Dementia and High Dose Journeys - A Mindful Approach to Dementia & Psychedelics

Should People with Dementia have High Dose Journeys?

There has been much in the news about psychedelics and high dose journeys. There are studies by elite universities that point to high dose journeys of psilocybin relieving existential anxiety in people with a terminal diagnosis such as cancer. There is a movement to allow high dose journeys for End-Of-Life. I support these possibilities but when it comes to dementias, such as Alzheimer’s, I have many questions and doubts.

It took many years for me to come to understand plant medicine as an opportunity to meet the inner landscape of meditation. The possibilities of a high dose journey kept coming into my radar and piqued my interest. This was especially true when my husband was posted in Bogotá, Colombia in the early 2000s through the United Nations. We were invited to have ayahuasca with one of the most respected shamans in one of Colombia’s lowlands regions. As much as I wanted to go, I was too nervous dealing with extremely high blood pressure (attributed to the high altitude). At the time, I knew I would not be settled in myself, I would be nervous and unable to let go, and not give myself fully into the experience.

Being in the Andes felt like home since it was in the Andes, albeit in Ecuador, where Henry and I met, married, and lived together for over a dozen years (he much longer). I was disappointed that I never did have the ayahuasca experience while we lived in Colombia but having a big dose of psychedelics wasn’t something that was a priority for me either. In fact, when I met Henry in 1980, he recounted how he had had an ayahuasca experience in the Amazon region in the 1970s, not that far from where we lived. This was far before ayahuasca was in the cultural parlance. He was invited to ingest by a shaman he knew through work. He would often recount how he ran barefoot through the jungle that night, following his shaman friend. He even understood lowland Quechua, a language he didn’t know otherwise. He saw and played with all sorts of animals — rabbits, birds, and others in the nearby trees. Every time he recounted this experience, it never occurred to me that I would be interested to visit this shaman or have an ayahuasca experience — my life in Ecuador was magical enough, my meditation practice the rudder of my life. For many years, even after we left Ecuador for the Indian subcontinent, Henry’s experience with ayahuasca in the Ecuadoran Amazon felt like a tale from yesteryears.

More than ten years passed after we had left Colombia. In the interceding years we lived in Bangladesh and then settled in Costa Rica upon retirement. A Kofán shaman from Colombia was coming to where we live in Nosara. I was called to have a ceremony but when I found out that 20 gringos would also be present, I shied away. Then a few more years passed before all the pieces felt right. This speaks to set and setting and the importance of feeling like the optimal set and setting are in place before embarking on a high dose journey.

The journey took place with trusted friends who had years of experience guiding high dose psilocybin journeys. I was ready! I was very much looking forward to having my own experience. At the last minute Henry said he, too, wanted to join in. Our friends, a husband and wife team, said one would attend to me, the other with Henry. They assured me that I would have my own experience and that there was no need to think about Henry.

After ingesting a second round of medicine, I walked outside and settled down under a tree. The shade of the leaves and the warmth of the summer sun were my perfect natural setting as I remained in a blissful state throughout my journey. I was also blissfully unaware of Henry. That is until the end of the afternoon when I passed by him on the way to the bathroom. His breath was heavy but shallow. He was very unsettled and in a nervous state. I learned later that he had been like that from the beginning. It seemed that he was in a state of panic for hours.

Later, during an integration opportunity, our guides said the dementia (at that time undiagnosed but suspected) was not a contraindication for them to give the medicine. I had my doubts. I also questioned whether Henry’s blood pressure was elevated and contributed to his difficulty breathing. I would never know but what I did observe is that Henry felt out of sorts for more than a month after his high dose psilocybin experience.

It is said that things can be learned from even difficult journeys. Although lessons did come out of this experience, I felt Henry had not even entered into the experience. Not only did I question if someone with dementia should be doing a high dose but it also propelled me into a deeply mindful approach to these sacred medicines.

The guides for Henry’s psilocybin journey later reassured us that dementia is not contraindicated. They also said other people have an even more difficult time than Henry. Was it Henry’s own anxiety? Nervousness to let go? To trust?… One will never know but I continue to question if people with dementia should have high doses. When conversing with a well-respected Colombian medicine man who serves ayahuasca, he, like me, felt the energy/spirits — that part of Henry that is common with someone with Alzheimer’s — could better benefit from non-psychoactive herbal baths and treatments that calm the soul and ground the sense of presence. However another shaman, a highly respected Kofán, supports a high dose of ayahuasca as a way to help communicate and better understand what he views as “entities” or the spirits common to people with Alzheimer’s.

When Henry had the 20-minute Bufo experience (that I previously wrote about) and experienced a blissful experience beyond the day-to-day, I was very happy for him. I felt that embodying this experience of such peace and well-being was instrumental as he proceeded down the Alzheimer’s journey. I was also hopeful the Bufo experience would quench any desire for another psychedelic experience.

Yet, as the year passed into another and more information about the benefits of psychedelics swirled around in conversation, Henry was curious to have another try at a high dose psilocybin journey. I wanted no part of it. Nor did I want to be responsible for the after-care, which required vigilance the last time.

As it turned out a well-qualified person, trained in the Ralph Metzner lineage, offered to sit with Henry for a high dose. Within this tradition, as long as the person is cognitive about their decision to take the high dose and there are no other contraindications, then a high dose of psilocybin is supported. He checked through his mentor, and even offered Henry to have his journey under his mentor’s guidance. It would be several days after I was to leave for a 10-day retreat. In other words, I would not be around or responsible for whatever occurred.

As it turned out, Henry struggled throughout. Thankfully rather than panic for hours on end, Henry said he was able to recognize his struggle without letting it overtake him. He is still not feeling 100% and attributes bouts of dizziness to recovering from the experience. He admitted that it did not go as he had hoped and that he has no intentions of seeking out another high dose of magic mushrooms. I hope it to be so.

I believe high dose journeys as well as microdosing hold valuable benefits — but it is not for everybody or for everything. Mindfully approaching these medicines — having both beginner’s mind and discernment — can make all the difference.

- Lauren Alderfer, PhD.