Taking psychedelics seriously
Background: Psychiatric research in the 1950s and 1960s showed potential for psychedelic
medications to markedly alleviate depression and suffering associated
with terminal illness. More recent published studies have demonstrated
the safety and efficacy of psilocybin, MDMA, and ketamine when administered
in a medically supervised and monitored approach. A single or brief series
of sessions often results in substantial and sustained improvement among
people with treatment-resistant depression and anxiety, including those
with serious medical conditions.
Need and Clinical Considerations: Palliative care clinicians occasionally encounter patients with emotional,
existential, or spiritual suffering, which persists despite optimal existing
treatments. Such suffering may rob people of a sense that life is worth
living. Data from Oregon show that most terminally people who obtain prescriptions
to intentionally end their lives are motivated by non-physical suffering.
This paper overviews the history of this class of drugs and their therapeutic
potential. Clinical cautions, adverse reactions, and important steps related
to safe administration of psychedelics are presented, emphasizing careful
patient screening, preparation, setting and supervision.