Psilocibin for Treating Death

note: relevant to preceeding posts about drugs and healing.
michael

STAIRWAY TO HEAVEN: PSYCHEDELICS SOOTHE DYING

NYU RESEARCHERS STUDY USE OF PSILOCIBIN OR ‘MAGIC MUSHROOMS’ TO HELP THE
TERMINALLY ILL

By Susan Donaldson James
ABC News
April 19, 2010

http://abcnews.go.com/Health/Green/scientists-study-psychedelic-mushrooms-ca
ncer-patients-face-death/story?id=10409043

For the last eight years, Nicky has struggled with advanced ovarian cancer,
and despite repeated rounds of chemotherapy and radiation, it’s unclear how
long she has to live.

“Ovarian cancer has a very bleak outlook — less than 30 percent make it to
five years,” said the 67-year-old former New York City French teacher. “I
was diagnosed in 2002, and I was going in to my fourth year and had a
recurrence — which was like the proverbial shoe dropping — and it
frightened me so much.”

“For the moment, there is no pain,” she said. “The most difficult part is
leaving this world early. I wasn’t ready to get on that bus.”

Coming of age in the drug-infused 1960s, Nicky, who, for privacy reasons,
did not want to use her last name, didn’t smoke marijuana and avoided the
hippie sub-culture. “It never interested me,” she said. “It wasn’t necessary
in my life.”

But last May, Nicky volunteered to take a psychedelic “trip” on psilocibin
— the hallucinogenic compound from “magic mushrooms” — which has been used
for thousands of years by indigenous cultures to reach higher levels of
spirituality and consciousness.

Today, even after losing seven friends from her cancer support group in 15
months, Nicky said she is less afraid of death and is living her life more
“honestly and authentically.”

Nicky was one of the first terminally ill participants in an ongoing study
at New York University on the use of hallucinogens to help those with
terminal illnesses.

“I had a wonderful life, a fabulous child and beautiful grandchildren, and
here my life was cut short,” she said. “I thought of my two granddaughters
and not seeing them growing up and graduating from college — it made me
profoundly sad. I wanted to do something for myself, to be able to live more
in the moment, rather than worrying about the future and having all these
existential thoughts about what life was all about.”

Her “trip” took place under full medical supervision in a warm, living
room-like setting with art books, fresh fruit, flowers and soothing music.
She was given a pill in an earthenware chalice and a single rose, then
hunkered down on a cozy sofa with eyeshades and headphones.

“I was in a dome and it was all bejeweled with colors, mostly striped, like
a kaleidoscope, but not turning,” she said. “Every once in awhile, the dome
would open up at the top and send a luminescence,” she said. “I was in awe
and could feel myself taking deep breaths. At the same, tears were running
down my face, but I was not crying.”

“It was incredible,” she said. “I wanted to share it. I couldn’t believe the
world could be so beautiful.”

Researchers at New York University say that in a controlled setting,
hallucinogens, which alter perception and cognition, can help patients
reduce the anxiety, personal isolation and fear of death.

“I am still not ready to die,” said Nicky, who just returned from trips to
Mexico and Bali and boxes with a trainer several times a week. “It’s
definitely improved my interactions with those closest to me and figuring
out how I want to live my life.”

“Has my anxiety of dying gone away? I would say no, I don’t ever want to
die,” she said. “Will I be able to walk toward death with a little less
fear? Perhaps. “I know it sounds trite, but I live more in the moment,” she
said.

The three-year study, “Effects of Psilocybin on Anxiety and Psychosocial
Distress in Advanced Cancer Patients,” is being privately funded by the
Zurich-based Heffter Research Institute , which promotes the use of
psychedelics for the alleviation of suffering. Fully approved by the Food
and Drug Administration (FDA), it adheres to rigorous safety guidelines and
protocols.

Researchers hope that it will one day lead to reclassification of Schedule 1
hallucinogens so that doctors may prescribe them to patients for palliative
care, depression and even addiction.

“It’s daunting working with people in the midst of death,” said principal
investigator Dr. Stephen Ross, assistant professor of psychiatry and
director of the NYU Langone Center of Excellence on Addiction. “To help
people to have a good death, and not more chemotherapy, to prepare for the
final part of life and to die with dignity and do it in a way that they are
not frightened, that is one of the most important endeavors as a physician.”

NYU Looking for Participants in Hallucinogen Study

Ross and his colleagues are looking for 32 patients who are willing to
participate in the random, double-blind study. To be eligible, patients must
be 18 to 76 years old with the diagnosis of a “potentially life-threatening
disease” or advanced or recurrent cancer who are displaying symptoms of
acute stress, anxiety or adjustment disorder due to their disease.

Patients are screened carefully — those with psychotic spectrum disorders,
such as schizophrenia, bipolar disorder and severe depression cannot
participate.

“Mysticism is really the cornerstone of all major religions going back
millennia,” said co-principal investigator Anthony Bossis , professor of
psychiatry and anesthesiology at the NYU School of Medicine.

“It is characterized by a sense of unity, transcendence, connecting to the
broader universe and a sense of life and the promotion of personal
spirituality,” he said. “It recalibrates how we see our life and gives a
sense of sacredness and reshapes how we view death.”

A mystical experience can help root patients like Nicky more in the present,
according to Bossis. “People with cancer can spend their final days and
months not anxious and improvement in quality of life is attainable,” he
said. “These experiences have the potential to do that.”

Scientists across the country have shown a renewed interest in the medical
uses of hallucinogens. So far, 80 to 90 patients have had similar
experiences in studies on psilocybin at other universities including Johns
Hopkins and UCLA.

If these studies are “robust enough,” Ross and Bossis hope hallucinogens
like psilocybin — a Schedule 1 drug with no therapeutic ability, according
to the FDA — can be declassified and doctors might be able to prescribe
them for patients.

