• Psychedelic Medicine

HOSPICE | +80 articles

rodrigo-ni-o_1_orig.jpg



'My fear of dying was gone'

by Kashmira Gander | The Independent

As a commercial real-estate developer in New York, Rodrigo Nino is clear that he is as rational as they come. But when at 41 he was diagnosed with stage three melanoma - the most aggressive form of skin cancer that can quickly spread to the organs - he was consumed by anxiety about dying. The disease taking over his body caused his perception of life to shift, so he did something his former self would have regarded as pretty irrational. Nino headed to the Amazonian jungle to take hallucinogenic drugs.

"I had a near death experience because my chances of surviving were very bad. The cancer had gone into my lymphatic system and it forced me to confront death." As Nino was faced with the fact that he might die, he realised that while he always knew he would die one way or another, he wasn't prepared in the slightest for losing his life.

Searching online, he found his feelings had a name: end of life anxiety. Like 40 per cent of cancer patients, he was suffering from psychological distress linked to the disease. He then stumbled across theories of how ayahuasca, a psychedelic drug used in religious ceremonies by tribes in the Amazon basin for centuries, could ease it.

"It was like waking up from one nightmare to a nightmare worse than the one before. It was a nightmare come true," recalls Nino, who has been clear of cancer for five years. So, he flew from the Peruvian capital of Lima and took an air taxi into the jungle of Iquitos to the north of the Amazon. There, he visited the Shipibo people to see if ayahuasca could shake his fear of death. What he experienced was so profound that he struggles to articulate it.

"It was scary. It was very scary. After four sessions I had this inner knowing that my fear of dying had gone... Well, not gone but it made me look forward to death. The paradoxical part is that it gets you out of the fear of dying and appreciating life in a much greater way."

"I'm a New Yorker,"
he says matter-of-factly. "I'm a father of three kids. I'm a real estate developer and I'm very science- and data-driven. To me, hallucinogenics were just another illegal drug just like heroin or cocaine, but I couldn't have been more wrong."

Nino says the impact ayahuasca had on him chimes with what psychologist duo Pahnke-Richard define as "a mystical experience. It varies from person to person. The experience comes with a great deal of forgetting, like waking up from a very vivid dream. By the time you're back in bed you don't remember 90 per cent of the dream, that's how it works. There is some recollection but what matters are the long-lasting effects on your health. You are left with hope. That can help a person with anxiety and depression or all sorts of different addictions."

"The experience comprises of six different factors. Firstly, there is a sense of unity which is another way of saying you find your soul. There is a feeling that you are one with everything and that everything is interconnected. Then there's animism where everything around you has a soul and a spirit. The third is the feeling that time and space shifts. The fourth is a paradoxical sense where you can understand that different realities can take place at the same time. You are also given a sense of sacredness of knowing something bigger than yourself, and you also face a truth that is more real than truth itself. Most patients report having these feelings and end up with therapeutic benefits associated with this."


 
Last edited:
Projects_1500_HarborUCLA_01.jpg

Harbor-UCLA Medical Center

How psychedelic drugs are helping cancer patients face the end of life

by Dana Sitar | Seven Ponds

A study conducted by psychiatrist Charles Grob, a researcher at Harbor-UCLA Medical Center, administered psilocybin to cancer patients near the end-of-life to see if it could reduce their fear of death. The research, completed in 2008 and published in the Archives of General Psychiatry in 2011, showed that the psychedelic could, in fact, be administered safely and reduce the anxiety and depression associated with the end-of-life.

Grob is not alone in his interest in the relationship between psychedelics and death-related emotions. Dr. John Halpern, head of the Laboratory for Integrative Psychiatry at McLean Hospital in Belmont, Massachusetts, used MDMA to quell the anxiety in two patients with Stage 4 cancer. Ongoing studies at New York University's medical school and Johns Hopkins Bayview Medical Center are using psilocybin with terminally-ill patients.

"This research is in its very early stages," Grob told the New York Times, "but we're getting consistently good results."

Research into the healing power of psychedelics has seen a resurgence in recent years, with drugs like MDMA, psilocybin, and LSD tested for their effectiveness in treating symptoms of severe conditions like PTSD and alcoholism.

Grob and other researchers understand the possible concerns that surround the use of these controversial treatments, and they are careful about the image they cultivate in their research. He considers the drug use that is associated with the 60s as "out of control," and ensures the work of he and his colleagues is not like that at all.

http://blog.sevenponds.com/something...cs-end-of-life
 
Last edited:
src.adapt.960.high.shulgin_060414.1401920536489.jpg



Use of psilocybin in treating existential distress associated with cancer

Charles Grob, Roland Griffiths, Anthony Bossis

While living with advanced cancer may for some patients be a process of depression, despair, and increased distress, for others it can provide an opportunity for personal meaning, enhanced interpersonal relationships, spiritual growth, clarity, and acceptance. Frequently, a life-threatening cancer triggers a search for meaning and transcendence and an awakening of spirituality. A growing body of literature now substantiates the importance and relevance of spiritual well-being and spirituality in palliative and hospice care. For many patients, the search for meaning that is frequently triggered by end-of-life-stage cancer is a courageous and difficult journey. Ideally, dying should be viewed, not as a medical problem, but as an important and vital part of life experience with potential for discovery and meaning.

Researchers from several decades ago reported encouraging results from their early efforts developing a psychedelic treatment model with patients suffering from the psychospiritual distress and demoralization often associated with advanced-stage cancer. More recent efforts to re-explore the judicious application of psychedelic treatment with patients struggling with existential anxiety in the face of a life-threatening cancer diagnosis have similarly observed significant amelioration of psychological suffering. While valuable knowledge can be gleaned from clinical studies conducted from the 1950s to the early 1970s, it is necessary to conduct modern investigations utilizing state-of-the-art research methodologies in order to definitively establish the safety and efficacy of this novel treatment. To date, contemporary studies conducted at three academic medical centers are producing positive results. While still preliminary, these encouraging reports will hopefully facilitate the development of additional investigations with the psychedelic treatment model, particularly in patient populations refractory to conventional therapeutic approaches.

A unique aspect of utilizing a classic psychedelic (e.g., psilocybin) to treat the severe psychological demoralization and existential anxiety seen in life-threatening medical illness is its seeming capacity to facilitate powerful states of spiritual transcendence that exert in the patient a profound therapeutic impact with often dramatic improvements in psychological well-being. Recently conducted research at Johns Hopkins University has demonstrated that, under carefully structured conditions in normal volunteer subjects, induction of such transcendent and mystical states of consciousness occurs in most subjects studied. This is a critical advancement in the field because, for the first time, a specific treatment has been developed that is able to reliably facilitate the emergence of a transpersonal level of consciousness that appears to have significant therapeutic value. For a patient population struggling with often overwhelming levels of existential anxiety and demoralization, such a therapeutic intervention may have the capacity to re-infuse a sense of meaning and purpose into their lives. The psychedelic treatment model therefore offers a novel and potentially valuable approach for addressing the existential crisis often observed in cancer patients, with the potential of significantly improving overall quality of life and psychospiritual well-being for the time that remains in their lives.

https://www.researchgate.net/publication/278689788_Use_of_the_Classic_Hallucinogen_Psilocyb in_for_Treatment_of_Existential_Distress_Associate d_with_Cancer
 
Last edited:
Dreamland.jpg



The Existential Medicine

Decades after psychedelic drugs were outlawed, Johns Hopkins trials are revealing their dramatic therapeutic potential.

by Ron Cassie | Baltimore Magazine

The diagnosis of Clark Martin's liver cancer came at the same time as the birth of his daughter, with doctors informing the clinical psychologist that he had a year and a half to live. "It was emotionally very upsetting," the soft-spoken Martin recalls. "Not because of the dying, but because of my daughter."

His late-stage cancer, however, proved one of the rare cases that responded to the initial chemotherapy. I was lucky, he says. But not out of the woods. During the next two decades, cancer cells would reappear in his lungs, metastasizing into tumors. On each occasion, Martin battled the disease into remission, but the endless regimens and surgeries and ever-looming threat of cancer drove him into bouts of anxiety and depression as he obsessed over his health and micro-managed his treatment plans. "I have a scientific background and became very narrowly focused," he says. "I felt like I needed to know more than the doctors. I withdrew from life."

Ultimately, his friends and daughter, entering college by this time, convinced him that he needed to address his mental wellbeing. He tried counseling, but it didn't improve his outlook. Neither did antidepressants. Partly from desperation to pop out of his funk and partly out of professional curiosity, the Vancouver, WA-based Martin flew to Baltimore to participate in a clinical trial at Johns Hopkins where he would ingest a powerful dose of psilocybin.

"All of a sudden, things in the room, things you feel inside, start feeling unfamiliar. Like my brain was going offline," Martin says. "The experience in my head was just of being in a void," he continues. "I'm a boater, and Ill use this analogy: Imagine you fall off a sailboat into the open ocean and when you turn around, the boat is gone. And then the water's gone. And then you're gone."

"At one point, I was in a stadium-like building with stained glass, it may have been a giant cathedral. At another point I had the feeling of living on a bubble. I had my space on the bubble and other people had theirs. But mostly there was just an experience of tranquility,"
Martin continues. "No people, no architecture, no thoughts, no ideas, nothing. Just calm presence."

Today, six years later, Martin credits psilocybin, as well as the preparation and guidance that went with it, with parting the fog of his depression. He also credits his psychedelic session with transforming and opening his relationships with his daughter, friends, and even his Alzheimer's suffering father. "I still think about it every day," he says, choking up for a moment.

"I am still unpacking and integrating what I learned into my daily life."

Martin describes his clinical “trip” with the Schedule I drug—like LSD, it was banned during the Nixon administration because it reputedly offered no medical purpose—as among the most profound spiritual experiences in his life. It turns out that this is not unusual. In fact, it puts him among the overwhelming majority of now more than 200 clinical trial subjects at Hopkins, says Roland Griffiths, professor in the departments of psychiatry and neurosciences, and the lead architect of psilocybin studies at the medical school’s Bayview campus.


mushrooms-griffiths-1000x600.jpg

Roland Griffiths

“After our first few sessions, I realized we had to develop new questionnaires if we were going to capture what people were experiencing and trying to express,” Griffiths says. “I would ask people what they meant by one of the most meaningful experiences of their lives and they’d compare it afterward to the birth of their first child or the recent death of a parent. When we followed up with them at two months, and again at 14 months, it persisted."

“When we initiated the study, I hoped we would come across something interesting,” Griffiths continues, “but in all honesty, I was unprepared for these kinds of reports—especially when they proved enduring.”


Ten years ago, Hopkins researchers, led by Griffiths and Bill Richards, a 76-year-old clinical psychologist whose work with psilocybin dates back to the heady days of psychedelic research in the early ’60s, published their first paper on their new pilot studies. Cited as a landmark report by former National Institute on Drug Abuse Director Charles Schuster, the ongoing research at Hopkins—and now other universities—has begun revealing a host of potentially dramatic therapeutic applications for the ancient psychedelic used by indigenous Mexican and South American communities in religious rituals for thousands of years. Two examples: Hopkins’ initial trial with heavy smokers documented an 80 percent abstinence rate more than a year out from the subject’s session—an unheard of success rate that is roughly 2.5 times better than reported results of those taking varenicline, the active compound in Chantix, generally considered the most effective smoking cessation treatment option. In London, an Imperial College pilot study of a dozen individuals suffering from major depression for an average of 18 years—and who had previously tried at least two standard antidepressants—found that psilocybin sessions provided a reprieve from the depression in all 12 volunteers for three weeks and kept it at bay in five subjects for three months.

Meanwhile, early returns from other university studies are indicating that psilocybin has the potential to become a revolutionary tool in treating alcoholism, drug addiction, OCD, as well as anxiety and depression associated with cancer diagnoses such as Martin suffered. Other studies show psychedelic treatment could be useful therapy for ex-offenders, in terms of reducing recidivism, by reducing substance abuse and domestic violence. Researchers acknowledge it’s not exactly clear how psilocybin manages to reduce, and in some cases eliminate, depression and the fear of death, or, ironically cravings for other drugs and substances. What is known is new fMRI imaging shows one of the immediate effects of psilocybin is decreased activity in the region of the brain that involves habitual behaviors and thinking patterns (known as the default mode network) and the perception of the self—the ego, in other words. And, that throughout recorded history, transcendent mystical experiences have produced life-altering changes in human beings. Think St. Paul’s white-light conversion on the road to Damascus; the visions of the peasant girl Joan of Arc in France; Siddhartha Gautama’s awakening beneath the Bodhi tree.

Peter Hendricks, a University of Alabama at Birmingham researcher investigating the effects of psilocybin on people addicted to cocaine, has collaborated with the Hopkins’ team. He says psychedelic sessions, properly guided, can produce a kind of therapeutic “reboot.” Which doesn’t mean he diminishes the epiphany experience and cosmic consciousness that so many psilocybin trial subjects describe. “I call it the Ebenezer Scrooge moment,” Hendricks says. “Something profound happened to Ebenezer Scrooge.”

As strange—or alarming—as it may sound to some, it’s the belief of scientists at Hopkins and elsewhere that if FDA-approved Phase II and Phase III trials currently underway continue along the same trajectory, it may not be long before psilocybin is removed from its Schedule I classification. Researchers envision a future where psilocybin, which works in similar fashion as LSD—though its effects wear off in six to seven hours, as opposed to LSD’s eight to 10 hours—is legally available for physicians and licensed counselors for use in hospice, rehab, clinical care, and therapeutic settings. Griffiths and his team are quick to caution that powerful substances such as psilocybin are not appropriate for everyone by any means, and that trial subjects are carefully screened and guided through their experience. Nonetheless, their enthusiasm is hard to overstate.

