How Do American Psychiatrists View Psychedelics?

Although a majority of American psychiatrists still view psychedelics with worry, many seem open to their potential according to a study by Barnett et al [1]. Interesting differences in opinion also emerged based on age, gender, and professional status. As new psychedelic research continues to be published, can we draw any conclusions?


How do American psychiatrists view psychedelics? It’s complicated. Although a study by Barnett et al. said that a majority still seemed leery, a “large minority” [1] appeared optimistic about their potential.

For example, considering psychiatric disorders, 64.9% of survey respondents thought that psychedelic use increased the risk, yet 80.5% thought it deserved further research. Nearly the same percentage thought that psychedelic use “shows promise in treating psychiatric disorders” (42.5%) as “increases the risk for long-term cognitive impairment” (47.8%).

The Barnett et al. study examined survey responses from 324 members of the American Psychiatric Association (out of 1000 surveys requested). It focused on relatively older psychedelics (such as LSD and psilocybin), as opposed to more recent psychedelic compounds (such as MDMA and ketamine). The study also used the term “hallucinogen” instead of “psychedelic.”

The overall percentages of study respondents who moderately or strongly agreed with the survey’s seven statements can be seen here:

Percentage Who Moderately or Strongly Agreed
“The use of hallucinogens…”

The study authors had previously wondered if psychiatrists might be more suspicious about psychedelics than average Americans, since they’re sometimes on the front lines of dealing with negative psychedelic experiences. Yet the authors found that opinions of the survey respondents “seemed to parallel those of the general public” [1], which have also been leery but slowly growing more open. Suspicion among psychiatrists might also mirror some lingering negative opinions about psychedelics in the American media.

It could be encouraging that relatively few psychiatrists thought that psychedelics were “unsafe even under medical supervision.” Perhaps talking with therapists trained to supervise psychedelic treatments would open more minds. Since the number of therapists with psychedelic training has been increasing around the world [4], that type of interaction might be happening more often.

Interesting demographic differences emerged in the Barnett et al. study. The results for each demographic that had significant results can be viewed in the charts below. Click on the buttons to see the results for each demographic.

Percentage Who Moderately or Strongly Agreed
“The use of hallucinogens…”

About these demographic differences, Barnett et al. wrote: “Male and trainee respondents, as compared with female and attending respondents, reported less concern about the risks of hallucinogens and greater optimism about their therapeutic potential. Younger psychiatrists also seemed more optimistic.”

Barnett et al. thought that personal experiences might have been a contributing factor in these differences. They noted that according to the National Survey on Drug Use and Health, men have “reported roughly twice the lifetime prevalence of hallucinogen use as women did” [1]. This didn’t mean that male survey respondents in the Barnett et al. study were more likely to have used psychedelics themselves, but it might have suggested they knew more people who had safely tried psychedelics. However, the study authors were careful to emphasize that they did not ask participants about personal psychedelic use in order to avoid privacy concerns.

The study thought that higher optimism among trainees and younger psychiatrists might have been due to recent exposure to positive articles and studies about psychedelics. In addition, trainees and younger psychiatrists might have had few experiences with the types of negative stories so widely distributed in the 1960s.

Those positive articles and studies have been coming rapidly recently. For example, this month saw the release of a major new psilocybin study in JAMA Psychiatry, which stated that “psilocybin-assisted therapy was efficacious in producing large, rapid, and sustained antidepressant effects in patients with major depressive disorder” [2]. The previous few months also brought two other positive articles in JAMA Psychiatry, one about “The Current Status of Psychedelics in Psychiatry” and an editorial about “Psilocybin-Assisted Supportive Psychotherapy in the Treatment of Major Depression – Quo Vadis?”

The November 2020 election legalized psilocybin therapy in Oregon and decriminalized psilocybin in Washington D.C. Other communities, such as Denver, Oakland, Santa Cruz, and Ann Arbor had already decriminalized psilocybin. You can read more about decriminalization and legalization efforts around the United States here. Perhaps the illegal status of psychedelics and the long stigma attached to psychedelic research [3] could be contributing to suspicions among psychiatrists. It might be interesting to see if these attitudes change in places where psychedelics have been legalized or decriminalized. A survey about ketamine might already show some of these effects, since it can be legally prescribed throughout the United States.

How do American psychiatrists view psychedelics? Like the rest of the United States, they seem to be in flux. There are signs of growing interest and openness to psychedelic therapy, but in general, Barnett et al. noted that “American psychiatrists seem to remain concerned about the possibility of adverse psychiatric and neurocognitive effects from hallucinogen use” [1]. As more studies are published and psychedelic therapy becomes more available, perhaps that concern will start to wane.


References:

  1. Barnett, B., Siu, W., & Pope, H. (2018). Psychiatrist Views on Hallucinogens. The Journal of Nervous and Mental Disease, 206(6), 476-480. https://doi.org/10.1097/nmd.0000000000000828
  2. Davis, A., Barrett, F., May, D., et al. (2020). Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder A Randomized Clinical Trial. JAMA Psychiatry, online, 4 Nov. 2020, https://jamanetwork.com/article.aspx?doi=10.1001/jamapsychiatry.2020.3285
  3. Griffiths, R., Johnson, M., Carducci, M., et al. (2016). Psilocybin Produces Substantial and Sustained Decreases in Depression and Anxiety in Patients With Life-threatening Cancer: A Randomized Double-blind Trial.” Journal of Psychopharmacology, 30(12), 1181-1197. https://dx.doi.org/10.1177%2F0269881116675513
  4. Nutt, D., Carhart-Harris, R. (2020). The Current Status of Psychedelics in Psychiatry. JAMA Psychiatry, online, 29 July 2020, https://doi.org/10.1001/jamapsychiatry.2020.2171

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