Meaningful Trips: A Qualitative Study of Patient and Carer Perspectives on Psychedelic-Assisted Therapy in Advanced Cancer

Abstract

Cancer is one of the leading causes of mortality globally. Along with being physically gruelling for patients, it also entails profound psychological, emotional and spiritual challenges. In the case of advanced or secondary diagnoses, patients must manage these difficulties for the entirety of their remaining life. It is not surprising then that rates of psychopathology – particularly anxiety and depression – are high for late-stage patients. Presently, psychopathology in this patient group does not appear to be effectively managed with conventional treatments, however emerging research suggests psychedelic-assisted psychotherapies might hold promise. While the benefits demonstrated by these treatments in clinical data seem attractive, the development of interventions utilising these compounds faces a range of barriers. Given the context –that psychedelics are largely Class A drugs, and advanced cancer patients are a vulnerable population – taking stock of stakeholders perspectives is crucial. This work sought to qualitatively assess the knowledge, beliefs, attitudes and (mis)perceptions held by advanced cancer patients and their carers about psychedelics generally, and their therapeutic use. Following thematic analysis of data gathered in semi-structured interviews, eight key themes in participants’ responses were identified, falling into two over-arching categorisations. The results suggested that participants approached the concept of psychedelic-assisted therapy with a high degree of openness. Knowledge of psychedelic compounds and their therapeutic use was varied, and often lacking nuance but never completely absent. Most derived their knowledge at least in part from a cultural awareness of drug use in the Hippie era, which proved a source of both familiarity and at times concern for participants. Experiences and cultural knowledge of cannabis were also commonly drawn on in assessments of psychedelics and related therapies. Participants’ reactions to specific treatment elements appeared to be underscored by a desire for safety. Overall, this study suggests advanced cancer patients and their carers are supportive and interested when it comes to psychedelic-assisted therapies for distress in advanced cancer. It also orients future research to some of the common concerns, gaps in knowledge, and misperceptions that might be addressed in order to optimise the potential for safe, effective and acceptable exploration of interventions with psychedelics.