Psychedelic Therapy

Interest in psychedelic medicine in therapeutic settings has grown in recent years. While legal and ethical challenges exist, many clinicians and researchers advocate for change as new information and social attitudes evolve. With hope, many proponents feel mental health providers will have legal access to psychedelics in the future.

Obstacles

We cannot ignore that many indigenous peoples have used many plant medicines for centuries. Examples include ayahuasca, mescaline, and psilocybin (magic mushrooms). Other psychedelics such as MDMA (3,4-methylenedioxymethamphetamine) and LSD (lysergic acid diethylamide) are recent inventions. Many psychedelics gained strong attention from psychiatrists for various mental health conditions in the decades before the 1970s. However, as a part of the counterculture movement from the 1960s, a new federal campaign emerged, legislated as the Control Substances Act, classified these substances as having "no currently accepted medical use," "lacked accepted safety," and contained "high potential for abuse." Subsequently, the research abruptly ended, and recreational use went underground.

Four decades later, these substances remain illegal federally in the United States. A small handful of jurisdictions, such as Denver, Colorado; Oakland and Santa Cruz, California; Washington DC, and a few others, have decriminalized the use of some of these. Ketamine (used off-label) is legal in all 50 states when administered under medical supervision with a prescription. Research has been accelerating, however, with the assistance of organizations such as the Multidisciplinary Association for Psychedelic Studies (MAPS), John Hopkins Medicine, Usona Institute, and others.

The use of psychedelics by licensed mental health providers has profound legal circumstances just now being evaluated by some licensing boards and national organizations. Until the DEA reclassifies these substances, research and clinical use is complicated. Ethical standards are evolving as discussions are moving out of the shadows. Only in the last few years has the therapeutic application of psychedelics in clinical settings been formally taught by legitimate educational institutions. With the publication of FDA-designed studies, including MDMA, and psilocybin, meaningful conversations are occurring more frequently.

Hope

Western psychonauts have understood the effectiveness of many psychedelic medicines for years. Now, scientific research is creating more optimism. For example, research sponsored by MAPS in FDA-approved research shows significant responses for PTSD with MDMA. The studies demonstrate an extremely positive safety profiles, post-treatment durability, and higher response rates than current gold-standard approaches. Research using psilocybin shows considerable improvements in reducing depression, substance abuse disorders, cancer-related anxiety, and other psychiatric disorders. Ketamine (currently legal) is presently used for depression, trauma, OCD, and more. Most encouraging, responsive therapeutic results require significantly less time than traditional psychotherapy, especially with treatment-resistant conditions.

Next

In some ways, we're close to significant changes when psychedelics may become available to licensed clinicians. Meanwhile, some individuals seek psychedelics on their own, often using a "shamanic guide" to help facilitate healing. Researchers know while most anecdotal reporting suggests positive experiences, it is still "the wild west" as agencies, boards, and providers "figure this out." And there are risks: for example, street MDMA is often "cut" with very-risky drugs such as fentanyl (a narcotic painkiller).

Researchers also understand the importance of "set and setting," a controlled environment, a solid trauma-informed approach, and other essential attending skills not typically experienced in traditional psychotherapy settings. In other words, effective and safe treatment isn't in "the medicine" per se, as much as how the provider employs the psychedelic clinically.

Until psychedelics are legalized and available to trained clinicians, new research is being published, and decade-long efforts with the FDA and the DEA are moving forward with optimism. For now, some therapists around the country are learning how to help clients integrate their psychedelic experiences. Some providers are choosing to be at the forefront of a significant evolution in mental health, advocating for change while also increasing professional competency.

Helpful Links
https://maps.org/
https://usonainstitute.org/