“Why wouldn’t you want to use something like psilocybin that has been shown it can be administered safely, that’s not toxic or addictive, and makes that kind of impact in people’s lives?” Richards says. “Think of the number of people who die from smoking-related diseases alone each year. What’s the dangerous drug here?”

*From the article here :
 
Last edited:
Jens_Wazel_esalen-institute_DSC01283-edit.jpg



Psilocybin and end-of-life anxiety*

by Jyllian Kemsley | In Chemistry | 17 Jan 2017

Psilocybin targets serotonin receptors, and its effects seem to stem from patients' experiences when their consciousness is altered. But instead of undergoing psychotherapy during the acute psilocybin experience, researchers encourage patients receiving psilocybin to focus inwardly and process their experience with a therapist afterward.

The best treatment outcomes are with those subjects who, during the course of the psilocybin session, had what they described as a profound psychospiritual epiphany, says Charles Grob, a professor of psychiatry and pediatrics at the UCLA School of Medicine, and chief of child and adolescent psychiatry at Harbor-UCLA Medical Center.

Cigarette smokers given psilocybin report that the drug helps them understand their nicotine craving. That makes them able to quit more successfully when they're also undergoing a cognitive behavioral therapy program for tobacco addiction, Griffiths says.

For patients struggling with the existential fears associated with dying, It's hard to say what the nature of the attitude shifts are, Griffiths says. But there seems to be an increased sense of wonder and openness to the mystery of life and death. In spite of the tragedy that they're dying, they might see that there's something beautiful and organic about the process.

*From the article here: https://inchemistry.acs.org/content/inchemistry/en/atomic-news/hallucinogenic-drugs.html

-----

Psychedelics shown to ease psychological distress in the dying

INELDA

Of all the symptoms that burden people facing death, depression is most predictive of poor quality of life. According to a study conducted by Dr. Robert L. Fine of Baylor University Medical Center, up to 77 percent of people with a terminal illness exhibit signs of depression. Other studies indicate that clinical depression affects anywhere from 15-50 percent of terminal patients. Regardless of the statistics, it is clear that depression has a major impact on people with a terminal illness and is under reported and under diagnosed.

In recent years researchers have achieved amazing results in FDA approved trials using the psychedelic medication psilocybin. Part of what makes this approach so promising is that it requires only one to two doses to produce incredibly beneficial results that last for at least six months. And there are no observable side effects beyond a headache or slight upset stomach that some people experience, and which disappears within hours of taking the medication.

“Our study (with psilocybin) at New York University and one conducted at John Hopkins showed immediate, substantial, and sustainable positive results for anxiety and depression the likes of which have not been seen in the history of psychiatry,” says Dr. Anthony Bossis, one of the principle researchers for the New York University (NYU) study. “Up to 80 percent of the 29 participants maintained their improvement in depression and anxiety at the six-month follow-up appointment,” he added, “which shows how effective this treatment is.”

The study at John Hopkins University that involved 50 participants showed the same kind of results. At the six-month mark, 78 percent of participants continued to feel a dramatic improvement in their depression; 65 percent were almost fully recovered, 83 percent of participants continued to feel much less anxious, with 57 percent almost fully recovered.

Both of these studies were conducted with people suffering a terminal cancer diagnosis. Similar studies conducted at major academic medical centers during the early 1960s to early 1970s, using primarily LSD with people having a terminal illness, also showed dramatically positive results. Those earlier studies had a total of several hundred participants who reported marked improvement in existential and psychological distress.

http://inelda.org/psychedelics-shown...istress-dying/
 
Last edited:
Speaker-Dennis-McKenna-305x295px-2.jpg



Death and family healing with psilocybin*

by Wesley Thoricatha | Psychedelic Times | 31 May 2017

One of the great lessons that psychedelics are known for revealing is how profoundly connected we are with the natural world, but nature is not just the sum of all living things- it is the dynamic process of life, death, and rebirth. The kingdom of Fungi, which contains the psychedelic mushrooms such as Psilocybe cubensis, happens to play a critical role in the decomposition process, turning dead plants, animals, and even humans into fertile, nutrient-rich soil which gives rise to new life. Is it a coincidence that these master decomposers may have something incredibly valuable to teach us about death, not just in ecosystems but also in the minds of the curious humans who consume them?

Brothers Dennis and Terence McKenna were early apostles of psychedelic mushrooms, and did much to bring them into mainstream cultural awareness with their classic book on mushroom cultivation: Psilocybin – Magic Mushroom Grower’s Guide. While Terence, the great bard, would go on to spread the legendary psychedelic meme of the “heroic dose”- 5 dried grams of psilocybin mushrooms taken in complete darkness; his brother Dennis was a founding member of the Heffter Research Institute which has published research on psilocybin’s uncanny ability to treat depression and anxiety in terminally-ill cancer patients. We spoke with Dennis recently about what mushrooms have to teach us about dying with dignity, and how much greater that could be than fighting and fearing death until the very end.

Thank you again for speaking with us Dennis. What do you believe is wrong with how we currently treat death and dying in the medical world?

Biomedicine has got all sorts of problems, but one of the major ones is that we don’t do death well. We just don’t. For a physician to say their patient has died is to say that they failed, and that’s not always true. Sometimes the most merciful thing is to let a person die with dignity. Nobody lives forever, and eventually medicine is going to fail, unless we get immortality worked out, but I don’t think that would be a good thing frankly. Medicine has got to get beyond this idea of survival at all costs at the sacrifice of quality of life and dignity- that’s not the point of medicine. The point of medicine is to do what you can within limits and when the times comes, and let it go. Substances like psilocybin can be integrated in a compassionate and useful way if we can come to terms with the idea that people deserve to die a beautiful death, if we can accept that concept.

What makes psilocybin particularly good at dealing with death?

Psilocybin is kind of the perfect medicine for hospice situations. It’s non-toxic and people can be quite ill and yet tolerate high doses because it’s very compatible with human metabolism. It’s perfect for people in terminal states, and I hope that eventually we will be using it far more often for these sorts of situations.

People who are in a terminal state are often very anxious about dying, they are totally focused on it and can’t really get away from that stress. When they undergo psilocybin therapy what that does for them based on post-session interviews is they all say the same thing, “I realized there was no point in worrying about death, I’m alive now, I’m not dead, so let’s focus on that. When death comes it will come, but it’s not something I can stop or control.” That’s the therapeutic breakthrough that psilocybin offers, and we don’t necessarily need a drug to realize this but many people seem to need it.

What would the ideal use of psilocybin in a hospice scenario look like?

What I would love to see is whole families coming together at a hospice center for a shared psilocybin experience before someone is too ill to interact. Can you imagine how cool that would be, and how healing that would be for everyone in the family? Psilocybin puts you in a state where you can actually say things to each other that maybe you could never say before. In my own experience with death, my brother and my mother and my father all dead, and all difficult situations in the terminal stages, it’s just very hard sometimes to express yourself. You want so much to be able to say something to a family member but you just can’t do it because this static in the system that builds up over years and years. I think psilocybin can and will be incredibly healing for people in these situations. That is a revolution in medicine if you can change attitudes towards death. I think the potential is very much there.

I can definitely see that. People so often carry around guilt and regrets related to what they never got to say to loved ones before they died, and that makes mourning so much harder. In a retreat situation like you describe with family, all of that would come out and then some. I can imagine people being able to embrace the situation in a really healthy way, both the dying person and their family.

Just to be able to actually communicate directly to the person and say ‘I forgive you, and if I hurt you, I’m sorry’… that can resolve so much. When that is not resolved, you carry it inside and it eats away at you. When a person is gone, they’re gone, so we might as well use the present moment to come to terms with things. I’ve also seen this happen with ayahuasca in the retreats I do. Ayahuasca is not the ideal medicine for people that are dying because it can be hard on you physically, much harder than psilocybin, but in many situations I’ve had families come, like a father and a couple of kids. They are not dying but they’re at that point where the kids are grown up and they are entering into a new kind of relationship. I’ve seen amazing reconciliations happen. They carried all these conflicts over the years, and it’s not that they all go away immediately, but after the ceremonies they can relate to each other in a much more honest way. The shared psychedelic experience facilitates communication, and I’ve seen a lot of good effects come out of that.

*From the article here :
 
Last edited:
banner-itin-CA-SF-to-LAX-via-the-coast-Big_Sur_Coast_California.jpg



The role of psilocybin in cancer hospice

by Michael Pena | May 29, 2018

Some studies suggest spirituality and religion can improve the quality of life for terminally ill cancer patients in hospice care. Enhanced spiritual well-being serves as a buffer against depression and hopelessness, and a positive outlook is associated with better medical outcomes. So if faith and spirituality can do all this, what about dropping shrooms?

Clinical studies in the '60s and '70s suggested that psilocybin-assisted psychotherapy can help, yet a renewed War on Drugs put the kibosh on such research because, you know, who needs psychedelics when you got prayer, right? The medical cannabis revolution revived interest in medical mushrooms in recent years, and a 2016 study published in the Journal of Psychopharmacology sought to examine the role psilocybin might play in helping patients with cancer.

For the study, New York- and California-based researchers conducted double-blind trials with 29 cancer patients who suffered from cancer-driven depression and anxiety. In conjunction with psychotherapy, the patients randomly received a single-dose of psilocybin (the active ingredient in psychedelic mushrooms) or niacin, and the researchers tested the outcomes. What happened?

"Psilocybin produced immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, and increased quality of life," the researchers reported. "At the 6.5-month follow-up, psilocybin was associated with enduring anxiolytic and antidepressant effects (approximately 60 to 80 percent of participants continued with clinically significant reductions in depression or anxiety), sustained benefits in existential distress and quality of life, as well as improved attitudes towards death."

Two years later, the researchers took a closer look at four of the participants and published the findings in the April 2018 Frontiers in Pharmacology. The deeper dive provided interesting details about the patients' experiences.

"Although the content of each psilocybin-assisted experience was unique to each participant," the follow-up study explained, "several thematic similarities and differences across the various sessions stood out. These four participants’ personal narratives extended beyond the cancer diagnosis itself, frequently revolving around themes of self-compassion and love, acceptance of death, and memories of past trauma, though the specific details or narrative content differ substantially. The results presented here demonstrate the personalized nature of the subjective experiences elicited through treatment with psilocybin, particularly with respect to the spiritual and/or psychological needs of each patient."

As far as specifics, a twentysomething named Victor said, "I would say I have less anxiety about my body and my sickness coming back, my cancer coming back…. I saw this body for what it’s worth, I picked it, it’s mine…. I think that acceptance has been liberating."

Tom, a Christian male in his 50s, had never used psychedelics before and claimed it was his belief in a cloud-surfing god that kept him strong, not the psilocybin. Still, he experienced "moderate benefits in anxiety, depression, demoralization, and death anxiety," and the experience did motivate him to say he discovered "there's nothing but love. Like the Beatles did sing, 'All you need is love,' that’s very true." Fittingly, the Beatles wrote that song during the band's psychedelic heyday.

Chrissy, a self-described atheist and fifty-something year-old breast cancer patient, experienced "significantly decreased anxiety, depression, death anxiety, hopelessness, demoralization, and increased purpose in life, spirituality, and death transcendence" after taking psilocybin. She said, "The psilocybin experience brought my beliefs to life, made them real, something tangible and true—it made my beliefs more than something to think about, really something to lean on and look forward to."

The fourth patient, a woman named Brenda in her 60s, claimed the experience produced profound change. "What’s so funny is that nobody can really see it, but yet, for me, everything has changed," she explained. "I feel more contented and happy about my place in the world in all the things I’m doing.… Maybe death is a beautiful thing."

Generally speaking, patients said the use of psychedelics aided them in "restructuring their thinking and emotional responses in everyday life," and their unique experiences produced quality-of-life benefits that persisted through the follow up.

The researchers concluded, "Not only did these experiences meet each person’s psychological needs, they also helped them understand what their needs were. Thus, one therapeutic function of psilocybin may be to assist participants in achieving insight into the cause of their distress, which is supplemented by our supportive and integrative psychotherapy treatment model."

On the topic of cancer and fully prohibited drugs, the Journal of Clinical Oncology conducted a survey asking oncologists about medical cannabis and cancer care. The results? "Whereas only 30% of oncologists felt sufficiently informed to make recommendations regarding medical cannabis, 80% conducted discussions about it with patients, and 46% recommended medical cannabis clinically. Sixty-seven percent viewed it as a helpful adjunct to standard pain management strategies, and 65% thought it is equally or more effective than standard treatments for anorexia and cachexia."

Cancer is one of the most destructive diseases on the planet, and the therapeutic options are limited. The federal government must lift its prohibitions on cannabis and psilocybin so the scientific community can fully research their therapeutic potential for aiding cancer patients.

https://prohbtd.com/the-role-of-psilocybin-in-cancer-hospice
 
Last edited:
Portal_of_the_Sun%2C_Pfeiffer_Beach%2C_Big_Sur%2C_California.jpg



New study using magic mushrooms to treat terminally ill patients with depression

by Elfy Scott | Jan 14, 2019

Psilocybin, the psychoactive compound from magic mushrooms, is being used to treat depression and anxiety in terminally ill patients in a new trial at Melbourne's St Vincent's Hospital.

The trial, headed by St Vincent's clinical psychologist Dr Margaret Ross, will begin in April with 30 patients recruited from the hospital's palliative care who have not responded to anti-depressant or anti-anxiety therapies.

The patients will be given a single dose of 25mg of synthetic psilocybin in conjunction with psychotherapy sessions.

