The Potential of Psilocybin Therapy in Palliative Care

Explore the potential of using psilocybin, derived from “magic mushrooms,” to enhance the quality of life for patients with life-threatening illnesses. 

Palliative care is a specialized medical approach that aims to improve the quality of life for patients with life-threatening illnesses. It focuses on addressing physical, psychosocial, and spiritual distress experienced by patients and their families. Recent developments in the therapeutic use of psilocybin, a psychedelic substance derived from “magic mushrooms,” show promise in this field.

Palliative care focuses on alleviating suffering for patients and their families facing life-threatening illnesses, addressing physical, psychosocial, and spiritual dimensions. Spiritual care, which supports the whole person, is increasingly recognized as important. Mounting scientific evidence suggests that psychedelic-assisted psychotherapy, and psilocybin therapy in particular, may contribute to addressing spiritual distress and transforming palliative and geriatric care.

A recent paper has outlined the potential of psilocybin's application in palliative medicine, highlighting potential benefits and some of the barriers that limit access to this treatment. 

What is Psilocybin?

Psilocybin is a natural psychoactive compound that is derived from “magic mushrooms” and has been traditionally used in indigenous cultures for healing purposes and spiritual ceremonies. When consumed, psilocybin metabolizes into its active form known as psilocin within the body. Psilocin then interacts with 5-HT2A receptors, which are small proteins in the brain.

This interaction with 5-HT2A receptors leads to the reorganization of certain brain networks and triggers profound shifts in consciousness, including changes in thought patterns, emotions, and an individual's perception of their surroundings and even themselves. 

The authors of a recent paper titled 'Psilocybin in Palliative Care: An Update' highlight that psilocybin, unlike traditional antidepressants, can intensify thoughts and emotions, providing a unique opportunity for fresh insights and perspectives. These profound experiences are believed to offer therapeutic benefits to individuals in palliative care.

The Therapeutic Potential of Psilocybin in Palliative Care 

Research and field reports suggest that psilocybin can significantly and durably alleviate certain mental health conditions such as depression and end-of-life anxiety with a favorable safety profile — Psilocybin has been found to induce moderate cardiovascular effects and does not carry the risk of dependence, as reported in previous studies.

Studies have consistently demonstrated that psilocybin therapy leads to notable improvements in well-being, life satisfaction, and a reduction in anxiety and depression that can last for months following treatment. Furthermore, psilocybin therapy holds promise in relieving existential distress and facilitating positive life changes, with potential long-term effects.

In addition to its psychological benefits, psilocybin may also enhance cognitive function by promoting cognitive flexibility, creative thinking, and an overall improved quality of life. These effects on cognition have the potential to greatly benefit geriatric patients by expanding their inner world and promoting overall well-being.

Limited research on psilocybin in palliative care suggests it is well-tolerated and effective, even among older adults. However, legal, ethical, and financial barriers hinder widespread access to psilocybin therapy, particularly for geriatric and palliative care patients.

Expanding Treatment Options: The Right to Try Act 

Legislative efforts, such as the Right to Try Act, aim to provide access to therapeutic interventions like psilocybin for severely ill patients. These laws are designed to provide a legal framework and pathway for patients to seek and utilize experimental treatments or therapies that have not yet received full approval from regulatory bodies like the Food and Drug Administration (FDA).

The purpose of this act is to give patients the right to try potential life-saving or life-enhancing interventions that are still in the experimental stage, providing them with a chance to pursue alternative avenues of treatment when traditional options have been exhausted. The authors make a case for the inclusion of psilocybin and similar interventions within the scope of palliative care under Right to Try laws, emphasizing the importance of ethical considerations and evidence-based practices.

From Prohibition to Peace: The Drug Peace Plan

In considering the broader public health approach, the authors recognize that psychedelic drugs are being used in various contexts. However, there are important factors that apply to these substances, ensuring maximum benefits and respect for human well-being. These considerations can be applied to any drugs that hold societal, cultural, and spiritual significance.

Taking into account the negative consequences of the prohibitionist approach to drugs, which, the authors argue, has contributed to our current public health challenges related to substance use, they propose the implementation of a “Drug Peace Plan” in both policy and clinical practice. The essence of this plan is to foster a more peaceful and constructive relationship between humans and certain mind-altering substances such as psilocybin.

The Drug Peace Plan aims to acknowledge the connection between humans and certain psychoactive substances, recognizing their potential for harm as well as their potential benefits. It emphasizes the importance of safety in contexts where these substances are used for spiritual and therapeutic purposes.

Overall, the authors advocate for a shift in drug policies and clinical practices that align with the principles of the Drug Peace Plan, fostering a more balanced approach towards drugs like psychedelics that prioritizes both human dignity and public health.

Exploring Psilocybin for Palliative Care: A Promising Frontier:

With the growing demand for alternative approaches in palliative care, psilocybin therapy emerges as a promising avenue for addressing emotional, spiritual, and physical pain in patients facing terminal illnesses. Although promising results have emerged from clinical trials, the number of patients receiving psilocybin therapy in research settings remains small.

Further research and large-scale controlled trials are necessary to fully explore the benefits and safety considerations associated with psilocybin therapy. Careful screening, preparation, and therapeutic oversight are essential to ensure safety and informed consent.

Furthermore, the authors emphasize that legislative support, such as the implementation of Right to Try laws, could play a crucial role in ensuring access to these therapeutic interventions for individuals requiring them. Embracing these advancements has the potential to provide comprehensive support and promote improved well-being within palliative care settings.

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Dr. Ana Holmes, Physican, Philadelphia, US

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Dr. Ana Holmes, Physican, Philadelphia, US

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