Psilocybin and the approach to death

A second favorable mainstream-media story about hallucinogens within a week, this time on their use to help people face terminal diagnoses.

Another strongly favorable mass-media story about the hallucinogens, this time focusing on work at NYU using psilocybin to help patients with possibly terminal diagnoses confront the path ahead of them. At what point do the advocates for the dying, and in particular the providers of hospice care, decide to climb on to this bandwagon?

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

One thought on “Psilocybin and the approach to death”

  1. Again, I hope that Mark’s optimism is warranted, and that psilocybin and other psychedelic agents are studied for their potential applications in clinical practice. However, I think that the funding source for the studies will need to be a public one. Unless they can be patented, no drug company is likely to have an incentive to fund the kind of study that would be needed for FDA approval. But there could be political backlash if the grants for the studies come from the National Institutes of Mental Health (NIMH.) You can imagine the uproar if the Obama administration allowed this to happen.

    The National Institute on Drug Abuse (NIDA) did fund a small study of psilocybin a few years ago (Griffiths RR et al, Psychopharmacology 2006;187(3):268-283) that was done at Johns Hopkins. The main endpoint of that study was a set of measures of mystical experience which were meaningful to the participants. Even though psilocybin is Schedule I, NIDA does not consider it to be a drug of addiction because it, like other hallucinogens, does not produce compulsive drug-seeking behavior in the manner of cocaine, alcohol, and heroin.

    Still, this was a pretty small study, and was not studying the application of psilocybin for the treatment of a “disorder.” The Nathan Cummings Foundation funded a very small study of its use in 9 patients with obsessive-compulsive disorder (Moreno FA et al, J Clin Psychiatry 2006;67(11):1735-40). But this is nothing like the scale on which the research would need to be carried out for hallucinogens to become widely accepted.

    So the economics of the situation would need to be overcome, in addition to the perpetual contest of reason to triumph over fear.

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