Ross told BuzzFeed News that this a mid-range dosage that will provide patients with a psychedelic experience that will last in the range of four hours but they will be supervised for up to eight hours after the psilocybin has worn off.

"We don't want it to be underwhelming, we don't want it to be overwhelming," she said.

"We know that higher doses are associated with anxiety but if it's too low a dose you're not really going to experience that psychological shift in the thinking that we're really looking for."

While Ross said that risk of physical dangers is low, patients with a history or predisposition to psychosis or who have suffered from trauma-related disorders will be excluded from the study.

The rate of depression among terminally ill patients is high, with up to 77% of patients thought to suffer from the condition. It has also been found that the more symptoms that a patient is experiencing of disease, the higher the likelihood that the patient will experience depression.

Anxiety is also common, with up to 48% of terminally ill cancer patients reporting major anxiety symptoms and approximately 14% classify as having an anxiety disorder.

Dr Vince Polito, a researcher from the Department of Cognitive Science at Macquarie University who is not involved in the study, told BuzzFeed News that internationally results with psilocybin in depression and anxiety treatment have shown a lot of success so far.

"It's reasonably early days for this kind of research but the results have been really promising. There have only been a handful of studies but they've had quite dramatic results," he said.
So, how does the magic mushrooms compound help to treat depression?

In a 2016 study led by Johns Hopkins University, a high dose of psilocybin (20mg per 70 kilograms of body weight) produced a substantial decrease in depression and anxiety symptoms among terminal cancer patients that was sustained after a six-month follow-up.

The Johns Hopkins researchers found that participants attributed improvements in attitude, mood, relationships, and understanding of spirituality to their dose of psilocybin.

Ross notes that the St Vincent's trial will expand on this research by including terminally ill patients with more forms of illness including kidney and respiratory diseases.

Previous studies have shown that psilocybin is effective in treating forms of depression that are resistant to traditional treatment methods.

"There is this small subset of people with depression for whom at the moment we just don't have any treatment gaining any kind of traction," said Polito.

"These initial reports indicate that psychedelics may be effective in these cases where other treatments haven't worked."

A study from London's Imperial College in 2017 showed decreased depressive symptoms in patients with treatment-resistant depression after receiving two doses of psilocybin (a small 10mg dose followed by a 20mg dose one week apart) in addition to therapy.

The Imperial College study also looked at fMRI scans of the participants' brains before and after their doses and found that the brain activity had changed significantly; the fMRI's showed decreased blood flow to the amygdala (the emotional-processing centre of the brain responsible for fear reactions).

Previous studies have also shown that psilocybin decreases activity in the default mode network (DMN), which is network of brain structures associated with recalling memories, daydreaming, and thinking about the future.

The DMN is associated with understanding of oneself in reference to memories as well as the theory of mind – understanding other's motivations and actions.

Patients with depression have shown increased DMN activity, which is associated with depressive rumination.

A 2018 article by oncologist and palliative care physician, Dr Anthony Black, published in the Journal of Palliative Medicine, titled What Psilocybin Taught Me About Dying describes Black's personal experience taking the drug and how it changed his perceptions of self in reference to the world.

Black describes a sensation of having "small and banal" concerns seem insignificant as having his "small self" fall away.

"What has changed is that I know now that it is possible to allow the small self to dissolve in a way that feels exhilarating..."

"Could there be a way to talk to patients about goals that leaves this possibility open, that doesn't restrict me to the realm of this small self?"


Polito notes that it is also important to understand how taking a psychedelic can be a significant and impactful event that can alter people's psychology. "The lasting effects can be thought of as similar to those experienced when somebody develops post-traumatic stress disorder (PTSD)," Polito said.

PTSD is developed after a single intense and traumatic event, which has marked effects on the brain and causes lasting changes that are difficult to alter with therapy and medication.

"The idea of this analogy is to kind of think about what happens in a psychedelic session as almost a positive opposite of that," said Polito.

However, Polito also stresses that there are no guarantees with a powerful psychedelic such as psilocybin and its effects have to be managed skillfully to see the psychological benefits.

"The role of context, both the environment and the person's mindset (their beliefs, expectations, mood) are crucially important."

"A key feature of all of these studies is that they painstakingly manage and curate safe, supportive environments for participants."


The St Vincent's trial is the first research to be conducted in Australia using psychedelics and it has taken more than a year to be approved by ethics committees.

"The process for approval was 'arduous' and required going to painstaking measures in the experiment to mitigate risk and get approval to use the prohibited substance," Ross said.

Polito said that the fact that Ross's study is the first in Australia is exciting but also shows how far behind international research Australia is in this area.

"There's been problems with groups who have wanted to do research for example using MDMA as a treatment and haven't been able to find ethics committees who will even review the work."

"We're one of the only top research countries that hasn't had psychedelic research – until now,"
he said.

https://www.buzzfeed.com/elfyscott/australias-first-psychedelics-trial-is-about-to-use-magic
 
Last edited:
DavidNicholsHeadshot_.jpg

David Nichols, Ph.D

Research with psychedelic psychotherapy for dying patients

by David Nichols, Ph.D

You might ask yourself , "What does a scientist at a major Midwestern university know about psychedelics, death, and dying?" I was on a panel with Tim Leary many years ago at a conference on psychedelics and when I started my remarks I said, "I am a reductionist scientist." Tim immediately leaned forward, looked at me, and said, "Well, David, you aren't a reductionist scientist all the time." I quipped back, "Yes, but no one is supposed to know that."

I find it impossible to be completely reductionist in my out look when I have seen so many things that cannot be explained by conventional science. For example, my first wife had a number of paranormal experiences that I witnessed first hand. Soon after we were married, she awakened from a dream where a small girl had come to her, leading her to the scene of an auto accident where she and her mother had been killed, asking for help to save her father. The next morning we found that such an accident had occurred at the same time as she had been having the "dream," and in exactly the spot as in the dream. A mother and her young daughter had been killed, and the father was in intensive care in a local hospital. As another example, in a vivid dream late one summer her deceased paternal grandmother came to her and told her that she was coming back on the 19th at 6 am. She awoke from the dream and told me about it. Her father had cancer that had been progressing for some time, but at that moment he was holding his own. He died several months later on October 19th at 6 am. I witnessed these events, and many similar others, first-hand. How can science explain things like that?

I began my graduate studies in the fall of 1969, specifically to study psychedelics (or psychotomimetics, as we were forced to call them then). While I was a student, however, Congress passed the Controlled Substances Act of 1970; a future studying psychedelics now seemed very remote. Nevertheless, I continued to work in this field, believing that someday things might turn around.

You may study the chemistry and pharmacology of psychedelics, but you cannot read only science; the cultural and sociological issues are too large. As a scientist, I felt I couldn't study these substances in a sterile environment, without appreciating the impact that my work might have on society. Being somewhat culturally disconnected by living in the Midwest, however, the literature I read was hit or miss. The summer of love was not something in the news in Cincinnati, Ohio. I was fortunate, however, to stumble upon the work of Eric Kast, who first discovered the remarkable effects of LSD in dying patients. It was natural then to find the subsequent work of Kurland, Grof, et al. in Maryland, who had expanded Kast's seminal findings in their studies of psychedelics in terminal patients. Reading the excellent books by Stan Grof, and the parallels between psychedelic peak experiences and the so-called near-death experience reinforced my belief that psychedelics represented powerful tools to help in understanding death and dying. I was convinced that this research needed to be continued. Yet, as a Ph.D., and not an M.D., there seemed not much I could do except follow the chemistry and pharmacology of these amazing substances... and hope.

In the mid-1980s, I made the acquaintance of a psychology professor at Purdue who had lost a son to a drug overdose and as a result had become very interested in death and dying. He offered a course every other year on the subject, and invited me to present a lecture on the use of psychedelics in dying patients. I eagerly agreed, and it was always fun to see the shock and amazement on the faces of the students, most of who were in the nursing program, when I introduced the subject of giving LSD to terminal patients. By the end of the hour, however, they were excited and full of questions.

As time went on, I became more and more frustrated by my own lack of qualifications to do clinical research, and by the fact that no one who was qualified had picked up the ball. In a meeting at Esalen in 1984, I recall asking Oz Janiger why he and others who had been pioneers hadn't tried to restart research, but his reply to me was dismissive; that I just didn't understand how badly they had all suffered. It baffled me that folks who had seen the presumed therapeutic effects of psychedelics first hand, and who had extolled their virtues, could just give up like that. I really did not understand.

So, for years I went to scientific meetings, and in the evenings sat over beers with colleagues who would listen, bemoaning the fact that no one was doing clinical research on psychedelics. I would argue that it wasn't impossible; you just needed private money to do it. Everyone seemed to have the misconception that it wasn't possible, but I countered that no one who was qualified had really tried. There were many important players in the community who didn't believe me, but I remained convinced that if you had qualified researchers you could restart clinical research. The proof of principle finally came as I worked with Rick Strassman, who became the first clinician in more than twenty years to give a psychedelic to humans under an FDA-approved protocol. Even then, Daniel X. Freedman, then the head of psychiatry at UCLA who was a mentor for the project, counseled Rick to "Forget about therapy. Just measure physiological parameters." It was good advice for getting research funding and publication in a solid journal, but of course avoided the most interesting issues, many of which could finally be explored in Rick's book DMT: The Spirit Molecule.

As I sat over a beer sometime around 1990 telling the same story for the umpteenth time, it suddenly occurred to me that I might ultimately be sitting in a rocking chair many years hence, old and decrepit, telling the same old story; still waiting for someone else to take the initiative. I was spurred to action by that thought and contacted a number of psychiatrist and neuroscientist colleagues and friends and said, Let's do it. The rest, as they say, is history... or nearly so. We became the Heffter Research Institute, and incorporated in 1993. It is gratifying to see that the Heffter Institute has now been instrumental in initiating and supporting a study of psilocybin in OCD, and three clinical studies of psilocybin in cancer patients, dreams that motivated me to found the Institute in the first place. But how do psychedelics work? We have a modest but robust basic clinical neuroscience program in Zurich under the very capable direction of Dr. Franz Vollenweider to find out. Finally, it seems that things are moving. It has taken longer than I originally thought, but as they say, better late than never. What a journey for a reductionist scientist from the Midwest!

https://www.maps.org/news-letters/v20n1/v20n1-34to35.pdf
 
Last edited:
adorable-bird-animal-owl-photography-sasi-smith-fb.jpg


The role of psychedelics in palliative care reconsidered: The case for psilocybin

Kelmendi, Corlett, Ranganathan, D’Souza, Krystal

Psychiatric research with classic hallucinogens has enjoyed a resurgence of late. While studies performed in the late 1960s and early 1970s with LSD and psilocybin demonstrated therapeutic promise by producing a rapid and sustained reduction in anxiety, improvement in mood, and enhanced quality of life in patients with terminal cancer, a fuller exploration of their use in palliative medicine was curtailed by the establishment of a strict federal regulatory environment. Now, after decades of research inactivity, the potential of psychedelics to alleviate the distress associated with a terminal illness has been significantly advanced by the results of two recent studies investigating the efficacy of psilocybin in the treatment of anxiety and depression in patients with life-threatening cancer. Using double-blind, placebo-controlled, crossover designs, the studies conducted at Johns Hopkins University (JHU) and New York University (NYU) were methodologically rigorous and broad in the scope of their outcome variables. Both studies demonstrated that a single-dose of psilocybin can produce both an acute and enduring reduction in depression symptoms, anxiety, and existential distress in patients with life-threatening cancer.

That the studies replicated one another is a source of confidence in their findings. However, there were also informative differences between the studies. The group at JHU led by Griffiths et al. investigated the effects of a very low dose versus high dose of psilocybin administered five weeks apart in 51 patients diagnosed with life-threatening cancer and suffering with symptoms of depression and/or anxiety. The group at NYU led by Ross et al. compared the effect of high-dose psilocybin with niacin (used as an “active” control) in 29 patients, and both groups received targeted psychotherapy. All patients were screened and prepared for the study intervention through several meetings with staff who estab- lished rapport and provided an understanding of the range of altered states of consciousness that might be encountered during their treatment sessions. The psilocybin experience was well tolerated by all patients, and there were no serious medical or psychological adverse events.

Both studies evaluated a broad range of outcome measures, including the common measures of anxiety and depression, as well as quality of life, spirituality, and mystical experiences. In the Griffiths et al. trial, high-dose psilocybin produced large and sustained decreases in clinician- and patient-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning and optimism, and decreases in anxiety related to death. In the NYU trial, psilocybin produced rapid, substantial, and enduring reductions in cancer-related anxiety and depression, improved quality of life, increased spiritual well-being, and improved measures of existential distress, and was associated with improved attitudes toward death. At follow-up at six-and-a- half months, the initial robust clinical effects observed after the administration of a single dose of psilocybin endured in 60–80% of the patients, and when patients were asked to reflect on what they thought of their psilocybin session, 52 and 70 percent rated the psilocybin experience as the singular or top 5 most spiritually significant, or the singular or top 5 most personally meaningful experience of their entire lives, respectively, while 87 percent reported increased life-satisfaction or well-being attributed to the experience. The findings that single-dose psilocybin can produce acute and sustained improvements in cancer-related anxiety and depression is perhaps the most important and novel finding of the two studies, and add to and extend the findings of a similarly designed trial in patients with terminal cancer where a single low dose of psilocybin showed non-significant trends for benefit compared with placebo.

