Scientists at St Vincent’s Hospital in Melbourne have today started the world’s first clinical study of this kind. Specifically, they’re studying the effects of synthetic psilocybin, which used in conjunction with psychotherapy may help alleviate the psychological distress experienced by patients with advanced terminal disease. Over three-and-a-half years, the trial involved 35 participants, including Michael Quinn, a 74-year-old former builder battling prostate cancer that had metastasized throughout his body. This Australian-first clinical trial aims to explore how psychedelics can reduce anxiety and improve the quality of life for patients facing imminent death.
The trial is a significant step forward in palliative care. It promises a more tailored approach to a demographic that has long struggled with conventional therapies. The study was conducted by psychiatrists Dr. Margaret Ross and Dr. Justin Dwyer. They stressed that integrated psychotherapy is an essential component of the treatment continuum. Participants adhered to a highly monitored regimen. They were given two doses of psilocybin, six to seven weeks apart, with extensive psychotherapy before and after each dose.
Treatment Structure and Environment
The treatment protocol also produced a calming environment for the dosing sessions. During treatment, patients spent seven hours in a quiet, dimly lit room, listening to soft music while counselors monitored their post-psilocybin experience. This was done to create an environment with minimal external stimuli, so participants could concentrate fully on their internal experiences. The other half of participants were randomly assigned to receive a placebo for dose one. Compared to one another, the subjects received psilocybin for their second dose.
Dr. Dwyer highlighted the significance of psychotherapy in the treatment: “The focus of the study is a really interesting one. It’s a population that traditionally hasn’t done well with a lot of the traditional approaches,” he stated. He noted that many of the existing therapies are very dependent on sedative medications. These approaches frequently miss the mark, leaving patients with terminal illness in need of specialized psychological treatment to address their existential suffering.
“So to kind of be able to sit with, and face and walk through and transform this experience of terror in the face of the unbearable meant that people could actually go, no, I’m still alive.” – Dr. Margaret Ross
Patient Experiences and Outcomes
Thematic analysis of qualitative interview data revealed participants had positive, personal, and often transformative experiences throughout the trial. Michael Quinn, who before treatment, had lived with an all-consuming dread of death, experienced peace and joy after the therapy. His wife, Pat Quinn, expressed her gratitude for the care provided by Dr. Ross and Dr. Dwyer:
“Marg and Justin, what they did for Michael I think was outstanding. The difference that it made and the difference that it made for me.” – Pat Quinn
Dr. Ross said these findings showed dramatic decreases in depression, anxiety, hopelessness and demoralization in participants. These results indicate an increase in quality of life in addition to reductions in mental health symptoms.
“We did see reductions in depression, anxiety, hopelessness, demoralization — so we saw big reductions in psychological distress,” Dr. Ross confirmed. “But not only that, we also saw increases and improvement in quality of life.”
Beyond this, participants had powerful emotional reconciliations and felt a profound sense of reconnection to humanity. Dr. Ross elaborated on these profound insights:
“They experienced acceptance, a strong sense of connection to humanity, and peace in the face of death.” – Dr. Margaret Ross
Towards a Broader Application
The treatment has exhibited tremendous potential, but it remains cost-prohibitive and labor-intensive. Patients should not have to look forward to more than $26,000 in costs as it would involve great intervention from clinicians. As Australia’s national medical regulator approved the therapeutic use of certain psychedelics for specific mental health conditions in 2023, researchers are keen to explore how to make this treatment more accessible.
Dr. Ross acknowledged the need for further investigation: “We need to be looking at how we can roll this out in a more cost-effective, time-effective and accessible way.” The research is a significant breakthrough in the quest to demonstrate the therapeutic impact of psilocybin-assisted therapy on improving end-of-life care.
Professor Ian Hickie weighed in on the findings, suggesting that psychedelic drugs may create a window for more effective psychological treatments:
“There may be a window that’s created to make psychological treatments more effective as a consequence of using psychedelic drugs.” – Professor Ian Hickie
He warned not to overstate the benefits of psychedelics by itself.
“The psychedelics alone won’t be the solution. What’s the best combination? What opportunity is created and can you capitalize on that?” – Professor Ian Hickie
