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Cross-Cultural Psychology

Psychedelics Reconsidered: Reflections on Drugs and Culture

What’s behind renewed interest in psychedelics, and what's next for research?

Key points

  • Evidence suggests psychedelics may have therapeutic value in treating major depression, end-of-life distress, and addictions.
  • After years of dormancy, science is still catching up to explain how psychedelic therapies can be used and how they work.
  • A fundamental promise of psychedelic therapies is their potential to usher in a more holistic vision to medicine and psychology.

Psychedelic science has flourished in recent years, expanding to investigate a subset of currently illicit drugs for therapeutic potential for a host of psychological conditions.

For a generation, research in this area remained at a standstill, largely due to stigma around the substances and political baggage related to recreational use in the 1960s. Notably, John Ehrlichman, domestic policy counsel during the Nixon administration, publicly admitted the political motivations behind the Controlled Substances Act, which made cannabis and the psychedelics illegal across the United States in 1970, saying,

The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people…We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.

From this standpoint, the criminalization of psychedelics may be seen more as unfortunate collateral damage fueled by politicized agendas than evidence-based public policy. Furthermore, with growing taboo around the psychedelics that had become such a cultural phenomenon during the tumultuous 1960s, scientific research on psychedelics also fell out of fashion until roughly the turn of the century. Additionally, the laws that placed psychedelics in Schedule I—the most highly restricted class of drugs, considered to have high abuse potential and no medical value—are now coming into question as growing evidence suggests these substances may indeed have therapeutic value in treating various maladies including major depression, end-of-life distress in seriously ill patients, and ironically, perhaps, addictions.

How have we gone from the prohibitionist “just say no” mentality of the late 20th century to the current landscape of shifting public perception and growing research (including government-funded studies) on psychedelics? The substances themselves have not changed. Although more novel psychoactive substances and related chemical compounds have certainly emerged in the interim, the “classic psychedelics”—LSD, psilocybin, mescaline, and DMT (found in ayahuasca)—remain the same as they ever were.

How to Explain Renewed Interest in Psychedelics

The current wave of renewed interest seems fueled by a confluence of historic and cultural factors. Just as the antiwar, Civil Rights, and Women’s Liberation movements of the 1960s pushed for social progress and reform, their echoes in present-day Black Lives Matter and Me Too movements highlight the ongoing struggle to achieve a just and equitable society. Increasing concern about climate change; feelings of alienation from ourselves, each other, and the natural world; a global pandemic; and resulting doubts about the fabric of our social structures have also helped set the stage for questioning past narratives about the relative risks and values of psychedelics.

Concurrently, cannabis, which for years was touted as a risky gateway drug, has now found favor as a medical and recreational substance across much of the United States. Meanwhile, growing mental health concerns have led to widespread pharmaceutical intervention with as many as one in six Americans taking psychiatric medication in the past year. With limited novel avenues for effective mental health treatments emerging over the past several decades and a growing penchant for “natural” treatments over mass-manufactured synthetic pharmaceuticals, psychedelics seem poised to be adopted as the next big wellness trend.

But after years of dormancy, the science is still catching up to explain how psychedelic therapies can be used and how they work. Buzzwords like neuroplasticity and default mode network have captured the public and scientific imaginations, and rightly warrant further study to elucidate the biological pathways driving psychedelics’ peculiar effects, which appear to hold transdiagnostic therapeutic potentials. Though the symptoms and neurochemical signaling involved in diverse conditions like depression, anxiety, substance dependence, obsessions, compulsions, and the like may look different, my sense is that they often comprise our own unique biopsychosocial expressions of coming to terms with our impending mortality.

One insight the psychedelic experience seems particularly well-positioned to evoke is precisely that confrontation of facing our imminent demise. As Marcus Aurelius poetically observed, “Swiftly the remembrance of all things is buried in the gulf of eternity,” and high-dose psychedelics can drive this realization home in a deep and visceral way, frequently providing useful insight and perspective to recalibrate our thoughts and behaviors.

Ultimately, the ability to focus on the neurochemistry of drugs and psychopathology may be seen as its own form of scientific privilege that regularly dismisses the larger sociocultural phenomena underlying psychiatric conditions at a mass level. This reductionistic approach bespeaks a myopia that focuses deeply on explanations like chemical imbalances and avoids matters like poverty, inadequate education, food insecurity, lack of health care, homelessness, isolation, and a palpable sense of collective dread about the future of our species and planet that can also detract from mental health. This type of tunnel vision is directly at odds with the axioms of interconnectedness and unity that lie at the heart of so many profound and transformative psychedelic experiences.

The naturalist John Muir noted, “When we try to pick out anything by itself, we find it hitched to everything else in the Universe.” This closely parallels the Buddhist concept of interdependent arising, the notion that all that exists depends on and influences everything else. These holistic views warn against the folly of studying only the parts and ignoring the whole. Similarly, a fundamental promise of psychedelic therapies is their potential to usher in a more holistic vision to health care, bringing an integrative body, mind, and spirit approach back to medicine and psychology.

What’s Next for Psychedelic Research

As for where psychedelic research goes next, I see a few key directions.

First, well-designed Phase 3 clinical trials should be conducted to establish therapeutic efficacy for conditions that already show good promise (e.g., depression, anxiety, addictions). This will pave the way for FDA approval and rescheduling, and lower the cost and regulatory burden of future research.

Second, in areas with a sound empirical or theoretical basis, exploratory studies of psychedelics for new indications like neurodegenerative disorders and other conditions in urgent need of novel treatments to support potential efficacy should expand further.

Third, research on best practices for psychedelic therapy is needed to establish parameters for optimizing safety and positive outcomes. We have a good starting point based on decades of clinical psychedelic research, with most volunteers reporting enduring benefits, but determining how exactly to tailor these treatments and implement them widely will be central to training clinicians to deliver these interventions properly and getting them out to the public.

Finally, the underlying biological and psychological mechanisms of psychedelics, and their use for the betterment of well people (e.g., to enhance creativity), should continue to be studied. Of course, this brings us back to sociocultural issues, funding sources to conduct such research, and equitable access to psychedelic therapies should they be approved. Nevertheless, the work has found a way to persist and flourish, albeit slowly, with perseverance and the help of forward-looking philanthropists.

For now, a great deal of uncertainty remains around the directions in which this psychedelic renaissance might take us. For many patients, psychedelics may lead to new and powerful forms of therapy that could accelerate the path toward recovery. However, it is critical to highlight that psychedelics are not a panacea or miracle cure, and that psychedelic therapies will not work for everyone nor ameliorate the urgent sociocultural crises we now face.

For scientists, psychedelics provide a fascinating tool for not only better understanding the mind and brain but also for probing long-standing philosophical issues like the nature of creativity, spirituality, and, arguably, consciousness. For the broader public, my hope is that wider access to psychedelics could lead many to a renewed sense of meaning and purpose, reinvigorate collaborative efforts to better society, and help move us collectively toward the possibility of a world reimagined.

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