In both studies, mediation analysis indicates that the mystical experience was a significant mediator of the effects of psilocybin dose on therapeutic outcomes. Mystical experience is defined as encountering a profound sense of unity, transcendence of time and space, deeply felt positive mood, noetic quality (sense of understanding), ineffability, transiency, and paradoxicality infused with a renewed sense of purpose and meaning. Further evidence for the role of the mystical experience and/or higher doses in therapeutic outcomes comes from two open-label trials for addiction where the mystical experience was correlated with improved smoking cessation and drinking outcomes. Furthermore, Carhart-Harris et al. recently investigated the safety and efficacy of psilocybin in treatment-resistant depression, and showed that a higher dose correlated with a better treatment outcome. The association between psychedelic-induced mystical experience and therapeutic outcome, while not new, requires further exploration, as when induced under optimal conditions and in a controlled setting, it could provide a valuable therapeutic intervention for disorders that are otherwise difficult to treat.

Although not the primary aim of these studies, directionality of the relationship between the pharmacology of the drug, mystical experiences, and clinical outcome remains inconclusive. We do not know for certain whether these mystical experiences are a cause, consequence or corollary of the anxiolytic effect or unconstrained cognition. For instance, it is possible that mystical experiences associated with psilocybin serve as a measure of adequate drug effects rather than mediating an antidepressant and/or anxiolytic effect. Perhaps future studies could shed some light on this relationship by employing other drugs, such Salvinorin A and other kappa opioid receptor agonists, capable of producing perceptual alterations and mystical experiences similar to serotonergic hallucinogens but pharmacologically different. Also intriguing is whether the psychoactive effects of psilocybin influence its efficacy through, not yet fully understood, psychological mechanisms that continue to exert their effect well beyond the acute pharmacological effects. Rapid alleviation in mood is also reported with a single administration of ketamine, a dissociative anesthetic known to occasion mystical experiences. However, the antidepressant effects are relatively transient and typically disappear after a week. Moreover, not all the psychotropic substances that induce dissociative and/or mystical experiences produce an acute and enduring clinical benefit. Is there a differentially unique characteristic about the pharmacology of psilocybin and its enduring clinical effects compared with other serotonin receptor (5-HT2A) agonists such as DMT or DPT.

Imaging studies in healthy controls indicate that psilocybin decreases blood flow to regions of the brain regions collectively known as the default mode network (DMN) and promotes unconstrained cognition. Increase in metabolic activity in the DMN has been associated with increase in ruminative thinking and has been implicated in depression and anxiety but normalized by a range of effective treatments. One theoretical framework that might link mystical experiences to a new, more positive outlook through changes in brain function is Predictive Processing. This theory posits that the brain is a prediction machine and its hierarchically organized neuroanatomy is geared toward predicting future inputs based on prior experiences. Any mismatches or prediction errors can gather new learning based in their precision. We have previously argued that psychotomimetic drugs may induce their psychedelic or mystical effects by altering the balance between predictions and prediction errors such that errors are registered inappropriately and perceptual inferences become deranged. These experiences can gather new learning, expanding the possibility space for future inferences. This may be reflected in the significantly elevated trait openness, which persists for 14 months following a single infusion of psilocybin. Future work will need to discern how and why these drugs can have psychotomimetic effects in some individuals and antidepressant effects in others. The environmental setting and individual’s baseline are clearly crucial to the effects a psychedelic drug can have. Thus expectations and environments may enhance the drug’s potential to foster religious and spiritual experiences. In his book Heaven and Hell, Aldous Huxley observes, “Many schizophrenics have their times of heavenly happiness; but the fact that (unlike the mescaline taker) they do not know when, if ever, they will return to the reassuring banality of everyday experiences causes even heaven to seem appalling.”

These studies have demonstrated a critical advancement in this field. Psilocybin may offer a novel and potentially valuable approach for addressing the psychological suffering of dying often observed in this patient population, particularly given the limited efficacy of extant treatments. These studies also raise a number of important questions that warrant further research. How necessary are the acute psychedelic effects of psilocybin for its antidepressant and anxiolytic effects? What are the predictors of beneficial effects and adverse effects? Would moderate doses have similar effects? How specific are the effects? For a single dose of a drug to have effects that are still detectable six months later opens a new era of potential psychopharmacological treatments. But it also begs the question: What is/are the mechanism/s underlying the sustained beneficial clinical effects of psilocybin?

https://pdfs.semanticscholar.org/def0/47c4b93261a628599adf0d906fb1d832d72b.pdf
 
Last edited:
tingri-everest-base-camp-trek.jpg



Using magic mushrooms to treat terminally ill patients with depression, study

by Elfy Scott | Jan 14, 2019

Psilocybin, the psychoactive compound from magic mushrooms, is being used to treat depression and anxiety in terminally ill patients in a new trial at Melbourne's St Vincent's Hospital.

The trial, headed by St Vincent's clinical psychologist Dr Margaret Ross, will begin in April with 30 patients recruited from the hospital's palliative care who have not responded to anti-depressant or anti-anxiety therapies.

The patients will be given a single dose of 25mg of synthetic psilocybin in conjunction with psychotherapy sessions.

Ross told BuzzFeed News that this a mid-range dosage that will provide patients with a psychedelic experience that will last in the range of four hours but they will be supervised for up to eight hours after the psilocybin has worn off.

"We don't want it to be underwhelming, we don't want it to be overwhelming," she said.

"We know that higher doses are associated with anxiety but if it's too low a dose you're not really going to experience that psychological shift in the thinking that we're really looking for."

While Ross said that risk of physical dangers is low, patients with a history or predisposition to psychosis or who have suffered from trauma-related disorders will be excluded from the study.

The rate of depression among terminally ill patients is high, with up to 77% of patients thought to suffer from the condition. It has also been found that the more symptoms that a patient is experiencing of disease, the higher the likelihood that the patient will experience depression.

Anxiety is also common, with up to 48% of terminally ill cancer patients reporting major anxiety symptoms and approximately 14% classify as having an anxiety disorder.

Dr Vince Polito, a researcher from the Department of Cognitive Science at Macquarie University who is not involved in the study, told BuzzFeed News that internationally results with psilocybin in depression and anxiety treatment have shown a lot of success so far.

"It's reasonably early days for this kind of research but the results have been really promising. There have only been a handful of studies but they've had quite dramatic results," he said.

So, how does the magic mushrooms compound help to treat depression?

In a 2016 study led by Johns Hopkins University, a high dose of psilocybin (20mg per 70 kilograms of body weight) produced a substantial decrease in depression and anxiety symptoms among terminal cancer patients that was sustained after a six-month follow-up.

The Johns Hopkins researchers found that participants attributed improvements in attitude, mood, relationships, and understanding of spirituality to their dose of psilocybin.

Ross notes that the St Vincent's trial will expand on this research by including terminally ill patients with more forms of illness including kidney and respiratory diseases.

Previous studies have shown that psilocybin is effective in treating forms of depression that are resistant to traditional treatment methods.

"There is this small subset of people with depression for whom at the moment we just don't have any treatment gaining any kind of traction," said Polito.

"These initial reports indicate that psychedelics may be effective in these cases where other treatments haven't worked."

A study from London's Imperial College in 2017 showed decreased depressive symptoms in patients with treatment-resistant depression after receiving two doses of psilocybin (a small 10mg dose followed by a 20mg dose one week apart) in addition to therapy.

The Imperial College study also looked at fMRI scans of the participants' brains before and after their doses and found that the brain activity had changed significantly; the fMRI's showed decreased blood flow to the amygdala (the emotional-processing centre of the brain responsible for fear reactions).

Previous studies have also shown that psilocybin decreases activity in the default mode network (DMN), which is network of brain structures associated with recalling memories, daydreaming, and thinking about the future.

The DMN is associated with understanding of oneself in reference to memories as well as the theory of mind – understanding other's motivations and actions.

Patients with depression have shown increased DMN activity, which is associated with depressive rumination.

A 2018 article by oncologist and palliative care physician, Dr Anthony L. Black, published in the Journal of Palliative Medicine, titled What Psilocybin Taught Me About Dying describes Black's personal experience taking the drug and how it changed his perceptions of self in reference to the world.

Black describes a sensation of having "small and banal" concerns seem insignificant as having his "small self" fall away.

Polito notes that it is also important to understand how taking a psychedelic can be a significant and impactful event that can alter people's psychology. Polito said that the lasting effects can be thought of as similar to those experienced when somebody develops post-traumatic stress disorder (PTSD).

PTSD is developed after a single intense and traumatic event, which has marked effects on the brain and causes lasting changes that are difficult to alter with therapy and medication.

"The idea of this analogy is to kind of think about what happens in a psychedelic session as almost a positive opposite of that," said Polito.

However, Polito also stresses that there are no guarantees with a powerful psychedelic such as psilocybin and its effects have to be managed skillfully to see the psychological benefits.

"The role of context, both the environment and the person's mindset (their beliefs, expectations, mood) are crucially important. A key feature of all of these studies is that they painstakingly manage and curate safe, supportive environments for participants."

The St Vincent's trial is the first research to be conducted in Australia using psychedelics and it has taken more than a year to be approved by ethics committees.

Ross said that the process for approval was "arduous" and required going to painstaking measures in the experiment to mitigate risk and get approval to use the prohibited substance.

Polito said that the fact that Ross's study is the first in Australia is exciting but also shows how far behind international research Australia is in this area.

"There's been problems with groups who have wanted to do research for example using MDMA as a treatment and haven't been able to find ethics committees who will even review the work.

"We're one of the only top research countries that hasn't had psychedelic research – until now,"
he said.

 
Last edited:
banner-itin-CA-SF-to-LAX-via-the-coast-Big_Sur_Coast_California.jpg



End of Life advocates are excited about psychedelics*

by Kathryn Tucker | April 12, 2019

As an advocate, I have engaged in multidimensional advocacy to press for recognition of the rights of terminally ill patients on various frontiers for nearly three decades. I have argued in favor of dying patients having access to as much pain medication as they need to get relief, even if it advances their time of death. The US Supreme Court recognized this right in 1997, including the right to a specific treatment known as “palliative sedation,” which involves physician administration of intravenous medication to eradicate consciousness, so the patient has no awareness of suffering, titrating the medication to maintain the patient in an unconscious state until death arrives. The Court found choice for such pain management to be among the liberties protected by the United States Constitution. In addition, I have engaged advocacy in both the legislative arena and through litigation to establish the right of a dying patient to obtain a prescription for medication to precipitate a peaceful death, a practice known as “aid in dying” (“AID”; sometimes referred to as “death with dignity”). Today, a growing number of states empower dying patients with access to AID, including Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, and New Jersey.

These hard-won developments represent progress toward improving end-of-life care and expanding the autonomy of terminally ill patients. However, they primarily address physical suffering; the guidelines for provision of palliative sedation require physical distress. Hence the recent clinical studies showing the efficacy of psychedelic substances in relieving anxiety in terminally ill patients are of great interest to patient advocates. A powerful new tool appears at hand for non-physical suffering experienced by some patients.

In light of the fact that psychedelic substances are not legally accessible under current law, the question becomes how to galvanize changes in law to make these valuable medicines available. The main road to medical access involves rescheduling under the federal Controlled Substances Act; this effort is underway, with leadership from MAPS and others.

Unwilling to wait for (or count on) rescheduling, various state efforts have begun to emerge around the US to make access to psychedelic substances possible. These measures would alter state law, leaving potential federal criminal exposure a risk.

Medicinal use of psychedelics could lead the way

Advocacy to move the clinical findings about the efficacy of psychedelics in mitigating and palliating anxiety related to terminal illness into the public eye will be a necessary and powerful force to galvanize changes in law and policy, thereby enabling patient access. Outreach to inform the public and elected representatives of the potential of these agents to improve the lives (and deaths) of millions of people will be necessary. Powerful message bearers would include the hospice and palliative care professional associations, public health associations, mental health associations, and patient rights advocacy organizations.

It appears that Oregon or Washington (or possibly California), states that have the most experience with AID, are the best candidates for exploring statutory permission for medicinal psychedelics. In addition to the reason outlined above, selecting a test state that permits AID is strategic because, in the debate leading to passage of the statutory permission for aid in dying, all stakeholders emphasized the need to ensure that eligible patients be provided with good palliative care to ensure that no patient would choose to precipitate death due to inadequate palliative care. Thus, adding another intervention to the “tool box” of palliative measures available to terminally ill patients should be particularly welcomed in these states.

Conclusion

Research is demonstrating the remarkable therapeutic uses of psilocybin and related agents in a variety of clinical contexts, including in the relief of non-physical suffering in terminally ill patients. These substances remain Schedule I drugs under the federal Controlled Substances Act. A number of advocacy efforts are emerging for expanding access to psilocybin. These advocacy strategies could benefit from considering lessons from other social change movements, including that for end-of-life liberty.

*From the article here:

 
Last edited:
513261.jpg

Johns Hopkins Psychedelic Research Unit

When psychedelics make your last months of life worth living

by Donovan Farley | Mar 31 2019

In the spring of 2018, Dan G. learned that the melanoma he had beaten 18 years earlier had returned and spread to his liver and lungs. After several months of chemo and immunotherapy, the 44-year-old decided the traditional treatments he’d been undergoing weren’t enough. The crippling side effects of the drugs had left him feeling hollow—and only exacerbated his already acute feelings of anxiety and depression. He often felt too decimated, both physically and mentally, to spend quality time with his wife and four-year-old son.

Unable to control what was happening in his body and discouraged by conventional treatments, Dan began to ponder the things he could control about his situation—namely his mental state—and started looking into options. The literature he found examining the correlation between improved mental health and psilocybin, the psychoactive compound in magic mushrooms, intrigued him, and his experiments with psychedelics over the next six months would significantly reduce the mental dread consuming his life.

