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The Potential of Psychedelic Therapy for End-of-Life Care : Benefits and Risks

  1. Introduction — The Potential of Psychedelic Treatments for End-Of-Life Care

    1. Definition of End-of-Life Care

      As someone is nearing the end of their life, they need physical, emotional, and spiritual support. End-of-life care seeks to alleviate physical and emotional suffering for patients and their loved ones as they approach and experience death.

    2. Overview of Current Treatments for End-Of-Life Care

      Both pharmaceutical and non-pharmaceutical approaches are used in modern end-of-life care. Pharmacological treatments include opioids, benzodiazepines, and other medications that target pain, anxiety, and other symptoms. Non-pharmacological interventions include spiritual care, counseling, and complementary therapies such as massage and acupuncture.

    3. Definition of Psychedelic-Assisted Therapy

      Psychedelic-assisted therapy is a therapeutic technique that uses psychedelic chemicals such as psilocybin, MDMA, and LSD to support emotional and psychological recovery. Psychedelic-assisted therapy is typically administered in a controlled environment under the guidance of a trained therapist.

    4. Purpose and Significance of the Article

      This article aims to assess the current studies on the utilization of psychedelic-assisted therapy in end-of-life care and to examine the possible advantages and disadvantages of this treatment. The importance of this article lies in the potential of psychedelic-assisted therapy to enhance the well-being of individuals receiving end-of-life care, as well as to provide a novel therapeutic approach for this group.

  2. Literature Review

    1. Current Research On The Use Of Psychedelic-Assisted Therapy For End-Of-Life Care

      The literature on psychedelic-assisted therapy in palliative care is expanding. In those with terminal illnesses, psychedelic-assisted therapy has been found to improve quality of life, decrease anxiety and depression, and boost spiritual well-being (Gasser et al., 2014); (Griffiths et al., 2016); (Ross et al., 2016).

      Overview of Studies and Findings

      Psilocybin, a hallucinogenic compound found in several species of mushrooms, was shown in one research to significantly reduce anxiety and depression in patients with terminal cancer after just one dose (Griffiths et al., 2016). Another study indicated that the psychedelic MDMA, well known by its street name ecstasy, helped patients with terminal illnesses feel less anxious and better about their situation (Gasser et al., 2014). In a third trial, patients with terminal cancer reported significant increases in their spiritual well-being after receiving psilocybin-assisted therapy (Ross et al., 2016).

      Analysis of Research Methods and Limitations

      Small sample numbers and a lack of randomized controlled trials have hampered the research on psychedelic-assisted therapy for end-of-life care, despite the promising outcomes. Furthermore, psychedelic-assisted therapy’s long-term effects in this demographic are unknown.

    2. Discussion of the Potential Benefits of Psychedelic-Assisted Therapy For End-Of-Life Care

      Psychedelic-assisted therapy may have several applications in palliative care. Benefits include lower stress and sadness, higher spirits, better quality of life, and more comfort towards the end of life (Grob et al., 2011), (Griffiths et al., 2016).

      Psychedelic-assisted therapy can also help individuals in end-of-life care to come to terms with their own mortality, as well as to gain a deeper understanding of their relationships and life experiences (Ross et al., 2016). In addition, those who are dying and feeling alone can find comfort in the community created through psychedelic-assisted treatment.

  3. Mechanisms of Action

    1. Overview of How Psychedelic Substances Work In The Brain

      To produce their effects, psychedelic drugs modulate the functioning of specific neurotransmitters and brain areas, most notably those associated with emotional processing and self-awareness. Psilocybin, for instance, has been shown to decrease activity in the amygdala, a region implicated in fear and anxiety, while increasing activity in the default mode network, a network of brain regions engaged in self-referential reasoning (Carhart-Harris et al., 2012). A new outlook and a feeling of oneness with the world can emerge as a result of this transformed behavior

    2. Analysis of How This Mechanism Could Help Individuals In End-Of-Life Care

      Those receiving end-of-life care may benefit from the altered state of consciousness generated by psychedelic medications because it can give them a new perspective on life and death. Individuals receiving end-of-life care may feel less alone and more supported as a result of enhanced connection and empathy.

    3. Discussion of Potential Risks and Benefits of Psychedelic-Assisted Therapy In End-Of-Life Care

      The benefits of psychedelic-assisted therapy in palliative care are promising, but the therapy is not without its share of hazards. There is always the chance that a patient will have an  unpleasant reaction to the medications, that an existing mental health condition will worsen, and that the patient will go through an emotional or psychological crisis during therapy.

