Psychedelics and End-of-Life Care: A Policy Lag

“The evidence for psilocybin in end-of-life anxiety is among the strongest in all of psychedelic medicine. The policy response has been among the slowest.”

The 2016 Johns Hopkins and NYU studies of psilocybin for end-of-life anxiety in terminal cancer patients found that a single psilocybin session produced rapid and sustained reductions in depression and anxiety, with 80 percent showing clinically significant improvement at six months in both studies.

In the United States, psilocybin remains Schedule I, end-of-life psilocybin therapy is not accessible to dying patients outside clinical trials requiring specific eligibility and geographic proximity. Australia moved faster: in February 2023, the TGA approved psilocybin for treatment-resistant depression with provisions including palliative care contexts. Australia became the only country where licensed psychiatrists could prescribe psilocybin to dying patients as standard of care.

Oregon's Measure 109 permits end-of-life access, a person needs only to be 21 or older, without a diagnosis requirement. This means in Oregon, a dying person can legally access psilocybin at a service center, a flexibility the clinical trial infrastructure does not provide.

Huxley requested LSD on his deathbed in 1963. The clinical evidence for this use has been strong since 2016. The policy infrastructure to enable it broadly in the United States has still not arrived. The evidence is not the bottleneck.

Sources

• Griffiths et al., J. Psychopharmacol (2016)
• Ross et al., J. Psychopharmacol (2016)
• TGA Australia (2023)