Psilocybin-Assisted Psychotherapy for End-of-Life Distress and Palliative Care
Are you caring for a patient who is experiencing end-of-life distress as a result of a terminal or life-threatening Illness?
You may consider recommending psilocybin-therapy.
What is Psilocybin Assisted Psychotherapy?
Psilocybin-assisted psychotherapy refers to the professionally guided use of psilocybin (‘magic mushrooms’) in combination with psychotherapy.
This treatment option involves a treatment protocol that encompasses careful medical oversight of the treatment session, as well as pre- and post -psychotherapy sessions. This therapy has been shown in numerous clinical studies to reduce existential distress, relieve depression and reduce or eliminate the fear of death.
“Having Cancer is like being dragged behind a horse, it is terrifying and out of your control. How I feel now [after psilocybin therapy] is a little closer to riding a horse, as opposed to being dragged by it. We are still on the horse and we are still going places but it’s not so out of control.…to experience the lack of anxiety is beyond words, it is amazing.”
Thomas Hartle, Saskatchewan,
First patient to access legal psilocybin therapy in Canada
How Can TheraPsil Help Your Patient?
TheraPsil is a non-profit patient advocacy organization based in Victoria, BC, and supports patients Canada-wide. We assist patients who are suffering from end of life distress to access legal, psilocybin assisted psychotherapy.
We do this by supporting patients with an application to the Minister of Health, so they may receive an exemption to section 56 of the Controleld Drugs and Substances Act (CDSA), allowing them to use psilocybin (magic mushrooms) for a therapeutic purpose. These exemptions are the same as those that were used to grant the first few medical cannabis patients access to cannabis in the late 1990’s.
If an exemption is approved, TheraPsil connects patients with therapists who are trained in psilocybin-assisted psychotherapy and who can facilitate their treatment, including preperatory sessions, the psilocybin session, and post-integration sessions.
Our Steps & How You Can Support your Patient in Accessing Psilocybin Therapy through TheraPsil
- Ensure your patient meets TheraPsil’s initial inclusion criteria below:
- 18+ Resident of Canada, with a terminal diagnosis OR in remission from a life-threatening diagnosis and/or receiving palliative care
- As a result of past or present life-threatening diagnosis, experiencing psychological distress (anxiety/ depression/ demoralization)
- Interested in trying psilocybin therapy and have identified a potential supply of psilocybin mushrooms
- Emotional distress has not successfully responded to other treatments
If your patient meets the initial inclusion criteria, please follow the following steps:
- Talk to your patient about psilocybin assisted psychotherapy as a treatment option for their end of life / existential distress.
- If they are interested, direct them to www.therapsil.ca/patients to enter their information into our website’s patient e-form.
- Let your patient know that after they complete the website e-form, if they may meet the inclusion criteria, TheraPsil’s Clinical Intake Director will be in touch with them via email to schedule an initial intake appointment.
- Initial intake is used as a first step in screening whether the patient qualifies to be supported by TheraPsil and to identify any contraindications or red flags regarding psilocybin-assisted psychotherapy.
- If a TheraPsil Clinical Intake Director determines the patient may meet inclusion criteria, the patient then requires our Patient Inclusion Criteria (PIC) Form to be completed by a medical doctor. If after PIC form completion, the physician supports the patient’s application for exemption, the supporting physician provides an official letter of support.
If you would like to support this portion on your patient’s application, email our Clinical Intake Director, Natasha Fearnley, at email@example.com for detailed instructions and supporting documents.
- Once PIC form and letter of support are completed, TheraPsil will assist your patient in writing a personalized letter to the Minister of Health as part of their section 56 exemption application. TheraPsil will ensure the section 56 exemption application is completed and submitted to the Minister of Health.
- Within 15 business days your patient’s exemption should be approved and TheraPsil will advise of next steps so your patient can be paired with a therapist trained in psilocybin assisted psychotherapy.
“ [After receiving psilocybin therapy] I've been able to be happy and anxiety-free and not worry about what’s going to happen tomorrow. I’m able to live in the day and in the moment”
Laurie Brooks, British Columbia
Psilocybin Assisted Psychotherapy is an EVIDENCE based treatment option
Research from leading organizations such as Johns Hopkins, NYU and UCLA indicates that psilocybin-assisted psychotherapy is a safe and effective treatment option for those suffering from existential distress.
“Psilocybin produced large and significant decreases in clinician-rated and self-rated measures of depression, anxiety or mood disturbance, and increases in measures of quality of life, life meaning, death acceptance, and optimism. These effects were sustained at 6 months.”
- Griffiths et.al, 2016
We have developed a comprehensive reading list of original scientific research papers from the past decade relating to psilocybin-assisted psychotherapy in the treatment of end-of-life distress. The items in this bibliography collectively document that more than 2000 doses of psilocybin have been safely administered since the early ‘90s.
Collectively, they indicate that psilocybin-assisted psychotherapy is an effective and low-risk treatment for end-of-life distress when conducted according to research-established protocols by suitably trained therapists.
“Psilocybin produced immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, and increased quality of life.”
- Ross et. al, 2016
Psilocybin Therapy is a COMPASSIONATE Treatment Option
“[In palliative care] the one challenging symptom which we do not have treatment for is 'existential suffering' or profound despair. This symptom is complex and impacts on all other symptoms. It is so dramatic, it is palpable to anyone entering the room with the patient. Family members agonize as well as their care providers - feeling helpless in the face of this suffering. The experience that my patient had has made me realize that psilocybin treatment is a powerful tool that, in conjunction with a trained therapist, can alleviate a symptom which we previously could do nothing about.”
- Dr. Valorie Masuda, Palliative Care Physician, British Columbia
Today, palliative care advances are keeping people alive longer, however, it also means that their dying time becomes more complicated.
Patients are told they have terminal or life threatening illness but they go through periods of 'ambiguous dying'. They undergo treatment after treatment, trying to prolong life, living through periods of hope with each treatment and then hopes dashed as their disease progresses. This roller coaster of emotions - fear and reassurance, hope and hopelessness, optimism and despair - often set the stage for existential distress. Finally, however, they all have to face their dying time as that last line of chemotherapy stops working.
Psilocybin Therapy can provide much needed relief for patients who are emotionally suffering from end-of-life related distress.. The Minister of Health has granted patients compassionate access to psilocybin therapy because it can provide much needed relief, that previously could only be provided by deep sedation or MAiD.
“Twenty-four hours [after my patient’s psilocybin therapy session], the effect was remarkable...For the first time in many months, she reported NO pain. Her family remarked that she was doing much better, and even cracking jokes. She enjoyed being able to be present with her family and friends, without intractable pain and fear. Two days after her treatment, [my patient] calmly told me that she was no longer afraid to die. She had called several friends to come visit and say goodbye, and she was able to have meaningful connections, clear and alert with friends and family. She died peacefully and without fear, surrounded by her family. A ‘Good’ Death.”
- Dr. Valorie Masuda, Palliative Care Physician, British Columbia
Frequently Asked Questions
Become Trained in Psilocybin Therapy
If you are a healthcare professional interested in becoming a TheraPsil Clinical Associate who is trained in how to facilitate psilocybin therapy for patients with approved section 56 exemptions, please visit our training page and sign up to our waitlist.