Psychedelics and dying care: A historical look at the relationship between psychedelics and palliative care

This review article (2019) retraces the history of psychedelics (specifically LSD) for palliative care and the possibility of reducing (end-of-life) anxiety.

Abstract

“This article examines the historical relationship between psychedelics and palliative care. Historians have contributed to a growing field of studies about how psychedelics have been used in the past, but much of that scholarship focused on interrogating questions of legitimacy or proving that psychedelics had therapeutic potential. Palliative care had not yet developed as medical sub-specialty, more often leaving dying care on the margins of modern, pharmaceutical-based treatments. As psychedelic researchers in the 1950s began exploring different applications for psychoactive substances such as LSD and mescaline, however, dying care came into clearer focus as a potential avenue for psychedelics. Before that application gained momentum in clinical or philosophical discussions, psychedelics were criminalized and some of those early discussions were lost. This article looks back at historical discussions about LSD’s potential for easing the anxiety associated with dying, and considers how those early conversations might offer insights into today’s more articulated discussions about psychedelics in palliative care.”

Author: Erika Dyck

Summary

This article examines the historical relationship between psychedelics and palliative care, focusing on discussions about LSD’s potential for easing the anxiety associated with dying, and how those early conversations might offer insights into today’s more articulated discussions about psychedelics in palliative care.

Introduction

Aldous Huxley took LSD in 1953 and became fascinated by the possibilities of using psychoactive substances to alter one’s perception. He corresponded regularly with Humphry Osmond and introduced the word “psychedelic” into the English lexicon.

Osmond and Huxley saw in psychedelics a tool for exploring human consciousness on a philosophical level, and later recognized that this tool was valuable in the field of dying care.

Two early psychedelic thinkers ruminated on the Sacred, and Huxley in particular drew attention to the rituals associated with peyote, which involved modesty, humility, tolerance, and empathy.

Aldous Huxley’s decision to take LSD on his deathbed emerged from his experience as a caregiver to his first wife, Maria (née Nys), who died from cancer. Huxley believed that modern human civilization was ignoring the needs of dying individuals.

Aldous and Maria had direct experience with mescaline and LSD, and had become interested in mysticism, Indigenous rituals, hypnotism, and parapsychology during their time in California. Aldous spoke of Peace, of moving past memories of life, and overcoming the barriers created by regrets, remorse, and anxiety.

Aldous Huxley shared his initial and raw musings about death with Gerald Heard, who encouraged him to pursue the topic further with the intention of improving care. Huxley consulted psychiatrist Humphry Osmond, who responded by stepping back from the immediacy of the situation and placing their grief in a broader human context.

Huxley’s views on this topic were neither flippant nor superficial, and his work had taken on a new set of perceptions guided by his personal curiosity about mind-altering drugs, mescaline and LSD in particular.

Aldous Huxley was an intellectual thinker who identified most with a humanist tradition, but who was firmly associated with the history of biology through his family connections. He wrote 50 books and many essays and screenplays, and was perhaps best known for his dystopic views about the modern world.

Huxley developed a keen interest in parapsychology and mysticism, and his correspondence with Osmond exposed their shared conviction that science was best handled in partnership with a humanist tradition. He believed that the living could do a great deal to make the passage easier for the dying.

Huxley and Osmond’s reflections on the art of dying and psychedelics showed a cultural ambivalence towards the mechanization of human healing, which was consistent with their trepidation about technology overall.

Palliative care

The death rate is expected to increase, and the way we die is also changing, as people live longer and acquire more illnesses requiring complicated pain management regimens and professional medical care.

Palliative care is a relatively new idea, and has steadily moved into clinical spaces. It has become a much more medicalized experience than ever before in human history.

Different belief systems throughout history tell different stories about how we should understand the dying process, but all allow for acceptance, reconciliation, and closure.

Medical historians suggest that medicine has lost sight of its original tenets about the relief of suffering, and that it has only been accepted as a clinical category of its own in the latter half of the twentieth century.

The psychedelic renaissance and dying care

By the end of the decade, psychedelic research was still in ascendance, but the reputation of psychedelics in medicine changed, and many units abandoned their studies under pressure from colleagues and regulators. Eric Kast’s findings continued to animate discussions about dying care.

Walter Pahnke left Harvard in 1967 to work with Richard Katz, Timothy Leary, Richard Alpert, and others at Spring Grove Hospital. Their work helped to lay the groundwork for more recent studies on the psychological impact of spiritually induced reactions from substances.

Bill Richards, a clinical psychologist and theologian, claims that psychedelics have tremendous therapeutic, as well as spiritual, value. He includes LSD, mescaline, psilocybin, and DMT among the list of non-addictive, non-toxic substances that commonly invoke an indescribable feeling. Richards describes his own first experience with mystical feelings, in which he was overcome by the perceptions he acquired and felt lost in trying to find words to capture the insights.

Griffiths and Richards are not the only ones using modern medicine to explore the mystical elements of psychedelic encounters. Franz Vollenweider has been using brain scans to compare the effects of psychedelic drug use and Buddhist meditation.

Over the past decade, many studies have made the connection between psychedelics and end-of-life care, particularly as it addresses the anxiety associated with facing death.

Gabor Maté, a Western-trained family physician, straddles different disciplinary and ideological traditions, embracing harm reduction models that connect with Indigenous traditions, spiritualist interventions, and non-biomedical conceptualizations of addiction.

The leading scientists and physicians in the psychedelic renaissance are looking to historical antecedents for inspiration, as well as lobbying regulators for better access to pharmacological substances that tap into more traditional, or at least non-orthodox, healing practices.

Psychedelic therapy relies on an appreciation for the value of spiritual elements in healing. This history should be revisited to understand how biomedicine has handled issues of spirituality in the context of healing and caring.

Palliative care is a relatively new medical subspecialty, and historians and medical practitioners alike have been reluctant to study dying as a coherent or generalizable experience. Yet, the issue of spirituality looms large.