It's a Real Thing: Taking Psychedelic Drugs to Ease End-of-Life Anxiety

By Sherry Amatenstein LCSW

*Sheila, a 57-year-old patient diagnosed six months earlier with terminal cancer sat in my office, twisting Kleenex in her fingers.

“Sherry, my anxiety is off the charts.”

In addition to our once-a-week sessions, she had a loving family, was in a support group for people with cancer, and taking Prozac.  None of this made much of a dent on her mounting emotional turmoil.  She said, “I’m really desperate. What do you think of psychedelic drugs to help with my terror of dying?”

It was a fair question.

Not surprisingly, 40 percent of cancer patients suffer from psychological torment linked to their diagnosis.

In the ‘50s and ‘60s studies were done on the efficacy of psilocybin – the hallucinogenic ingredient in mushrooms   – as a therapeutic tool to help people come to terms with their imminent death. By the early ‘70s this research fell into disfavor, as psychedelics were increasingly associated with the counter culture movement. (Paging Timothy Leary!)

A 2011 Pilot study on psilocybin for anxiety in patients with advanced-stage cancer renewed interest in this treatment, as it seemed to result in reduced anxiety and improved moods for the participants, with no adverse effects reported. A NYU study published in 2016 of 29 patients suffering from end of life anxiety and depression found, in conjunction with therapy that a single moderate dose of psilocybin produced positive psychological changes. Another study at John Hopkins, also published in 2016, involving 51 cancer patients also produced good results.

This research suggests that one dose of psilocybin can potentially be more effective than pharmaceutical drugs at easing anxiety and depression in people with fatal illnesses.

Study participants reported experiencing spiritual breakthroughs that help them better cope with being delivered what might be a death sentence.  Dr. Stephen Ross, who directed the NYU study, has been quoted as saying, “People who had been palpably scared of death – they lost their fear. The fact that a drug given once can have such an effect for so long is an unprecedented finding. We have never seen anything like it in the psychiatric field.”

Dinah Bazar decided to take part in Ross’s study after she began experiencing her worst anxiety two years after going into remission for ovarian cancer. During college, she’d had a bad mescaline trip but years later, felt a closely monitored clinical trial would be safe.

In 2016, the then 69-year-old wrote about her experience of taking a single dose of psilocybin while sitting in a “peaceful” room at NYU in an article for time.com. “At first it was terrifying, as though I were tumbling through space, or on a ship in a stormy sea.” Soon though she began to feel as though she were floating in the music emanating from her headphones. She described feeling “bathed in love and it was overwhelming, amazing, wonderful. I kept floating and floating.”

The powerful feeling of inner peace and love lingered for weeks and best yet, the fear and anxiety were “completely removed.”

Subsequently, when she felt ill and feared a potential recurrence of cancer, rather than diving into a pit of helplessness and fear, she remained relatively centered.

It is fitting that anxiety – which is all about fear of losing control – is “controlled” only by ceding control, at least temporarily. Dinah’s voluntarily submitting to the onslaught of images and emotions allowed her to drop down to and retain a deeper truth: We cannot always prevent stressful events, just control our actions and reactions to those stressors.

However promising the NYU and John Hopkins studies appear, they are preliminary. Psilocybin is not FDA approved. Herbert Kleber, director of the substance-abuse division at Columbia University, has offered cautionary praise for the scientific investigations of psilocybin and end of life anxiety. The psychiatrist has been quoted as noting both that sample sizes in the studies are small, and that it is essential to have an experienced guide in the room to ensure the experience for the patient is productive, not terrifying. (Dinah reported having NYU researchers at her side during the whole experience.)

When my patient Sheila asked whether she should go this route to help ease her fears, my job wasn’t to tell her what to do. Rather, my task was to guide her on how to research the available information on this option – pros and cons – and help her sort through her feelings.

At one point she asked, “Sherry, if you were in my shoes, what would you do?”

I answered truthfully, “I would likely do what you are doing – not rule it out of hand and not dive into it instantly either. But yes, there is nothing to lose by looking into it.”

Sheila hasn’t yet made a decision on whether or not to make the leap.  During our most recent session, she said, “Just knowing psilocybin is out there has helped me feel more balanced.”

* The patient’s name has been changed.

Sherry Amatenstein, LCSW is a NYC-based therapist, speaker and author of four books, including How Does That Make You Feel?: Confessions from Both Sides of the Therapy Couch and The Complete Marriage Counselor: Relationship-Saving Advice from America’s Top 50-Plus Couples Therapists. Her website is www.marriedfaq.com.