Dan’s various caregivers weren’t encouraging when he asked them about alternative paths to managing his situation—they seemed to want to stick to oxycontin for his pain, and not much else. Desperate to alleviate his crushing stress, this letdown led Dan toward the decision to experiment with psilocybin. “I didn’t even consider something like tripping when I was first diagnosed in May,” Dan says. “However, there was a point in my treatment where I started to improve physically and felt strong enough to be willing to try it. Reading Michael Pollan’s book, How To Change Your Mind, and the research being done at Johns Hopkins gave me motivation.”

For more than 15 years, the Johns Hopkins Psychedelic Research Unit has been the foremost research team in the US for psychedelic studies. Key among the topics being explored were psilocybin’s effects on addiction, depression in the physically healthy, and the depression and anxiety brought on by a cancer diagnosis. Many of the results of this research have shown psilocybin to be an invaluable mental health tool, one unlike anything else in modern medicine.

“People with cancer who have substantial distress are stuck with thoughts of ‘why did this happen to me?’ and ‘life is meaningless.’ Very understandably, they become so obsessed with the cancer that they can’t enjoy the life they have left,” says Matthew W. Johnson, associate professor of psychiatry at Johns Hopkins University School of Medicine. “A lot of these people are physically healthy in the now, but their life is absolutely hell because they are so preoccupied with the cancer and can’t get past it. They’re not able to get up and enjoy the sunshine or their family because of these feelings.”

That was exactly what Dan was going through. “I very much wanted to be more present for my son and my wife, who are everything to me,” Dan says, his voice quivering with emotion. “My wife and I have had to have these conversations—when am I ready to die? When are you ready for me to die? She’s so great and loving but it’s like, how do you even figure these things out? That and the other negativity just consumes you.”

Johnson says that the results of Johns Hopkins’s randomized cancer studies are profound. “Cancer patients show dramatic reductions of depression and anxiety that have lasted at least six months and sometimes a year—which is amazing,” he says. “It’s not just cancer patients either, our studies showed a similar improvement in depression in non-therapeutic subjects [subjects that don't have a specific disorder like tobacco addiction or cancer-related distress]. These results are unique to psilocybin as it’s medication, but it’s a medication that provides an experience. It’s like psychotherapy in a way.”

Determined to find a better way to treat his intense anxiety, Dan turned to old friends on a Phish message board, where he opened up about his situation and his search for psychedelic relief. Soon enough, Dan had what he was looking for and began to prepare for his journey. “My friends on Phantasy Tour ended up being one of my best resources, actually,” Dan says, laughing. “They came through with so many donations to my family’s gofundme and with so much great advice on everything from alternative medicines to their own experiences with cancer and psychedelics to funny stuff like ‘just dim the lights and turn on the Allmans.'”

Nervous but excited to try something new, Dan went about setting up a time and environment that would provide maximum comfort for his trip. Equipped with mushrooms a friend procured for him, Dan got himself set up for the journey—select music, noise canceling headphones, pen and paper to record his thoughts, comfortable and ample space to meditate—and then took the plunge. “In the moment I felt absolute joy and ecstasy as well as absolute anxiety and fear—at the same time. I think the ability to accept those two concepts and acknowledging the extremes about my situation is important,” he told me, awe in his voice. “It felt like pure nothingness, and I understood it to be a good representation of what dying itself is.”

“I had this epiphany, saying,
‘Enough already. I don’t need to pretend everything is fine.’ That was a real takeaway: It’s okay for me to step away from this constant optimism. I realized it was okay for me to think, ‘Well, actually, this sucks. I’m not going to get through this. I am going to die.' It helped me focus on what was real—time with my loved ones.”

Johnson was happy to hear that Dan had respected the process and focused on the inward significance of the experience, but adamantly reiterated the risks involved with taking psilocybin outside of a medical setting. Hallucinations, severe anxiety, and paranoia are among the negative side effects that could befall a user. He also pointed out the importance of having a specific intention for a trip.

“You can have these transcendent psychedelic experiences outside of clinical settings, and that can be very helpful, but it’s hard to truly let go when you’re at, say, a concert and you’re worried about your wallet and phone and the police,” Johnson says. “You probably don’t want to be crying in a corner about your mom at a party or something, but if you’re doing one of these studies, and you feel the need to cry about your mom, then that’s exactly what you should be doing.”

Though Dan says the bulk of that first trip was high anxiety, he praises the overall experience and says that from then on his perception of death was dramatically altered—but more importantly, so was his perception of the life he has left. “The power that I feel being able to accept death as a reality is truly a gift,” Dan says, “because this thing that’s happening to me then doesn’t have complete power over me anymore—that acceptance allowed me to take back that power and realign my focus.”

After the success of his first dose, Dan settled into a microdosing regimen ingesting .2-.4 grams every third day. The results were exceptionally beneficial for him. Basic functions like being able to eat were accessible to him again. Not only could Dan show up at the dinner table, he could be his old self again, however briefly. “I was able to sit down and have some of the last meals I’m ever going to have with my son and my wife. To be able to sit there and function... it's like, ‘Hey, daddy’s being silly and fun again,’ you know? I’m not miserable. I’m not totally out of it on pain pills.”

This ability to free the mind enough to be present in the moment is at the core of why Johnson and his colleagues are so excited about their findings. His team says that no other medicine has been able to produce results akin to those of psilocybin, both in the treatment of depression and addictions of all kinds.

It’s important to note that due to the experimental nature of the treatment, studies of this type have been relatively small and homogeneous thus far. Psychedelic research of any kind can be difficult for a variety of reasons—blinding is difficult to impossible, the substance in question is illegal, and this type of therapy and medicine hybrid treatment is uncharted territory. Despite promising findings, this type of research is still in its preliminary stages.

Still, Johnson is a bit frustrated with the public’s perception of psychedelic mushrooms as a recreational drug or “woo woo” remedy. “Some people may say it sounds like snake oil. But for me it comes down to the fact that these people are stuck, mentally and behaviorally, with addiction, or with something like depression,” he says. “There is so much benefit here.”

Colorado and Oregon are currently considering the legalization of mushrooms, and Dan hopes his story can help illuminate how much good this plant could do for someone going through depression. “There’s something out there that’s unexplainable, something that this taps into. I am at peace with what’s next," he says. “The more I prepare to say goodbye, the more at peace I become with that reality. My experience has provided me with a peace despite all this, a peace I’ve been able to share with my family in my final days.”

 
Last edited:
25937084-25937084.jpg


Psilocybin helped me process the sudden death of my mom and close friend

reset.me | April 26, 2019

In January of 2016, I received a phone call from a friend that effectively changed my life forever. He had spent the day traveling home from his Christmas holidays only to arrive back at his apartment, where he found our beloved friend Julian’s suicide scene. To this day I can still hear, to the exact tone, the way his voice sounded when he made that call to me, although much of what happened in the months subsequent has become a blur.

In May of 2016, I received another phone call from my older sister to say that our mother had suffered a cardiac-arrest and that I needed to return home to the UK as quickly as possible. In that moment I could feel deep inside of me that within the next few days I would inevitably have to say goodbye to my mum. This was just a few months after the passing of my close friend.

Looking back, I can safely say that for the rest of summer 2016 I was in pretty bad shape. I was feeling deeply disconnected from the part of myself that I’m no longer afraid to call the soul. I had fallen across a hollowness inside of myself that, upon connection, was enough to make me feel physically sick and scared. I then started to recluse myself to only a hand full of people and only from time-to-time. I also began to experience earthquakes of anxiety in my daily life. I would be paying for a train ticket and then BAM!!! Right out of the blue, I would feel a sense of impending danger. I mention these incidents only as a prelude to the story of my use of psilocybin mushrooms.

So, enter the mushrooms, I guess. In July of that same summer, I stumbled across a man who had perfected the art of raw chocolate, containing a Mexican strain of the mushrooms. It’s worth noting that despite up until this point I had never tried a traditional psychedelic, I had for many years been utterly fascinated by the research going into the study of these natural substances. Their therapeutic values are remarkable; treatment for depression, anxiety, PTSD and addiction etc. I decided I was going to jump in and give the mushrooms a go and see what they could offer me during this difficult time.

I was terrified of what the psychedelic experience actually entailed, probably due to all the bullshit propaganda that the western media loves to throw all over such subjects. Nevertheless, I found my stones, and with my girlfriend in the other room if needed, I ate a handful of the chocolate. Sparing you guys another trip report here on how beautiful it was, it’s safe to say that my first experience was one of my toughest to date (not ruling out the future). There were moments during the trip where the anxiety I had been suffering from felt like it had doubled ten fold. I literally remember looking at the radiators in my bedroom breathing and pulsating and thinking out loud, “why have I done this to myself,” and “I’m not sure this is actually for me.” However, with the calming influence of my dearest lady, I was able to see out the remaining few hours of the mushroom experience.

If you got this far then listen astutely here folks. The next morning I woke unscathed and with a feeling of freshness, a feeling that I hadn’t awoken with in quite some time. I literally rose with a pleasant smile and a sense of achievement that I couldn’t quite place. For the rest of the day, I felt very light about everything that had been going on with me on a daily basis. It was like someone had said, “Hey Jonny, let me carry some of that for you for a little while.”

In fact, this feeling lasted for a few weeks after. I mean I still cried from time to time. Every now and then I had moments of anxiety, but the lingering effects of these seemed fairly distant. Less heavy on my the chest so to speak.

A little over a month after that first experience I decided I would do it again. Only this time my fear of what the mushroom experience might hold didn’t seem to be as present. Even so, I was of course still very nervous. This time the experience was a complete parallel to the first. It was beautiful, funny (hysterical laughter) and there were moments of deep emotional insight into my life.

To round all this up, I would like to say that it is now a little over 3 years since the passing of my mum and my close friend. Both of whom I was very connected with on a deeply meaningful level. Don’t get me wrong, I am still learning how to build myself with brand new pieces, but I am doing this on a daily basis. The mushroom experience has been by my side every now and then since the events earlier in 2016 as a tool for insight and only should I need it. The depression in my life comes and goes, much like life itself, but the space between the cloudy weather is so much further apart.

My anxiety is also pretty much dealt with, at least in the sense that it does not hinder my quality of life anymore. I feel a deep love and connection towards nature in my every day. Also, more so than ever, I have found an inner spirit that I never knew existed in me before now and am certain that this is a gift from the psychedelic experience.

To finish up, I am still me underneath it all. I’m still essentially that same Jonny. But, I am now so much better at being me. So much better equipped to deal with this journey we like to call life. I’ve grown so much as a person and I owe that in part to the mushrooms and in part to my own bravery and sheer will. I’d like to say to anyone who feels like they suffer or struggle for a meaning in life that help is always nearby. You simply have to look in the deepest of places.

 
Last edited:
348ce2f3da345bc4e8dd991219478243--ocean-sunset-the-ocean.jpg



Can psychedelic advocates learn from the movement for End of Life Liberty?

by Kathryn L. Tucker | April 12, 2019

As an End of Life advocate, I have engaged in multidimensional advocacy to press for recognition of the rights of terminally ill patients on various frontiers for nearly three decades. I have argued in favor of dying patients having access to as much pain medication as they need to get relief, even if it advances their time of death. The US Supreme Court recognized this right in 1997, including the right to a specific treatment known as “palliative sedation,” which involves physician administration of intravenous medication to eradicate consciousness, so the patient has no awareness of suffering, titrating the medication to maintain the patient in an unconscious state until death arrives. The Court found choice for such pain management to be among the liberties protected by the United States Constitution. In addition, I have engaged advocacy in both the legislative arena and through litigation to establish the right of a dying patient to obtain a prescription for medication to precipitate a peaceful death, a practice known as “aid in dying” (“AID”; sometimes referred to as “death with dignity”). Today, a growing number of states empower dying patients with access to AID, including Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, and New Jersey.

These hard-won developments represent progress toward improving end-of-life care and expanding the autonomy of terminally ill patients. However, they primarily address physical suffering; the guidelines for provision of palliative sedation require physical distress. Hence the recent clinical studies showing the efficacy of psychedelic substances in relieving anxiety in terminally ill patients are of great interest to patient advocates. A powerful new tool appears at hand for non-physical suffering experienced by some patients.

In light of the fact that psychedelic substances are not legally accessible under current law, the question becomes how to galvanize changes in law to make these valuable medicines available. The main road to medical access involves rescheduling under the federal Controlled Substances Act;[ii] this effort is underway, with leadership from MAPS and others.

Unwilling to wait for (or count on) rescheduling, various state efforts have begun to emerge around the US to make access to psychedelic substances possible. These measures would alter state law, leaving potential federal criminal exposure a risk.

Lessons from the movement for End of Life Liberty: It can take successive efforts

The movement for end-of-life liberty demonstrates that sometimes it will take several efforts before success (defined as having a measure enacted into law) is achieved. Oregon was the first state to enact a “Death with Dignity” law through the initiative process in 1994. That success stood on the shoulders of narrowly defeated initiative efforts in 1991 in Washington and 1992 in California. Although they failed, these early campaigns served a critically important function, and advocates learned from the failed efforts. Most significantly, the Oregon effort put forth a measure tailored to meet the concerns with the broader measures that had been advanced in Washington and California. The text of the law presented to voters in Oregon was considerably narrower than the preceding measures.[v] The early campaigns educated advocates about how to tailor the measure, facilitating the successful effort in Oregon.

In light of the two failed attempts before it, Oregon’s measure was designed to avoid vulnerability to attack by opponents claiming it was not sufficiently narrow and restrictive. Hence, it provides for limited access and imposes a heavily regulatory scheme for determining who is eligible, the process the patient must go through to get the medication, the process the physician must follow in order to establish the patient’s eligibility and provide a prescription, and extensive requirements including multiple requests for the medication, witnessing of requests, a mandatory waiting period, and reporting of data about patients who obtain the prescription, among others.