      The presence of skilled therapists to help clients through the experience, along with thorough pre- and post-testing, can help reduce some of these hazards. Furthermore, psychedelic-assisted therapy may be worth investigating further for use in end-of-life care because to its potential benefits, notably in enhancing quality of life and alleviating anxiety and sadness.

  4. Clinical Applications

    1. Overview of Current Clinical Trials and Studies on Psychedelic-Assisted Therapy For End-Of-Life Care

      Many clinical trials examining the utility of psychedelic-assisted therapy in palliative care are actively recruiting participants. Psilocybin-assisted therapy for cancer-related distress: a Phase 3 clinical trial by the Usona Institute is the most prominent of these studies (Yvan Beaussant, 2022). MDMA-assisted therapy for anxiety in terminally ill patients is the subject of another ongoing trial (Philip E. Wolfson, 2020), and the exploration of ketamine-assisted therapy for end-of-life depression.

    2. Discussion of Outcomes and Effectiveness Of These Studies

      Initial findings from these trials have showed encouraging results in terms of easing patients’ fears and sadness, enhancing their quality of life, and giving them a sense of purpose in the face of impending death. Psilocybin-assisted therapy for psychiatric diseases has been shown to have a sizeable effect in meta-analyses, suggesting it could be a useful therapeutic alternative for palliative care (Irizarry et al., 2022).

    3. Implications for Future Clinical Applications

      It’s conceivable that psychedelic-assisted therapy will become an increasingly essential tool in the treatment of end-of-life distress as the outcomes of these trials continue to emerge. However, further research is needed to establish best practices for dosage, administration, and patient selection.

  5. Ethical Considerations

    1. Discussion of Ethical Considerations In The Use Of Psychedelic-Assisted Therapy In End-Of-Life Care

      The use of psychedelic substances in medical treatment raises several ethical considerations, including issues of safety, informed consent, and potential for misuse. Patients considering psychedelic-assisted therapy should be provided with comprehensive pre-treatment information and counseling in a safe, nurturing setting.

    2. Analysis of the Potential Impact Of Psychedelic-Assisted Therapy On The Dying Process

      A sense of calm and acceptance may be given to terminally ill patients through psychedelic-assisted treatment. However, it is important to acknowledge that these substances can also bring up difficult emotions and experiences, and that patients should be prepared for this possibility.

    3. Implications for Patients, Families, and Healthcare Professionals

      Although psychedelic-assisted therapy may call for a departure from conventional hospice care paradigms, it is crucial that medical staff be well-versed in its utilization. Families of patients undergoing psychedelic-assisted therapy may also require support and education.

  6. Cultural and Social Implications

    1. Overview of Cultural And Social Factors That May Impact The Use Of Psychedelic-Assisted Therapy In End-Of-Life Care

      The use of psychedelic chemicals is still frowned upon in many societies due to its troubled past. This stigma may impact patient and family willingness to consider psychedelic-assisted therapy, and may also impact the availability of the treatment in certain regions.

    2. Discussion of The Impact of Cultural and Social Factors On Access To Psychedelic-Assisted Therapy

      Cultural and social considerations, in addition to legal and regulatory hurdles, may restrict people’s ability to participate in psychedelic-assisted treatment. It is important to consider ways to address these barriers in order to ensure that patients have access to all available treatment options.

    3. Analysis of Strategies For Addressing Cultural and Social Factors

      Strategies for addressing cultural and social factors may include education and outreach campaigns to increase awareness and reduce stigma, as well as advocacy efforts to change regulations and policies related to psychedelic substances. Additionally, incorporating traditional healing practices into psychedelic-assisted therapy may help to bridge cultural divides and increase patient comfort with the treatment.

  7. Challenges and Limitations

    1. Discussion of Ethical Considerations and Safety Concerns

      Ethical considerations about patient autonomy, informed consent, and access to therapy arise when psychedelics are used in terminal care. Patients must be capable of making educated treatment decisions and have access to all relevant information about the risks and benefits of psychedelic-assisted therapy. Additionally, there are safety concerns regarding the use of psychedelics in patients with underlying medical conditions, as well as potential risks for adverse effects such as anxiety, paranoia, or delusions (Schlag et al., 2022).

    2. Analysis of Regulatory Challenges and Barriers To Implementation

      Regulatory challenges and barriers to implementation of psychedelic-assisted therapy for end-of-life care include legal restrictions, lack of funding, and limited access to trained therapists. The classification of psychedelics as Schedule I drugs by the U.S. federal government has hindered research and limited access to treatment for patients. Additionally, the cost of treatment and the need for specialized training for therapists pose significant challenges to the widespread implementation of psychedelic-assisted therapy.

