Psychedelic trips and near-death experiences result in strikingly similar attitude shifts

In 2014, Tracy Morgan was in a car accident that nearly took his life. The former Saturday Night Live and 30 Rock cast member suffered near paralyzing injuries in the accident that killed his friend James McNair. In 2019, he told Oprah Winfrey how the crash fundamentally changed his attitude.

“The way I am with people, something’s just different. I find myself saying, ‘I love you’ 200 times a day to strangers.”

Such shifts in attitude about life and death are common among people who have had near-death experiences. Studies have found that those who describe themselves as having experienced near-death events have lower ratings in metrics assessing fear of death and higher ratings for belief in a happy afterlife.

Similar changes in attitude are often described by people who have psychedelic drug experiences. For example, a pivotal 2016 study that looked at the effect of psilocybin treatments in terminal cancer patients found that patients who took the drug had dramatic “increases in quality of life, life meaning, and optimism, and decreases in death anxiety.”

But what do near-death events and psychedelic experiences have in common? That’s what Johns Hopkins University School of Medicine researchers sought to parse. Their results, published Wednesday in the journal PLOS One, raise intriguing questions about what shifts our attitude toward life and death.

Here’s the background — Roland Griffiths is the director of the Center for Psychedelic and Consciousness Research at Johns Hopkins University School of Medicine. He was the first author on the 2016 psilocybin cancer patient study and has long been interested in attitude shifts resulting from psychedelic experiences.

What that study showed, Griffiths tells Inverse, is that “a single dose of psilocybin produced remarkable decreases in anxiety and depression that endured.”

What predicted these positive outcomes, he explains, was “a constellation of features of the experience.” These are classically defined as mystical experiences, though Griffiths cautions that some people may misunderstand what that means. “It’s not a supernatural thing; these have certain features that we can define empirically.”

Those features include “Sacredness, deeply felt peace and joy, transcendence of time and space,” and “internal unity and external unity.” The cliche but accurate way to describe that unity is feeling “one with the universe.” A psychedelic experience with those qualities is predictive of decreased anxiety and depression, as well as shifts in attitude about death and dying.

“If you look at the phenomenological features of near-death experiences, there's something called a near-death experience questionnaire, it looks again suspiciously like the mystical experiences, there are so many features in common,” Griffiths says. “So that prompted us to wonder, ‘do we have a model [with psychedelics] that is very similar — in terms of brain mechanisms or psychological changes — to experiences that occur naturally.”

Griffiths and his colleagues decided to hone in on that question by directly comparing a group of people who claim to have had a near-death or “non-ordinary” experience that altered their attitudes about death and dying with a group who reported similar changes after taking a psychedelic drug.

What the researchers did — Researchers administered a survey to 3192 people. There were 900 in the near-death or other non-ordinary experience group; the remaining participants were sorted into groups based on the drug responsible for the experience in question: LSD, DMT, psilocybin, or ayahuasca — a psychoactive brew derived from specific shrubs that have traditionally been used in spiritual ceremonies by indigenous peoples in the Amazon basin.

Participants were given a series of questionnaires designed to parse different aspects of their experience and the enduring effects. To quantify the “cognitive, affective, paranormal, and transcendental” aspects of their experience, participants were given the Greyson Near-Death Experience Scale. These questions revolved around the thoughts, perceptions, and feelings that defined the person’s experience. The subjective aspects of the experience, as well as the attitude shifts following it, were evaluated using several other surveys.

What they found — One of the most striking findings is how similar the two groups were to each other.

“Almost 90 percent of both groups reported decreased fear of death following the experiences,” Griffiths says. “Both groups rated the experience very high for personal meaning and spiritual significance, and both groups reported persistent positive changes in personal well-being, life satisfaction, life purpose, and life meaning.”

Slight deviations occurred between the two groups; for example, those in the near-death experience group were more likely to report the experience as the single most meaningful of their life. The one exception was the ayahuasca subgroup, those participants rated the experience more closely to the near-death group: as the most meaningful of their life.

Interestingly, the psychedelic drug group rated the experience higher on the mystical and near-death experience questions than the participants in the actual near-death experience group.

Digging into the details — The reasons behind some of the slight discrepancies between the near-death and psychedelic groups were fairly obvious. For example, the near-death group was more likely to believe their life was in danger during the experience because, as Griffiths says, “they clinically were.”

Other differences, especially those among the psychedelic drug subgroups are less clear, though Griffiths offers some possible factors.

The ayahuasca subgroup being so similar to the near-death experience group on the singular meaningful experience metric may be the result of different demographics, or different contexts.

“The Ayahuasca group tended to be older, more affluent, and female,” Griffiths says. “And ayahuasca is more likely to be taken in a ceremonial setting. So there’s a set and setting difference there that’s distinct from psilocybin or LSD.”

While he can’t say for sure those account for the differences, they “may be very important to how those effects are interpreted.”

The answers likely won’t elude the researchers at the Center for Psychedelic and Consciousness Research for too long. They’re studying many different aspects of psychedelic-assisted therapy.

“We're looking at different therapeutic indications for these drugs. We have studies on alcohol use disorder, OCD, anorexia, Alzheimer's, Lyme disease, and PTSD,” Griffiths says. “We’re also looking at the brain mechanisms involved in psychedelic experiences. We have a whole line of investigation in healthy volunteers aimed at more fully understanding the longer term implications of some of these profound experiences.”