The success in Oregon has become the “model.” Other states have enacted very similar measures. Hence, it is important to be aware that a pioneering success may become replicated; this reality encourages careful thought as to what form that first enactment takes.

Medicinal use of psychedelics in a state that permits AID could lead the way

Advocacy to move the clinical findings about the efficacy of psychedelics in mitigating and palliating anxiety related to terminal illness into the public eye will be a necessary and powerful force to galvanize changes in law and policy, thereby enabling patient access. Outreach to inform the public and elected representatives of the potential of these agents to improve the lives (and deaths) of millions of people will be necessary. Powerful message bearers would include the hospice and palliative care professional associations, public health associations, mental health associations, and patient rights advocacy organizations.

It would appear that Oregon or Washington (or possibly California), states that have the most experience with AID, are the best candidates for exploring statutory permission for medicinal psychedelics. In addition to the reason outlined above, selecting a test state that permits AID is strategic because, in the debate leading to passage of the statutory permission for aid in dying, all stakeholders emphasized the need to ensure that eligible patients be provided with good palliative care to ensure that no patient would choose to precipitate death due to inadequate palliative care. Thus, adding another intervention to the “tool box” of palliative measures available to terminally ill patients should be particularly welcomed in these states.

Other states may offer a favorable legal landscape to enable access to psychedelics for other reasons. Hawaii, for example, has a unique provision relating to terminally ill patients’ ability to access “remedial agents.”

When a duly licensed physician or osteopathic physician pronounces a person affected with any disease hopeless and beyond recovery and gives a written certificate to that effect to the person affected or the person’s attendant nothing herein shall forbid any person from giving or furnishing any remedial agent or measure when so requested by or on behalf of the affected person.

The purpose of this provision is to give terminally ill patients the option to access treatment not approved by the government. Hawaii is among the states permitting AID. In light of the existing statutory landscape, it could be a favorable jurisdiction in which to advocate for access to psychedelic agents in the context of palliative care for terminally ill patients; indeed, one could argue there is no need for any further State permission and that practice can begin and emerge subject to this standard of care.

Conclusion

Research is demonstrating the remarkable therapeutic uses of psilocybin and related agents in a variety of clinical contexts, including in the relief of non-physical suffering in terminally ill patients. These substances remain Schedule I drugs under the federal Controlled Substances Act. A number of advocacy efforts are emerging for expanding access to psilocybin. These advocacy strategies could benefit from considering lessons from other social change movements, including that for end-of-life liberty.

 
Last edited:
2017SB_PacificCoast_KenjiSugahara.jpg



New law gives critically ill people the 'Right to Try' psychedelics

by Reilly Capps | 22 Jun 2018

So long as patients are trying a drug of their own volition and free will, no government should stand in their way.

The Right to Try Act lets people with life-threatening illnesses try experimental drugs, some lawyers assert. That includes mushrooms, LSD and ecstasy. One guy's already doing it.

With tumors in his spine that spread into his brain, unable to work and doctors unsure how long he has to live, Jerry (not his real name) is taking psilocybin mushrooms to deal with it.

Jerry tells Rooster Magazine that psilocybin helps him with the physical pain as well as the anxiety and PTSD that comes from the fear of dying.

And he's doing it legally, he believes.

This is an untested legal theory, but one that could open up a new front in the battle to legalize drugs.

And it's all based on a new law called the Right to Try Act. President Trump signed the bill in late May, which says that people who have a "life-threatening" illness can try drugs that aren't fully approved by the FDA.

Trump signed it surrounded by folks with cancer and a kid with a rare disease.

But psilocybin, MDMA (ecstasy) and LSD are also experimental drugs, that also have also been through the first phase of clinical trials at the FDA — and so are seemingly eligible for the Right to Try law.

Jerry's assertion that tripping for him is legal is supported by Denver for Psilocybin, which is pushing to legalize the drug in Denver. The Nowak Society, a Colorado nonprofit promoting responsible use of drugs, believes this as well after consulting with the cannabis law firm Vicente Sederberg.

Jerry isn't using his real name because while he believes what he's doing is legal, he's still afraid to go public. There have been no test cases on Right to Try. And he has to be vague about where he gets his mushrooms. But Jerry got the psilocybin approved by his doctor, as the law requires.

This fight mirrors one that happened during the early stages of the movement to legalize marijuana, when cancer and AIDS patients used weed to soothe their worst symptoms. Society listened, and carved out exemptions in the laws for them.

For Nowak board member Shannon Hughes, this is personal. In 2013, when her husband Teno — a former Marine with a charismatic personality — was 37, a stomach ache turned out to be colorectal cancer. He would be dead within a year and a half.

Teno was terrified. Searching online, he came across studies from Johns Hopkins Universities on psilocybin and death. Hopkins had 51 cancer patients take psilocybin. 80% of them said it helped them feel more optimistic and less scared of death. "He wanted to have an experience like that," Hughes said.

Back then, Hughes had no idea where to get mushrooms or how to do them. Today, thinking about the missed opportunity, Hughes tears up.

"What a gift this would have been for him," Hughes said.

Armed with the conviction that they've found a new legal way forward for folks like Teno — a way to let grass grow from a crack in the concrete, they say — The Nowak Society is working to build a network of people interested in testing the Right to Try law, so that more people besides Jerry can take advantage of the new law.

Interested parties are starting to line up.

Kim Mooney, for example, has been working in hospices for 22 years and runs a business called Practically Dying. She's sort of a death coach. After hearing from the Nowak Society about Right to Try, and attending an information session this week in Boulder, Colorado, she plans to tell her clients about the possibility.

"Most of them are saying, how do I get out of this without being afraid?" Mooney said. "This could easily be the step that could help people to transition."

For Jerry, the man with the life-threatening tumors, psilocybin works. He says Xanax and Valium just mask the symptoms of his end-of-life anxiety, while he feels the psilocybin is actually rewiring his brain. This is making it easier for him to live, which could make it easier for him to die.

 
Last edited:



Just one dose of psilocybin found to ease anxiety stemming from advanced cancer

by Alexandra Sifferliy | TIME | 1 Dec 2016

Cancer is a brutal disease on both the body and mind. Not only do treatments like chemotherapy take a massive toll, but the emotional side effects can be hard to bear. Depression and anxiety are high among people with cancer, including those in remission. But two new studies offer promising relief through an unlikely source: psychedelic drugs.

In two new studies released simultaneously by researchers at New York University and Johns Hopkins, doctors reveal that a single dose of psilocybin can ease anxiety and depression for up to six months. The results have great potential for people dealing with the fear associated with a cancer diagnosis, but also for people with psychiatric disorders that haven't responded to traditional treatments like psychotherapy or antidepressants.

The studies, both published in the Journal of Psychopharmacology, are accompanied by 11 editorials of support from leaders in psychiatry, including two past presidents of the American Psychiatric Association. "Our results represent the strongest evidence to date of a clinical benefit from psilocybin therapy, with the potential to transform care for patients with cancer-related psychological distress," says NYU study author Dr. Stephen Ross, director of substance abuse services in the Department of Psychiatry at NYU Langone in a statement.

The NYU Langone Medical Center study involved 29 people who had serious psychological distress, like anxiety or depression, stemming from advanced cancer. Each person received either a capsule of psilocybin or a placebo capsule; in a second session, they were given the pill they hadn't yet taken. The sessions lasted from four to six hours in a room equipped with head phones, a couch and a sleep mask.

People had their own individual experiences with the drug. But the results were remarkable: 60-80% of people in the study reported reductions in their depression and anxiety symptoms that lasted six months after the treatment.

The Johns Hopkins study, which involved 51 adults, had similar results. They each received one large dose of the drug, and six months later, 80% of the people in the trial continued to show decreases in depression and anxiety symptoms. Eighty-three percent of people reported increases in their well-being and life satisfaction, and 67% said the trial was one of the top five most meaningful experiences in their lives.

Several people described experiencing an overwhelming feeling of love while on the drug and felt they had changed immediately. The feeling of immense love lingered for weeks, and four years later I still feel it at times, says participant Dinah Bazer, who was experiencing severe anxiety about a possible ovarian cancer recurrence. My fear and anxiety were completely removed, and they haven't come back.

Lisa Callaghan's late husband, former TV news director Patrick Mettes, was also in the NYU trial. Mettes eventually died from cancer of the bile ducts, but undergoing the trial "gave him a sense of peace," says his wife. "In his trip there was an evolution through all of these stages of emotional development," says Callaghan. "He was reborn into this place of personal and universal love. He said he felt it all around him, and he felt a sense of forgiveness too."

The potential therapeutic use of psilocybin has been recognized for years, but strict drug laws implemented 45 years ago stalled research. In the 1950s and 1960s, several teams in the United States studied psychedelic compounds for potential mental disorder treatments. But widespread recreational use of the substances became cause for concern and overshadowed the possible therapeutic benefits. In 1971, psilocybin and other psychedelic compounds were classified as schedule 1 drugs, meaning that the government believes they have high potential for abuse. This classification makes it very difficult for research to continue, despite the fact that experts argue adverse side effects from psilocybin (when used responsibly) are rare.

"I tried to understand how something this big has been buried," says Ross. Due to these restrictions, says it took the hospital a couple years to get their study off the ground.

Some of the men and women in the studies did experience side effects, like nausea and headaches, but none were severe. It's unclear precisely how psilocybin works, but the study authors say that the drug may activate parts of the brain that are impacted by serotonin, which can play a role in anxiety, mood and depression.

Significantly more research is needed before psilocybin could be considered as a clinical therapy. The researchers stress that psilocybin in the trials was given in a very controlled environment with multiple investigators present, and that people should not attempt the drug on their own. There's also some concern that pharmaceutical companies may not see financial incentives in single-dose therapies.

Still, many people in the medical community are hopeful. "We're excited about finding a medicine that can be helpful to people suffering from conditions not successfully treated by standard treatment," says Dr. George Greer, medical director of the Heffter Research Institute, which helped fund the studies. "There's a lot of interest."

http://time.com/4586333/psilocybin-cancer-anxiety-depression/
 
Last edited:
First-ever-study-launched-to-explore-benefits-of-microdosing-LSD-730x410.jpg



Specialists investigate psychedelic therapy for those facing death*

By Luke Slattery | The Age | Jun 22 2019

Palliative care, Building A, St Vincent's Hospital Melbourne, is not a place you want to be; not, at least, for any length of time. The terminally ill, bedridden for the most part when I visit on a grey autumn afternoon, are fighting for their lives and, at the same time, contending with the unimaginable fear of imminent death. Circling discreetly around them are specialists, clinicians and nurses in light blue uniforms, with clipboards and cannulas in hand.

I'm waiting for psychologist Margaret Ross and psychiatrist Justin Dwyer, who walk swiftly along the palliative care unit's sixth-floor corridor to greet me. Ross and Dwyer are at the centre of the country's first clinical trial of psychedelic drugs for treating severe depression in the terminally ill. Within a month, they will begin recruiting 40 depressed and incurable patients in an attempt to relieve their distress with a novel treatment: between one and two 25-milligram doses of synthetic psilocybin, the psychedelic ingredient found in "magic mushrooms", accompanied by intensive psychotherapy sessions.

The trial is part of a revolutionary shift in attitudes towards psychedelic drugs believed to have therapeutic benefits for treatment-resistant depression, post-traumatic stress disorder, and even commonplace addiction to alcohol or tobacco. Half a century after Woodstock, several illegal recreational substances are being recast as drugs of last resort, from psilocybin, marijuana and MDMA to ayahuasca, a psychedelic plant-based tea from the Amazon. LSD administered in high doses has lost favour among neuroscientists and therapists for largely practical reasons: its effects are too powerful, too unpredictable and too protracted.

Psilocybin, with its famed capacity to induce mystical experiences, is the focus of worldwide clinical trials. This compound, found in more than 100 species of fungi and once revered by the Aztecs who named it "flesh of the gods", is at the vanguard of attempts to tackle the despair and anguish of imminent death among the terminally ill. The depression many experience often makes it impossible to connect to family, friends, society, memory – self.

"Depression and anxiety in some cancer patients can be treated by meds, and others by talking therapy, but there are those who still face death with overwhelming fear," says Ross, who speaks rapidly, in sure-footed sentences, while her dark hair twists and falls over her shoulders. "We can't touch it. Some try to do it tough and you eventually discover huge reservoirs of fear, hidden beneath the surface. Many withdraw from friends and family, depriving themselves and their loved ones of this precious time."

Within palliative care wards, antidepressants have not been particularly useful in treating the dying. "Antidepressants tend to make people feel a little less awful," explains Dwyer, who has been working for 12 years at the intersection of psychology and palliative care and heads St Vincent's Department for Psychosocial Cancer Care. "One of the psychological problems is that when you get cancer, you are defined by cancer," he says as we pass by a pod of nurses. "What is happening to your body never leaves your mind."

"But with psilocybin, you can have an experience that enables you to reflect on the important things in life, to see life itself differently, and to have experiences where you no longer feel so tethered to suffering and to the body."

Forty-five-year-old Dwyer, who's wearing round-framed glasses and is clad
entirely in Melbourne black, describes the effect on patients as a "resetting" of the brain.

We cross from the palliative care unit to the oncology and haematology wards, where some patients are receiving high-risk chemotherapy that knocks out benign as well as malignant cells, lowering their ability to fight infection – fatally in some cases. "I see a lot of death," says Ross, as we head to the nearby lifts that will take us to their office. "Every one of the dead leaves a mark. I have a little essence of every one of them." A psychologist since 2004, Ross turns to me with a flash of steel behind her bright gaze: "You carry that. It's harrowing. Like ghosts," adds Dwyer.

