Most Palliative Care Doctors Back Research Into Psychedelic Medicines for End of Life Care
A survey of palliative care doctors in New Zealand and Australia has found overwhelming support for more research into psychedelic medicines for patients facing terminal illness, adding weight to growing calls for a regulated pathway that would allow clinicians to explore what some researchers describe as transformative treatments.
The study, which surveyed 93 palliative care physicians across both countries, found 88 per cent agreed that clinical use of psychedelic medicines for palliative patients warranted further investigation. Three quarters of respondents rejected the idea that psychedelics were inherently unsafe or should be prohibited for medical purposes, a finding that researchers say reflects a significant shift in medical attitudes towards substances that were effectively banned from scientific inquiry for several decades.
The results come as scientists at several New Zealand universities press ahead with clinical trials examining whether substances such as MDMA, psilocybin, and related compounds can alleviate the anxiety, depression, and existential distress that many people experience when confronting the end of life.
David Menkes, an associate professor at the University of Auckland, has been among the local researchers working in this field. He told RNZ that MDMA can be spectacularly helpful for some individuals who are facing death from cancer, pointing to trial results that had shown dramatic improvements in some patients. He added that decades of prohibition under the international war on drugs had essentially frozen progress in this area, meaning researchers were only now recovering lost ground. Psychedelic research had basically stopped for 30 years and had only recently been resurrected, Menkes noted, leaving significant gaps in what is known about dosing, safety, and which patients might benefit most.
Psilocybin, the active compound found in magic mushrooms, has shown particularly encouraging results in randomised trials involving patients with terminal cancer experiencing anxiety and depression. In some cases, a single supervised session has produced lasting improvements in symptoms and quality of life that persist for months. While psilocybin remains unregistered and illegal in New Zealand outside of clinical research settings, the weight of early evidence has prompted growing calls for the regulatory framework to be updated to reflect what researchers are learning.
A clinical trial already under way in New Zealand involves a collaboration between the University of Otago, the University of Auckland, and Mana Health. Known as the EMMAC study, it is assessing the usefulness of MDMA-assisted psychotherapy in treating depression and anxiety in patients with advanced-stage cancer. Dr Lisa Reynolds, one of the researchers involved, has said that if the results are positive, the goal is for the treatment to become widely available for advanced cancer patients within the next few years.
The research is also attracting attention in the context of New Zealand’s End of Life Choice Act, which has been in operation since 2021. Menkes has suggested that effective psychedelic-assisted therapy could, for some people, reduce the desire to pursue assisted dying by giving patients a new way of processing their situation and potentially more meaningful time with family. The idea that these medicines might complement rather than compete with existing end-of-life options has been welcomed by some clinicians, though others urge caution about drawing conclusions before larger trials have been completed.
The survey found that younger doctors expressed more openness to the potential clinical benefits of psychedelic medicines than their older counterparts. Researchers say this generational shift is significant, as it suggests that as newer cohorts of physicians enter the workforce, professional attitudes will continue to move towards acceptance of what was once a deeply controversial area of medicine.
Australia moved ahead of New Zealand in 2023 when it allowed psychiatrists to prescribe MDMA for post-traumatic stress disorder and psilocybin for treatment-resistant depression, making it the first country in the world to formally recognise these substances as medicines. New Zealand has yet to follow suit, though advocates argue that the growing body of clinical evidence and the latest survey results make a compelling case for a similarly measured approach.
Critics have pointed out that the research, while promising, remains early-stage, and that regulatory approval requires robust large-scale evidence of both safety and efficacy. The history of psychedelic medicine is also complicated, with some high-profile trials in the United States falling short of the standards required by regulators. But proponents argue that those setbacks reflect the difficulty of conducting research in a heavily restricted environment rather than fundamental problems with the therapies themselves.
For New Zealand’s palliative care community, the survey signals a field in transition. The patients these doctors care for are among those with the least to lose from cautious experimentation with novel therapies, and among those who might have the most to gain. As clinical evidence continues to accumulate, questions about how New Zealand’s regulatory system should respond are likely to grow more pressing in the months and years ahead.
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