Psychedelics at End-of-Life: Why Wait?

Psychedelics are one of many therapeutic tools for individuals dealing with anxiety, depression, or fear during end-of-life. Research in this area is still in its early stages, but studies show promising results.

Some people want to explore psychedelics way before a diagnosis. It helps them better embrace impermanence and reduce any existential angst right now, rather than wait.

Which Psychedelics Reduce Death Anxiety?

The following psychedelics have helped people reduce fears of death.

Psilocybin (Magic Mushrooms)

Psilocybin reduces anxiety and depression. Research has shown that it facilitates mystical experiences and increases psychological well-being. Psilocybin-assisted therapy is typically administered in a controlled environment with professional support.

MDMA (Molly, Ecstasy)

While not strictly a classic psychedelic, MDMA shows promise in treating post-traumatic stress disorder (PTSD). Researchers also investigate it as a tool for end-of-life anxiety reduction. Some studies suggest that MDMA-assisted psychotherapy helps individuals process emotions, reduce anxiety, and enhance emotional well-being.

LSD (Acid)

LSD has been used in therapeutic settings, although research specific to terminal diagnoses is limited. LSD-assisted psychotherapy may help individuals confront existential concerns, reduce anxiety, and enhance well-being. However, due to its potency and long duration, LSD therapy requires careful preparation, supervision, and integration.

Ketamine (Special K)

Ketamine, although not a classic psychedelic, has gained attention in recent years for its potential therapeutic effects, including in end-of-life care. It is also legal to use and many cities have ketamine clinics and therapists trained in ketamine integration.


DMT is a powerful psychedelic compound found naturally in certain plants, like ayahuasca, and animals, like the Sonoran Desert Toad, as well as produced synthetically. Some ayahuasca retreats are legal in the United States. While research on the therapeutic applications of DMT is limited, some studies suggest that it may have benefits for individuals at the end of life.

How Psychedelics Reduce Fears of Death

Psychedelics help reduce fears of death through various mechanisms. Here are some ways in which psychedelics may potentially contribute to this reduction:

Mystical Experiences

Psychedelics like psilocybin, DMT, and LSD induce profound mystical experiences characterized by interconnectedness, euphoria, unity, and transcendence. These experiences provide individuals with a broader perspective on life, death, and their place in the universe. They may lead to a sense of acceptance and peace.

Expanded Consciousness

Plant medicines often provide individuals with a unique perspective on their existence and the nature of reality. It may allow them to explore unresolved personal issues, gain insight into their life’s purpose, and reconcile with difficult emotions or relationships. This expanded consciousness may promote personal growth, acceptance, and a sense of closure.

Existential Understanding

DMT experiences often involve encountering entities or alternate dimensions, leading some individuals to report a greater understanding of the nature of life and death. Such insights help us develop a more comprehensive worldview, reduce existential distress, and find meaning and purpose in our life’s journey.

Ego Dissolution

Psychedelics can temporarily dissolve one’s sense of ego, or self-identity, leading to a sense of egolessness and interconnectedness with others and the world. This dissolution of ego boundaries may help individuals transcend their fears by recognizing the impermanence of the individual self and embracing a broader perspective on existence.

Spiritual Experiences

Psychedelics can induce profoundly altered states of consciousness that some individuals describe as spiritually significant. These experiences may also involve feelings of interconnectedness. Similar to classic psychedelics, the spiritual experiences facilitated by ketamine may help individuals confront existential concerns and find meaning.

Palliative Care

Ketamine is sometimes used in palliative care settings to manage pain and provide relief from distressing symptoms caused by terminal illnesses. It can help alleviate physical and emotional suffering, which indirectly contributes to improving overall well-being and quality of life.

Increased Psychological Flexibility

Psychedelics have been associated with increased psychological flexibility, which refers to the ability to adapt to changing circumstances and accept or process uncomfortable thoughts, emotions, and experiences. By enhancing psychological flexibility, psychedelics help individuals face and process their fears more effectively, leading to reduced anxiety and distress.

Mood Enhancement

Ketamine has rapid-acting antidepressant effects and has shown promise in treating depression and anxiety, including in individuals with terminal diagnoses. By relieving symptoms of depression and anxiety, ketamine may help improve the psychological well-being and emotional state of those who take it.

Integration and Meaning-Making

Following a psychedelic experience, the integration process is crucial. Integration involves reflecting on and making sense of the insights gained during the experience. Skilled therapists and death doulas help people process their emotions, reflect on the meaning of their experiences, and provide support during their end-of-life journey.

Because the experiences can be intense and challenging, it’s essential to approach them with respect, caution, and appropriate support.

Rescheduling and Decriminalizing Psychedelics

In recent years, there has been a growing interest in the therapeutic potential of psychedelics, and some cities, counties, and states have taken steps to decriminalize or reschedule certain substances for medical or research purposes.

For example, psilocybin-assisted therapy has been granted breakthrough therapy designation by the U.S. Food and Drug Administration (FDA) for the treatment of depression, and MDMA-assisted therapy is undergoing Phase 3 clinical trials for post-traumatic stress disorder (PTSD).

Ketamine is legal throughout the United States.

Arguments in Support of Legalization

There are several arguments put forth in favor of rescheduling and decriminalizing psychedelics for various purposes.

Therapeutic Potential

Psychedelics, such as psilocybin, MDMA, and LSD, have shown promising results in clinical trials for treating mental health conditions. Rescheduling and decriminalizing these substances would remove legal barriers, allowing for further research and the development of evidence-based therapeutic approaches.

Personal Autonomy

Individuals should have the right to make informed decisions about their own consciousness and mental well-being. Responsible adults should have access to psychedelic experiences if they choose, under appropriate guidance and safeguards.

Reduced Harm

Treating psychedelics as a public health issue rather than a criminal one reduces harm. Decriminalization shifts the focus from punishment to harm reduction, allowing individuals to seek help without fear of legal consequences. It may also reduce the risks of the illicit market and unregulated substances.

Indigenous and Cultural Practices

Psychedelics have been used for centuries in indigenous and cultural contexts for spiritual, healing, and ceremonial purposes. Respecting and recognizing these traditions promotes cultural diversity and supports the rights of indigenous communities.

Potential for Scientific Research

Current legal restrictions on psychedelics hinder scientific research and exploration of their therapeutic potential. Rescheduling or decriminalization could facilitate more rigorous scientific studies, leading to a better understanding of their risks, benefits, and optimal therapeutic applications.

Why Wait for a Death Diagnosis?

Waiting until you’re sick or terminally ill to explore psychedelics isn’t mandatory. Many psychedelic retreats, therapists, and death doulas legally and safely work with people decades away from death. The benefit of early exploration is to become more aware and enlightened for a better death someday and a more meaningful life right now.

Of course, you don’t need psychedelics to do this work. Meditating, breathwork, and seeing a licensed mental health counselor or death doula can facilitate awakening and help you better embrace impermanence. If you’d like end-of-life support, no matter where you are in your life’s journey, reach out and contact me today.

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