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Palliative Care+

The Role of Psychedelics in Palliative Care: Real-World Cases – Dr. Houman Farzin, M.D.

September 13, 2024 / Palliative Care+ / By

Introduction to Psychedelic-Assisted Therapy in Palliative Care

Psychedelic-assisted therapy is emerging as a transformative approach in palliative care, offering new hope for patients facing the profound challenges of advanced cancer and end-of-life distress. In his presentation at the ICPR 2024, Dr. Houman Farzin, MD, a palliative care physician and clinical faculty member at McGill University, provided insights into the evolving field of psychedelic therapy, specifically focusing on its application in advanced cancer care. Drawing from real-world case studies in Montreal, Canada, Dr. Farzin highlighted the therapeutic potential of psilocybin and MDMA in alleviating physical and psychological suffering, offering a compelling vision for the future of palliative care.

Recording of ICPR 2024 talk. Discover more recordings here.

about Dr. Houman Farzin: Pioneer in Psychedelic-Assisted Therapy and Palliative Care

Dr. Houman Farzin, M.D. is a leading physician specializing in psychedelic-assisted therapies, nutrition, and lifestyle modification to address trauma, existential distress, and enhance overall well-being. As an attending physician in the Division of Palliative Care at the Jewish General Hospital in Montreal, Dr. Farzin integrates emerging treatments and digital health technologies with mindfulness, music, and psychedelic medicine to improve quality of life and alleviate suffering across all life stages.

A lecturer at McGill University Medical School, Dr. Farzin also contributes to the McGill Programs in Whole Person Care, where he teaches resilience and Mindful Medical Practice to future physicians. His extensive training includes expertise in MDMA, psilocybin, and ketamine therapies, and he has been instrumental in organizing Quebec’s first psilocybin therapy training programs.

Dr. Farzin’s research focuses on the societal views of psilocybin therapy for existential distress and innovative treatments for chemotherapy-induced peripheral neuropathy. His contributions to the field are further exemplified by his role as a site physician for MAPPUSX, a study on MDMA-assisted psychotherapy for PTSD. He is also a co-founder of injoy (formerly Phyla), a digital health tool utilizing AI to connect diet, lifestyle, and microbiome health.

Passionate about indigenous cultures and altered states of consciousness, Dr. Farzin’s work is deeply informed by Eastern philosophies and his anthropological studies of ancient practices. His commitment to advancing psychedelic therapies in mainstream healthcare continues to inspire confidence in their potential to transform palliative care and mental health treatment.

Case Studies: Real-World Applications of Psychedelic Therapy

Dr. Farzin’s presentation at ICPR 2024 was grounded in the real-world application of psychedelic therapies, illustrating their profound impact on patients with advanced cancer. His work highlights the effectiveness of individual and group therapy sessions, tailored to each patient’s unique needs.

Case 1: Floran’s Journey with Psilocybin Therapy

One of the most compelling cases involved a patient named Floran, who underwent psilocybin-assisted therapy as part of her treatment for advanced cancer. Her first session, which involved a five-gram dose of psilocybin mushrooms, was characterized by intense emotions and a confrontation with deep-seated fears. However, it also opened up new pathways to healing, as depicted in a drawing she created afterward, illustrating her experience of moving from darkness to vibrant colors.

Case 2: A Retired Nurse Finds Peace

Another case involved a retired nurse in her seventies, suffering from advanced cancer and severe anxiety. Despite her reliance on multiple medications, the psilocybin session had a profound impact, providing her with a sense of peace and acceptance that had eluded her for years. Months after the session, she reported a transformative change in her outlook on life, illustrating the long-term benefits of psychedelic therapy.

Case 3: Rediscovering Poetry Through Psychedelic Therapy

A younger cancer patient rediscovered her love for poetry during her psilocybin-assisted therapy. The experience allowed her to reconnect with her inner child, a part of herself suppressed due to the trauma of her illness. This reconnection empowered her to express her emotions and creativity in ways that had previously been inaccessible.

The Importance of Somatic Awareness and the Mind-Body Connection

A critical component of Dr. Farzin’s approach to psychedelic therapy is the emphasis on somatic awareness—the recognition and processing of emotions and trauma stored in the body. This concept, supported by experts like Dr. Gabor Maté, posits that trauma can manifest as physical ailments, including cancer and autoimmune diseases. In psychedelic therapy, patients explore these bodily sensations to access and resolve deep-seated emotional issues.