    3. Potential Solutions To These Challenges

      Potential solutions to these challenges include regulatory reform, increased funding for research, and expanded access to training for therapists. More research into the safety and efficacy of psychedelic-assisted treatment for end-of-life care may be possible if psychedelics were rescheduled and more funding was made available for research. Patient access to care could also be improved by the creation of specialized training programs for therapists.

  8. Future Directions

    1. Analysis of Potential Future Research On The Use Of Psychedelic-Assisted Therapy In End-Of-Life Care

      Optimal dose and treatment methods, as well as the long-term consequences of treatment, could be explored in future study on the use of psychedelic-assisted therapy in end-of-life care. Depression and anxiety are also common near the end of life, so it would be worthwhile to study the potential benefits of psychedelic-assisted therapy for these conditions.

    2. Discussion of Challenges and Limitations In The Field

      More research is needed to establish safety and efficacy of psychedelic-assisted therapy for end-of-life care, and therapists will need specific training. Additionally, the cost of treatment and limited access to care pose significant challenges to the widespread implementation of psychedelic-assisted therapy.

    3. Potential Implications For The Future Of End-Of-Life Care

      Improvements in patients’ quality of life, reduced symptom burden, and enhanced spiritual and psychological well-being are just some of the potential implications of psychedelic-assisted treatment for the future of end-of-life care. The potential for psychedelic-assisted therapy to revolutionize end-of-life care may also inspire more people to speak up for better support during the final stages of life.

  9. Conclusion

  1. Summary of Key Findings

    Anxiety, sadness, and existential anguish are all common in the terminally ill, and psychedelic-assisted therapy has shown promise as a possible treatment for these conditions. However, ethical considerations, safety concerns, and regulatory challenges pose significant barriers to the widespread implementation of this treatment modality.

  2. Discussion of the Potential Impact Of Psychedelic-Assisted Therapy On End-Of-Life Care

    Improved symptom management, greater spiritual and psychological well-being, and increased patient autonomy and agency in end-of-life decision-making are just some of the potential impacts of psychedelic-assisted therapy on end-of-life care.

  3. Final Thoughts On The Future Of Psychedelic-Assisted Therapy For End-Of-Life Care

    While the future of psychedelic-assisted therapy in palliative care is unclear, more people may have access to it if efforts are made to study it, advocate for it, and educate the public. Psychedelic-assisted therapy has the potential to significantly improve the quality of life for terminally ill patients if the associated ethical and safety problems are properly addressed.

References:

  • Carhart-Harris, R. L., Erritzoe, D., Williams, T., Stone, J. M., Reed, L. J., Colasanti, A., Tyacke, R. J., Leech, R., Malizia, A. L., Murphy, K., Hobden, P., Evans, J., Feilding, A., Wise, R. G., & Nutt, D. J. (2012). Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. Proc Natl Acad Sci U S A, 109(6), 2138-2143. https://doi.org/10.1073/pnas.1119598109
  • Gasser, P., Holstein, D., Michel, Y., Doblin, R., Yazar-Klosinski, B., Passie, T., & Brenneisen, R. (2014). Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. J Nerv Ment Dis, 202(7), 513-520. https://doi.org/10.1097/nmd.0000000000000113
  • Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol, 30(12), 1181-1197. https://doi.org/10.1177/0269881116675513
  • Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M., McKay, C. R., Halberstadt, A. L., & Greer, G. R. (2011). Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Arch Gen Psychiatry, 68(1), 71-78. https://doi.org/10.1001/archgenpsychiatry.2010.116
  • Irizarry, R., Winczura, A., Dimassi, O., Dhillon, N., Minhas, A., & Larice, J. (2022). Psilocybin as a Treatment for Psychiatric Illness: A Meta-Analysis. Cureus, 14(11), e31796. https://doi.org/10.7759/cureus.31796
  • Philip E. Wolfson, J. A., Rick Doblin. (2020). MDMA-Assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study. Scientific Reports.
  • Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., Mennenga, S. E., Belser, A., Kalliontzi, K., Babb, J., Su, Z., Corby, P., & Schmidt, B. L. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol, 30(12), 1165-1180. https://doi.org/10.1177/0269881116675512
  • Schlag, A. K., Aday, J., Salam, I., Neill, J. C., & Nutt, D. J. (2022). Adverse effects of psychedelics: From anecdotes and misinformation to systematic science. J Psychopharmacol, 36(3), 258-272. https://doi.org/10.1177/02698811211069100
  • Yvan Beaussant, D.-F. (2022). Pilot Study of Psilocybin-Assisted Therapy for Demoralization in Patients Receiving Hospice Care (PATH). U.S.National Library of Medicine.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:April 10, 2023

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