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Near-Death Experiences and Psychedelics: Parallel Paths to Transforming the Fear of Death

A Johns Hopkins study reveals striking similarities between drug-induced and spontaneous near-death experiences

At a time when the fear of death is plunging many people into existential crises—especially in the face of terminal illness or in old age—a groundbreaking study from Johns Hopkins University sheds new light on two seemingly completely different phenomena: near-death experiences and psychedelic experiences. The research, published in PLOS ONE in August 2022, shows that both types of experiences can have remarkably similar effects on attitudes toward death and life.

The Study Design: An Unprecedented Comparison

The research team led by Roland R. Griffiths analyzed online survey data from 3,192 people who reported that a single experience had fundamentally changed their beliefs about death and dying. The participants were divided into five groups:

  • Non-drug group: 933 people who have had near-death experiences or other extraordinary experiences without substance use
  • LSD group: 904 people
  • Psilocybin group: 766 people (magic mushrooms or pure psilocybin)
  • Ayahuasca group: 282 people
  • DMT group: 307 people (mostly smoked)

The study provided a detailed account of the circumstances surrounding the experience, mystical and near-death-related subjective characteristics, changes in attitudes toward death, and other lasting effects.

The key finding: Remarkable parallels despite different triggers

Roland Griffiths summarizes the study’s key message: “The characteristics of psychedelic experiences may not only resemble near-death experiences—both are considered among the most significant life experiences, and both produce similar lasting reductions in fear of death and increases in well-being.”

Mystical and near-death experiences

Although both groups—psychedelic and non-drug participants—showed significant increases in standardized measures of mystical and near-death experiences, these scores were significantly higher among the psychedelic participants.

This means that psychedelic experiences appear to evoke more intense mystical qualities, such as:

  • A sense of oneness with the universe
  • Transcendence of Time and Space
  • The indescribable nature of the experience
  • Noetic quality (the feeling of having grasped profound truths)

At the same time, they also exhibited more pronounced characteristics typical of near-death experiences:

  • Out-of-body experiences
  • Passing through a tunnel or a dark room
  • Encounters with beings of light or the deceased
  • Life Review
  • A sense of peace and cosmic unity

The Significance of Experience

A fascinating finding: Participants who did not use drugs were more likely to describe their experiences as the single most significant, spiritually meaningful, insightful, and challenging experience of their lives.

This suggests that near-death experiences—even though psychedelic experiences exhibited more intense mystical qualities—are perceived as even more significant for personal identity. This may be due to the immediate confrontation with one’s own mortality or to the fact that they occur completely involuntarily and unexpectedly.

Substance-specific differences: Not all psychedelics are the same

Within the psychedelic groups, some interesting nuances emerged:

Ayahuasca and DMT: More intense long-term effects

When comparing various psychedelic substances, the ayahuasca and DMT groups tended to report stronger and more positive long-term effects of the experience than the psilocybin and LSD groups, which were largely indistinguishable from one another.

There could be several reasons for this:

  • Contextual factors: Ayahuasca is often used in structured, ritualistic group settings with spiritual guidance
  • Pharmacological differences: DMT (the main active ingredient in ayahuasca) has a unique neurochemical profile
  • Expectations: The cultural context of ayahuasca within shamanic traditions could shape the experience

Psilocybin and LSD: Virtually identical

As previous studies have shown, the psilocybin and LSD groups were virtually indistinguishable in their reports—despite their different molecular structures and durations of effect.

The transformative power: Tangible changes in attitudes toward death

Reduction of the fear of death

Both types of experiences—psychedelic and spontaneous—led to lasting reductions in fear of death. This is particularly noteworthy because fear of death is often deeply ingrained, and conventional therapeutic approaches have only limited success.