For instance, during a session, a patient might experience intense physical sensations, which are then explored as manifestations of underlying trauma. By addressing these sensations directly, patients often access emotions and memories that are not readily available in their normal state of consciousness. This process aids in the release of stored trauma and fosters a deeper understanding of the mind-body connection, crucial for holistic healing.

The Evolution of Psychedelic Therapy in Canada

Psychedelic-assisted therapy has a complex history, marked by periods of intense research interest followed by decades of legal and cultural suppression. In Canada, psilocybin, the active compound in magic mushrooms, was banned in 1974, closely following the United States’ regulatory actions. However, a significant shift occurred in 2020 when an advocacy campaign led by four terminally ill patients resulted in legal exemptions for psilocybin use under Section 56 of the Controlled Drugs and Substances Act.

This legal breakthrough marked the beginning of a new era in Canadian healthcare, enabling patients facing end-of-life distress to access psilocybin-assisted therapy. The initial exemptions allowed patients to source psilocybin from the black market, setting a precedent that has since expanded into the Special Access Program (SAP), allowing broader clinical use under regulated conditions.

Dr. Farzin’s involvement with TheraPsil, a Canadian nonprofit dedicated to advancing legal access to psilocybin therapy, underscores the collaborative effort required to integrate these treatments into mainstream healthcare. The inclusion of psilocybin and MDMA in the SAP represents a significant milestone, enabling healthcare practitioners to apply for the use of these substances on a case-by-case basis for patients who do not respond to conventional treatments.

Psypal, The First EU-Funded Multi-Site Clinical Study into Psychedelic-Assisted Therapy

The EU marked a significant step forward in integrating psychedelic-assisted therapies into mainstream palliative care practices as it granted Psypal, a multi-site clinical study into psychedelic-assisted therapy, over €6.5 million. PsyPal aims to study the use of psilocybin in treating psychological distress in patients with progressive, incurable illnesses requiring palliative care. It consists of a European consortium of 19 partners, including the OPEN Foundation learn more.

Ethical Considerations and the Future of Psychedelic Therapy in Palliative Care

While the benefits of psychedelic therapy are increasingly recognized, the field is not without its ethical challenges. Dr. Farzin addresses these concerns by acknowledging the complexities of offering these treatments to vulnerable populations. One primary ethical consideration is the potential for these therapies to alter a patient’s perception of their illness and treatment choices, particularly in the context of end-of-life care.

Some may argue that providing psilocybin or MDMA therapy to terminally ill patients could influence their decisions regarding medical aid in dying (MAID). However, as Dr. Farzin notes, the goal of psychedelic therapy is not to steer patients away from MAID but to offer them additional tools for coping with their illness. In some cases, patients may still choose MAID after undergoing psychedelic therapy, but with a greater sense of peace and acceptance.

Conclusion: A New Paradigm in Palliative Care

Dr. Houman Farzin’s work represents a significant step forward in integrating psychedelic therapies into mainstream healthcare, particularly in palliative care. His pioneering efforts in Canada demonstrate the profound impact these therapies can have on patients facing the challenges of advanced cancer and end-of-life distress. By combining rigorous scientific research with compassionate patient care, Dr. Farzin is helping to pave the way for a new paradigm in palliative care—one that embraces the transformative potential of psychedelics to heal the body, mind, and spirit.

As the field of psychedelic therapy continues to evolve, healthcare professionals, researchers, and policymakers must collaborate to ensure that these treatments are accessible, ethical, and grounded in the best available evidence. Through innovation and teamwork, the potential for psychedelics to revolutionize palliative care is immense, offering new hope and healing to those who need it most.

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How to Change Your Mind: The New Science of Psychedelics

December 25, 2021 / Anxiety Disorders / PTSD, Depressive Disorders, Palliative Care+ / Leave a Comment / By

How to Change Your Mind: The New Science of Psychedelics. Michael Pollan. The Penguin Press. ISBN: 9781594204227

A highly accessible and enjoyable read through the history of psychedelic research and use starting in the 1960s up to the present day. Pollan applies his quintessential experiential journalism approach to various psychedelic substances – starting off hesitantly, as he weaves through the research and has several personal experiences, Pollan becomes a measured advocate for the power psychedelics have to change our minds and more.

