Person examining psilocybin mushrooms in lab.

When the Promises of a Policy Do Not Meet the Reality of Its Practice: Ethical Issues Within Oregon’s Measure 109

By Tahlia Harrison

As a practicing therapist in Oregon working with complex trauma survivors, I was optimistic at first about the passage in 2020 of Measure 109 and its promise of legalizing psilocybin-assisted therapy. Psilocybin has been shown in small samples to be an effective intervention for many challenges my clients face; I was excited about this option to further support their healing. As a bioethicist and researcher examining topics related to psychedelic-assisted therapy, and a former faculty member at one of the psilocybin facilitation programs, Measure 109 also brought feelings of trepidation and a flood of questions such as: Would my national associations be amenable to this intervention? Would my liability insurance provide coverage? What about the ethics of engaging clients in a treatment involving a federally illegal substance? What about informed consent and other ethical issues? While the current informed consent form used by facilitators does address some aspects of concern (like the use of touch, 333-333-5040 (9)), it does not address other aspects like suggestibility or power dynamics within the facilitator/client relationship. Additionally, the form states “I understand that psilocybin services do not require medical diagnosis or referral and that psilocybin services are not a medical or clinical treatment,” yet it is reported that many are still seeking this as part of treatment for a medical diagnosis. How do multiple licensures apply to understanding scope of practice? Three years later, many of these questions remain unanswered, and the option of offering psilocybin-assisted therapy remains illegal and off the table.

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wirikuta hikuri hallucinogen mexican peyote flower.

Should Sacred Plant Medicines Have Standing? The Original Instructions and Western Jurisprudence

By Keith Williams and Ariel Clark

The resurgence of interest in psychedelics, or sacred plant and fungal medicines and their psychoactive constituents, has been described as a kind of “renaissance” much like the European renaissance that blossomed between the 14th – 17th centuries. The comparison is apt—for, in addition to a flowering of learning and human achievement, the psychedelic renaissance, like its namesake, is only possible because of the underlying extractivist colonial logic informing activity in this domain. We are both writing as people with ancestry from Indigenous communities, and we have a profound interest in respecting, honoring, and becoming-with our more-than-human kin. A business-as-usual approach to the so-called psychedelic renaissance will only reinforce the harmful extractivism inherent in contemporary global capitalist culture and will foreclose the kind of collective healing possible with reciprocity as an orienting principle. This post offers a brief sketch of the potential for Rights of Nature legislation to safeguard these sacred medicines by recognizing them as rights holders unto themselves and by embedding into law a relational positionality of respect and responsibility with our plant and fungal kin.

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Composite collage image of four peoples' hands holding lightbulb puzzle pieces.

Common Problems in Psychedelic Science, and How to Fix Them

By Eiko I. Fried and Michiel van Elk

Much optimism has been expressed about the potential of psychedelics to treat mental health problems such as suicidal ideation, depression, and post-traumatic stress disorder. This optimism goes hand in hand with a notable increase in research publications, investments from pharmaceutical companies, patent filings, media exposure, as well as shifts in political and legislative landscapes. In the U.S., hundreds of ketamine clinics have emerged in the last years, and Australia just recently acknowledged psychedelics as medicines.

In our new paper in print in the journal Therapeutic Advances in Psychopharmacology, titled “History repeating: Guidelines to address common problems in psychedelic science,” we critically discuss whether this optimism is warranted, given current empirical work. One of us (Dr. Eiko Fried) is an Associate Professor in Clinical Psychology who studies and teaches conducting and evaluating clinical trials for mental health problems such as depression, with a focus on the question what valid inferences can be drawn from empirical data. The other (Dr. Michiel van Elk) is an Associate Professor in Cognitive Psychology, with a long-standing interest in the topic of altered states of consciousness (including, but not limited to, states induced through psychedelics), who, together with the PRSM lab, uses a multi-method research approach, open science practices and replication studies to study these experiences in the lab and in naturalistic settings.

