How Psychedelic Therapy is Going Mainstream

Why should you care about psychedelics? They’re poised to reshape how we think about therapy and mental health. With remarkable speed, these compounds have gone from fringe to mainstream.

In the past year I’ve spoken to countless healthcare professionals looking for ways to incorporate psychedelic therapy into their practices. I’ve met entrepreneurs building solutions to make psychedelic therapy more effective, safer and more affordable. I’ve participated in psychedelic therapy myself—both individual and group experiences.

Here’s what I’ve learned about psychedelic therapy and where it’s headed.

I recently attended a talk at NeueHouse Madison Square called?Mainstreaming Psychedelics.

“How many of you have tried psychedelics?” one panelist asked. About two-thirds of the crowd of mostly young professionals raised their hands. “Wow, that’s high for New York,” she said.

Then she asked: For those who have used psychedelics, how many of you would say it was one of the five most meaningful experiences of your life? About half the audience raised their hands. Studies show 60 percent of people say yes to this question, the panelist said.

What is psychedelic therapy?

Indigenous people around the world have used psychedelic substances as medicine and in rituals and religious ceremonies for centuries.?

A growing body of research shows psychedelic therapy can help people struggling with depression, PTSD, and addiction. More people are sharing their stories of psychedelic therapy changing lives.

Every week we’re seeing more signs that these practices—long illegal in the US, spoken about in whispers, done secretly in shaman-led ceremonies—are about to go mainstream.

It’s an exciting time for psychedelic therapy:

• Oregon and Washington, D.C. in 2020 decriminalized psilocybin, the active ingredient in “magic mushrooms,” for mental health treatment. Starting in 2023, the Oregon Health Authority (OHA) will oversee magic mushroom consumption at service centers in the presence of licensed facilitators.
• The Biden administration announced last month ?it’s preparing for potential FDA approval of MDMA-assisted therapy for PTSD.
• Netflix released the docuseries “How to Change Your Mind ,” based on Michael Pollan’s bestselling book, with episodes on the therapeutic properties of LSD, mescaline, psilocybin, and MDMA.
• NFL star?Aaron Rodgers last week credited ayahuasca therapy ?with improving his on-field performance.

The New York Times ran a story ?recently about Veterans Affairs clinicians, frustrated with existing treatments for addiction and PTSD, who have turned to use of MDMA and?psilocybin ?to treat mental illnesses that have been resistant to current therapies for many veterans.

After decades of criminalization, psychedelic drugs are on the cusp of entering mainstream psychiatry.

Legalization, federal funding and the emerging ecosystem

Many health experts believe psychedelic therapy will be legalized in the US in the next few years. This could open up the floodgates for basic research.

Experts compare the mainstreaming of psychedelic therapy to the legalization of cannabis. Decriminalization of psychedelics would make it easier for people to use these compounds; legalization would support clinical research and help bring effective treatments more quickly to people in need.

One panelist at NeueHouse highlighted the infrastructure that will be needed to support psychedelic therapy:

“We’re focused on creating the building blocks required for the psychedelics ecosystem to exist, be equitable, safe and sustainable. An ecosystem for psychedelic therapy must include insurance, reimbursement, therapist training, and certification.”

Training psychedelic therapists, improving access

The NeueHouse panel highlighted the challenge of training enough psychedelic therapists to meet expected demand.

As MDMA and psilocybin are expected to advance through the FDA approval process, millions of people may be seeking legal psychedelic therapy. Experts believe thousands of trained therapists will be needed.?

Dozens of schools are popping up around the US to offer training in psychedelic therapy. They include the?California Institute of Integral Studies ,?Naropa , and?Compass Pathways Plc . The most well-known training center may be the?MDMA Therapy Training Program at?Multidisciplinary Association for Psychedelic Studies (MAPS) , which?has enrolled over a thousand students.

A company called Synthesis, which offers psychedelic retreats in the Netherlands, including one?program focused on depression , is creating a training program on a 124-acre estate in Ashland, Oregon.

One challenge: There’s no standard-setting body for psychedelic training. Some clinicians worry that the lack of governance can make it difficult for prospective students to choose reliable programs.

There’s a risk with psychedelic therapy that unlicensed practitioners could cause harm. Experts say training is important because psychedelics put people in a very vulnerable state. They can be emotionally destabilizing and create feelings of susceptibility and emotional intimacy, which creates a risk of sexual misconduct. Developing appropriate safety protocols will be critical.

One NeueHouse panelist said:

“We need to increase cult education with respect to psychedelics. Formal religious structures like church are deteriorating. But people are still seeking transcendent experiences, language around transcendence, and community. That’s prime territory for cults to flourish.”

