. He is capable of linking the individual process with the collective process–which may be a great comfort and relief, especially for dying people.

David: What kind of process and struggles did you have to go through to get your LSD study approved?

Peter: During the approval process for the study, there were two critical questions that needed to be addressed. The first one was: Is it possible to convince the Ethics Committee that the potential risk of LSD-assisted psychotherapy is not higher than in other drug research studies, and that the potential benefits that could be gained from this study make it worth doing? As you can imagine, the answer to this questions can’t be obtained with any kind of mathematical precision, and rather depends upon the attitudes and prejudices of the members of the committee. Ethical decisions are always decisions of personal judgment, even if they rely on a clear and rational decision process. Fortunately, the Ethics Committee was able to discuss the question of LSD-assisted therapy in an open manner, and after much discussion, finally, it was decided that yes, such work could be done.

The second question was: Will the authorities at the Ministry of Health be influenced by political processes that might inhibit an approval of our study? It was satisfying to learn that their work was based on legal, ethical, and scientific requirements. I am convinced that Kairos, the Greek God of the opportune moment, was lending a hand, as something that brings together and orchestrates so many factors, and results in a success like this, must have played a role. It was greatly satisfying for everyone involved in this study that Albert Hofmann was still alive when the research began. He witnessed that steps were being taken to help develop LSD into what it only sometimes was, a medicine.

David: Can you share an anecdote or two from your studies, and talk a little about how your subjects are responding to the LSD-assisted psychotherapy?

Peter: Since we have a placebo-controlled design–and because of the obvious inherent difficulties involved with giving inactive placebos to subjects in psychedelic drug studies–the placebo patients also receive a very low dose of the active drug, which is 20 micrograms of LSD. Albert Hofmann said that he was convinced that even a low dose of 20 micrograms was enough to create a psychic effect in people–and he was right. One patient (who received placebo) reported that he had a very realistic impression that the floor of the room we were in opened up and the devil appeared. Although this scene was quite short, it was very naturalistic.

Of course, the 200 microgram verum dose that the experimental subjects get is much more powerful and longer lasting. I was very touched when one subject, a 57 years old man suffering from metastatic gastric cancer, reported his LSD session. It was his first session in the study, as well as the first experience with psychedelics in his life. He went out of his body, and had the experience of flying like a bird, which was very fulfilling for him. Then he flew up higher and higher, until he met his dead father. The patient had had a difficult relationship with his father, who withdraw from conflictual situations in the family, leaving the patient alone with his overwhelming mother.

Although his father had died a long time ago, the patient was full of criticism and reproach towards him. However, his encounter on LSD was very different. He felt free. It was just two men meeting at the same level, without any father/son dynamics. The patient loved feeling the closeness, and there was no longer any feeling of building up an inner wall when he thought of him. Later the subject said that he thought that in his process of dying it was very important for him to meet with his father at his place, where the dead people are, and to feel their vicinity without any fear or negative feelings.

David: Have you seen anything in your sessions that influenced your understanding of, or perspective on, death?

Peter: For me, one of the most satisfying aspects of my work in this study comes from my encounter with the patients. People who are going to die automatically put more emphasis on the “here and now.” They search and long for intensity and open awareness right now, not in some distant future which might not exist. This is what makes working with these people so rich.

David: What sort of promise do you see for the future of LSD research?

Peter: My mission is to show that LSD-assisted psychotherapy is safe and effective, so that we can plan further studies based on that result. This is not something new for insiders, but it would be new to much of the world. I absolutely believe that LSD has broad potential for healing and relief.

https://www.maps.org/news-letters/v20n1/v20n1-42to43.pdf
 
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The most convincing argument for legalizing psychedelics

by German Lopez | VOX

I have a profound fear of death. It's not bad enough to cause serious depression or anxiety. But it is bad enough to make me avoid thinking about the possibility of dying — to avoid a mini existential crisis in my mind.

But it turns out there may be a better cure for this fear than simply not thinking about it. It's not yoga, a new therapy program, or a medicine currently on the (legal) market. It's psychedelic drugs — LSD, ibogaine, and psilocybin, which is found in magic mushrooms.