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Colorful vitamins, pills and tablets on green background.

History Rhymes with the Psychedelic Boom

By David Herzberg

As a historian of psychoactive pharmaceuticals in the 20th century U.S., I see history rhyming in potentially dangerous ways in the current psychedelic boom. After decades of being associated with insanity, violence, and social disorder, psychedelics are now being embraced as potential wonder drugs. What appears to be a radical, 180-degree shift in reputation, however, masks an underlying similarity: both of these mirror-image stories belong to the mythologies of the consumer culture, which attribute broad transformational power to individual acts of consumption. Seeing drugs through this mythological lens prevents us from accessing their potential benefits, while exposing us to the real possibility that they could make things worse.

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iridescent holographic waves.

The Psychedelics Industry: Psychedelic Evangelism in Second Wave Research

By Patric Plesa

As interest in psychedelics research and popular psychedelics culture resurges, it is becoming progressively more difficult to discern facts from fantasy. As an academic with expertise in psychology, I too share in the growing enthusiasm for psychedelics research, especially toward therapeutic ends. But I believe a critical perspective, characterized by open science practices and critical theoretical lenses, is indispensable if this field is to avoid the errors of the past and the neoliberal pitfalls of the present.

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Doctor asking patient to fill out survey before medical treatment.

Psychedelics in the Clinical Setting: The Potential for Harm and the Promise of Healing

By Caroline Hayes

The psychedelic renaissance is well underway, with hundreds of clinical trials currently looking into a plethora of different mental health conditions. I was a sub-investigator on a clinical trial researching a psychedelic study drug to treat depression, but I have since stepped back from psychedelic clinical trials due to personal ethical concerns about the way the field is evolving. Despite the seemingly boundless optimism for their potential as pharmacological treatments, there are a number of unique issues that psychedelics present in a clinical setting that are yet to be adequately addressed. I believe it is essential that these issues are rectified to minimize the potential harm to those desperately seeking relief from their mood symptoms.

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colorful soap bubble bursting.

Introductory Editorial — Critical Psychedelic Studies: Correcting the Hype

By Neşe Devenot

Since the 2022 publication of “Preparing for the Bursting of the Psychedelic Hype Bubble,” a JAMA Psychiatry Viewpoint by David Yaden and colleagues, a wave of scholarship and commentaries has emphasized the ethical importance of nuanced science communication about the still-nascent field of psychedelic medicine.

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Hundred dollar bills rolled up in a pill bottle

Ketamine Is the New Viagra

By Vincent Joralemon

Spravato, the first FDA-approved psychedelic therapy, just outsold Viagra. Johnson & Johnson’s ketamine-based formulation generated $183 million in Q3, surpassing Pfizer’s erectile dysfunction (ED) drug, which earned $110 million over the same period. Remarkably, a therapeutic made from ketamine, once dismissed as a “club drug” or “horse tranquilizer,” now sells more than one of the most notable 21st-century pharmaceuticals. 

Yet, these two drugs have more in common than meets the eye, and the path Spravato has taken looks strangely similar to that of Viagra. By looking at the journey traversed by Viagra over the past twenty years, we can predict where Spravato (and other psychedelic therapies) are headed.

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Contemporary art collage. Human hands knitting brain.

Want to Change Minds About Psychedelics? Start with PTSD

By Vincent Joralemon

Psychedelics have a public relations problem, due in part to overzealous promoters, genuine risks, and bad science. But, recent psychedelic legislation sponsored by conservative congressperson Dan Crenshaw shows minds can be changed in this space.

Public perceptions will shape efforts to reclassify, decriminalize, and make psychedelics available for therapeutic use. The most effective way to change peoples’ opinions is to highlight the success stories of those who have tried psychedelics. And, as Crenshaw’s story shows, psychedelic-assisted therapy for post-traumatic stress disorder (PTSD) is a compelling application for precisely those who harbor the most skepticism towards these drugs.

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