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Therapies & Interventions | Psychedelic intervention
A scoping review of variations in psychedelic interventions for psychological suffering associated with the end of life

Published: Sep 2025

Authors

Sarah Kratina

Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th fl, Toronto, Ontario, Canada, M5T 3M6

Carol Strike

Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, Ontario, Canada, M5T 3M7

Robert Schwartz

Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th fl, Toronto, Ontario, Canada, M5T 3M6; Institute for Mental Health Policy Research, Centre for Addiction and Mental H

Ayah Nayfeh

Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th fl, Toronto, Ontario, Canada, M5T 3M6

Sydney Jopling

Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th fl, Toronto, Ontario, Canada, M5T 3M6

Chris Lo

Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, Ontario, Canada, M5T 3M7

Brian Rush

Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, Ontario, Canada, M5T 3M7

Abstract

Background

Psychedelic substances are recognized for their potential to ease psychological suffering linked to end-of-life issues, yet policy remains restrictive. The wide range of both substances and therapeutic approaches used in end-of-life populations has not been adequately covered by reviews to date.

Aim

To identify and learn from the variety that exists within the research on therapeutic psychedelic interventions reported in populations coping with psychological suffering associated with life-threatening illness and the end of life itself.

Methods

Following Arksey and O'Malley's (2005) framework for scoping reviews, updated methodological guidance, and the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews guideline, data extracted from selected studies covered intervention details, substances used, participant characteristics, measured outcomes, and theorized mechanisms.

Results

Fifty-nine studies on six types of psychedelic substances for end-of-life issues were identified, with case study designs most common. Interventions were categorized into dosing alone, preparation/dosing/integration, and dosing with any psychotherapeutic support not provided within the tripartite model. Most studies reported challenging experiences, with a large proportion considering them therapeutic. Outcome measures spanned biopsychosocial-spiritual domains, with affective and cognitive-affective sub-domains most often assessed; neurobiological mechanisms were reported in 54 % of studies, psychological in 51 %, and spiritual in 44 %, indicating diverse therapeutic processes.

Conclusion

There is extraordinary variety in how psychedelics are studied to address the experience of psychological suffering associated with end-of-life concerns. The variability in psychedelic research reflects an early and exploratory phase, differences in beliefs about how therapeutic psychedelic interventions effect change, and the genuine richness in possibilities for therapeutic psychedelic interventions.

Access

Web link: https://doi.org/10.1016/j.socscimed.2025.118536

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