This is the case for legalizing psychedelics. Although the drugs have gotten some media attention in recent years for helping cancer patients deal with their fear of death and helping people quit smoking, there's also a similar potential boon for the nonmedical, even recreational psychedelic user. As psychedelics get a renewed look by researchers, they're finding that the substances may improve almost anyone's mood and quality of life — as long as they're taken in the right setting, typically a controlled environment.

This isn't something that even drug policy reformers are comfortable calling for yet. "There's not any political momentum for that right now," Jag Davies, who focuses on psychedelic research at the Drug Policy Alliance, said, citing the general public's views of psychedelics as extremely dangerous — close to drugs like crack cocaine, heroin, and meth.

But it's an idea that experts and researchers are taking more seriously. And while the studies are new and ongoing, and a national regulatory model for legal psychedelics is practically nonexistent, the available research is very promising — enough to reconsider the demonization and prohibition of these potentially amazing drugs.

Psychedelics' potentially huge benefit: ego death

The most remarkable potential benefit of psychedelics is what's called "ego death," an experience in which people lose their sense of self-identity and, as a result, are able to detach themselves from worldly concerns like a fear of death, addiction, and anxiety over temporary — perhaps exaggerated — life events.

When people take a potent dose of a psychedelic, they can experience spiritual, psychedelic trips that can make them feel like they're transcending their own bodies and even time and space. This, in turn, gives people a lot of perspective — if they can see themselves as a small part of a much broader universe, it's a lot easier for them to discard personal, relatively insignificant and inconsequential concerns about their own lives and death.

That may sound like pseudoscience. And the research on psychedelics is so early that scientists don't fully grasp how it works. But it's a concept that's been found in some medical trials, and something that many people who've tried psychedelics can vouch for experiencing. It's one of the reasons why preliminary, small studies and research from the 1950s and '60s found psychedelics can treat — and maybe cure — addiction, anxiety, and obsessive-compulsive disorder.

Charles Grob, a UCLA professor of psychiatry and pediatrics who studies psychedelics, conducted a study that gave psilocybin to late-stage cancer patients. "The reports I got back from the subjects, from their partners, from their families were very positive — that the experience was of great value, and it helped them regain a sense of purpose, a sense of meaning to their life," he told me in 2014. "The quality of their lives notably improved."

In a fantastic look at the research, Michael Pollan at the New Yorker captured the phenomenon through the stories of cancer patients who participated in psychedelic trials:

Death looms large in the journeys taken by the cancer patients. A woman I'll call Deborah Ames, a breast-cancer survivor in her sixties (she asked not to be identified), described zipping through space until she arrived at the wall of a crematorium and realized, with a fright, "I've died and now I'm going to be cremated. The next thing I know, I'm below the ground in this gorgeous forest, deep woods, loamy and brown. There are roots all around me and I'm seeing the trees growing, and I'm part of them. It didn't feel sad or happy, just natural, contented, peaceful. I wasn't gone. I was part of the earth." Several patients described edging up to the precipice of death and looking over to the other side. Tammy Burgess, given a diagnosis of ovarian cancer at fifty-five, found herself gazing across "the great plain of consciousness. It was very serene and beautiful. I felt alone but I could reach out and touch anyone I'd ever known. When my time came, that's where my life would go once it left me and that was O.K."

But Mark Kleiman, a drug policy expert at New York University's Marron Institute, noted that these benefits don't apply only to terminally ill patients. The studies conducted so far have found benefits that apply to anyone: a reduced fear of death, greater psychological openness, and increased life satisfaction.

"It's not required to have a disease to be afraid of dying," Kleiman said. "But it's probably an undesirable condition if you have the alternative available. And there's now some evidence that these experiences can make the person less afraid to die."

Kleiman added, "The obvious application is people who are currently dying with a terminal diagnosis. But being born is a terminal diagnosis. And people's lives might be better if they live out of the valley of the shadow of death."