In a study on 36 patients at Johns Hopkins, researchers looked at the
effects of psilocibin on depression. At the 14-month follow-up, more than 60
percent of volunteers rated the experience as among the five most meaningful
and spiritually significant of their lives; 58 percent reported a “complete”
mystical experience.

“We have come a long way in pain management with the use of opiods, but the
sheer anxiety is so hard to address in a medical setting,” said Bossis, a
clinical psychologist whose specialty is end-of-life care.

“The heart of this study is to address these levels of suffering and get at
the existential [fear] of not being here any longer that we all face,” he
said. “We provide an empirical experience where the patient goes into a
journey — his own journey — and can find resolution and peace and
transformation and return back here to integrate it into their lives.”

Psilocybin, an alkaloid compound in the tryptamine family, is produced by
hundreds of species of fungi, acts on the serotonin receptors in the part of
the brain responsible for non-verbal imagery and emotion. Its mind-altering
effects can last anywhere from three to eight hours.

It is in the same class of chemicals as mescaline, contained in the peyote
cactus, which is used in religious ceremonies by Native Americans, and
dimethyltryptamine, which is contained in ayahuasca, used by indigenous
South American religions. The effects are sometimes described as similar to
near-death experiences. Some research has shown that brain activity under
psilocibin mimics closely that of Buddhist monks.

“It appears we are hardwired with neuro-circuitry to meditate and have the
spiritual experience,” said Ross.

Abuses of LSD Lead to a Ban on Hallucinogens in 1966

Psychologist Timothy Leary popularized hallucinogens like LSD in his 1964
book with Ralph Metzner, “The Psychedelic Experience,” which he hailed as a
way to “journey into new realms of consciousness.”

“It opens the mind, frees the nervous system of it ordinary patterns and
structures,” Leary wrote.

Experiments with LSD took place as early as the late 1940s and 1950s, after
it was discovered in an ergot fungus by Swiss chemist Dr. Albert Hoffman.

By 1965, more than 2,000 papers had described positive results in 40,000
patients with few side effects and a high level of safety in treating
patients with anxiety disorders, depression, sexual dysfunction, bereavement
and even addiction, according to the British Journal of Psychiatry.

But by 1966, the drug was made illegal after abuses by the hippie
counterculture, scientists distanced themselves and the government cracked
down on research licenses. By the 1970s, under pressure from the U.S.
Justice Department, virtually all research ended.

“It got demonized as a most addictive drug, but the irony is that it is not
addictive,” said Ross. “Used in the models we describe, it can actually lead
to sustained sobriety.”

Volunteers in the NYU study agree to take part in two full-day sessions,
seven weeks apart, where they are administered either a placebo or the
psilocybin. They are monitored for anxiety and outcomes two to four weeks
prior to drug administration, then one day prior, then again seven hours,
one day and several weeks’ intervals until 26 weeks post administration.

Investigators also measure depression, pain and quality of life as well as
attitude toward their disease progression at designated intervals.

Beforehand, they undergo preparation for the experience in psychotherapy.
“We take their life narrative and their cancer narrative and review all the
safety parameters — what happens if X,” said Ross.

When the drug is administered, the patient is paired with a male and female
therapist to monitor responses and for comfort.

“Emotional stability optimizes the chance for a good experience,” said
Bossis. “Trust with the monitors is crucial . If the patient doesn’t feel
safe, we don’t go forward.”

Sometimes the experience is traumatizing, but facing fears is part of the
process. Doctors have an antidote to abort the experience, if necessary, or
use valium to calm a patient down.

“We encourage them to go inward, to minimize the communication with us and
enter the experience, even if it’s something dark and difficult that comes
before them,” said Bossis. “We tell patients that no matter where they find
themselves, they will return to a normal state of consciousness within six
hours,” said Bossis.

Two of the three patients in Nicky’s group have already died. Both reported
extraordinary experiences — “a cleansing of the body and soul of grief and
sadness and an increase in the acceptance of the disease and the dying
process,” according to Bossis.

The patients said they wanted to give back more — financially or
emotionally  and were able to reconnect with estranged friends and family
members. Both were “peaceful and thankful,” at the end, he said.

As for Nicky, the first hour of her psychedelic journey was awe-inspiring,
but the second part was deeper and more emotional. At several points, she
had to sit up and take off her eyeshades and seek the comfort of Ross and
her other therapist.

“I became profoundly sad, and I actually had to sit up after 45 minutes and
talk to them and I cried a lot,” she said. “Then I lied down again and there
was another scenario then I went through the rest by myself.”

In six hours, when it was all over, she stayed and analyzed her experience
with the doctors.

“In therapy we had been working on my top five [issues with death or
family],” she said. “During my experience, I reordered the hierarchy of
issues to lead a more authentic life emotionally. I didn’t realize my number
four was actually number one.”

“It was such an enormous gift,” said Nicky. “It’s really amazing that a
king’s ransom arrived at my door step.”

Today, Nicky said she would take psilocybin again — “in a New York minute.”
She continues her therapy at NYU and will go on a drug trial soon for
late-stage ovarian cancer. She also hopes that her openness about the
psychedelic experience will help others.

“I don’t think people should be so afraid of something that could be so
helpful when you are nearing the end of life,” she said. “I had huge insight
into my head. I can still conjure it up and I tried for very long to relive
it — it was breathtaking.”

Nicky is not a religious person and never expected to find God. “I didn’t
have that spiritual experience, but my dome was very close,” she said. “When
it opened up several times and let in the light, I would have thought it was
my creator if I had been religious.”

For more information on how to participate in the study, contact patient
coordinator Krystallia Kalliontzi at 212-998-9252 or kk71@nyu.edu.