Register for an account


Enter your name and email address below.

Your email address is used to log in and will not be shared or sold. Read our privacy policy.


Website access code

Enter your access code into the form field below.

If you are a Zinio, Nook, Kindle, Apple, or Google Play subscriber, you can enter your website access code to gain subscriber access. Your website access code is located in the upper right corner of the Table of Contents page of your digital edition.


Psilocybin Could Help Terminal Patients Face Their Fear of Death

Psychedelics like psilocybin, found in magic mushrooms, could help terminal patients comes to terms with their fear of death.

By Lauren SlaterApril 10, 2018 12:00 AM
Psychedelics Header
(Credit: George Peters/Getty Images)


Sign up for our email newsletter for the latest science news

In February 2008, 53-year-old Carol Vincent found a strange swelling on her body. Having just recovered from a bout of illness, she dismissed it as the last flutterings of the flu. Her fiancé persuaded her to consult her doctor, which she did, almost breezily, assuming he would tell her that the enlarged knuckle-like node was of no real concern.

Instead, as her doctor pressed and palpated, a shadow passed over his face, and fear took hold in Vincent. The next thing she knew she was being X-rayed and biopsied. Later, dressed and seated in her physician’s office, Vincent was informed she had lymphoma, a kind of cancer for which there is no cure and no consistently effective treatment, either. As days and weeks went by, the strange swelling migrated and multiplied, appearing in her armpit and the cradle of her collarbone.

Vincent, a writer and an entrepreneur in British Columbia, had a full life, a life she loved, a life that included a home, a fiancé, a grown son and meaningful work. As she waited to find out whether the cancer would progress to the point where it would require radiation and chemotherapy, she decided to do everything in her power to conquer her disease.

She gave up sugar, caffeine and flour. She cleansed and juiced, drinking pureed wheatgrass so thick, it coated the sides of the cup and left a mark above her mouth. She logged on to the internet for hours each day, searching for studies, experiments and medications. Details gleaned from Google informed Vincent that she had seven years to live, 10 at the absolute outer limit.

“Emotionally, it was very stressful,” she says. “An anvil over my head. Every single decision was tricky. Should I drink superclean wheatgrass juice or just eat chocolate chip cookies because life is short? Do I pay off my mortgage or rack up my credit cards?” When the strange swellings abated, Vincent began to believe that her diet might be healing her. High on hope, she was shattered when the hard nodes returned, in new places on her body. A certain paranoia, or heightened awareness, overtook her. Was an outgrowth emerging on her ankle? What was that bump behind her ear? Her body became a bomb, detonating slowly over days, then weeks, then months. Even though the end was some unknown number of years away, Vincent began to lose hope.

Roland Griffiths started to wonder about wonder itself. And from that wondering grew his interest in psilocybin and its effects on the human psyche. (Credit: André Chung)

An Epidural for Death? 

Eventually, when she was near the point of surrendering hope entirely, it would return in the form of Roland Griffiths, a psychopharmacologist and professor of behavioral biology at Johns Hopkins University. Griffiths was in the middle of an experiment that involved giving psilocybin, the active ingredient in so-called magic mushrooms, to 51 end-stage cancer patients in an effort to alleviate their fear of death.

Psilocybin, along with LSD, a similar hallucinogenic, is in a class of drugs known as psychedelics. As opposed to psychotropic drugs, whose primary function is to alter the mood or function of the brain, the main action of psychedelics is to change actual perception or cognition, bringing the brain somewhere beyond ordinary consciousness.

Known for his meticulous research methodologies, Griffiths also maintains a rigorous practice of meditation that he began about two decades ago. His meditation eventually caused a swerve in his thinking, and this stern scientist began to meander and muse. He started to wonder about wonder itself. And from that wondering grew his interest in psilocybin and its effects on the human psyche.

Shifting his laboratory focus away from animals and drugs of abuse, Griffiths homed in on psychedelics. In 2006, he published his landmark study, straightforwardly titled “Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance.”