Again, the current research on all of this is early, with much of the science still relying on studies from the '50s and '60s. But the most recent preliminary findings are promising enough that experts like Kleiman are cautiously considering how to build a model that would let people take these potentially beneficial drugs legally.

https://www.vox.com/2015/7/24/902736...chedelic-drugs
 
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Ann and Alexander Shulgin

Taking psychedelics to ease anxiety over a terminal diagnosis

by Sherry Amatenstein LCSW | Third Age

Sheila, a 57-year-old patient diagnosed six months earlier with terminal cancer sat in my office, twisting Kleenex in her fingers. “Sherry, my anxiety is off the charts.”

In addition to our once-a-week sessions, she had a loving family, was in a support group for people with cancer, and taking Prozac. None of this made much of a dent on her mounting emotional turmoil. She said, “I’m really desperate. What do you think of psychedelic drugs to help with my terror of dying?”

It was a fair question. Not surprisingly, 40 percent of cancer patients suffer from psychological torment linked to their diagnosis. In the ‘50s and ‘60s studies were done on the efficacy of psilocybin as a therapeutic tool to help people come to terms with their imminent death. By the early ‘70s this research fell into disfavor, as psychedelics were increasingly associated with the counter culture movement.

A 2011 Pilot study on psilocybin for anxiety in patients with advanced-stage cancer renewed interest in this treatment, as it seemed to result in reduced anxiety and improved moods for the participants, with no adverse effects reported. A NYU study published in 2016 of 29 patients suffering from end of life anxiety and depression found, in conjunction with therapy that a single moderate dose of psilocybin produced positive psychological changes. Another study at John Hopkins, also published in 2016, involving 51 cancer patients also produced good results.

This research suggests that one dose of psilocybin can potentially be more effective than pharmaceutical drugs at easing anxiety and depression in people with fatal illnesses. Study participants reported experiencing spiritual breakthroughs that help them better cope with being delivered what might be a death sentence. Dr. Stephen Ross, who directed the NYU study, has been quoted as saying, “People who had been palpably scared of death – they lost their fear. The fact that a drug given once can have such an effect for so long is an unprecedented finding. We have never seen anything like it in the psychiatric field.”

Dinah Bazar decided to take part in Ross’s study after she began experiencing her worst anxiety two years after going into remission for ovarian cancer. During college, she’d had a bad mescaline trip but years later, felt a closely monitored clinical trial would be safe.

In 2016, the then 69-year-old wrote about her experience of taking a single dose of psilocybin while sitting in a peaceful room at NYU in an article for time.com. “At first it was terrifying, as though I were tumbling through space, or on a ship in a stormy sea.” Soon though she began to feel as though she were floating in the music emanating from her headphones. She described feeling “bathed in love and it was overwhelming, amazing, wonderful. I kept floating and floating.”

The powerful feeling of inner peace and love lingered for weeks and best yet, the fear and anxiety were “completely removed.” Subsequently, when she felt ill and feared a potential recurrence of cancer, rather than diving into a pit of helplessness and fear, she remained relatively centered.

It is fitting that anxiety, which is all about fear of losing control, is “controlled” only by ceding control, at least temporarily. Dinah’s voluntarily submitting to the onslaught of images and emotions allowed her to drop down to and retain a deeper truth: We cannot always prevent stressful events, just control our actions and reactions to those stressors.

However promising the NYU and John Hopkins studies appear, they are preliminary. Psilocybin is not FDA approved. Herbert Kleber, director of the substance-abuse division at Columbia University, has offered cautionary praise for the scientific investigations of psilocybin and end of life anxiety. The psychiatrist has been quoted as noting both that sample sizes in the studies are small, and that it is essential to have an experienced guide in the room to ensure the experience for the patient is productive, not terrifying. (Dinah reported having NYU researchers at her side during the whole experience.)

When my patient Sheila asked whether she should go this route to help ease her fears, my job wasn’t to tell her what to do. Rather, my task was to guide her on how to research the available information on this option – pros and cons – and help her sort through her feelings.

At one point she asked, “Sherry, if you were in my shoes, what would you do?”

I answered truthfully, “I would likely do what you are doing – not rule it out of hand and not dive into it instantly either. But yes, there is nothing to lose by looking into it.”

