Psychedelics are a popular topic nowadays, partly because psychedelic users are no longer keeping their use a secret. People from all walks of life are learning about the therapeutic potential of psychedelics and are openly discussing their experiences. The conversation is slowly shifting from taboo to mainstream. But having a conversation about psychedelics with a friend is certainly different than with a doctor, therapist, or mental health professional.
It may not have even crossed your mind that you should talk to your medical or mental health professional about past or upcoming psychedelic use. In short, you should, particularly if you have preconditions that may make psychedelic use riskier, such as a heart issue or a history of schizophrenia, bipolar disorder, or seizures.
But like many other emerging therapies in western medicine, most health professionals are reluctant to endorse or support psychedelic use. In this article we’ll discuss why that is, the integration of psychedelics into western medicine, and things to consider when you speak to your therapist or doctor about psychedelic experiences.
Why Most Medical Professionals Are Reluctant to Discuss Psychedelics Use
Lack of Research and Regulatory Approval
Though psychedelics have a long record in human history, they are just now being recognized as medicine in western-oriented health and mental care. However, medical research and regulation have a lot of catching up to do. Psychedelics are not currently approved by the Food and Drug Administration (FDA), and most psychedelic substances are listed as federally scheduled narcotics by the Drug Enforcement Agency (DEA). 60+ years of psychedelic prohibition has created a lack of peer-reviewed articles and research, and most medical and mental health professionals don’t have firsthand experience with psychedelic substances. So it becomes clear why some doctors and therapists are reluctant to endorse psychedelic use.
Risk of Losing Licensure
The current illegal nature of psychedelics (except for ketamine) prevents medical health professionals from openly endorsing their use. Today, many doctors and therapists are taking a cautious approach with psychedelics, waiting for these substances to be FDA approved to limit the risk of losing their license. There are certainly plenty of other therapists providing underground psychedelic-assisted therapy, but they are taking a very real risk in offering that service. Many mental health professionals recognize the benefits of psychedelic use, but must ask themselves, “is administering or endorsing these illegal substances worth losing my license over?” The research is clear, psychedelics work to treat stubborn conditions like PTSD and depression; otherwise the FDA wouldn’t have designated them as breakthrough therapies. But until state-approved psychedelic therapy programs become functional or federal restrictions lessen, mental health professionals will continue to be reluctant.
Another complexity at play here is the relationship between pharmaceutical companies and prescribing medical professionals. Pharmaceutical companies spend money to influence physicians and other drug prescribers, about $20 billion per year, compared to about $6 billion per year for direct-to-user advertisements. In 2015, 48% of U.S. Physicians have accepted some kind of payment from a biomedical or pharmaceutical manufacturing company. This creates some favoritism and bias where a doctor is more likely to prescribe a traditional medication that they have had some exposure to, instead of an unfamiliar and unregulated psychedelic substance. It is a shame for the patient, however, whose options for mental health treatment typically revolve around anti-anxiety and antidepressant medications that have potential side effects such as nausea, fatigue, insomnia, sexual dysfunction, constipation, anxiety, irritability, and suicidal thoughts.
Western Medicine & Psychedelics: Bridging the Gap
A growing (and compelling) body of research suggests that psychedelics can be helpful in healing trauma, alleviating depression, breaking addictions, and even coping with our own mortality. This research is invaluable and carries the power to help incorporate psychedelic therapies into modern medical, psychiatric, and spiritual practice. Though the upcoming integration of psychedelics into modern medicine is a major step forward, the simple fact is that the current U.S. mental and medical healthcare model has limitations.
With psychedelics, there are anecdotal, spiritual, and intangible effects of psychedelics that simply don’t translate well into quantitative data (the kind of tangible information researchers love best). Empirical research carries some caveats when applied to psychedelics—how do scientific and medical professionals quantify the intangible aspects of the experiences, and then use that data to demonstrate patterns and benefits of psychedelic use?
Essentially, ongoing scientific research is verifying the benefits of psychedelic use that certain indigenous cultures and communities have known for centuries. And if America stays on trend, we may experience a beautiful integration between western medicine and ancient plant healing that may make these treatment alternatives more accessible. These studies will likely never be able to explain the full mechanisms by which psychedelics work their magic, but every additional piece of research brings us one step closer to legitimizing their use.
FDA approval will be a big step. And if that’s followed by DEA descheduling, medical professionals can then explore psychedelics as viable treatments. And if anything can be gleaned from the cannabis industry, state-wide legislation will also create major progress. Oregon is pioneering the movement with the November 2020 passing of Measure 109 and Measure 110 which creates a state-approved psilocybin therapy program and decriminalizes all drugs, respectively. Oregon has two years to develop and initiate the therapy program, and it will be interesting to watch how it will unfold.
