Psychedelic-Assisted Therapy and Chronic and Serious Illness

Psychedelic-assisted therapy for chronic and serious illness (CSI) aims to relieve symptoms and stress related to a persons’ illness while focusing on the client’s needs, not their prognosis.

It aims to support their mental health and well-being regardless of the stage they are at in their journey.

A Brief History

There is an ever-growing body of evidence that psychedelic medicines coupled with psychotherapy offer safe and significant potential benefit to those experiencing grief, existential distress or anxiety, and other mental health challenges when contending with serious complex, chronic, and terminal illness. Some key historical events are highlighted below.

1960s

Kast (1964) first administered psychedelic medicines to the terminally ill in the 1960’s. Kast administered LSD to several patients with advanced-stage cancer, finding that it provided longer-lasting pain relief than opioids.

2004

Grob (2011) looked at efficacy of moderate-dose psilocybin-assisted therapy on 12 advanced-stage cancer patients with high levels of anxiety. The results were very promising, though not as dramatic as subsequent trials that offered higher doses of psilocybin.

2016

Griffiths et al. (2016) at Johns Hopkins University and Ross et al. (2016) at NYU administered high doses (25 mg) psilocybin and found immediate improvement of depression, anxiety, and quality of life. These improvements persisted when checked at the 6-month, 3-year, and 4-year intervals.

Health Professional Tip

Compared to treating depression, anxiety, and other conditions, working with clients who have a chronic and serious illness is different because the therapy is not focused on treating their underlying condition (the chronic and serious illness). How should health professionals best approach psychedelic-assisted therapy for clients with a chronic and serious illness?

The primary difference in the approach to psychedelic-assisted therapy is the themes that will come up. Health professionals are more likely to encounter clients with unique fears, emotions, and thoughts related to their existential distress. It is therefore important that health professionals are comfortable talking about:

Death
Hopelessness
Suicidality
Cognitive dissonance
Trauma
Regret
The “why me” narrative
Others

Video: Saskatchewan Man Granted Exemption to Use Psilocybin-Assisted Therapy for End-of-Life Anxiety

2:49

In this video, one client of psilocybin-assisted therapy talks about his chronic and serious illness, how his condition has impacted his daily life, and how psilocybin-assisted therapy may give him some relief.

Required Reading

Please read the following paper about how psychedelic-assisted therapy can be used when working with clients who have a chronic or serious illness and who are experiencing existential distress.

Anderson, B. T., Danforth, A., Daroff, R., Stauffer, C., Ekman, E., Agin-Liebes, G., Trope, A., Boden, M. T., Dilley, J., & Mitchell, J. (2020). Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: An open-label safety and feasibility pilot study. eClinical Medicine, 27(100538).
Byock, I. (2018). Taking psychedelics seriously. Journal of palliative medicine, 21(4), 417-421.

Learn More

To learn more about treatment options for existential distress and evidence supporting these interventions, please read this optional reading.

Ross, S., Agrawal, M., Griffiths, R. R., Grob, C., Berger, A., Henningfield, J. E. (2022). Psychedelic-assisted psychotherapy to treat psychiatric and existential distress in life-threatening medical illnesses and palliative care. Neuropharmacology. 15(216).
Yaden, D. B., Nayak, S. M., Gukasyan, N., Anderson, B. T., & Griffiths, R. R. (2021). The potential of psychedelics for end of life and palliative care. Disruptive Psychopharmacology, 169-184.

References

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. Journal of psychopharmacology (Oxford, England), 30(12), 1181–1197.

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. Archives of general psychiatry, 68(1), 71–78.

Kast, E. C. & Collins, V. J. (1964). Study of Lysergic Acid Diethylamide as an Analgesic Agent. Anesthesia & Analgesia, 43(3), 285-291.

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. Journal of psychopharmacology (Oxford, England), 30(12), 1165–1180.