Shrooms For End of Life Care

Dan Simms Last Updated: October 15, 2021

Magic mushrooms are now being used in end-of-life care facilities to support the existential anxiety that accompanies a terminal diagnosis.

Here’s everything you need to know about using psilocybin for end-of-life care and coping with existential anxiety.

What Are Magic Mushrooms & Psilocybin?

Magic mushrooms are a class of fungi that contain psilocybin and psilocin. These compounds are psychedelic, meaning they interact with the central and peripheral nervous systems.

Research suggests that psilocybin and psilocin mimic serotonin [1], a neurotransmitter naturally found in our brains that are linked closely with mood, outlook on life, and our ability to perceive the world around us.

When an individual consumes psilocybin or psilocin, they will typically experience the world differently through a stark change in sensory perception.

Most users also report experiencing a powerful emotional or mystical (spiritual) event — allowing them to see things from a different perspective even long after the immediate effects have worn off.

This can be extremely powerful as a source of medicine for the mind. It has the power to alter our outlook on life and change our understanding of life and death.

How is Psilocybin Being Used In Palliative Care?

Palliative care is an approach to caregiving that focuses on making patients with complex and terminal diagnoses feel more comfortable.

This form of care focuses on relieving symptoms, making them feel more comfortable, and helping the individual to cope with the unsettling concept of death.

Some doctors are using magic mushrooms and the active ingredient, psilocybin, as a part of their palliative care efforts in Canada, where psilocybin is legal for end-of-life patients. Others use it as a means of managing depression, anxiety, severe pain, and other mental health disorders [2].

In the few places it’s been legalized for medical purposes — including Canada, as well as Oregon and Washington D.C. — psilocybin is administered in the presence of a certified doctor. It can be injected intravenously, but it’s typically administered orally in the form of a psilocybin tablet.

The main reason for using psilocybin with terminally ill or end-of-life patients is to alleviate existential anxiety.

Related: What is psychedelic-assisted psychotherapy?

What is Existential Anxiety?

Existential anxiety is any anxious or overwhelming feeling regarding your sense of self, self-worth, or place in the real world.

This type of anxiety arises when we question our life’s purpose or the purpose of life as a whole.

Many people coping with existential anxiety struggle to find meaning in life and to understand the purpose and pain of existence. Most who are diagnosed with existential anxiety struggle with a plan for their future and finding importance in what they do on a daily basis.

Existential anxiety is common in the elderly and people who have been given a terminal diagnosis.

Research: Magic Mushrooms For Existential Anxiety

Psilocybin and psilocin have been used to help treat existential anxiety and aid people in coping with their existence, meaning, and connection to the world around them.

Research completed by Johns Hopkins Medicine supported that psilocybin produced clinically significant results in treating terminally-ill cancer patients who were dealing with depression and existential anxiety.

The drugs helped patients cope with their condition and situation and allowed them to find meaning and comfort in the present. Most importantly for end-of-life patients, mushrooms can reduce confusion and fear about the future.

Here are three top-level studies on the role of psilocybin for managing existential anxiety. 

Study #1: Perceived Depression

A small study was completed by the Beckley Foundation and published in 2016 notes that psilocybin produced clinically significant improvements to patients’ perceived depression levels after dosing [3]. Perhaps most crucially, the benefits lasted about six months after the psilocybin was administered.

Study #2: Outlook On Life

Another study completed in 2011 confirmed that psilocybin dramatically improved the outlook and mood of patients being treated for depression and existential anxiety related to terminal illness [4]. Patients exhibited a much healthier mental state and were able to accept and embrace their meaning in the world and their future.

Study #3: Psilocybin Microdoses

A clinical study involving nearly 300 people who were offered microdoses of psilocybin — typically around 0.2 g — suggests that the compound can severely improve the outlook, mood, and attitude of patients diagnosed with depression [5].

Alternatives to Psilocybin For End of Life Care

Research has shown that psilocybin and psilocin can be useful treatment options for patients dealing with depression and anxiety related to their terminal illness.

However, it’s not the only substance that can help treat end-of-life patients. There are several other psychedelic substances that have shown promise for this type of treatment.

1. LSD

Lysergic acid diethylamide (LSD) — commonly referred to as “acid” — is another psychedelic drug that was made illegal in the 1960s.

More recently, researchers have found that it can be used to treat existential anxiety, as it can provide patients with an alternative, honest, and open view of the world around them and an improved outlook on life and self-worth [6].

2. 5-MeO-DMT

5-MeO-DMT is a substance derived from the venom of a specific species of toad (Bufo alvarius). It’s been shown to be a hallucinogenic compound in humans and other mammals.

A study completed by Johns Hopkins Medicine confirmed that 5-MeO-DMT alleviated symptoms of depression and anxiety when used in the right context and with the right integration [7]. This could make it a viable alternative for helping end-of-life patients cope with their ailments and future.

3. 4-AcO-DMT

4-AcO-DMT — also called O-acetylpsilocin and, more commonly, “synthetic shrooms” — is an analog of psilocin that shares similar effects to magic mushrooms [8].

In fact, after taking 4-AcO-DMT, it’s converted into the active form, psilocin — which is the same active ingredient in magic mushrooms.

