A Community of Practice Program With Psilocybin-assisted Therapy for End-of-Life Patients

Inclusion Criteria * Patient must have a terminal diagnosis whereby there is a limited life expectancy (predicted life expectancy less than 2 years). * Ages 19-80 years of age * Male, menopausal female, if childbearing age not pregnant, using birth control and negative pregnancy test prior to psilocybin administration. * Ambulatory (Palliative performance status 50% or greater) * eGFR \>20 ml/min ❏AST \< 3xULN and bilirubin \<50 umol/L * Patient has emotional distress that has not successfully responded to other treatments: other treatments failed, patient could not tolerate other treatments, patient is unable to access other treatments, or patient refused other treatments for reasons acceptable to our treatment team. * Patient demonstrates comprehension sufficient for understanding the consent form. Exclusion Criteria: * Treatment in a clinical trial where psilocybin therapy would disqualify them from their primary treatment trial. * If female is:a) pregnant (positive pregnancy test),b) nursing, * Currently taking on a regular (e.g., daily) basis: \>investigational agents, \>medications that are MAO inhibitors \>UDG modulators, and inhibitors of UGT1A9 and 1A10, aldehyde or alcohol dehydrogenase inhibitors, SSRI's, SNRI's. * Patients are given the option to wean themselves off their medications prior to the psilocybin to be included in the trial. Patients taking MAO-A inhibitors (especially the irreversible inhibitors) will require a minimum 2-week washout period. The …