The participants reported:

  • Less fear of one's own death
  • Greater acceptance of mortality
  • A changing understanding of what death means
  • Often a feeling that consciousness continues to exist in some form

Improving well-being and life satisfaction

These experiences not only led to less anxiety, but also to more:

  • Life satisfaction
  • Sense of Meaning and Purpose in Life
  • Spiritual Growth
  • Appreciation for life itself

Changes in Values and Priorities

Many participants reported fundamental shifts in what matters to them:

  • Less materialistic
  • More altruistic and compassionate
  • Greater interest in spiritual or philosophical questions
  • A deeper connection with other people and nature

The phenomenological similarity: Why do these experiences resemble one another?

This research raises fundamental questions about the nature of consciousness:

Common neurobiological mechanisms?

It is possible that both psychedelic substances and near-death experiences activate similar brain regions or neurochemical systems. Psychedelics primarily act through serotonin 2A receptors, but near-death experiences could also—due to oxygen deprivation, stress, or other factors—trigger endogenous neurochemical changes that produce similar states of consciousness.

Access to fundamental states of consciousness?

An alternative interpretation: Both types of experiences could provide access to deeper states of consciousness that are normally obscured by the filtering function of our everyday waking consciousness. From this perspective, both psychedelics and near-death experiences would temporarily suspend these filters.

The Role of Context and Environment

The research emphasizes that the context of the experience is crucial:

  • Set (mental state, expectations, intention)
  • Setting (physical and social environment)

With near-death experiences, the “setting” is, of course, beyond our control—they occur unexpectedly. With psychedelic experiences, however, research shows that careful preparation, therapeutic support, and a safe environment greatly increase the likelihood of positive, transformative experiences.

The Quality of Memory: More Real Than Reality

Previous research has shown that near-death experiences possess an exceptional quality of memory. Studies have shown that NDE memories contain more characteristics than memories of real-life events and memories from comas, suggesting that they cannot be regarded as imagined memories of events.

These memories:

  • They are exceptionally vivid and rich in detail
  • Contain more self-referential and emotional information
  • Are clearer than other memories
  • Remain remarkably consistent over decades
  • Are often described as “more real than real”

Interestingly, this also applies to intense psychedelic experiences, which are likewise remembered with remarkable clarity for years to come.

Clinical Implications: New Approaches to Treating Fear of Death

Psychedelic-assisted therapy for existential crises

This research could inform studies on the clinical use of psychedelics in the treatment of mood disorders and other psychiatric conditions, such as anxiety at the end of life.

Recent clinical studies show promising results in:

  • Cancer patients with existential anxiety: Psilocybin-assisted therapy led to significant and sustained reductions in anxiety and depression
  • Treatment-resistant depression: Psychedelic therapy proves effective where conventional antidepressants fail
  • Substance Use Disorders: Experiences of a Mystical Nature Correlate with Abstinence Rates

The Paradox of Therapeutic Benefit

A fascinating paradox: To reduce the fear of death, it seems helpful to have an experience that, in a sense, “simulates” death or provides insight into what might come after. This stands in contrast to conventional therapeutic approaches, which often seek to avoid confronting death or to rationally reframe it.

Categories of Near-Death Experiences: Diversity in the Phenomenon

Systematic analyses have classified near-death experiences into four main categories:

1. Emotional experiences

  • Feelings of inner peace
  • Overwhelming Love
  • Joy and bliss
  • Sometimes also fear or despair (in traumatic NDEs)

2. Cognitive experiences

  • Life Review
  • Time distortion or timelessness
  • Exceptional clarity of thought
  • Access to knowledge or insights

3. Spiritual and religious experiences

  • Encounter with the Divine Presence
  • A sense of connection with all life
  • Insight into cosmic truths
  • The Transformation of Religious Beliefs

4. Supernatural Experiences

  • Out-of-body experiences: The sensation of viewing one's own body from the outside
  • Supernatural and metaphysical experiences: encounters with the deceased, beings of light, or other dimensions of reality

The most common near-death experiences were supernatural experiences, particularly the experience of leaving the body.