The idea and the experiment were not new, of course. The novelist Aldous Huxley first tried psychedelics in the early 1950s and famously continued ingesting them to the very end. In 1963, dying of laryngeal cancer and unable to speak, he made a written request of his wife to inject him with LSD on his deathbed so that he could leave this world in a psychedelic swirl of stars. What Huxley wanted, and what the work of Griffiths could realize, is for death to be less of a physiological process and more of a spiritual one.

Around the time of Huxley’s death, an anesthesiologist at the Chicago Medical School named Eric Kast was finding normal analgesics insufficient for managing the most intense pain of his dying patients. He decided to explore whether LSD might be an effective alternative. In a study published in 1964, he compared the analgesic properties of Demerol and Dilaudid with those of LSD. The subjects of the study were 50 people suffering from various severe cancers, gangrene of the feet and legs, and a single case of shingles. Kast’s statistical analysis showed that LSD proved superior to the more common analgesics. On LSD, patients not only developed “a peculiar disregard” for their suffering and for the seriousness of their situations, but also they discussed their death more freely and with considerably less fear.

(Credit: Atomazul/Shutterstock)

The Original Magic Mushrooms  

Kast and Huxley were among the earliest modern psychedelic pioneers, but they were not the ones to bring into popular use the drug that would eventually help Carol Vincent and so many others. That honor belongs to R. Gordon Wasson, a public relations executive for J.P. Morgan & Co. and an amateur ethnomycologist — someone who studies the historical uses and sociological impact of mushrooms. As a businessman who wore a pressed suit to work every day, he was hardly a likely candidate for the job of mushroom messenger. In fact, up until his honeymoon, Wasson had hated mushrooms, calling them toadstools or “excrescences.” His Russian-born wife, however, convinced him of their majesty and beauty.

Wasson had heard stories of magic mushroom ceremonies in Mexico that supposedly occurred only under the cover of darkness and were led by a sacred shaman. Research revealed to Wasson and his wife that when Hernán Cortés overtook Mexico, he discovered the Aztecs were using different kinds of mushrooms in their religious rites, calling the plants teonanacatl, “God’s flesh.” Were they purely a plant of the past, or did they still exist? On June 29, 1955, Wasson and his friend Allan Richardson traveled to a remote Mexican village in Oaxaca, in the Mixteca region, in search of teonanacatl. Wasson wrote a Life magazine story about it two years later.

The village was small, dusty and sunstruck, its streets eerily empty. At an altitude of 5,500 feet, it was remote, and the past so well preserved, that most native inhabitants still spoke no Spanish. In the town hall, Wasson found a young indigenous man — a síndico, the local official in charge — sitting in a large, empty room. Wasson leaned down and asked if the síndico could help him “learn the secrets of the divine mushroom.” Nothing could be easier, the síndico replied.

Thus Wasson and Richardson found themselves, that evening, as the first known white men ever to partake in the local’s ancient mushroom ceremony. It took place in the lower chamber of the síndico’s house after 8 p.m. The room was filled with locals sitting on mats, waiting to be served. Before midnight, the mother and daughter shamans passed out the mushrooms, giving each adult a portion and keeping most for themselves. Richardson had promised his wife he would not ingest any mushrooms, but he found himself swept into the ceremony, as was Wasson, for whom this was the culminating moment in a long pursuit.

Both men bit into the fresh fungi and chewed them slowly. After half an hour had passed, spectacular visions began appearing to Wasson — a steady stream of gorgeous geometrics, then palaces of pearl, gardens, chariots pulled by mythological beasts. Each image was perfectly etched, clearer than clear, so that Wasson felt that for the first time he was really seeing reality.

Wasson and Richardson were utterly awed by their experience. On successive trips, they brought along world-renowned mushroom expert Roger Heim in an effort to identify all the types of hallucinogenic mushrooms and to procure enough of a supply that it could be used for laboratory study. Eventually, mushrooms were sent to Albert Hofmann, the first man to synthesize LSD, at the laboratory of the pharmaceutical firm Sandoz in Basel, Switzerland. Hofmann ate a few and recorded his experience — “everything took on a Mexican character” — and later discovered their active ingredient, psilocybin.