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Mapping an Agenda for Psychedelic-Assisted Therapy Research in Patients with Serious Illness

March 16, 2022 / Palliative Care+, Papers / Leave a Comment / By / , , , , ,

Abstract

Background: With support from the Radcliffe Institute for Advanced Study at Harvard University, we convened researchers representing palliative care, psychosocial oncology, spiritual care, oncology, and psychedelic-assisted therapies. We aimed to define priorities and envision an agenda for future research on psychedelic-assisted therapies in patients with serious illness. Over two days in January 2020, participants engaged in an iterative series of reflective exercises that elicited their attitude and perspectives on scientific opportunities for this research. Objectives: The aim of the study is to identify themes that shape priorities and an agenda for research on psychedelic-assisted therapy for those affected by serious illness. Methods: We collected data through preconference interviews, audio recordings, flip charts, and sticky notes. We applied thematic qualitative analysis to elucidate key themes. Results: We identified seven key opportunities to advance the field of psychedelic-assisted therapies in serious illness care. Four opportunities were related to the science and design of psychedelic-assisted therapies: clarifying indications; developing and refining therapeutic protocols; investigating the impact of set and setting on therapeutic outcomes; and understanding the mechanisms of action. The other three pertained to institutional and societal drivers to support optimal and responsible research: education and certification for therapists; regulations and funding; and diversity and inclusion. Additionally, participants suggested epistemological limitations of the medical model to understand the potential value and therapeutic use of psychedelics. Conclusions: Medicine and society are witnessing a resurgence of interest in the effects and applications of psychedelic-assisted therapies in a wide range of settings. This article suggests key opportunities for research in psychedelic-assisted therapies for those affected by serious illness.

Beaussant, Y., Tulsky, J., Guérin, B., Schwarz-Plaschg, C., Sanders, J. J., & Radcliffe Institute for Advanced Study Working Group on Psychedelic Research in Serious Illness (2021). Mapping an Agenda for Psychedelic-Assisted Therapy Research in Patients with Serious Illness. Journal of palliative medicine, 24(11), 1657–1666. https://doi.org/10.1089/jpm.2020.0764

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Acute and Sustained Reductions in Loss of Meaning and Suicidal Ideation Following Psilocybin-Assisted Psychotherapy for Psychiatric and Existential Distress in Life-Threatening Cancer

March 16, 2022 / Mushrooms / Psilocybin, Palliative Care+, Papers / Leave a Comment / By / , , , , , , , , , ,

Abstract

People with advanced cancer are at heightened risk of desire for hastened death (DHD), suicidal ideation (SI), and completed suicide. Loss of Meaning (LoM), a component of demoralization, can be elevated by a cancer diagnosis and predicts DHD and SI in this population. We completed a randomized controlled trial in which psilocybin-assisted psychotherapy (PAP) produced rapid and sustained improvements in depression, demoralization, and hopelessness in people with cancer. Converging epidemiologic and clinical trial findings suggests a potential antisuicidal effect of this treatment. To probe our hypothesis that PAP relieves SI through its beneficial impacts on depression and demoralization (LoM in particular), we performed secondary analyses assessing within- and between-group differences with regard to LoM and an SI composite score. Among participants with elevated SI at baseline, PAP was associated with within-group reductions in SI that were apparent as early as 8 h and persisted for 6.5 months postdosing. PAP also produced large reductions in LoM from baseline that were apparent 2 weeks after treatment and remained significant and robust at the 6.5 month and 3.2 and 4.5 year follow-ups. Exploratory analyses support our hypothesis and suggest that PAP may be an effective antisuicidal intervention following a cancer diagnosis due to its positive impact on hopelessness and demoralization and its effects on meaning-making in particular. These preliminary results implicate psilocybin treatment as a potentially effective alternative to existing antidepressant medications in patients with cancer that are also suicidal, and warrant further investigation in participants with elevated levels of depression and suicidality.