Ross and Dwyer show me their office, a small reclaimed space personalised by the psych staff as a bulwark of normality against the reality of their daily work with the terminally ill. "We got a run-down sty and just tried to make the best of it," says Ross.

It's from here that the psychedelic drug trial will be planned, administered and assessed. There are shelves loaded with coffee, tea, chocolate and gifted bottles of wine. Three guitar cases and a portable synthesiser stand propped in a corner, alongside a taxidermied owl picked up at a flea market, a poster illustrating several species of fungi, from the edible to the downright deadly, a bottle of Moët, a bar fridge and a book of Freud's lectures with a doodled thought bubble floating beside the ear of the father of psychoanalysis that says, hip-hop style: "Tell me 'bout yo mama …" The doodle turns out to be Ross's work.

hallucinations-drug-abuse_f_600x250.jpg


A 2006 study of 30 healthy volunteers at Johns Hopkins University in Baltimore came to the conclusion that psilocybin, when administered "under supportive conditions", could promote mystical and euphoric experiences. Roland Griffiths, the university's wiry, silver-haired professor of psychiatry and behavioural sciences, explains that most volunteers – none had prior experience of the drug – felt a mystical sense of "unity with all people and things" on their assisted psilocybin trip, along with a sense of the "sacred" and a "deeply felt" apprehension of "ultimate reality". Most rated their trip as one of the most significant events of their life, on par with the birth of a child or the death of a parent.

A decade later, Professor Griffiths again shook the medical and psychiatric communities when he published results from a similar trial involving 51 cancer patients suffering acute despair. The study showed that 80 per cent of volunteers who received psychological counselling together with a high dose of psilocybin – 25 milligrams – had significant reductions in death-related anguish. The remaining 20 per cent reported no significant lessening of their symptoms, but no worsening. Adverse side-effects were in some cases physical – hypertension, headache and nausea – and in some psychological: fleeting anxiety and paranoia. "But all these symptoms were temporary," Ross says. "No rescue medication was required."

This 2016 study, and another the same year reporting similar results from New York University (NYU), was the catalyst for Ross to act. She and Dwyer, specialists in the treatment of psychological trauma among cancer patients, hope that the drug's mystical ego-dissolving effects will help release the terminally ill from depression's grip in order that they might face death with equanimity.

"I could see from these studies that after one dose of psilocybin, death anxiety declined," says 42-year-old Ross. "Optimism rose. And the benefits were sustained for at least six months. Nothing in psychology comes close to that!" she adds, her voice vaulting an octave. It's a view echoed by Griffiths, who describes the results as "unprecedented within the field of psychiatry".

At the hub of the brain's hardware is a "Default Mode Network" (DMN), Ross explains. It appears to be most active when people are both sedentary and reflective – as the ill tend to be – and is deeply involved with story-telling. Stories can, as writers so often attest, take on lives of their own. And this is especially true of the brain, the primal author. "When you have depressive ruminations and anxiety, you can get into some very rigid patterns of thinking," Ross says. "And rigid, pessimistic self-talk is a hallmark of depression."

Psilocybin stills this network, lulls it to sleep, promoting what Ross calls "the possibility of new ways of thinking, new perspectives." When the DMN is quietened, the doors of perception are unlocked and flung open. "It is deeply personal and allows reflection that's a little more free and profound, and that's perhaps why they've had to date such phenomenal results in the overseas trials," she says.

Experiments with a synthetic version of psilocybin began in earnest in 1960 at Harvard University under psychologist Timothy – "Turn on, tune in, drop-out" – Leary. Three years later, Leary and his assistant were sacked by Harvard, following concerns that their methods were slipshod and undergraduate volunteers were at risk. But the psychedelic genie had been released from the lab. Within a few short years, cannabis, psilocybin, LSD, violent war protests, generational disaffection and Leary himself – who had by then become a high priest of the counter-culture – were one and the same problem.

Banned in the US in 1968, psilocybin was added to a list of drugs prohibited by the 1971 UN Convention on Psychotropic Substances. Researchers had by then concluded that its risks, which include paranoia and anxiety, outweighed any potential benefits. In Australia, it's classified as a Schedule 9 substance; an illicit drug. Over time, however, researchers with an interest in the treatment of mental illness have picked up Leary's abandoned thread, and there is a powerful move afoot to make peace with the outlaw drug.

In last year's bestseller How to Change Your Mind: The New Science of Psychedelics, Michael Pollan writes of his own modest psychedelic journeys – three recent trips on different drugs are detailed in the book – as a wide-angle lens "through which we can glimpse the subject-hood – the spirit! – of everything, animal, vegetable, even mineral … Spirits, it seems, are everywhere."

I reach Pollan in San Francisco, where the journalist and food writer is preparing for an Australian tour next month to promote the paperback edition of How to Change Your Mind. The book is part science journalism, part autobiography, part cultural history and part advocacy: it proclaims a "renaissance" of psychedelic research that might heal mental illness and unravel the mysteries of consciousness. "There hasn't been much good news about psychedelics for the past 40 years," Pollan tells me. "But the new cycle of scientific tests has changed that."

The book might not have been written if he hadn't spoken to the volunteers of the 2016 Johns Hopkins and NYU psilocybin trials, his curiosity piqued by word of a new wave of psychedelic research. "Many of them had terminal diagnoses, while some had a terrifying fear of recurrence of their cancer, which had been treated," he says. "But they all had paralysing levels of anxiety and depression, and in about two-thirds of them this was lifted by the drug experience. I ended up talking to people who had completely lost their fear of death. It was quite remarkable."

While the patients in these trials had experiences as various as their own individual dispositions, the cancer patients shared a similar inward trajectory. "They would travel into their body imaginatively and encounter their cancer, and, in the particular case of one woman, her fear. She had had ovarian cancer and was terrified of recurrence, and during her trip, she travelled into her body and saw a black mass under her ribcage; she knew it wasn't her cancer because it wasn't in the right place, but she recognised it as her fear. So she screamed at it."

"She screamed
'Get the f... out of my body!' And as soon as she did, the black cloud evaporated and so did her fear, and she has not been fearful since. She said that while she couldn't control her cancer – it was either going to come back or not – she could from that day control her fear. And it was exactly what she needed."

Pollan believes this kind of visual, or symbolic, encounter is something the cancer patients in the St Vincent's trial can expect. Ross describes her proposed 25-milligram dose as a "decent measure; we don't want it to be overwhelming but neither do we want it to be underwhelming." With this relatively high dose, Pollan predicts, "the mind is going to go where it wants to go, and you're going to have visions and memories and encounters with people and literally travel in your head to places."

The more conventionally religious among the patients may have imagined encounters with their personal deity, Pollan says, while others may have a powerful sense that a part of them will survive their death. In his own experience, "I had a feeling of a very strong connection with nature and other people," he says, "a powerful current of love." He suspects that the mystical experiences reported in the earlier US trials were, in part, coloured by cultural background. "The American therapists who started all this had a more spiritual orientation," he says. "The English are kind of allergic to spirituality. I'm looking forward to seeing what happens to the Australians."

Pollan is aware that sceptics accentuate negative drug-induced experiences such as panic attacks, hallucinations, nausea and irrational behaviour: a 12-year-old boy in Britain was found running in front of passing cars after taking magic mushrooms. But Pollan points to the difference between a precisely measured dose of psilocybin administered in a hospital, and magic mushrooms taken at a party or a rock concert. He recalls his own recent experiences: "Was I seeing things that weren't there? Yes. Were my senses confused? Yes. I felt I could touch musical notes." But he emerged from the experience with an intense sensation of oneness with the world. "I came out of it feeling that consciousness was much more evenly distributed over species than I had thought," he says.

Pollan is not, on the other hand, dismissive of the dangers. "Of course, there is a dark side. People do have terrifying experiences. They can run up against existential despair and a sense of nothingness. But when people are adequately prepared, the dark experiences can even be productive. Researchers tend to use the word 'challenging', rather than 'bad', trip; and I think they really mean it. But if you're alone and you're thrown into this hellish underworld, it can induce a panic attack and leave you really rocked. You shouldn't mess around with these drugs."

Atmosphere, mood and setting are all important. As is music. For Pollan, listening to a Bach cello suite performed by Yo-Yo Ma "had the unmistakable effect of reconciling me to death … I felt as if I'd passed beyond the reach of suffering and regret."

chronic-pain.jpg


On the day I visit Ross and Dwyer at St Vincent's, they admit to a delay in the trial as they await a shipment from the UK of synthetic psilocybin in tablet form. Ross jokes about the fun she'll have furnishing the most chilled space in Melbourne – the only one dedicated to the legal exploration of psychedelics – with stuff from Ikea and Ishka. Two qualified therapists – Ross and Dwyer in the first instance – will assist and monitor them for the entire six-hour trip.

"We'll be as unobtrusive as possible," says Dwyer. "It's not like we'll be saying every few minutes, 'Soooo, how are you feeling?' The patients lead and we follow. A critical part of the treatment, he says, "is that the experience is supported with psychological therapy before and after. This may be the most important part."

Ross nods enthusiastically. "Think of the psychotherapy as the secret sauce," she says. "People often think that it's just the psilocybin that creates lasting change, but it's actually the psychotherapy scaffolding the dose sessions. There are three standard preparatory sessions, the dose day and three integrative sessions post that dose session." The follow-up psychotherapy is designed to integrate the experiences in meaningful ways that "help leverage more enduring changes in mood, thinking and behaviour. The psilocybin facilitates it; the psychotherapy weaves it into their psyche in a lasting way."

Ross worked in clinical trials prior to her doctorate, and afterwards was a research fellow in the Department of Psychiatry at the University of Melbourne. A specialist in complex trauma, psycho-oncology and palliative care, she takes both the nuances and the ethics of data collection and analysis with the utmost seriousness. But the trial is not without its reputational risks, and colleagues have warned her that researching a psychedelic compound might spell career death. "I consoled myself with the thought," she says with an impish smile, "that a career in floristry wouldn't be so bad."

In Australia the psychedelic "renaissance", to use Michael Pollan's term, has really only begun with this year's psilocybin trial at St Vincent's. But last year, the US Food and Drug Administration (FDA) cleared the way for a global study of MDMA (the main ingredient in ecstasy) for the treatment of trauma. Meanwhile, psilocybin-assisted therapy has been given "breakthrough" status by the FDA, accelerating, legitimising and extending research efforts. Trials involving 400 patients have begun in Europe and North America into the use of psilocybin for drug-resistant depression.

The Australian Medical Association, meanwhile, is keeping a close eye on the psychedelic trials abroad – and now at home. "There's emerging evidence that looks promising," says the body's spokesman on psychiatry, University of Queensland professor of psychiatry Steve Kisely. "We need more work on it."

Also sounding a cautionary note is Dr Gillinder Bedi, head of substance use research at Orygen, the National Centre of Excellence in Youth Mental Health in Victoria. Orygen is a not-for-profit company specialising in youth mental health and Bedi, a clinical psychologist, warns that some advocates for psychedelic therapy lack experience with mental health research.

"Mental ill health is very complicated and we need to investigate a full range of responses to this kind of suffering," she says. "I really worry about the sense coming from some quarters that the psychedelic approach is going to be a panacea to modern society's ills, and will shift the paradigm in mental illness. It strikes me as quite similar to the previous approach, that these drugs are totally bad – a few years back, we were being told that ecstasy puts holes in your brain – just from the other side. It'd be really nice to have a more middle-ground approach."

She is not an opponent, she adds, of the St Vincent's trials. On the contrary, she is calling for "bigger studies on a broader scale", and at the same time a strong focus on the "potential risks" for the young.

Ross and Dwyer are acutely aware that their trial needs to be clinically rigorous and above reproach. Patients will be carefully selected, screened and profiled before they go anywhere near the drug, and afterwards they will be thoroughly monitored. Those with a history of psychosis, bipolar disorder, a familial history of schizophrenia, or complex trauma will be turned away. "And we don't know enough about the impact of psilocybin on adolescents, so for safety reasons we can't include patients under 18," says Ross. "Even under medical supervision, these drugs aren't for everyone." Some patients in the first stage of the trial will be given a placebo.

Already, 100 terminally ill people have made contact with Ross, seeking help. She shares with me an edited email from a woman who writes of her cancer metastasising and her poor prognosis, her daily struggle with "death anxiety", and her use of medication to "manage panic episodes". The unnamed patient has read about the possible benefits of psilocybin, but is "too cautious" to try it outside a hospital.

Clinical trials have found that the psilocybin experience is enhanced by eyeshades – focusing the attention inward – and music. The hospital has compiled a playlist to match the drug's lift-off stage, its peak and its taper.

"White Rabbit is a must-have," I suggest, referring to the classic Woodstock song by Jefferson Airplane. Dwyer shakes his head. "More ambient stuff," he says. "Everything from German electronic music to classical. Some world music, too. We've been looking for things that are unlikely to trigger memories or associations."

So "eye-wateringly good" were the results from Johns Hopkins and NYU, along with a smaller study at Imperial College, London – these revealed clear changes in brain activity among depressed people after a single dose of psilocybin – that Ross assumed that the trials would soon be replicated in Australia. She waited. But nothing happened. Meanwhile, non-profit body PRISM (Psychedelic Research in Science and Medicine), established in 2011 in the hope of contributing to the burgeoning international research in the field, made a couple of attempts to sponsor trials, one at Deakin University. They failed. Progress stalled.

In December 2017, the organisation's president, research scientist Martin Williams, spoke about the state of play in psychedelic research at a conference in Melbourne, and in the audience that day was Ross. Afterwards, she emailed Williams, a post-doctoral research fellow in medicinal chemistry at Monash Institute of Pharmaceutical Sciences, to talk about the possibility of a local trial.