Back in Boston, Timothy Leary, a psychologist and professor at Harvard University who would become famous for the admonition to “turn on, tune in and drop out,” learned about the magic mushrooms. He then ate them in Cuernavaca, Mexico, leading him to conceive of and implement the Harvard Psilocybin Project, whose goal was to study the effects of hallucinogens on a wide range of subjects: prisoners, parishioners, divinity students and the dying.

Psychedelics and Spirituality 

The Good Friday Experiment is perhaps the most famous study of the role of psilocybin in spirituality. Conducted in 1962 by Walter Pahnke, the experiment gathered 20 Protestant Harvard Divinity School students outside the Marsh Chapel at Boston University to receive a capsule of white powder right before a Good Friday service. Ten of the pills contained psilocybin, and 10 contained nicotinic acid, an active placebo that causes flushing in the face. Of the 10 students who received the psilocybin, eight said they had a mystical experience, wandering around Marsh Chapel while saying things like, “God is everywhere.” Their behavior convinced Pahnke that a psilocybin high shared many aspects with a full-fledged mystical experience.

Persuasive as psilocybin is, recent scholars — such as Rick Doblin, the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS) in Santa Cruz, California — have found methodological flaws in Pahnke’s study. From 1986 to 1989, Doblin did a follow-up of the Good Friday Experiment, identifying all but one of the divinity students who took part in the 1962 study and interviewing the 16 who agreed to participate, including seven of the 10 who had taken psilocybin.

(Credit: Farmer Dodds/Shutterstock)

All seven of these subjects told Doblin that “the experience had shaped their lives and work in profound and enduring ways.” Doblin found, however, that the study failed to mention that some of the students had struggled with fear during the experiment. One of them even charged from the chapel and raced down the street, filled with the conviction that he was meant to announce the next Messiah, after which he had to be restrained and administered a tranquilizing shot of Thorazine to bring him back inside the chapel.

The Drug War, Finally Fading 

Although researchers are bringing psychedelics back into their various fields of study these days, it is difficult for us to imagine, given the paucity of psychedelics in a post–War on Drugs world, how freely available they were in the 1950s, ’60s and ’70s. The drugs became part of protests and alternative lifestyles, eventually causing the Nixon administration, in October 1970, to sign the Controlled Substances Act, making all psychedelics illegal. The Drug Enforcement Administration put them on Schedule 1, reserved for the highest-risk drugs with the most severe penalties attached, effectively erasing these substances not only from the culture but also from science. Indeed, Richard Nixon once famously called Leary “the most dangerous man in America.” By the mid-1970s, all research had come to a halt.

It is only in recent years, with the War on Drugs finally fading, that a new group of scientists is lifting the lid and peering at past work. Research is now taking place at several universities, but permission remains hard to obtain because psychedelics are stained by the excesses of the 1960s, a fact that makes both the scientists and their respective governments extremely cautious.

Charles Grob of the University of California, Los Angeles, along with Griffiths of Johns Hopkins, John Halpern of McLean Hospital and Stephen Ross of New York University, make up a group of researchers unearthing the studies of yesteryear, dusting them off and putting them back into practice. “It is enormously exciting to find what is, in essence, a treasure-trove of information from the past,” Grob says. “At the same time, we want to be very careful. We don’t want to be associated with flower power. We want to be seen as serious scientists.”

The goal of these recent end-of-life psilocybin experiments is to determine whether it is possible to reduce or even remove the fear of dying in end-stage cancer patients and perhaps, in future years, in healthy subjects as well. Grob, who calls psilocybin “existential medicine,” envisions treatment centers where the dying could go to get psilocybin administered safely and therapeutically. Doblin, however, finds that use of the drug too limiting. “Why confine this to just the dying?” he asks. “This powerful intervention could be used with young adults who could then reap the benefits of it much earlier.”

