Social acceptability of psilocybin-assisted therapy for existential distress at the end of life: A population-based survey.

BACKGROUND: Internationally, there is a growing interest in the potential benefits of psilocybin-assisted therapy to treat existential distress at the end of life. However, the social acceptability of this therapy is not yet well known. AIM: This study assesses the social acceptability of the medical use of psilocybin to treat existential distress at the end of life. DESIGN: An online survey was conducted in Canada between November 23 and December 4, 2022. The questionnaire included items pertaining to perceptions, attitudes and concerns towards psilocybin-assisted therapy to treat existential distress at the end of life. PARTICIPANTS: The sample (n = 2800) was stratified by province, age and sex. Participants were adults from four provinces of Canada: Québec, Ontario, Alberta and British Columbia. RESULTS: Overall, 79.3% considered psilocybin-assisted therapy a reasonable medical choice for a patient suffering from existential distress at the end of life, 84.8% agreed that the public health system should cover the costs of the intervention and 63.3% would welcome the legalisation of psilocybin for medical purposes. Previous psilocybin use (p < 0.0001, for all dependent variables), exposure to palliative care (p < 0.05, for all dependent variables) and a progressive political orientation (p < 0.05, for all dependent variables) were associated with more favourable attitudes towards psilocybin-assisted therapy at the end of life. CONCLUSION: The social acceptability of psilocybin-assisted therapy for existential distress at the end of life is rather high in Canada. These findings may contribute to efforts to mobilise resources and improve access to this emerging therapy in palliative and end of life care settings.

Subduction of the Cocos plate in the Mid America Trench.

The Mid America Trench, off the Pacific coast of southern Mexico and central America, is the site of northeastward subduction of the Cocos oceanic plate under the North America and Caribbean plates1 (Fig. 1). In Guatemala, the North America and Caribbean plates are separated by the Polochic-Motagua left-lateral strike-slip faults (Fig. 1). The trench itself appears to be divided into two distinct sections at its intersection with the Tehuantepec Ridge. To the south the margin of the trench is wide and consists of a well developed shelf basin2 bounded on the east by a huge volcanic cordillera parallel with the trench axis at a distance of ∼200 km. In contrast, to the north, the margin is narrow and devoid of shelf basin; landwards, the trans-Mexican volcanic belt trends oblique to the trench. This volcanic chain would be anomalous if it were related to the subduction of the Cocos plate off southern Mexico. In 1979, as part of the International Phase of Ocean Drilling (IPOD) of the Deep Sea Drilling Project, Legs 66 and 67 respectively explored the northern (off Acapulco, Mexico) and southern (off San Jose, Guatemala) section of the Mid America Trench3-6 (Fig. 1). Since then short topographical surveys of the trench have been carried out by RV Jean Charcot8 using the sea-beam technique7. We report here that both sets of data, together with UTMSI multichannel seismic profiles10,11 can be used to reconstruct the processes of subduction along the Mid America Trench.