Sheila hasn’t taken a decision on whether or not to make the leap. During our most recent session, she said, “Just knowing psilocybin is out there has helped me feel more balanced.”

https://thirdage.com/taking-psyched...-over-a-terminal-diagnosis-its-a-real-option/
 
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New York University

Can magic mushrooms help us come to terms with death?
by Gavin Butler | VICE

Promising research suggests psychedelic experiences could be the future of palliative care.

In 2016, researchers from New York University blindfolded a handful of terminally ill cancer patients and gave them a potent dose of psilocybin. The 29 patients had volunteered to take part in the medical experiment for somewhat comprehensible reasons: they were unable to handle the certainty of their own deaths.

At the same time, Johns Hopkins University was conducting a similar experiment. Volunteers were given psilocybin, isolated in a room with a purpose-built playlist, and carefully monitored by a pair of psychotherapists. The idea of both studies was that maybe a hallucinogenic could play a positive role in the context of palliative treatment. By giving a terminally ill person just one intense, psychedelic trip, could we maybe alleviate some of that crushing end-of-life anxiety? Anyone who has achieved a sense of clarity and inner peace with recreational drugs will get the idea.

This is a completely different way of working with people, clinical psychologist Dr Stephen Bright tells VICE. What we try to do in palliative care at the moment is to relieve the pain and suffering as much as possible by giving people pain medication. But morphine is not going to take away their anxiety or their depression.

As vice president of Australia's Psychedelic Research In Science and Medicine association, Dr Bright has been keeping a well-trained eye on the progress of these studies overseas. And much to his delight, the results have so far been decisive.

Subjects showed a significant and enduring reduction in anxiety, depression, and existential distress. In a follow-up assessment some six months after the treatment, 70 percent of the patients from the NYU trial later reflected on the psilocybin experience as one of the top five most spiritually significant experiences of their entire lives, while 87 percent reported increased life satisfaction overall.

A research paper published in the Journal of Psychopharmacology attributes a large part of these therapeutic outcomes to the so-called mystical experience of psilocybin, which it defines as encountering a profound sense of unity, transcendence of time and space, and a deeply felt positive mood, infused with a renewed sense of purpose and meaning. That is one way of putting it. But the potential palliative benefits of the drug become slightly less abstract when we consider the effect psilocybin has on the way we see the world.

The mystical experiences associated with drugs like psilocybin and LSD most likely stem from their influence on the Default Mode Network of the brain, that is, the neural network that allows certain parts of our brain to communicate while simultaneously cancelling out crosstalk from other parts. The DNS is important to our everyday functioning, as it keeps us focused on the things that are immediately relevant, like, say, the article you are reading, and sidelines those things that are not.

Dr Bright explains that psilocybin disables the default mode network, thus opening the lines of communication between different parts of the brain that would never normally cross talk. Hence the mystical experience, which he says may provide people with a completely different perspective on their situation and bring into focus those things that humans typically tend to repress or pass over. And counted among those, of course, is the biggest downer of all: our own inescapable demise.

It is almost taboo in Western culture to talk about death, says Dr Bright. And I think that part of the problem that people in these studies are having is, coming to grips with the idea of death because of the way the subject is treated in society.

The partners of these patients may not want to talk about it, and they may not want to bring it up. But after the psilocybin experience, they feel a sense that there is something else out there, and they are more likely then to talk heart-to-heart and have that meaningful conversation.


A not insignificant aspect of psilocybin's palliative benefits, then, might be the way in which it allows us to reach an understanding of death by facing it head on: to look it in the eye for the very first time and accept it for what it is. As far as psychiatrist Nigel Strauss is concerned, that makes this kind of research invaluable. After all, if we can truly help people come to terms with their own death, then we might just be able to dissuade them from wanting to take their own life.

One of the things that makes a life good is the acceptance of death, says Dr Strauss. In fact, we as a society should be thinking about death much more, because it is an inevitable part of our existence.

Strauss is well-versed in the subjects of psychedelic research and death. Just last year he had a paper published in the Australian Medical Journal which looked at the relationship between psilocybin-assisted psychotherapy and euthanasia.

