Anxiety, depression, adjustment disorder, and existential distress in seriously ill people often resist existing medical or behavioral interventions. A growing body of evidence suggests the safety and efficacy of psychedelic-assisted therapies (PATs) to improve these outcomes. As societal norms around the stigma of psychedelic agents shift, interest in integrating these treatment modalities into serious illness care increases. This article describes aspects of serious illness care that might be amenable to PATs, reviews evidence documenting the safety and efficacy of PATs in serious illness care, and highlights opportunities and challenges moving forward.
A single 25 mg dose of psilocybin, combined with preparation and integration sessions, was safely administered to ten terminally ill home hospice patients. No serious adverse events occurred. Demoralization scores dropped by an average of 8.8 points three weeks after the session, despite patients' ongoing physical decline. Grief and peace themes were common during the drug sessions. Although most participants rated the treatment favorably, some found the emotional intensity challenging. The results suggest that psilocybin-assisted therapy can be feasibly and safely integrated into hospice care, but larger studies are needed to confirm its benefits.