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cannabissciencetech.com | Psychedelics: New Frontiers in Alternative Medicine 9 psilocybin therapy / feature in my practice for almost five years to help people with severe, crushing, existential anxiety," said Dr. Aggarwal. Dr. Aggarwal and two of his ketamine therapy patients are party to a lawsuit against the DEA seeking legal authori- zation to provide psilocybin under state and federal right-to-try laws designed to allow humane access to drugs that are still under clinical investigation. An Emerging Palliative Care Leader In 2020, Dr. Aggarwal was named an Emerging Leader in Hospice and Palliative Care by the American Acade- my of Hospice and Palliative Medicine (AAHPM). AAHPM is the professional society that represents doctors who are medical board-certified in the specialty of hospice and palliative medicine, along with other health professionals who work in palliative care—a field that focuses on relieving pain and suffering and helping patients with serious illness to articulate and achieve their treatment preferences and goals for medical care. He was an inaugural member of AAH- PM's 360-member Safe Use of Psyche- delic-Assisted Therapies Forum, and he recently presented an online master prac- titioner class titled, "How Psychedelics Can Be Used for Relief of Spiritual and Existential Suffering," for 348 registered professionals at the Center to Advance Palliative Care in New York, New York. "I've also had my own personal expe- riences with these substances as a college student, discovering that they could offer valuable insights into human conscious- ness. That helped impel me on my path to- ward becoming a doctor," said Dr. Aggar- wal. He also has a BA in philosophy and chemistry, with a religious studies minor from the University of California, Berke- ley, and a PhD in medical geography from the University of Washington. He sees growing interest in psyche- delics by both health care profession- als and consumers. "We need to listen to our patients. They don't only want a clinical experience, but a ceremoni- al one, with entheogenic medications such as psilocybin." What Is Going on Here? For many experienced medical profession- als, psychedelic therapy to help termi- nally ill patients cope with the negative feelings that accompany their prognosis must seem like quite a stretch—despite the tantalizing outcomes to date from non-randomized studies of psilocybin therapy. Patients who receive just one or two therapist-accompanied treatments with post-treatment follow-up sessions to integrate what they experienced from the drug, report immediate and sustained relief of their debilitating anxiety and depression and improved psychological, spiritual, and existential well-being. "We believe these substances can be neuroplastic, which refers to the ability of the brain and neurological system to develop more new linkages and connec- tions between different neurons," Dr. Aggarwal explained. "When you have new connections and can build new neuropathways, you can think about things in new ways—which is impor- tant if you have gotten stuck mentally." Some might also say the healing re- sults from a mystical or spiritual en- counter, but Dr. Aggarwal does not have a clear answer. "It's nothing I can even explain. It's a conscious transformation in the person's life. It's an existential in- sight that changes their life—helping them let go of a lot of things," he said. How would this healing work in ther- apeutic practice? "Assuming that we had licensure to purchase and dispense psil- ocybin, patients would sign an informed consent, and then undergo a medical and psychological screening," he said. That's to make sure there are no underlying cardiac conditions, drug-drug interac- tion concerns, or other psychological or medical impediments to the treatment. Once it is clear that the patient is a good candidate, the interdisciplinary palliative care team starts the prep work: clarifying therapeutic intentions and what the patient is hoping for. The person who will be sitting with the pa- tient on their psychedelic journey can start to build a relationship with them. Psilocybin administration then hap- pens in a comfortable, peaceful, well-ap- pointed room, with offers of music, an- ti-nausea medications, and non-directive support. "That's similar to how we now give ketamine, although the psilocybin Bob Stanley Kathryn Tucker Dr. Sunil Aggarwal