24 Aug 2023
Psychedelics are Poised to Change How We Age and Die
Psychedelics are Poised to Change How We Age and Die
By Abbie Rosner
MAPS Bulletin: Volume XXXIII Number 2 • 2023
Studies have shown that, for those with a life-threatening condition, an intentional psychedelic journey can catalyze a profound mental shift – from worrying about death and how to postpone it to savoring the present moment. And yet, we all have a terminal condition. And for an entire generation of aging baby boomers, the opportunity to experience an end-of-life psychedelic ritual could create a radical new vision for how we grow old and die.
When it comes to dying, we can learn a thing or two from Dr. Roland Griffiths. Given a Stage IV cancer diagnosis, the esteemed Johns Hopkins researcher came to see it as a gift and the pivot point to the most awake and joyous time in his life (Griffiths was recently honored at a dinner at the Psychedelic Science conference in Denver). This remarkably uplifting attitude he attributes to a longtime meditation practice and, yes, some experiences with psychedelics.
The irony is bittersweet. Griffiths was the lead investigator on a landmark 2016 study showing the remarkable outcomes of psilocybin-assisted therapy in treating existential distress in cancer patients. As Griffiths admits with a smile, for all the times he wondered what the volunteers were getting out of the experience, now he knows.
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Psychedelics and the Death-Positive Movement
During a psychedelic journey, cancer patients often describe transcending their ailing bodies, supported by a unifying force field of joy and love. What follows is often a profound and enduring mental shift: from obsessively worrying about death and how to postpone it, to savoring the present moment.
To some extent, a similar shift is afoot in our culture. After decades where death was a taboo topic, we are increasingly willing to discuss and plan for it: with palliative and hospice caregivers, death doulas, and even strangers in death cafes. There is less shame and stigma–greater curiosity. Less medicine–more spirit.
I anticipate that once psychedelic-assisted therapy towards the end-of-life becomes widely available, the death-positive movement will be launched into another plane.
Entering expanded states of consciousness to illuminate life’s greatest mystery, whether through ritual practices or psychoactive substances, is nothing new and appears to be a fundamental human experience. Since prehistory, the opportunity to sip a potion, step into the shadow world, and “die before you die” has offered spiritual seekers comfort and context for the great unknown. Despite centuries of unrelenting repression by colonists, the church, and governments, Indigenous cultures continue to practice and teach us how to find meaning in mortality through sacred medicines.
I anticipate that once psychedelic-assisted therapy towards the end-of-life becomes widely available, the death-positive movement will be launched into another plane.
Behind the Data
Over the last 70 years, several hundred cancer patients have participated in clinical trials of psychedelic-assisted therapy to alleviate existential distress. The consensus from these studies is that while not everyone benefits, a large portion do. Some, profoundly so.
Participants who score highly on Mystical Experiences Questionnaires report dramatic increases in multiple measures of well-being. Behind the data points are intensely poignant stories: cathartic encounters with long-dead loved ones, terrifying and exquisite experiences of death and rebirth, and the release of dissolving into divine unity. Out of these journeys comes deep spiritual healing and grace that eases the pain and grief of inevitable loss.
Not every psychedelic journey leads to a transcendent, mystical-type experience, but with thoughtful set and setting and appropriate support, just submitting to the unknown places these sacred medicines take us can be the dress rehearsal for the ultimate letting go.
The Problem of Access
At this point, the only legal way most people can access psilocybin-assisted therapy for end-of-life distress-aside from a pricey overseas retreat-is to enroll in one of a very small number of clinical trials.
There are nowhere near enough trained guides/facilitators to meet the expected demand. If this form of therapy isn’t covered by insurance, it will be available, but only for the privileged and wealthy.
And yet, under “Right to Try” laws, which make experimental drugs available to those with a life-threatening illness even before FDA approval, psilocybin should be available to any patient with a terminal condition whose physician believes they would benefit from it. Washington state palliative care physician Sunil Aggarwal’s attempts to exercise that right on behalf of his patients have so far been blocked by the Drug Enforcement Administration. Aggarwal is appealing, and in parallel, several congressional initiatives to make psychedelic-assisted therapy more accessible are currently on the table.
If and when the DEA relents, patients around the country will start asking their doctors how they can get psilocybin-assisted therapy, which could be a tipping point for psychedelics’ entry into the mainstream.
Beyond the legal prohibition, formidable obstacles for widespread access to psychedelic-assisted therapy remain. There are nowhere near enough trained guides/facilitators to meet the expected demand. If this form of therapy isn’t covered by insurance, it will be available, but only for the privileged and wealthy. Furthermore, despite decriminalization measures, until psychedelics are federally legal, BIPOC who have been most impacted by the War on Drugs may not feel safe to access them.
For now, the underlying systems that will support psychedelic-assisted therapy to the dying are being set into place. The first psychedelic-assisted therapy facility located in a cancer center is now a site for clinical trials, a model ready to be replicated around the country once it is legally possible.
The palliative care field is preparing to offer psychedelic-assisted therapy to address the spiritual suffering of the chronically ill and dying. Death doulas are adding psychedelic integration support to their roster of services. And because the way we approach death and a psychedelic experience are both imbued with spiritual content, the chaplaincy is now training a cadre of “spiritual health clinicians” to support this end-of-life therapy.
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A New End-of-Life Ritual
We may be anxious about death. Or inquisitive. But one thing we all share in common is a terminal condition.
Now, an entire generation of baby boomers is approaching old age, just as the opportunity is opening up to have a safe, intentional, and legal psychedelic trip.
Back in the 60s and 70s, drugs helped us reimagine a new culture of youth. Now that we’re in our 60s and 70s, they may help us reconceive the way we experience aging and death.
I propose that the conditions are ripe for the institution of a new psychedelic end-of-life ritual – inspired by world cultures but personalized to one’s own cultural touchstones and sensibilities.
…we don’t need to wait until we’re at death’s door to appreciate the miracle of our life on this earth.
Undertaken with intentional planning, guidance, reverence and integration, a psychedelic life-cycle ritual could radically alter our attitudes about death – with positive repercussions at the individual, family, community, and societal levels.
Dr. Roland Griffiths, a baby boomer himself, reminds us that we don’t need to wait until we’re at death’s door to appreciate the miracle of our life on this earth. Whether our demise is imminent or eventual, there is no better time than now to awaken to the mystery of life.
Abbie Rosner
Abbie Rosner is a writer and baby boomer, focused on how mindful revisiting of the drugs of our youth can enhance the way we age and transition. If you or someone you know have had a meaningful end of life psychedelic experience, she would love to hear about it! abbieros@gmail.com