There has been a lot of conversation that I think misses the point, he says bluntly. For many of these people, pain is not the big factor. What the majority of people are requesting is early death or instant death because they are not coping with the thought of having to die in the next several months. They just can't accept that they are going to die.

Strauss cites studies conducted in parts of Europe, where assisted dying is legal, which indicate that more people request euthanasia on psychological grounds than physical ones. The way he sees it, palliative psilocybin could assuage the psychological weight that comes with a terminal diagnosis, and give a small flicker of hope to those who might otherwise want to short-circuit the process of dying.

Hopefully a number of people who would have that treatment would then say 'No, I can see what is happening. I feel a lot better and more positive, and even though I am dying, I don't want to use euthanasia: I want to use the next couple of months to come to terms with everything and everybody.'

By having the psilocybin experience they can see death in a whole different way and they are much more comfortable with it.

If the research so far is anything to go by, there is a more optimistic way to think about the end of our lives, and psychedelics may well be the key to unlocking that.

https://www.vice.com/en_ca/article/bjyqk8/can-magic-mushrooms-help-us-come-to-terms-with-death
 
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How psychedelic drugs are helping cancer patients face death

by Lauren Slater | New York Times

Pam Sakuda was 55 when she found out she was dying. Shortly after having a tumor removed from her colon, she heard the doctors dreaded words: Stage 4; metastatic. Sakuda was given 6 to 14 months to live. Determined to slow her diseases insidious course, she ran several miles every day, even during her grueling treatment regimens. By nature upbeat, articulate and dignified, Sakuda, who died in November 2006, outlasting everyone's expectations by living for four years, was alarmed when anxiety and depression came to claim her after she passed the 14-month mark, her days darkening as she grew closer to her biological demise. Norbert Litzinger, Sakuda's husband, explained it this way:

"When you pass your own death sentence by, you start to wonder: When? When? It got to the point where we couldn't make even the most mundane plans, because we didn't know if Pam would still be alive at that time, a concert, dinner with friends; would she still be here for that? "When" came to claim the couples life completely, their anxiety building as they waited for the final day."

As her fears intensified, Sakuda learned of a study being conducted by Charles Grob, a psychiatrist and researcher at Harbor-U.C.L.A. Medical Center who was administering psilocybin to end-stage cancer patients to see if it could reduce their fear of death. Twenty-two months before she died, Sakuda became one of Grobs 12 subjects. When the research was completed the results showed that administering psilocybin to terminally ill subjects could be done safely while reducing the subjects anxiety and depression about their impending deaths.

Sakuda's terminal diagnosis, combined with her otherwise perfect health, made her an ideal subject for Grob's study. Beginning in January 2005, Grob and his research team gave Sakuda various psychological tests, including the Beck Depression Inventory and the Stai-Y anxiety scale to establish baseline measures of Sakuda's psychological state and to rule out any severe psychiatric illness.

"We wanted psychologically healthy people," Grob says, "people whose depressions and anxieties are not the result of mental illness, but rather," he explained, "a response to a devastating disease."

Sakuda would take part in two sessions, one with psilocybin, one with niacin, an active placebo that can cause some flushing in the face. The study was double blind, which meant that neither the researchers nor the subjects knew what was in the capsules being administered. On the day of her first session, Sakuda was led into a room that researchers had transformed with flowing fabrics and fresh flowers to help create a soothing environment in an otherwise cold hospital setting. Sakuda swallowed a capsule and lay back on the bed to wait. Grob had invited her, as researchers do with all their subjects, to bring objects from home that had special significance.

"These objects often personalize the session room for the volunteer and often prompt the patient to think about loved ones or important life events," Roland Griffiths, of Johns Hopkins, says.

"The thinking is that with the aid of the psychedelic, you may come to see the object in a different light. It may help bring back memories; it promotes introspection, it can be a touchstone, it can be grounding," Halpern says.

