Today I want to talk about a project of ours at NYU using psilocybin-assisted psychotherapy to treat end-of-life distress in people with cancer. I also want to talk about where Americans die—generally, I think we die in the wrong place in this country—and about the domains of palliative care and what that means. Additionally, I want to discuss spirituality and the phenomenology and prevalence of end-of-life distress and the link between spiritual states as potential buffers against end-of-life distress and psilocybin as a potential modality for increasing spiritual states in patients coping with such distress.This is via Bob Jesse, a researcher on psilocybin, who posts over at the RBC. I find it interesting how that is Mark Kleiman's home as well—for those of you don't know, Kleiman is sort of the resident drug policy concern troll, a reliable anti-anti-drug war voice who is nevertheless fairly well-informed about the issues.
I suspect there's some room for commonality here. Most of the action in the drug policy reform community is on the big-time drugs: marijuana, cocaine, heroin, meth, maybe ecstasy; and rightly so, because that's where all the money, crime, and violence is. The psychedelics, on the other hand, have never been more than a fringe topic by comparison. They'll simply never be as popular as the big-time drugs, for the simple reason that the average person finds the experience at least unsettling, and probably rather unpleasant, especially if they're not prepared. Psychedelics aren't the kind of drugs you do on a whim without any experience.
Yet they're jammed in Schedule I as some of the "most dangerous" drugs (note that both cocaine and meth are Schedule II, a less restrictive category), a classification that is self-evidently preposterous, flies in the face of all experience and research on the subject, and really undermines the whole classification scheme of the Controlled Substances Act. It's obvious to anyone who looks at the issue for five minutes that the DEA has been flagrantly abusing their emergency scheduling power to jam all sorts of newer psychedelics into Schedule I regardless of effect. I think (hope) even someone like Kleiman should be able to get behind a proposal to set psychedelics aside into their own special category where they could possible be prescribed, especially in light of all the recent studies. As Dr. Ross notes:
There has been an unexpected renaissance in the long-taboo field of psychedelic research, highlighted by an ongoing study at John Hopkins University which recently concluded that a single dose of psilocybin (still a Schedule 1 substance in the U.S.) brought about “a measureable personality change lasting at least a year… in the part of the personality known as openness, which includes traits related to imagination, aesthetics, feelings, abstract ideas, and general broad-mindedness.”