Psychedelic medicine has the power to help so many people suffering with mental illness. But there are a lot of barriers standing between us and universal access to psychedelic therapy. Let’s dive into the challenges facing psychedelic medicine in 2022.
In the last decade we’ve seen so much need for mental health treatment. In 2019, almost 20% of the American population had experienced mental illness. More than half of adults with mental illness do not get treatment, and the unmet needs of this population have increased every year . It’s been clear for a long time that our current framework and systems are falling short, and that people are falling through the cracks.
Then the COVID-19 pandemic added more strain. In 2020 mental health issues doubled compared to 2019. In June of that year, two in every five adults reported mental health or substance use problems. COVID pushed many therapists into telehealth, but unmet needs have continued to rise as people deal with the ongoing pressure of living during a pandemic.
It’s impossible to quantify the population trauma that the pandemic has caused. Back-and-forth quarantining orders, mixed messaging from politicians, misinformation about vaccines, and limited access to medical care have made many of us realize that the world is a lot more uncertain than we thought.
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As it’s become clear that COVID isn’t going anywhere, we’ve had to figure out how to make life work within a “new normal”. We’ve found new ways of creating community, new ways of learning, and new ways of being with loved ones. We’ve adapted and become more resilient. Through psychedelic medicine, the hope is that we’ll create new ways of seeing and treating mental illness.
Our population needs a revolution in mental health treatment. By breaking down the barriers to psychedelic medicine, we can improve individual lives as well as the health of our population.
Since the 60’s, psychedelics have carried a stigma attached to the hippie counterculture. LSD is scheduled the same as ecstasy and heroin, despite much less evidence for harmful effects .
Yet in 2010 an estimated 32 million Americans used psychedelics . Psychedelic use among American adults rose 56.4% between 2015 and 2018 .
With increased use, comes more support for research and treatment. In December of last year, an online survey found that half of the responders had anxiety, depression, or PTSD. 62% of the people in this group were open to psilocybin, and 56% were open to MDMA .
In research, psychedelics are proving themselves to quickly and drastically improve mental health for patients. These positive results have led to more interest from western medicine, and new educational resources for providers. Communities of support and education for physicians are helping to bring more people into psychedelic medicine.
Mainstream media is also coming around to the idea that psychedelics are more than a hippie drug. News reports from major networks continue to shed light on how psychedelics can improve lives. Investments from Wall Street and major pharmaceutical companies are also legitimizing and funding psychedelic research.
Our culture is shedding it’s misconceptions about psychedelics. More people are experiencing their benefits. Yet increased illicit use shows a need for legal access, as well as for therapeutic integration.
Psychedelic Medicine Legislation
The need for better legislation in psychedelic medicine can seem like a large barrier for use. Yet some states and cities are already paving the way for expanded psychedelic access.
Denver decriminalized psychedelics in 2019, followed by Oakland, Santa Cruz, and Detroit. Last year, Oregon became the first state to facilitate psilocybin sessions for adults interested in self-growth, and their program will open in 2023. Yet DEA laws at the federal level mean that this legislation is somewhat tenuous, similar to legalized marijuana.
We hope for good outcomes in these areas, as other cities and states consider similar moves. Canada started off this year by expanding their Special Access Program to include psychedelics. This will give physicians the ability to request access to psychedelic medicines for patients with life-threatening illness.
We can use the success of ketamine as an example of the power of psychedelics to heal where traditional methods have fallen short. Since ketamine therapy has become available through off-label prescriptions, thousands of people have experienced life-changing results for their depression, anxiety, migraines, and more.
Other psychedelics have this same potential, and we have a duty as clinicians to bring better access to our patients.
Psychedelic Education for Clinicians
Even though psychedelic medicine isn’t available yet to the public, demand is already higher than we have the practitioners for. As people are having these experiences outside of medicine, they’re coming to their therapists with questions about integration.
Now is the best time to educate clinicians on therapeutic psychedelic practices. We expect a surge in need once psychedelic medicine is legalized. At the moment when legislation changes, we need to be able to meet the needs of our patients through psychedelic medicine. We need to grow the ranks of clinicians who are working to implement psychedelic medicines.