What Does This Mean For You?
So you’re someone interested in the therapeutic potential of psychedelics? Your safety and well-being are of the utmost importance, so here are some things to consider.
Be Open With Your Primary Healthcare Provider
If you are considering undergoing a psychedelic experience, it is important to be open and transparent with your healthcare provider, both for mental and physical health. Twenty years ago, it would be impossible to have conversations about psychedelics with a doctor. Today, patients can have those conversations and should exercise that right. Psychedelics are not for everyone, and talking with your healthcare provider before your first experience should be a part of your due diligence process. However, we acknowledge that most healthcare professionals may not support or endorse psychedelic use. Nonetheless, having open communication with your doctor or therapist is the first step. At a minimum, we suggest getting the clearance that you don’t fall into a high-risk category as a result of pre-existing conditions—more on this in the step below.
Though psychedelics are generally safe physiologically, they can have potential psychological consequences in unstructured and unsupported situations. There are also factors that potentially make psychedelic use more dangerous. Prescreening is an important process in preparing for a psychedelic journey where you are identifying and mitigating these factors. This includes things like making sure you are mentally and physically fit enough for the experience; identifying risky preconditions such as respiratory problems, heart conditions, or specific mental disorders; and making sure you won’t experience any unintended drug interactions. It is important to note that psychedelics can help alleviate specific mental disorders such as anxiety and obsessive compulsive disorder, but may exacerbate other disorders such as schizophrenia and bipolar disorder. This is why prescreening is crucial.
Seek Other Professional Support
The most important thing to remember is that the patient has the ultimate say in their mind, body, and the healthcare professional they choose. It is also important to note that doctors have varying levels of exposure, information, and research when it comes to psychedelics. Even if a professional were open to a patient self-medicating with a particular substance, they would be hard-pressed to provide actionable steps regarding dosage, safe consumption, and harm reduction. Luckily, there is a multitude of supporting professionals who can help. It is possible to find another mental health professional, an integration specialist, or even a psychedelic guide or trip sitter (this is what we do here at Psychedelic Passage). The MAPS website also has a list of over 350 coaches and mental health professionals who all state they are experienced in the integration of psychedelic experiences for wellness.
The best thing a patient can do is to ask questions with a variety of professionals to make the most informed decision possible. This is especially important when it comes to treatment-resistant mental health issues where the patient feels like they have tried every option already. Getting a second opinion is a good idea if the patient thinks psychedelic use can improve their well-being. Finding and speaking to other patients who have used psychedelics to alleviate a similar condition may also be helpful. Though this information is anecdotal in nature, it can provide the patients with more context and understanding until medical research and legislation catch up.
The Potential to Heal
Though integrating psychedelics into western medicine will increase accessibility for patients, it will not alleviate all of the pitfalls of U.S. mental healthcare. In fact, many individuals turn to psychedelics when conventional therapies have failed, especially for treatment-resistant mental health conditions.
It should be known that we have a deep respect for therapists and psychiatrists—but the current model is too dependent on prescription medications that often debilitate one’s quality of life. Psychedelics temporarily blur the lines of reality, merging your conscious and unconscious mind, body, and soul, which provides an entirely different form of transcendental healing.
So then, how do you know the difference between a spiritual emergency and a psychotic break? A mental health professional and a ceremonial shaman may have two very different opinions of the same situation. What happens when a psychedelic experience causes you to question your sense of self or years of social conditioning?
Ego-death cannot be measured in a graph. Returning to normal life can be jarring for most people—especially without support—this is why integration is so important. What we are highlighting is that mental health professionals are not the only resource available for people looking to be supported on a wellness journey with psychedelics. Coaches, mentors, spiritual teachers, and being a part of a community are also important to translate bewildering psychedelic experiences into meaningful healing.
Psychedelics can help rewire the brain to address negative and harmful patterns and replace them with healthier habits. Previously, people had to do much of this exploration on their own without sound information or guidance for safety. Luckily today, there are many professionals that can help you avoid potentially dangerous experiences and make the most of your trip.
It is becoming apparent that traditional western medicine alone cannot resolve all the mental health issues America is facing. Psychedelics show you that you are not a broken brain or a set of symptoms that require fixing. You are a human being who already has all of the tools to heal and live a fulfilling life— it’s just that psychedelics can serve as a key to access that toolbox.
If you want support during a psychedelic experience or a trained professional to talk to afterward, start by scheduling a call with one of our trip sitters and integration specialists. Psychedelic Passage serves in an intentional way that maximizes impact and minimizes risk, and we’d be honored to hear from you.