Ross, S., Agin-Liebes, G., Lo, S., Zeifman, R. J., Ghazal, L., Benville, J., Franco Corso, S., Bjerre Real, C., Guss, J., Bossis, A., & Mennenga, S. E. (2021). Acute and Sustained Reductions in Loss of Meaning and Suicidal Ideation Following Psilocybin-Assisted Psychotherapy for Psychiatric and Existential Distress in Life-Threatening Cancer. ACS pharmacology & translational science, 4(2), 553–562. https://doi.org/10.1021/acsptsci.1c00020

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Clinical and biological predictors of psychedelic response in the treatment of psychiatric and addictive disorders: A systematic review

March 14, 2022 / Depressive Disorders, Palliative Care+, Papers, Substance Use Disorder / Leave a Comment / By / , , , ,

Abstract

Background: The use of psychedelic treatments has shown very promising results in some psychiatric and addictive disorders, but not all patients achieved a response.

Aim: The aim of this review is to explore the clinical and biological factors which could predict the response to psychedelics in psychiatric and addictive disorders.

Methods: A systematic research was performed on MEDLINE, PsycInfo, Web of science, and Scopus databases from January 1990 to May 2020. All studies investigating the predictive factors of response to psychedelics regardless of psychiatric or addictive disorders, were included.

Results: Twenty studies investigating addictive disorder, treatment-resistant depression, obsessive-compulsive disorder and depressive and anxiety symptoms in patients with life-threatening cancer were included in this review. We found that, in all indications, the main predictive factor of response to psychedelics is the intensity of the acute psychedelic experience. Indeed, we found this factor for alcohol and tobacco use disorders, treatment-resistant depression, and anxiety and depressive symptoms in patients with life-threatening cancer, but not for obsessive-compulsive disorder.

Conclusion: The intensity of the acute psychedelic experience was the main predicting factor of response. The action mechanism of this experience was not clear, but some hypotheses could be made, such as a modulation of serotoninergic system by 5-HT2A receptors agonism, a modulation of the default mode network (DMN) with an acute modular disintegration of the DMN followed by a re-integration of this network with a normal functioning, or an anti-inflammatory effect of this treatment.

Romeo, B., Hermand, M., Pétillion, A., Karila, L., & Benyamina, A. (2021). Clinical and biological predictors of psychedelic response in the treatment of psychiatric and addictive disorders: A systematic review. Journal of psychiatric research, 137, 273–282. https://doi.org/10.1016/j.jpsychires.2021.03.002

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Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern-era clinical studies

November 30, 2021 / Anxiety Disorders / PTSD, Ayahuasca, Depressive Disorders, DMT, LSD, Mushrooms / Psilocybin, Palliative Care+, Papers, Psychology, Substance Use Disorder / Leave a Comment / By / , , ,

Abstract

Objective: To conduct a systematic review of modern-era (post-millennium) clinical studies assessing the therapeutic effects of serotonergic psychedelics drugs for mental health conditions. Although the main focus was on efficacy and safety, study characteristics, duration of antidepressants effects across studies, and the role of the subjective drug experiences were also reviewed and presented.

Method: A systematic literature search (1 Jan 2000 to 1 May 2020) was conducted in PubMed and PsychINFO for studies of patients undergoing treatment with a serotonergic psychedelic.

Results: Data from 16 papers, representing 10 independent psychedelic-assisted therapy trials (psilocybin = 7, ayahuasca = 2, LSD = 1), were extracted, presented in figures and tables, and narratively synthesized and discussed. Across these studies, a total of 188 patients suffering either cancer- or illness-related anxiety and depression disorders (C/I-RADD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD) or substance use disorder (SUD) were included. The reviewed studies established feasibility and evidence of safety, alongside promising early data of efficacy in the treatment of depression, anxiety, OCD, and tobacco and alcohol use disorders. For a majority of patients, the therapeutic effects appeared to be long-lasting (weeks-months) after only 1 to 3 treatment session(s). All studies were conducted in line with guidelines for the safe conduct of psychedelic therapy, and no severe adverse events were reported.

Conclusion: The resurrection of clinical psychedelic research provides early evidence for treatment efficacy and safety for a range of psychiatric conditions, and constitutes an exciting new treatment avenue in a health area with major unmet needs.