Another hurdle is establishing certificate programs for accreditation. Psychedelic clinicians need a baseline understanding of the dosing, pharmacotherapeutics, and negative effects of psychedelics. We need standardized, evidence-based methods of care.
Continuing education is another important component of the education process for clinicians. Psychedelic therapists need ongoing resources and support in their practice.
Because there is no formal board for psychedelic medicine, regulations for practice will likely come from pharmaceutical companies and a growing number of professional associations. Hundreds of clinicians have already gone through training programs to integrate psychedelic medicine into their practice.
But these trainings are not standardized, and we’re not sure what requirements pharmaceutical companies and FDA will put in place for practitioners. As clinicians, we have an opportunity to advocate for our patients and establish expectations for our peers.
We also need established networks for resources and dialogue. To meet the educational needs of practitioners and patients, Psychedelic Support creates resources to fill the void left by western medicine. We’re working to create a new ecosystem for education, and a collaborative community for educators and clinicians. We’re aiming to replace old misconceptions with education and open-mindedness.
Ethical Considerations in Psychedelic Therapy
Psychedelic medicine is a radical approach to therapy. It’s unlike any other treatment method, and it comes with it’s own unique ethical issues.
Psychedelic medicine comes from two very different approaches. On one hand, these substances have been used in spiritual practices and rituals by native groups. Its indigenous usage goes back thousands of years. More recently, western medicine has begun to discover its utility as a treatment for mental illness. Psychedelics straddle the ancient and modern, the aboriginal and the upstart.
As we move forward with implementing psychedelic medicine, we have a duty to respect it’s ancient roots. Too often, native communities are punished for their cultural practices while western culture adopts them. Indigenous communities haven’t had a seat at the table. We have a duty to include the communities that have understood the power of psychedelics for much longer than we have, and ensure that they benefit from the “mainstreaming of psychedelics”.
There are also ethical concerns around therapeutic implementation. One way psychedelic therapy is very different is in the use of touch. While in traditional counseling and therapy, touch is never used, it can often be a tool in psychedelic sessions. This comes with obvious ethical concerns for therapists. Widening the breadth of voices on this subject will help create expectations for the field.
If it’s not done correctly, psychedelic therapy can be traumatic. Patients often have strong emotions during sessions. It’s important that we train clinicians for scenarios where uncomfortable memories, childhood trauma, and embedded emotions rise to the surface. While these results often lead to life-changing improvements, the power of psychedelics means that we need clinicians who understand the best way to use them for patient outcomes.
People undergoing psychedelic therapies are a vulnerable group. The diagnoses of depression, anxiety, PTSD, and substance use disorders make these people needful of care. At the same time, psychedelics have been shown to make people more suggestible, and can permanently alter a person’s perception of their world . Expectations for clinicians will help us protect patients from harm after their sessions.
Ethics problems are not unique to the world of psychedelic medicine. More community growth and discussion around these issues will help us gain understanding, and help us establish ethical standards for the field.
Looking to the Future of Psychedelic Medicine
There’s a lot to overcome in the next several years of psychedelic medicine, but also so much to look forward to. It’s exciting to be on the frontier of a new framework in mental health medicine, one that can help so many people.
- The state of Mental Health in America. Mental Health America. (n.d.). Retrieved January 20, 2022, from https://mhanational.org/issues/state-mental-health-america
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- R. Andrew Yockey, Rebecca A. Vidourek, Keith A. King, Trends in LSD use among US adults: 2015–2018, Drug and Alcohol Dependence, Volume 212, 2020, 108071, ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2020.108071.
- Survey finds majority of affected Americans approve of psychedelics as an alternative treatment to address anxiety, depression and PTSD. Delic Corp. (2022, January 18). Retrieved January 21, 2022, from https://deliccorp.com/press-releases/delic-corp-harris-poll-results/
- Anderson, B. T., Danforth, A. L., & Grob, C. S. (2020). Psychedelic medicine: Safety and ethical concerns. The Lancet Psychiatry, 7(10), 829–830. https://doi.org/10.1016/s2215-0366(20)30146-2