Perspectives on Psychedelics in Hospice and Palliative Medicine: Results of a Cross Disciplinary Survey

Rationale
There is growing public support to legalize psychedelic substances for therapeutic use. Mounting evidence suggests that PAT offers rapid and sustained relief of existential and psycho-spiritual distress associated with life-threatening illness. (1,2) Clinician perspectives are vitally important in conversations regarding policy and implementation and thus far have not been well quantified.

Objectives
To elucidate perspectives of HPM professionals regarding PAT prior to federal legalization and widespread clinical availability.

Methods
Members of HPM-specific professional organizations were invited to complete a questionnaire covering 7 domains: existential distress in HPM, awareness of and attitudes toward psychedelics, risks and benefits, barriers to adoption, sources of information, professional interest and educational needs. (3-5) Analyses were conducted using SAS version 9.4 to perform univariate and bivariate analyses.

Results
620 clinicians from six distinct professional roles completed the survey. Most respondents (59%) believed PAT will be ‘very’ or ‘extremely’ important in the future of HPM. There was striking homogeneity across demographic characteristics with a few notable exceptions: 81% of mental health professionals endorsed strong importance while only 51% of chaplains shared this view. The oldest (75-84) and youngest respondents (20-34) were least likely to believe PAT will be extremely important. Knowledge about and exposure to psychedelics correlated to predicted degree of importance. Common concerns were lack of adequate training, integration into the current medical model, negative side effects and equitable access. The results are limited by a non-representative sample and the likely higher response rate of people more interested in the topic.

Conclusion
These results demonstrate robust HPM clinician interest in PAT. Over half of respondents predict PAT will be very or extremely important to the future of HPM although this varies by role, age, exposure and knowledge. Important concerns have also been raised and deserve our attention as the field continues to evolve.