Andersen, K., Carhart-Harris, R., Nutt, D. J., & Erritzoe, D. (2021). Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern-era clinical studies. Acta psychiatrica Scandinavica, 143(2), 101–118. https://doi.org/10.1111/acps.13249

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MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study

January 6, 2022 / MDMA, Palliative Care+, Papers / Leave a Comment / By / , , , , , , , , , , , ,

Abstract

The success of modern medicine creates a growing population of those suffering from life-threatening illnesses (LTI) who often experience anxiety, depression, and existential distress. We present a novel approach; investigating MDMA-assisted psychotherapy for the treatment of anxiety in people with an LTI. Participants with anxiety from an LTI were randomized in a double-blind study to receive MDMA (125 mg, n = 13) or placebo (n = 5) in combination with two 8-h psychotherapy sessions. The primary outcome was change in State-Trait Anxiety Inventory (STAI) Trait scores from baseline to one month post the second experimental session. After unblinding, participants in the MDMA group had one open-label MDMA session and placebo participants crossed over to receive three open-label MDMA sessions. Additional follow-up assessments occurred six and twelve months after a participant’s last experimental session. At the primary endpoint, the MDMA group had a greater mean (SD) reduction in STAI-Trait scores, – 23.5 (13.2), indicating less anxiety, compared to placebo group, – 8.8 (14.7); results did not reach a significant group difference (p = .056). Hedges’ g between-group effect size was 1.03 (95% CI: – 5.25, 7.31). Overall, MDMA was well-tolerated in this sample. These preliminary findings can inform development of larger clinical trials to further examine MDMA-assisted psychotherapy as a novel approach to treat individuals with LTI-related anxiety.Trial Registration: clinicaltrials.gov Identifier: NCT02427568, first registered April 28, 2015.

Wolfson, P. E., Andries, J., Feduccia, A. A., Jerome, L., Wang, J. B., Williams, E., Carlin, S. C., Sola, E., Hamilton, S., Yazar-Klosinski, B., Emerson, A., Mithoefer, M. C., & Doblin, R. (2020). MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study. Scientific reports, 10(1), 20442. https://doi.org/10.1038/s41598-020-75706-1

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Sustained subjective benefits of LSD for the treatment of end-of-life anxiety

December 6, 2021 / LSD, Palliative Care+, Publications / By

LSD_clinical_trial_bottle_small

Earlier, we reported on the first study with LSD in human subjects in more than forty years, conducted in Switzerland by Peter Gasser and his team. A follow-up of this study [1], based on qualitative interviews with participants, indicates lasting positive outcomes.

The original double-blind, placebo-controlled study was carried out on a sample of twelve subjects, nine of which went on to complete the full course of the study, including the 12-month follow-up. The participants, all terminally ill, underwent 6-8 non-drug psychotherapeutic sessions and two LSD experiences conducted by a co-therapist dyad. The four subjects who initially received the active placebo of 20µg of LSD were offered the possibility to take two full experimental 200µg-doses of LSD at the end of the actual study, an opportunity that was taken by three of them, who were subsequently included in the qualitative interviews.

All subjects had previously displayed significant anxiety and/or depression related to their life-threatening health situation. All of them reported considerable long-term benefits, among which are reduced anxiety, less fear of death, and an improved quality of life. Interestingly, most of them also reported positive changes in personality, which could be a subjective confirmation of the quantitative measures of trait anxiety (as opposed to state anxiety) that were reported. These trait measures dropped significantly after the LSD sessions, and remained low at the 12-month follow-up [2].

In subjective reports of the LSD sessions, participants described facilitated access to emotions and catharsis. Facing a short life prognosis, they reported that LSD intensified and allowed expression of associated emotions. The interviews suggest the patients benefited from this intensified emotional experience. LSD also enabled them to view themselves and their difficult situation in a new, broader perspective. “Dying is as usual or unusual as life itself,” said one patient. “I simply have to familiarize myself with the idea and the process.” The patients also reported drastic shifts in emotions during or between the two sessions, usually beginning with ‘negative’ feelings related to their life situation, such as anxiety, depression and hopelessness. This reportedly negative emotional state transformed into a positive one, felt with an intensity never experienced before and lasting for at least one year after the sessions. Although they were facing ongoing severe somatic diseases, none of the participants reported any adverse effects from the psychedelic sessions.

