Abstract

Despite significant advances in symptom management for patients affected by serious illness, physicians lack effective legal treatments for individuals suffering from demoralization, death anxiety, and existential distress. Psilocybin-assisted psychotherapy employs psilocybin-containing mushrooms or synthetic psilocybin grounded in indigenous traditions and within the context of a therapeutic mindset and environment ("set and setting") to achieve altered states of consciousness that promote healing and psychospiritual growth while reducing suffering. Current research evidence suggests that this form of therapy could serve as a safe and effective therapeutic tool for such patients.
 This presentation will describe a case series of patients with advanced cancer who received physician-supervised home-based psilocybin-assisted psychotherapy in Montreal, Canada. Our experience postulates the safety and efficacy of this laborious treatment process. By executing this clinical practice in the public healthcare system of Quebec for the first time, we have made an attempt to provide equitable access to these clinical therapies. Having performed these treatments outside the context of clinical trials, we have been able to tailor the therapeutic frame and treatment approach to a more patient-centric and culturally-informed manner. That being said, given the existing ​societal discrimination and stigma against this form of therapy, including by healthcare professionals, there remain further barriers to overcome in the equitable provision of care, especially to certain segments of the population. ​The authors will discuss these and potential solutions to addressing them.

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