He’s referring to the fact that subjects who have undergone psilocybin treatment report an increased appreciation for the time they have left, a deeper awareness of their roles in the cycle of life, and an increased motivation to invest their days with meaning. “Imagine allowing young adults, who have their whole lives in front of them, access to this kind of therapy,” Doblin says. “Imagine the kind of lives they could then create.”

The Crab 

None of the drug’s history was known to Vincent, who learned of Griffiths’ cancer patient study after her adult son read about it online. Here was something she could do, Vincent thought. She sent in her name on a long shot and was pleasantly surprised when the Johns Hopkins team got in touch with her. She flew to Baltimore to meet Griffiths and his colleagues and to undergo psychological and physical testing. By this point, fast approaching the life limit she had been given for the disease six years earlier, Vincent had become definitively depressed. She had tried almost every natural cure available, and still her nodes continued to swell, a constant reminder of her foreshortened future. “I thought a lot about death and dying,” she says. “It was so relentless. I remember crossing at an intersection. A car came toward me. Instinctively I jumped out of the way, but afterward I wondered if maybe I should have just stood there.”

Now 59, Vincent was accepted into Griffiths’ double-blind study. She would receive two doses of psilocybin on two occasions five weeks apart. One dose would be high and one would be either high or low. No one would know which was which.

In April 2014, Vincent stepped into a Johns Hopkins treatment room that researchers had stripped of its medical veneer and made to look like a comfortable living room. In doing this, they were adhering to the idea that set and setting are paramount for those ingesting psychedelic drugs. Vincent had two guides who would accompany her for the duration of her trip. She was not frightened. Her guides, Griffiths’ colleagues, asked her what her intentions were.

“This is not about just having a good time,” she said. “My intent is to find ways to deal with my diagnosis and to recover my normal state of mind as much as possible.”

To emphasize the noetic quality of the quest, Griffiths gives his subjects their psilocybin in a goblet, which he believes further connects the use of the drug to its ancient roots. Vincent clasped the goblet coolly. She swallowed the pill. Eventually, she felt faint. One of her guides suggested that she lie on the couch, then put headphones and an eye mask on her.

Through the headphones poured the most exquisite music Vincent had ever heard — concertos and chanting, the music physical, palpable, lifting her up on crystal crescendos and then dropping her back into dark depths that frightened her at first. Then colors came and the feeling of space, deep space, as she faced a massive and monolithic structure that was dark, impersonal and cold. She saw a gold shield, a huge black vault, and then motifs so drenched in stunning color that she wept for their beauty. Where’s the God? Vincent asked. Where’s the human? Where’s the connection? She posed her questions to an endless expanse of space and at first got no answers.

What she did get, however, was a collage of images — a fish, a rabbit, a huge pirate ship, a castle — and then a massive dark force coming closer and closer. In a moment of pure courage, Vincent reached out to touch the monstrosity, only to have it turn soft as fog. As she experienced this, a superhero in a red cape blew by and, from time to time, a white cartoon crab made an appearance, clacking away.

Vincent would later come to understand that the crab was her cancer. Through the crab, with the crab, Vincent saw that her illness and death were not nearly the big deal that she had made them out to be. “I was told to lighten up a little,” she says. “To lighten up a lot. I was told to have a sense of humor; after all, the crab was a cartoon.”

When her trip was over, six hours later, Vincent was changed. Though personally an atheist, she had felt connected to something larger than herself, “some kind of communal energy,” she says. She could understand that the world wouldn’t come to an end just because she did. Her mandate was to laugh about it. “You die and you say, ‘I’m here. I’m home. I’m back.’ ” Through psilocybin, Vincent found a quilt in a corner of the universe, a safe space she believed she would go to when her time came.

From the book BLUE DREAMS by Lauren Slater. Copyright © 2018 by Lauren Slater. Reprinted by permission of Little, Brown and Company, New York, NY. All rights reserved. 

2 Free Articles Left

Want it all? Get unlimited access when you subscribe.


Already a subscriber? Register or Log In

Want unlimited access?

Subscribe today and save 70%


Already a subscriber? Register or Log In