Another interesting aspect is the approach that was chosen. Two different approaches emerged from the early research with LSD between the 1950s and the 1970s. In psycholytic therapy, used mainly in Europe, patients underwent a high number of psychoanalytically oriented psychotherapeutic sessions with low to medium dosages of LSD (50-100 µg). The psychedelic approach, on the other hand, aimed to elicit mystical or peak experiences in patients by administering them high doses (200-500 µg) in a limited number of sessions. This latter method was more frequently used in the United States, and up to now, it is the only approach that was used in the treatment of end-of-life anxiety.

In the Swiss study, the approach was very much akin to the psychedelic method, however staying on the low side of the dosage range. The setting was also somewhat looser than in the traditional psychedelic approach, where the subject kept on eyeshades most of the time while listening to music through headphones. Most of the resulting experiences could be described as ‘peak experiences’, but do not match the criteria for full mystical experiences. These two types of experiences can be quite similar. Ego boundaries are loosened in peak experiences, but don’t dissolve completely as in mystical experiences. Intellectual functions also stay intact to a greater degree, which allows for a higher degree of interaction between subject and guiding therapists than in the traditional psychedelic approach. These peak experiences seem to be the main psychological mechanism of action involved, much more so than the cognitive and psychodynamic experiences that are also frequent as a result of LSD administration.

The Swiss study’s approach certainly has advantages, one of which being that it seems to normalize the results for all participants. In past studies with psychedelics for end-of-life anxiety, conducted during the first era of psychedelic research, the typical outcome would show a dramatic improvement in about one-third of the subjects, a moderate improvement in another third, and no significant changes in the remaining third [3]. In the present study, remarkably, every single patient experienced significant improvement, although none reported ‘dramatic’ effects. This result certainly warrants further study, especially in light of the development of different therapeutic approaches to be used in psychedelic therapy.

 
[1] Gasser, P., Kirchner, K., & Passie, T. (2014).
[2] Gasser, P., Holstein, D., Michel, Y., Doblin, R., Yazar-Klosinski, B., Passie, T., & Brenneisen, R. (2014).
[3] Kurland, A.A. (1985).
 
References
Gasser, P., Kirchner, K. & Passie, T. (2014). LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects. Journal of Psychopharmacology, 29(1), 57-68. [Abstract]
Gasser, P., Holstein, D., Michel, Y., Doblin, R., Yazar-Klosinski, B., Passie, T., & Brenneisen, R. (2014). Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-threatening Diseases. The Journal of Nervous and Mental Disease, 202(7), 513–520. [Abstract]
Kurland, A.A. (1985). LSD in the supportive care of the terminally ill cancer patient. Journal of Psychoactive Drugs, 17(4), 279–290. [Link to full text]

Lecture: Psilocybin in the treatment of end-of-life anxiety

December 6, 2021 / Mushrooms / Psilocybin, Palliative Care+, Publications / By

flashback-psychedelic-research-returns

Dr. Grob will come all the way from Los Angeles to give a lecture on his research into psilocybin, the active ingredient in ‘magic mushrooms’. The main focus of this lecture will be the investigation into the safety and efficacy of psilocybin as a therapeutic aid in the treatment of severe anxiety in adult patients with advanced-stage cancer. Research into substances such as MDMA and ayahuasca, also investigated at the Harbor-UCLA Medical Center, will be addressed as well. There will be ample time for questions and discussion. Students, health care professionals and therapists are encouraged to attend.

Dr. Charles Grob is professor in Psychiatry & Biobehavioral Sciences at UCLA, Los Angeles (USA). He has published extensively on topics such as substance misuse and the history of hallucinogens in psychiatry. He performed the first FDA approved study of the physiological and psychological effects of MDMA; a multi-national study of ayahuasca in Brazil and has performed a pilot investigation of the safety and efficacy of psilocybin in the treatment of anxiety in adult patients with advanced-stage cancer.
The lecture will take place on Friday 14 June, from 16:00 – 18:00.
LOCATION: CREA (Muziekzaal), Nieuwe Achtergracht 170 Amsterdam.
FEE: €5,- regular / students & alumni get in for free

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