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Psilocybin found to ease end-of-life anxiety in small study of patients with fatal cancer

The views expressed are those of the author and are not necessarily those of Scientific American.


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Can the active ingredient in "magic mushrooms" help those with terminal cancer cope with their fate? That was the question asked by researchers, who published the results of their investigation September 6 in Archives of General Psychiatry.

After all, impending death wreaks havoc on the psyche of not only the terminally ill patient but also their family and friends. More broadly, our society spends so much time avoiding death that it can be well nigh impossible to cope with its reality.

To try and address this, UCLA psychiatrist Charles Grob and his colleagues enlisted 12 cancer patients—11 of them women—between June 2004 and May 2008. All suffered from fatal cancers, ranging from breast cancer to multiple myeloma, as well as "acute stress disorder, generalized anxiety disorder, anxiety disorder due to cancer, or adjustment disorder with anxiety." All agreed to take a "moderate dose" (0.2 milligrams per kilogram of body weight) of psilocybin (and niacin on another occasion) to see if the psychedelic drug might offer some relief from their fear of death and disease.

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

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

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

Image: ©iStockphoto.com / Laurie Knight

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  1. 1. psykt 4:25 pm 09/8/2010

    C.F. Tibetan Book of the Dead & the state of ‘Bardo’ – perhaps it’s no accident that mushrooms evolved to have the effect they do…

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  2. 2. jtdwyer 4:55 pm 09/8/2010

    Alternatively, some of us poor souls would prefer voluntary euthanasia to pointless interminable suffering when the time comes.

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  3. 3. doug l 5:14 pm 09/8/2010

    For mental conditions, whether deep depression, anxiety, or in many cases self-destructive, abusive patterns involving substances, the use of psychodelics when used in a guided clinical setting is way for us to pull away from ourselves so that we can see objectively where our fears, misunderstandings and behavioral patterns are doing us and our loved ones harm, at which point we realize the futility of it and can at last detach ourselves from them, rewire our personalities to get the most enjoyment out of living again, for whatever span of time we have left.
    Too bad that because of the backward, moralistic, witchhunt conducted by fearful leaders who find anything aside from their personal choice of holy book to be evil, we are denied access to it "for our own good"…spare me from those who would save me from a life without their particular brand of superstition.

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  4. 4. mhearne 8:01 pm 09/8/2010

    Hey doug,
    There are a few of us who neither need nor want to be "guided". I am glad to see that there is finally some research being done. We’ve known the usefulness of psychedelics in these circumstances for years, but couldn’t get any research done because of the legalities involved. It is also well known that psychedelics do not kill pain, nor are they meant to. They will however, cause the patient to forget his pain for a time.

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  5. 5. doug l 9:13 pm 09/8/2010

    Appreciate that perspective and don’t mean to imply that everyone needs or should only use guided therapy with psychedelics. Their benefit to many who use them as their conscience dictates are well known. My intent regarding special circumstances such as ‘end of life’ situations or in the case of those for whom, for whatever reason, insight is not achieved when using, helping them to connect with insightful perspectives.
    The mechanism of the different kinds of pain: physical, psychological, and even neurological pain that the person may not themselves feel consciously, are not well understood, but when feeling it we all wish it to end as soon as possible and will likely do whatever our brain tells us will accomplish that. If all psychedelics do is distract or over-ride the pain generating cause, it can be a huge help. Cheers.

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  6. 6. bridean 5:48 pm 09/9/2010

    I’ve been interested in the topics of psychedelics since I first tried them 15yrs ago. Happy to see that finally they’re being taken seriously as enhancements of life experience. BUT the only people I’ve been able to discuss these amazing experiences with have been others who have tried them. It’s been impossible to discuss psychedelics with anybody else, there’s been such an eye-rolling stuck-up ignorant attitude towards these drugs, plants, whatever. Including marijuana. They have been blown off for far too long.
    What can be worse than facing death a state of fear and anxiety? There is nothing worse than suffering. It’s horrifying that agents which can be used to ease suffering (to say the least) have been suppressed for so long just because our culture has some crazy, irrational fear of hippies. The fear of a bad trip has always been there too, but we’ve learned so much by now about how to prevent them. With proper set and setting.
    Our culture is pretty sick with fear right now. We need these ‘drugs’ to be available to people who are stressed, angry, suffering, depressed, uninspired, apathetic, myopic, going through agony in general. In a nutshell: Psychedelics cure myopia. Myopia lies at the root of all of our problems, does it not?