Sakuda brought a few pictures of loved ones, which, Grob recalled, she clutched in her hands as she lay back on the bed. By her side were Grob and one of his research assistants, both of whom stayed with the subjects for the six-to-seven-hour treatment session. Sakuda knew that there would be time set aside in the days and weeks following when she would meet with Grob and his team to process what would happen in that room. Black eye shades were draped over Sakuda's face, encouraging her to look inward. She was given headphones. Music was piped in: the sounds of rivers rushing, sweet staccatos, deep drumming. Each hour, Grob and his staff checked in with Sakuda, as they did with every subject, asking if all was O.K. and taking her blood pressure. At one point, Grob observed that Sakuda, with the eye shades draped over her face, began to cry. Later on, Sakuda would reveal to Grob that the source of her tears was a keen empathetic understanding of what her spouse, Norbert, would feel when she died.

Norbert Litzinger remembers picking up his wife from the medical center after her first session and seeing that this deeply distressed woman was now glowing from the inside out. Before Pam Sakuda died, she described her psilocybin experience on video: I felt this lump of emotions welling up . . . almost like an entity, Sakuda said, as she spoke straight into the camera. "I started to cry. . . Everything was concentrated and came welling up and then . . . it started to dissipate, and I started to look at it differently. . . I began to realize that all of this negative fear and guilt was such a hindrance . . . to making the most of and enjoying the healthy time that I'm having." Sakuda went on to explain that, under the influence of the psilocybin, she came to a very visceral understanding that there was a present, a now, and that it was hers to have.

Two weeks after Sakuda's psilocybin session, Grob re-administered the depression and anxiety assessments. Over all among his subjects, he found that their scores on the anxiety scale at one and three months after treatment demonstrated a sustained reduction in anxiety, the researchers wrote in The Archives of General Psychiatry. They also found that their subjects scores on the Beck Depression Inventory dropped significantly at the six-month follow-up.

"The dose of psilocybin that we gave our subjects was relatively low in comparison to the doses in Stanislav Grof's studies," Grob told me. "Nevertheless, and even with this modest dose, it appears the drug can relieve the angst and fear of the dying."

http://www.nytimes.com/2012/04/22/ma...ace-death.html
 
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Psilocybin found to ease end-of-life anxiety

by David Biello | Scientific American

UCLA psychiatrist Charles Grob and his colleagues enlisted 12 cancer patients between June 2004 and May 2008. All suffered from fatal cancers, ranging from breast cancer to multiple myeloma, as well as acute stress disorder, generalized anxiety disorder, anxiety disorder due to cancer, or adjustment disorder with anxiety. All agreed to take a moderate dose of psilocybin to see if the psychedelic drug might offer some relief from their fear of death and disease.

The unusual decision to have each patient serve as both a subject and then as a control, rather than having two separate groups, one treated with psilocybin and one with niacin, was taken because the researchers believed that to be the ethical course to take, given the life circumstances subjects were encountering, (i.e. imminent demise). In other words, Grob and his colleagues felt that all the terminally ill patients should be allowed to experience any potential benefit from the psilocybin treatment. The patients were brought into the hospital, hooked up to a heart monitor and settled in a room decorated with fabric wall hangings and fresh flowers. Headphones played music of their choice. At 10:00 AM on the day of a treatment, each of the 12 patients in the study individually swallowed the appropriate dosage of psilocybin as a pill. Researchers then measured various vitals and checked on their status every hour thereafter until the psychedelic experience was over, roughly six hours later.

Eight of the 12 subjects had previous experience with psychedelics, either in the past year or as far back as 30 years ago. Though heart rate and blood pressure climbed as a result of taking the drug, none reported a bad trip and most enjoyed a significant reduction in end-of-life anxiety between one and three months after treatment, as measured by various psychiatric questionnaires. Their depression eased as well, a change that was sustained as much as six months later for those who survived that long. Unfortunately, the psilocybin, at this dose anyway, did nothing for physical pain.

The patients generally reported that the medication helped them to examine their lives and determine how they wished to address their limited life expectancy. Unfortunately, as of publication of the research, 10 of the 12 subjects have died. But the research suggests that using psychedelic drugs such as psilocybin may help to ease the existential anxiety and despair that modern medicine has largely found no other way to treat.

https://blogs.scientificamerican.com...-fatal-cancer/
 
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