(Adapted from “The Evolving Perceptions of Psychedelics,” a reMind special report written by Josh Hardman of Psychedelic Alpha)
Psychedelics may alter the perceptions of those who ingest them, but it’s the perception of psychedelics that will determine the extent to which they’re successfully integrated into Western medicine.
Psychiatrists and other mental healthcare practitioners will be key gatekeepers to the delivery of psychedelic therapy in the medical model. Their ability to effectively counsel patients will depend on their understanding of, and perspectives on, these new medicines.
Fortunately, a number of surveys have been carried out in recent years to ascertain the mood among healthcare practitioners toward psychedelic therapies. One in particular reveals a rapid change in attitudes over a 7-year period.
In 2016, Brian Barnett and a team of researchers from the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University surveyed 324 American psychiatrists about their attitude toward psychedelic medicine. Only 42.5% agreed that psychedelics show promise in treating psychiatric disorders.
However, in an identical follow-up study in late 2022 and early 2023, the researchers found a whopping 80.9% of psychiatrists agreed that psychedelics show promise in treating psychiatric disorders; nearly double the 2016 figure.
“Our data reveal a striking positive shift in attitudes toward the therapeutic potential of hallucinogens among American psychiatrists since 2016, with a majority of responding psychiatrists planning to incorporate hallucinogen-assisted therapy into their practice if regulatory approval is granted,” the researchers said.
Barnett et al.’s two surveys of psychiatrists not only demonstrated a significant positive change in this cohort’s perceptions of the therapeutic potential of psychedelics, it also revealed their desire to use them. A slim majority (50.4%) said that they were planning to incorporate psychedelic therapy into their practice if approved.
Of course, no classic psychedelics have yet been approved for medical use. (Ketamine, which is FDA approved, is often characterized as a psychedelic, but is in fact a dissociative anaesthetic.) And while psychiatrists as a group appear ready to embrace them once approved, most medical associations have taken a more cautious approach.
A number of professional bodies have released position statements on the topic of psychedelic therapies. Unsurprisingly, given that there have been no marketing authorizations for psychedelic-assisted therapies these bodies mainly call for further research.
The American Psychiatric Association (APA), for example, published a position statement on the use of psychedelic and empathogenic drugs for mental health conditions in 2022. The statement concludes that there is currently “inadequate scientific evidence for endorsing the use of psychedelics to treat any psychiatric disorder except within the context of approved investigational studies.”
The association supports further research, adding that “clinical treatments should be determined by scientific evidence in accordance with applicable regulatory standards and not by ballot initiatives or popular opinion.”
The American Medical Association (AMA), meanwhile, adopted a policy in June 2023 “instructing the AMA to advocate against the use of any psychedelics or entactogenic agents … to treat any psychiatric disorder except those which have received FDA approval or those prescribed in approved investigational studies.”
This move appeared to be in response to growing state and local policy reforms that are increasing access to psychedelics outside of the medical model. In the same session, AMA adopted a position of supporting continued psychedelic research and drug development “with the same scientific integrity and regulatory standards applied to other promising drug therapies.”