Set and setting

Mental health experts say?set and setting, a phrase popularized by Timothy Leary, are key elements of effective psychedelic therapy. Set refers to being in the right mindset; setting is about being in the right physical environment—a safe, welcoming space.

LA Magazine reported that every week in Los Angeles, there are?dozens of ayahuasca ceremonies ?and psilocybin-powered “sound ceremonies” held in private homes. Shamans are being flown in from Brazil and Peru to conduct ceremonies.

A panelist at NeueHouse talked about the potential to use psychedelics outside the therapeutic setting, or what healthcare professionals refer to as off-label use:

“For some people, psychedelics are a fast track into healing. Not for a diagnosable medical indication, like depression, but for personal growth—greater connectedness, spirituality. We want to allow people to access that also.

Our puritanical culture in the US has a hard time dealing with altered consciousness and pleasure and everything else that touches our soul. The heroic dose experience is the great opportunity, but there’s not great infrastructure to help them today.”

Dosing and delivery

Some people have begun to experiment with?microdosing?psychedelics, a regimen where users take a very small amount of LSD or psilocybin mushrooms to enhance creativity, focus and mental balance.

Ayelet Waldman , a novelist, published a memoir in 2017 called “A Really Good Day : How Microdosing Made a Mega Difference in My Mood, My Marriage, and My Life.”

The book “Stealing Fire” by Steven Kotler and Jamie Wheal ?describes how Navy SEALs and Silicon Valley entrepreneurs are using psychedelics to probe more deeply into their psyche, elevate their compassion, and make them better leaders.

Investors are pouring money into psychedelic research, betting that these compounds will evolve into a market worth billions.

There are at least a dozen compounds in clinical trials aimed at finding psychedelics with optimal delivery methods, more rapid onset, shorter half life, and more manageable psychedelic effects. Wired ran a piece recently titled “The High-Stakes Race to Engineer New Psychedelic Drugs ,” highlighting the scientists working to create patentable versions of hallucinogens.

There’s a debate about how important the psychedelic effects of these compounds are to therapeutic outcomes. I spoke to Dr. Steven Radowitz of?Nushama Wellness Center ?in New York. He said:

“I do believe having a dissociative?or psychedelic?experience is a part of the therapeutic?benefit. But we don't have studies yet showing that the deeper you go, the greater the benefit.”

Group psychedelic therapy could expand access

Dan Love, co-founder of?Beckley Retreats , cited the benefits of group therapy: “When we’re around people sharing their trauma and personal growth, being open and vulnerable, it gives others permission to go deeper.”

Beckley’s multi-day retreats combine psilocybin ceremonies, breathwork, meditation?and other transformational practices. After the retreats, they offer weekly group sessions to help participants sustain and integrate their retreat experience.

Group psychedelic therapy is not new. Scientists in the 1950s through 70s recorded success treating?depression, schizophrenia, and alcohol use disorder ?through psychedelic-assisted?group?therapy.?Research into the therapeutic uses of psychedelics including LSD stopped abruptly when the?Controlled Substances Act became law in 1970 .

A recent study in Switzerland ?found group therapy with MDMA and LSD to be effective in treating PTSD and other post-traumatic disorders. Participants get a deeper therapeutic benefit from their connection with their retreat group.

Retreat leaders often encourage participants to?share their intentions, fears, and other sensitive emotional material with the group. Psychologists believe this kind of self-disclosure is a key driver of trust and reciprocity, even among strangers.?

Dan Love spoke about the challenges of expanding access to group psychedelic therapy:

“No one knows what the accepted protocols are for group therapy. FDA licensure may be more challenging for psychedelic therapists in a group setting than in a medical clinic.”

Group therapy can be an effective way to bring down the cost of psychedelic therapy, said one panelist. Psychedelics companies are paying companies like Beckley Retreats to develop group ketamine therapy protocols. The goal is to standardize these programs and facilitate better clinical outcomes.

New technology for psychedelic therapy

Technology could make psychedelic therapy more effective and affordable. Here are a few?startups building solutions in this space :

• Patient management software:?Maya?and?Osmind?use measurement-based care to help practitioners and clinics manage psychedelic therapy practices and improve outcomes.
• Telehealth:?Journey Clinical ?is enabling therapists to turn their private practice into their own ketamine-assisted therapy clinic.
• VR / XR:?TRIPP ?is creating VR experiences to ease patients into the psychedelic trip, incorporating naturescapes and cozy images designed to increase therapeutic efficacy.

I’m a big believer in psychedelic therapy. I’ve seen first-hand how it can transform people’s lives. I’m inspired by the entrepreneurs and mental health professionals I’ve met who are building solutions to make psychedelic therapy safer and more effective.

The hope is that we’ll soon have more powerful, accessible treatments available to help people with mental health.