Psylocybin in palliative treatment is another area of medicine where psychedelics are beginning to make scientists think more about these substances. Palliative care is the last stop before death, the moment when we already know that no drugs will help and the end is imminent. Unfortunately, patients in palliative wards are often marginalized. This is usually due to a lack of health care resources. People there die of disease, pain, but they also die of loneliness, in deep depression and terror. But does it have to be that way? Is there any way to do this?
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What is palliative care?
Palliative care is the way in which terminally ill people are helped to alleviate their pain, to make life as comfortable as possible. The palliative care team consists of doctors, nurses, psychologists, psychiatrists, volunteers, physiotherapists, sometimes even clergy. Curing the patient is no longer possible, but it is possible to try to prolong his life by leveling the symptoms of the disease and smothering the suffering.
The idea is to reduce physical ailments, ease breathing, and alleviate depressive and anxiety states, provide support spiritually and at the emotional level, so that he can experience his death with dignity and in peace. In short, it is the care of a person who is at the end of life. According to statistics, palliative care at home lasts about three months. Unfortunately, not everyone has the opportunity to wait for such care, as there are, of course, patient limits in the health service.
Psylocybin in palliative treatment
Psylocybin is a naturally occurring substance in psilocybin mushrooms – these are commonly known as magic mushrooms. They have been used for health purposes and religious rituals for thousands of years by many ancient cultures, such as the Mayan and Aztec, they are found all over the globe, in different varieties. They are still used by indigenous people in religious ceremonies. Psylocybin is a psychoactive substance that, in addition to hallucinogenic sensations, causes the formation of new neural connections.
Some compare its effects to SSRI antidepressants, but psilocybin’s potential is much greater than that of SSRIs – you can read more about it in this topic Psychedelics in the treatment of depression. The use of psilocybin affects the neuroplasticity of the brain, and thus increases the number of neural connections that lead to improved mood, change the perspective of thinking, and co-create a kind of evolution of beliefs in our mind.
History of research on psychedelics in palliative medicine
Psychedelics, including magic psilocybin mushrooms have accompanied man as plant medicine practically since time immemorial, but they have lasted in the current culture for quite a while. The advent of LSD in the 1950s brought hope to many areas of medical science. The substance was developed by the Sandoz pharmaceutical company and was initially intended to help with respiratory diseases. LSD was synthesized from parasitic fungi present in ergot. Its potential and wide range of applications in neurology and psychiatry surprised its creator Albert Hofmann himself.
Research on LSD continued, offering a lot of hope. Among those who became interested in its unusual properties were psychiatrist Humphry Osmond, who tested LSD at Mental Hospital in Weyburn, and writer Aldous Huxley, who experimented psychedelic substances on himself. The two men exchanged correspondences, describing in detail the states after consuming psychedelics. One of the cases Huxley described was that of his wife, who was suffering from incurable cancer. The writer observed that by giving her LSD, the passage through death was mentally easier and calmer for her. As a witness to this disease and how her condition changed after being given the psychedelic, he decided that his death should also look like this.
Unfortunately, in the 1970s, research on psychedelics was stopped rather drastically for political reasons and reduced to the underworld. Some scientists have attempted to test psychedelic substances like psilocybin and lsd, but their research was conducted on a micro scale.
It wasn’t until the beginning of the 20th century that the topic was officially revived and new insights were offered into the effectiveness of psilocybin as a treatment for psycho-emotional problems, pain, fear and anxiety accompanying incurable diseases. The year 2018 brought a new perspective on the topic of working with terminally ill people.
A member of the American Academy of Hospice and Palliative Medicine announced: “Given the prevalence of persistent suffering and the growing acceptance of physician-accelerated death as a medical response. The time has come to revisit the legitimate therapeutic use of psychedelics” – thus giving hope to patients, their families and scientists, who will legally be able to return to research.
Psycho-emotional pain and total pain
“Total pain” – a term introduced by hospice founder Dame Cicely Saunders. Total pain is the extent of physical, emotional, social, as well as spiritual suffering that is an integral part of a person in his or her terminal stage. The goal of palliative care is to provide services that offset this suffering.
Treatment of chronic pain with psilocybin
Psylocybin is able to help offset chronic pain because nociceptive-modulating pathways occur at 5HT2a receptors and enhance neuroplasticity. You can read more about this research in a 2018 article by Dr. Thomas Flagan, where the scientist outlines the anti-inflammatory effects of psychedelic substances. In addition, there is also evidence of positive effects of treating brain injuries as they lead to neurogenesis of the hippocampus. Psilocybin given in a moderate dose, but also microdosing with psilocybin can produce a cure for chronic pain. However, further research into the complexity of pain is needed.
Use of psilocybin in palliative care
Why does psilocybin in palliative treatment work? Well, the renewed thinking perspective associated with the formation of new neural connections has the potential to heal disturbing psychoneurological patterns, i.e., for example, it can calm recurrent and excessive thoughts of death, loss, tragedy, low self-esteem, as well as leveling pain sensitization, or total pain.
According to documented studies, the extent of the patient’s experience and changes depends on the dose, the patient’s individual metabolic predisposition and factors such as “attitude,” which will be defined as the intention with which a person approaches taking psilocybin treatment. The effect after administration lasts from a month to several months.
Dr. Gabrelle Agin-Liebes measured the longevity of the effects after using psilocybin, and the results indicated that 70-100% of the patients experienced positive changes in their lives, depression and anxiety decreased in 60-80% of the subjects, and their condition persisted up to 6.5 months after psilocybin administration. Summarizing the experiment, it was concluded that psilocybin, even in small doses, was expected to result in a lasting positive effect.
Psylocybin in palliative treatment reduces existential suffering and provides an opportunity to “recode” the patient’s thoughts, evolving from inner suffering through cognitive flexibility, creative thinking, to a higher quality of life. Unfortunately, the legality of psilocybin, which is contained in psilocybin mushrooms – magic mushrooms – leaves much to be desired.
In the U.S. and Australia, patients can already legally receive treatment with psychedelics, but in Poland and many other countries it is still not legal. In a heartening development, more and more research centers are leaning toward studies involving psychedelics, and the results are promising. All that remains is to hope that psilocybin will share the fate of medical marijuana, which, after much solid research, has been allowed into the world of medicine and is helping people.
If you want to know more or show the topic to your loved ones in a more accessible way watch the documentary series on Netfix’s “How to Change Your Mind”– is a story in 5 episodes about several substances, including psilocybin and LSD, which depicts authentic people and their struggles with illness, and how their lives and approaches to illness changed after using psychedelic substances. Read more about reliable research at this link.