Williams has a clear recollection of Ross's email. "She said, 'Look, I'm a clinician. I've seen the research, I want to research this here in Australia for my terminally ill patients. Can you help me?'" The two met the next day over coffee, and then worked on the trial protocol for eight months. When it received ethics approval from St Vincent's, Williams recalls, "nobody was more surprised than we were. But we worked hard and made it bloody difficult for them to say 'No'."

PRISM provided funding to kickstart the trial – most of the money is coming from the hospital itself – and things started to move. State and federal government approval followed. But Ross wonders if she'd have managed to push her proposal forward without the release, last year, of Pollan's book. "I'm not sure this would have happened without Pollan," she says. "His book started to be widely read just as the decisions were being made. I owe that guy."

It may be premature to talk, as Pollan does, about a "renaissance" in psychedelic science that might heal mental illness and redefine our understanding of consciousness itself. The test results to date have been promising, but the volunteer groups remain small. Any long-term negative impacts need to be fully gauged. Unless psychedelics prove effective in the treatment of depression in all its varieties – something that even Pollan doubts – a psilocybin pill to banish the everyday blues seems a long way away.

Ross is keen to stress that she is investigating the effects of the drug, not presupposing an effect. "I need to underline the fact," she cautions, "that we're doing trials. We need to be level-headed."

*From the article here :
 
Last edited:
Ira_Byock.jpg

Ira Byock

Taking psychedelics seriously*

by Ira Byock

Palliative care clinicians occasionally encounter patients with emotional, existential, or spiritual suffering, which persists despite optimal existing treatments. Such suffering may rob them of a sense that life is worth living. Data from Oregon show that most terminally ill people who obtain prescriptions to intentionally end their lives are motivated by non-physical suffering. This paper overviews the history of this class of drugs and their therapeutic potential. Clinical cautions, adverse reactions, and important steps related to safe administration of psychedelics are presented, emphasizing careful patient screening, preparation, setting and supervision.

Even with an expanding evidence confirming safety and benefits, political, regulatory, and industry issues impose challenges to the legitimate use of psychedelics. The federal expanded access program and right-to-try laws in multiple states provide precendents for giving terminally ill patients access to medications that have not yet earned FDA approval. Given the prevalence of persistent suffering and growing acceptance of physician-hastened death as a medical response, it is time to revisit the legitimate therapeutic use of psychedelics.

Recently published studies in peer-reviewed journals and high-profile articles in the New Yorker, New York Times, and Wall Street Journal, have rekindled professional and public interest in the therapeutic use of psychedelic drugs. The magazine and newspaper articles include accounts of patients with profound depression, demoralization associated with terminal illness, and anxiety related to PTSD, who experienced remarkable improvements, including some who had previously considered suicide.

Nevertheless, psychiatric and palliative care clinicians who care for profoundly depressed, and seriously ill patients have every reason to be skeptical. As people become more mentally or physically ill and established treatments remain insufficiently effective, patients' susceptibility increases. Physicians play an important role in protecting vulnerable patients from spurious, nonevidence-based miracle cures, as well as from scientifically grounded, but overly zealous burdensome treatments that are certain to do more harm than good.

An abundance of caution should be accorded psychedelics. However, given the extent of emotional and existential suffering that palliative care clinicians encounter in the patients we serve, these medications deserve serious consideration by our field. Specialty palliative care teams serve the sickest patients in our health systems and communities. It is, therefore, not surprising that we occasionally encounter incurably ill people whose suffering persists despite all available evidence-based treatments.

In treating pain and other physical distress, established treatment protocols guide escalations of doses and combinations of analgesics and co-analgesic medications. When a patient is dying and physical pain, dyspnea, seizures, or agitated delirium persists and causes intolerable suffering, as a last resort, comfort can reliably be achieved with proportionate sedation.

However, not all suffering is based solely in physical distress. Palliative care clinicians and teams also encounter patients whose misery is rooted in emotional, social, existential, or spiritual distress. Cancer, heart failure, liver failure, and ALS or motor neuron disease are among the diseases that can result in a progression of personal losses: Of feeling in control. Of taking care of one's self. Of contributing to others. Of enjoyment. Of meaning and purpose. Ultimately, some ill people say they have lost any reason to go on living.

People who are incurably ill and living with progressive disease-related disabilities can experience anxiety, depression, and demoralization. Psychotherapy alone and drug treatments for such syndromes are often insufficient. Medications for depression may take weeks to become effective or prove ineffective. Antidepressants and anxiolytics carry side effects that can include mental slowing and confusion. These adverse effects are particularly common and hazardous in patients with advanced physical illness, who are also at risk of polypharmacy, multidrug interactions, and concomitant disequilibrium and falls. When nonphysical suffering persists despite prudent approaches, published, evidence-based guidelines are limited.

Severe psychological and existential suffering can rob people of feeling that life is worth living. A sense of unending helplessness and hopelessness compels some to consider ending their lives. Suicide rates have risen 24% over the past two decades and are highest among middle-aged and elderly adults, particularly men who may suffer most from feelings of dependency. Public health data from Oregon show that since implementation of the Death with Dignity Act, the large majority of patients who received prescriptions for lethal drugs were motivated by nonphysical suffering. Current or fear of future pain contributed in just 26% of cases, while loss of autonomy, decreased ability to enjoy life, and loss of dignity most often brought these people to contemplate hastening their deaths.

While psychedelic experiences vary significantly from one individual to another, those interviewed commonly express attributes including heightened clarity and confidence about their personal values and priorities, and a renewed or enhanced recognition of intrinsic meaning and value of life. People often voice a sense of exhilaration, insight, and strengthened connection to others, as well as a richer sense of relationship with nature or God. People who take psychedelics with an intention of spiritual introspection often report that the drugs opened windows into deeper realms of existential experience. In safe and supportive environments, these effects typically induce a state of wonder, conceptual frame shift, expanded capacity for love, and an intensified sense of connection. Patients living with medical conditions that had robbed them of hope or reason to live may experience a transformative shift in perspective and experience of inherent meaning, value, and worth.

For most of these drugs, a single six to eight-hour session or short series of sessions suffices. Alleviation of anxiety and depression may persist for weeks to months and, for some, proves permanent. Exceptions to this treatment pattern include protocols of daily low-dose ketamine for depression and recent nonmedical reports of daily or every third day micro-dosing of LSD.

Faced with novel therapies with reported clinical benefits that seem too good to be true, skepticism is warranted to protect vulnerable patients from harm. Cynicism, however, may prove more dangerous still. Unscientific bias and nihilistic assumptions can keep effective treatments from people who desperately need them.

Despite the controversial history of psychedelics, palliative specialists who care for patients with serious medical conditions and common, difficult-to-treat nonphysical suffering have a duty to explore these hopeful, potentially life-preserving treatments. Against the backdrop of physician-hastened death becoming legal in five states, expanded research of clinical psychedelics must proceed.

In reexamining the use of psychedelics in pharmaco-assisted therapy, we must not allow preconceptions, politics, or puritanism to prevent suffering people, who are now considered helpless and hopeless, from receiving promising, at times life-saving, treatments.

*From the article here :
https://www.liebertpub.com/doi/full/.../jpm.2017.0684
 
Last edited:
MDMA-Therapy-to-Treat-End-of-Life-Anxiety-e1461884562807.jpg


New research explores the use of MDMA therapy to treat end-of-Life anxiety

Psychedelic Times

For the past three years, system scleroderma has consumed John Saul’s life. The incurable autoimmune disorder has not yet spread to his lungs or kidneys, but if it does, death is nearly certain. But John isn’t scared – not anymore. As one of the first participants in Dr. Philip Wolfson’s new study investigating the impact of MDMA-assisted psychotherapy on end-of-life anxiety, he has spent the past six months moving slowly from a place of fear to one of acceptance, hope, and love. In an interview with the San Francisco Chronicle, he described one of the most profound moments experienced during the course of the therapy:

I had a vision of my adult, courageous self without a molecule of fear, finding this cowering, shivering little child, another version of myself, and taking him under his wing and saying, ‘Everything is going to be OK.’

Andy Gold, an attorney battling colon cancer, has born witness to both Saul’s transformation and his own. Andy sought out MDMA-assisted therapy after developing overwhelming anxiety following his cancer diagnosis. “I felt lost, like I had no purpose,” he says. But MDMA changed that, opening up new pathways to psychological healing, growth, and deep comfort. “MDMA gives you the ability to look inside and go through the closets of your life. It gives you access to your emotional content.”

The transformative potential of MDMA

Dr. Wolfson was first introduced to MDMA in the early 1980s while seeking out alternative healing methods for a particularly hard-to-treat client. At the time, MDMA was legal and fellow psychiatrist offered Dr. Wolfson and his wife a guided MDMA session to explore the drug as a therapeutic experience. “It was warm, it was easy to stay in touch, and it was in many respects – as it came to be know – ‘the love drug,’” Dr. Wolfson said in a 2014 interview. Immediately recognizing the revolutionary potential of MDMA-assisted psychotherapy, he began using MDMA both in his professional practice and in his personal life to facilitate deep process work that opened the door to expanded levels of consciousness and well-being.

While he saw profound transformation and self-discovery in his patients, he also came to be intimately familiar with the way MDMA-assisted psychotherapy can help people cope with death.

“It was a very valuable empathetic support in our lives and our ability to cope with a terrible illness,” says Dr. Wolfson of his MDMA-led journey toward healing. “It was a fantastic way of eliciting new kinds of consciousness and reaction.” The experience introduced the idea of using MDMA to alleviate end-of-life anxiety in those facing life-threatening illnesses and last year, the DEA finally approved his application for a clinical study that will test the safety and efficacy of using MDMA to treat anxiety in people with life-threatening illnesses.

End-of-Life anxiety and the limits of available treatments

Fear of death is a nearly universal experience, but for most of us, death remains a distant and nebulous threat, however inevitable. When you are diagnosed with a life-threatening illness, however, death becomes an all too real and immediate presence.

For many, experiencing a life-threatening illness elicits a host of painful emotions and brings to the surface overwhelming and deep-rooted fears. One study of terminally ill cancer patients found that 17% met the diagnostic criteria for major depression and many more report feeling an unbearable sense of anxiety and helplessness. As a result, you may lose interest in things you used to enjoy, experience sleep disruptions and loss of appetite, self-isolate, suffer from obsessive and intrusive thoughts, and even contemplate suicide. These symptoms can greatly interfere with your ability to function and damage your quality of life, robbing you of joy, hope, and acceptance.

Unfortunately, currently available treatments often offer little in the way of relief. “It’s really tough doing psychotherapy with people who have anxiety disorders because when you get to the heart of the matter it causes a panic attack,” says Dr. John Halpern, a psychiatrist at Harvard University’s McLean Hospital who’s currently researching the effects of MDMA on terminal cancer patients. “For somebody who has a particularly gruesome time trying to talk about important end-of-life issues, it bubbles into anxiety and nothing gets achieved.”

Approved anti-anxiety medications, such as benzodiazepines, may alleviate symptoms, but the doses needed to alleviate acute distress often also leave patients too sedated to engage in a meaningful and productive therapeutic process. As a result, “these people have a choice of being over-sedated and not having anxiety or being alert and suffering panic attacks.” MDMA-assisted psychotherapy, however, offers a third way.

The effects of MDMA-assisted psychotherapy

MDMA-assisted psychotherapy is a two-step process in which the psychedelic state is used to facilitate psychotherapeutic engagement, opening up the potential for deep healing typically inaccessible to us in our everyday lives.

Although the exact mechanisms by which MDMA acts on the brain are not fully understood, Dr. Wolfson says "the key to its efficacy is the way it affects two neurotransmitter sites that creates empathy for oneself and others and a greater tolerance for negative and traumatic experiences.”

In addition to modulating neurotransmitter activity, MDMA acts directly on the amygdala, the area of the brain involved in emotional regulation. As a result, MDMA creates a psychological openness that gives us greater access to difficult emotions and reactions. This phenomenon is experienced even by recreational users, who are frequently overcome with a sense of love, happiness, tranquility, emotional expansiveness, and connection. As Dr. Wolfson notes in a 1986 study, "MDMA is capable of producing a warmth and closeness that [generates] a sense of hopefulness, some calm in the storm, even for those who have extensive histories of trauma, anxiety, and distrust."

To alleviate end-of-life anxiety, MDMA-assisted psychotherapy harnesses the possibilities of this emotional access by guiding you through an exploration of your fears and facilitating deeper self-awareness, greater distress tolerance, and the ability to accept difficult emotions, experiences, and thoughts. “It does not take you away from the pain, but rather through the pain,” explains Rick Doblin, founder of MAPS.

As opposed to the standard 50-minute psychotherapy sessions, MDMA-assisted therapy can last for five hours or more, giving patients the chance to spend sustained, meaningful time within a nurturing therapeutic environment in which thoughts, feelings, and experiences can be explored safely. Although therapy sessions can only be held a handful of times over the course of several months, “the breakthroughs inspired by the drug persist, suggesting that it has the potential to permanently alter a patient’s perspective on the crises they seek to overcome.”

The future of MDMA research

The ultimate goal of Dr. Wolfson’s research is not simply to find out if MDMA-assisted psychotherapy is effective in the treatment of end-life-life anxiety — he and thousands of others has already witnessed its efficacy. Rather, he hopes that the study will be a step toward FDA approval of the drug for therapeutic use, moving it out of the illicit Schedule 1 category. While the move may have little effect on experienced users who currently seek out the drug on the underground market, FDA approval would allow those facing life-threatening illnesses to safely benefit from the tremendous healing potential of psychedelic therapy.

 
Last edited:
Top