Challenges and Unanswered Questions

Methodological Limitations

The authors point out some important limitations:

  • Retrospective self-reports: The experiences often took place years ago, which could lead to memory distortions
  • Self-selection: People who voluntarily participate in such surveys may differ systematically from the general population
  • Demographic representativeness: Future studies could help confirm these findings by including more participants from diverse demographic backgrounds and by distinguishing more precisely between different non-drug-related experiences, such as near-death experiences versus out-of-body experiences.

The ontological question

What science cannot answer—and perhaps never will—is the ontological question: Are these experiences “merely” neurobiological events occurring in a dying or altered brain, or do they provide access to a transcendent reality that exists independently of the physical world?

Research can describe:

  • What people experience
  • How their brains work in this process
  • What long-term effects occur

But she cannot definitively determine whether these experiences open windows to another dimension of reality or “merely” represent extraordinary states of human consciousness.

Traumatic near-death experiences

Not all near-death experiences are peaceful and positive. Research shows that there are three different types of distressing experiences:

  1. Phenomenologically similar to peaceful NDEs, but interpreted as unpleasant
  2. A sense of non-existence or eternal emptiness
  3. Graphic depictions of hellish landscapes and entities

These traumatic experiences can have profound and long-lasting psychological effects and deserve special therapeutic attention.

Practical Applications and Future Research

For palliative care

These findings have direct relevance for the care of the dying:

  • Validating spontaneous spiritual experiences: Medical staff should be trained to take near-death experiences seriously and respond to them with empathy
  • Possible therapeutic interventions: In the future, psychedelic-assisted therapies could become part of palliative care
  • Reducing anxiety at the end of life: For both patients and their loved ones

For psychedelic therapy

Research highlights the importance of:

  • Careful preparation: The setting and environment are crucial
  • Integrating the experience: Therapeutic support following the experience is essential
  • Individual differences: Not everyone reacts to psychedelics in the same way

For an understanding of consciousness

This research contributes to:

  • Neuroscientific theories of consciousness: How does the brain generate these extraordinary experiences?
  • Philosophical questions about the nature of reality: What is “real”?
  • Our understanding of spirituality: How does it relate to brain functions?

Perspective: The Implications for a Society on the Brink of Collapse

In Western societies, death is often a taboo subject, relegated to hospitals and nursing homes, and removed from our daily lives. At the same time, millions of people suffer from existential anxiety, especially when faced with terminal illnesses or in old age.

This research offers a scientifically grounded perspective on phenomena that for centuries were reserved exclusively for religious or spiritual frameworks of interpretation. It shows:

  1. Transformation is possible: Profound changes in attitudes toward death can be triggered by specific experiences
  2. Different paths lead to similar goals: Whether spontaneous or substance-induced, both types of experiences can be healing
  3. Consciousness is malleable: Our relationship with death is not set in stone, but can undergo a fundamental transformation
  4. Hope for clinical applications: Psychedelic-assisted therapy could become a new option for people with a fear of death

Conclusion: Bridges Between Science and Mystery

The Johns Hopkins study impressively demonstrates that not only can the characteristics of psychedelic experiences resemble those of near-death experiences—both are considered among the most significant life experiences, and both produce similar lasting reductions in fear of death and increases in well-being.

This research builds bridges:

  • Between materialistic and spiritual worldviews
  • Between neuroscientific research and phenomenological experience
  • Between conventional medicine and alternative healing approaches
  • Between the fear of death and the acceptance of mortality

Ultimately, this research reminds us that human consciousness is capable of extraordinary transformations—and that confronting our mortality, whether through a near-death experience or a psychedelic journey, has the potential to fill us not with fear, but with peace, meaning, and a deeper appreciation for the precious gift of life.

Dr. Lucas Pawlik


Source: Sweeney MM, Nayak S, Hurwitz ES, Mitchell LN, Swift TC, Griffiths RR (2022) Comparison of psychedelic and near-death or other non-ordinary experiences in changing attitudes about death and dying. PLoS ONE 17(8): e0271926.

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