This compound may offer end-of-life patients the ability to cope more readily with their condition and fate, and it can offer users a more open and honest outlook on their meaning, self-worth, and place in the world.

4. Mescaline

Mescaline is derived from the peyote and San Pedro cacti and acts similarly to psilocybin and LSD. It’s believed to offer relief from anxiety, depression, and mental anguish, and it could be a useful treatment for those coping with the ontological shock brought on when faced with one’s own mortality [9].

5. Ketamine

Ketamine is not a true psychedelic and is more readily classified as a dissociative drug. It’s believed that dissociatives like ketamine may help with ontological anxieties by temporarily inhibiting the sensation of “self” through a dissociative state.

Ketamine is also believed to be useful for treating low brain synaptic capacity, which is commonly associated with depression and anxiety [10].

Unlike most of the other psilocybin alternatives, the benefits are known to wear off quickly. As such, it’s typically only used to treat treatment-resistant depression in the United States [11].

The Importance of Set & Setting

Some people believe that hallucinogenic or psychedelic drugs alone are effective for treating depression or existential anxiety. In reality, most palliative care experts use a more holistic approach. They combine helpful substances with a generally positive mindset about the drugs, an appropriate setting for consuming them, and an in-depth discussion with a specialist afterward to internalize and integrate the experience.

When consuming psilocybin or psilocin, “set” refers to “mindset,” which is an important part of preparing to take psychedelics for end-of-life care. Psychedelics and hallucinogens often get a bad reputation because of the possibility of a “bad trip,” which is when the drug provides a traumatic experience that induces anxiety, panic, and even psychosis.

The patient should have a positive mindset about the drug, how it will affect them, and the lasting impact of using it. Anecdotal reports suggest that having a positive opinion of how the drug will affect one’s mind has a direct impact on the experience itself [12].

Additionally, the setting in which you consume psilocybin or other psychedelics reportedly makes a significant difference in your experience. Some research suggests that a proper setting can help avoid bad trips, bad experiences, and putting oneself in harm’s way when using hallucinogenic drugs like magic mushrooms [12].

For end-of-life patients, set and setting can mean the difference between existential anxiety being cured and getting worse following treatment.

Key Takeaways: Psilocybin and Psilocin for End-of-Life Care

Magic mushrooms are psychedelic fungi containing psilocybin and psilocin. These two hallucinogenic compounds have been shown to increase creativity, mimic serotonin in the brain, improve mood, alleviate anxiety, and offer other mental health benefits.

Psilocybin mushrooms were listed as a schedule I drug by the Drug Enforcement Agency (DEA) in the 1970s, but they have recently been re-evaluated by medical experts. Some doctors and researchers believe they could be useful in certain medical situations.

Psilocybin was legalized in Oregon and Washington, D.C. for medical use, and it is being used to treat depression and existential anxiety in terminally ill, end-of-life patients.

When consumed in the right setting and with the proper mindset and medical attention, terminally-ill patients can better accept their fate, cope with their emotions, and approach their future with better clarity and openness.

References Cited

  1. Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., … & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial. JAMA Psychiatry, 78(5), 481-489.
  2. Hutten, N. R., Mason, N. L., Dolder, P. C., & Kuypers, K. P. (2019). Motives and side-effects of microdosing with psychedelics among users. International Journal of Neuropsychopharmacology, 22(7), 426-434.
  3. Carhart-Harris, R. L., Bolstridge, M., Rucker, J., Day, C. M., Erritzoe, D., Kaelen, M., … & Nutt, D. J. (2016). Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry, 3(7), 619-627.
  4. 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.
  5. Anderson, T., Petranker, R., Christopher, A., Rosenbaum, D., Weissman, C., Dinh-Williams, L. A., … & Hapke, E. (2019). Psychedelic microdosing benefits and challenges: an empirical codebook. Harm reduction journal, 16(1), 1-10.
  6. Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., … & 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, 30(12), 1181-1197.
  7. Davis, A. K., So, S., Lancelotta, R., Barsuglia, J. P., & Griffiths, R. R. (2019). 5-methoxy-N, N-dimethyltryptamine (5-MeO-DMT) used in a naturalistic group setting is associated with unintended improvements in depression and anxiety. The American journal of drug and alcohol abuse, 45(2), 161-169.
  8. Malaca, S., Lo Faro, A. F., Tamborra, A., Pichini, S., Busardò, F. P., & Huestis, M. A. (2020). Toxicology and Analysis of Psychoactive Tryptamines. International Journal of Molecular Sciences, 21(23), 9279.
  9. Dyck, E. (2019). Psychedelics and dying care: A historical look at the relationship between psychedelics and palliative care. Journal of psychoactive drugs, 51(2), 102-107.
  10. R Vose, L., & K Stanton, P. (2017). Synaptic plasticity, metaplasticity and depression. Current Neuropharmacology, 15(1), 71-86.
  11. Serafini, G., H Howland, R., Rovedi, F., Girardi, P., & Amore, M. (2014). The role of ketamine in treatment-resistant depression: a systematic review. Current Neuropharmacology, 12(5), 444-461.
  12. Haijen, E. C., Kaelen, M., Roseman, L., Timmermann, C., Kettner, H., Russ, S., … & Carhart-Harris, R. L. (2018). Predicting responses to psychedelics: a prospective study. Frontiers in pharmacology, 9, 897.