Study examines challenges in integrating psilocybin therapy with palliative care

Coryn Mayer says the healthcare system needs to improve if psilocybin therapy is to become a mainstream tool.

Research suggests that the psychedelic substance psilocybin from so-called magic mushrooms helps patients in therapy. 24K-Production/Getty Images

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Studies indicate that therapy with psilocybin helps people facing life-threatening conditions.

Psilocybin is the psychedelic compound derived from so-called magic mushrooms.

A growing body of research suggests that people in palliative care experience relief from anguish with just a single dose.

However, integrating psilocybin therapy as a tool in caring for patients has a long way to go.

This is demonstrated in a study by researchers with the University of Virginia School of Nursing, who examined challenges in this field.

“As discussions of psychedelics are generally not incorporated in traditional medical, pharmacy, chaplaincy, or nursing curricula, our study emphasizes the importance of educating both current and future health care professionals on the physical, psychological, and existential effects of psychedelics,” the authors wrote.

They added that educating health care providers is “particularly important as the use of psychedelics becomes more mainstream”.

The study looked at a number of themes, and two of these relate to the understanding by palliative care workers of “existential distress”, and the “risks and benefits” of psilocybin.

The researchers noted that understanding existential distress or psychological turmoil is a “foundational element of providing quality palliative care”.

The work noted that providers “described a cultural lack of expectation for existential and spiritual care in the health care domain, which they reported as historically being the purview of religion”.

“As the existential dimension is often considered ‘taboo in [Western] medicine,’ participants discussed the culture of a dominant curative and commercial paradigm, which is fixated on prolonging life, avoiding death, and relying on ‘pills’ to fix problems rather than time, energy, and people,” the researchers explained.

Moreover, “Providers discussed how the organizational priority and pressure of productivity over quality impedes existential care, limiting the time health care professionals have to listen to their patients.”

As well, “participants described subsequent individual barriers being a lack of personal knowledge and skill to address existential distress, a lack of self-reflection in addressing one’s own existential distress, and personal discomfort talking about death and dying with patients”.

With regard to the theme of risks and benefits of using psilocybin in therapy, all participants “expressed uncertainty” about the subject.

“Familiarity, attitudes, and openness/support of psilocybin varied among providers,” the authors noted.

The level of knowledge and exposure to the field of psychedelics also varies among the participants in the study.

Hence, “providers expressed divergent views regarding the necessity, novelty, fruitfulness, accessibility, and applicability of PT [psilocybin therapy], which were reflective of their individual scopes of practice and expertise”.

To illustrate, “Those who had a closed/reluctant attitude about PT expressed concern that it would replace the human and interpersonal work needed to relieve existential distress.”

The study is titled “Exploring the Use of Psilocybin Therapy for Existential Distress: A Qualitative Study of Palliative Care Provider Perceptions”.

The paper was authored by Coryn Mayer, Virginia LeBaron and Kimberly Acquaviva.

The Journal of Psychoactive Drugs published the study online last month.

Mayer told CannCentral that her main takeaway from the paper is that the healthcare system is “not designed for the potential and optimization of psilocybin therapy, due to time constraints, historically exclusive spaces, and the lack of understanding of existential distress in general”.

“For me, it seems to be common sense that if psilocybin is to become mainstream as a legitimate pharmacotherapy, then the system needs to improve prior to adding a new drug into the mix,” Mayer stated.

Follow Carlito Pablo on Twitter at @carlitopablo

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