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  7. 7. Waldo Hatfield 10:03 pm 09/10/2010

    psilocybin made me feel unafraid of death, and I’m not even terminally ill. as others on here have said, it gave me a sense of detachment from my own psychology which was refreshing and empowering. however, I don’t think everyone would benefit from this any more than everyone would benefit from prozac or marijuana or ecstacy. being mentally healthy is something you have to practice, not something you can instantly cure with a pill or a drug experience. we need to get rid of the idea that we can better ourselves with no effort, and take control of our lives instead, and while drugs can offer perspective they can’t offer guidance. I am not suggesting any kind of regulation, but I think our society’s consumeristic cycles of greed, fear, consumption, numbness, etc. are a bigger problem for many people, and perscribing drugs is just a way of admitting we aren’t going to do anything to change those.

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  8. 8. bladaltongang 4:42 am 09/11/2010

    In the very early 60′s, after reading "Doors Of Perception" by
    A. Huxley, many of us went to Texas and Hautla de Jimenez and
    found the Sacraments: Peyote & Hongos Magicos. Personally, I
    experienced a spirituality that has served me to this day. I know
    a mastery of the semantics of ontology and have no need to
    ‘believe’. I find a great wonder at discoveries on cosmological
    AND nanotechnic spectrum. The conditions of overpopulated
    and over shot, broken natural cycles is certainly fundamentally
    changing the environment that beings (to be or not) grew their
    complexity within. This is not an opinion. This syntactic reality,
    a statment of fact making existence conflictful with ‘belief sytems’ in IGNOR(e)ant book burning collisions, different levels
    of warfare. Blood is seen in public places. Treasure explodes.
    I would laugh at it all, or cry insanely, but my spirit and curiousity disallows such behavior. I can only LOVE it all.
    To those who have commented with such enlightened truth and tolerance I say -AMEN our work is done.

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  9. 9. jtdwyer 3:11 pm 09/11/2010

    OK, I admit I started taking LSD in Viet Nam. The fourth time my tour of duty was almost up, and I was more than ready to go home. I was even volunteering for perimeter guard duty since it was safer than my day job.

    Somehow I got the feeling that night that the only reality was there in Viet Nam, that there was no ‘home’ in America – it was simply a ruse the Army had perpetrated on the troops to keep them going from day to day.

    I got to feeling better later, but despite all logic it seemed I could never quite shake that feeling. It didn’t stop me from trying…

    In a clinical, controlling hospital environment these kind of ‘head trips’ may or may not be avoidable, but still, facing immediate death, many trips could be a lot worse than what I experienced – I was just worried about getting home.

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  10. 10. ccross7 8:11 pm 09/13/2010

    jtdwyer,
    I completely agree that in many cases, voluntary euthanasia is a preferable option to a hallucinogenic life. I firmly believe that every person has their life to live and their own time to die. Even though the thought of dying scares some of us, I believe it is courageous but necessary for us to accept the end of our lives. Personally, if I were in a terminal state, I would not want to continue a painful existence, especially under the influence of a drug that would alter my sense of the world and my sense of self. In some ways it seems like a stain of a persons soul. I dont mean to say drug use itself is a stain, but rather the use of drugs to put off the inevitable. Quite frankly, using Psilocybin to prolong the lives of terminal cancer cases is somewhat cowardly and more than a bit unethical in my opinion. It goes against my belief that people need to be able to accept the limits of their existence in this world.

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  11. 11. ccross7 8:12 pm 09/13/2010

    jtdwyer,
    I completely agree that in many cases, voluntary euthanasia is a preferable option to a hallucinogenic life. I firmly believe that every person has their life to live and their own time to die. Even though the thought of dying scares some of us, I believe it is courageous but necessary for us to accept the end of our lives. Personally, if I were in a terminal state, I would not want to continue a painful existence, especially under the influence of a drug that would alter my sense of the world and my sense of self. In some ways it seems like a stain of a person’s soul. I don’t mean to say drug use itself is a stain, but rather the use of drugs to put off the inevitable. Quite frankly, using Psilocybin to prolong the lives of terminal cancer cases is somewhat cowardly and more than a bit unethical in my opinion. It goes against my belief that people need to be able to accept the limits of their existence in this world.

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  12. 12. e_caroline 8:02 am 09/14/2010

    What gets tiresome is having perfectly ordinary, expected mindstates labeled as "disorders" that require the paid intervention of "therapists" whose assertions are merely speculative philosophising by busybodies…..not "science" by any stretch of the imagination.

    "Gee"… we might wonder… "it sure is a ‘disorder’ to be upset by the contemplation of death in the near future. (not)"

    Or might we note that this situation has been eternally noted as one of the several ways people react to impending doom.

    Taking a psychoactive "trip" might well be comforting… but we cannot help but notice how the same "paid busybodies" politic to be intervening…. in other people’s most personal and private moments… and to insist upon being the "authority" who is going to rule others’ lives as they approach their end.

    The real "mental health issue" we see exhibited is for philosphic speculators with a strong dose of the busybody about them to keep pretending they do "science".. when they do not.

    And while engaging in this pretense they keep trying to extort paychecks out of society for being "in the way" in other people’s lives.

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  13. 13. e_caroline 8:05 am 09/14/2010

    It is not for YOU to decide how others are going to experience their last days of life.

    The lack of ethics lies on your part….. you decide you want to direct the lives of others… even when it has no direct impact on your personal existence.

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  14. 14. captain rhetoric 10:16 am 09/14/2010

    The voluntary usage of Psilocybin or the so called “magical mushrooms” is quite valid in my book but totally dependant upon the context of the situation. Basically it is ok for someone to use this temporary medication to ease the pain and emotion away from the course of death and using so in situations such as this only, like for the cancerous patients in the article. Logically speaking, this makes sense if the medication is given in controlled dosages to the point where it is not abused but at the same time diverts the thought of death for the user. When the user is satisfied by the Psilocybin, families and friends who are directly linked to him or her may get a positive vibe due to the changed attitude after medication. The ethical idea behind the whole concept is the strongest. It is ok to ease the pain of others, especially when death is near in the case of these cancerous patients. They will pass away soon and it is morally correct as a society to make it as least painful as possible. As far as the language of the article, it justifies in a strong and unbiased way.

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  15. 15. ccross7 4:25 pm 09/14/2010

    I don’t presume to judge what others’ do with their lives. I only point out that we all have our time to die and I know when my time comes I will be able to accept it without any medicinal procrastination. I would rather not put off my fate, especially with hallcinogenic drugs.

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  16. 16. enthusiastic-_- 11:19 pm 09/20/2010

    It is understandable that the use of psychedelics has been contained for as long as it has. Psilocybin twists a persons sense of awareness and emotion. The United States of America is considered to be a leading country in many different areas of progress. It is not surprising that when, decades ago, the abuse of hallucinogens became prevalent to the point of being frowned upon and viewed as a drug with little medical use. People need to be in control in order to be productive and useful. The use of psilocybin even makes a person appear to be psychotic. It is more probable that the drug would be abused and, if the use of the drug becomes more available to the public than being prescribed to only terminally ill patients, it would do more harm than good. There are many people in the world that would rather enjoy hallucinating than facing their problems head on and psilocybin has the potential to make cowards of us all.

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  17. 17. captain rhetoric 3:35 am 09/23/2010

    The voluntary usage of Psilocybin or the so called “magical mushrooms” is not just frowned upon by me but also by society as a whole in numerous cases. But in the case of these cancerous patients, I agree that it is ok for the usage of Psilocybin as a medication to release anxiety. Logically it seems okay that the patients are given controlled dosages to the point where it helps to alleviate pain and at the same time the amount doesn’t have any addictive or harmful side effects. Rather than being preoccupied by their current melancholy, the Psilocybin creates a euphoric atmosphere. Ethically it is okay to ease the pain rather than prolong their anguish. As a direct result, even families and friends of these patients benefit from this eased pain, knowing that their dear ones are taken care of. When death is so close, we must do everything we can in order to ensure that the rest of their days are gratifying.

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  18. 18. cferguson 9:01 am 09/23/2010

    There need not be a conclusion on whether the main chemical in whether psilocybin, the hallucinogenic chemical found in some species of mushroom, should be used to treat depressed cancer patients after only a small amount of tests have occurred. Not only is there not enough data, but there is simply no plan for promoting the drug to Americans simply because of what it is.

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