Could psychedelics usher in a mental health revolution?

“The 360” shows you diverse perspectives on the day’s top stories and debates.

What’s happening

Psychedelic drugs have been shown to have remarkable benefits for people who are struggling with a range of mental health issues, recent studies show. Many researchers now believe that before long, drugs like MDMA, ketamine and psilocybin (the active compound in magic mushrooms) could be a key tool for treating depression, PTSD, eating disorders, anxiety and addiction.

When psychedelics first gained popularity in the 1960s, some scientists saw potential benefits in their hallucinogenic properties. But the drugs were banned nationwide in 1970, bringing any studies of their possible health effects to a screeching halt. Psychedelics are still illegal under federal law, but researchers have been granted more opportunities to test their effects in clinical trials over the past several years.

For some people, the effects of psychedelic therapy have been life changing. Psychedelic therapy typically involves a patient taking a hallucinogenic drug in the presence of a mental health provider, who guides them through the experience and ensures their safety. The therapist later follows up with “integration sessions” to help patients process their experience. Experts aren’t entirely sure why this process seems to work so well, but the prevailing belief is that psychedelics may allow the brain to make new connections and reorganize itself in a way that makes people more receptive to therapeutic treatment.

Why there’s debate

The most optimistic scientists say we already have plenty of evidence to show that these drugs can be incredibly powerful tools that could revolutionize mental health care in the U.S. They argue that we’re only at the beginning of understanding how transformative psychedelic therapy could be once the rigid restrictions that limit its availability are lifted.

But other experts warn about being too hasty to draw broad conclusions based on results from small, highly controlled studies that may not translate into the real world. Many worry that rushing to expand psychedelic therapy could increase the risks of things going wrong, create potential opportunities for abuse and set vulnerable people up for crushing disappointment if this “miracle” cure doesn’t work as well as promised. They also point to massive questions that must be answered before any universal psychedelic therapy strategy can be implemented — including whether people can gain at least some of the benefits without the guidance of a therapist and how necessary it is for patients to “trip” during the experience.

What’s next

Two states, Oregon and Colorado, have decriminalized possession and use of certain psychedelics, but their use as a mental health treatment is still legal only in the context of clinical trials. That may change soon, however. Some researchers are hopeful that the Food and Drug Administration could approve psychedelics for therapy in the U.S. as early as next year. There is also a bipartisan push in Congress to increase funding for psychedelic therapy research specifically aimed at helping veterans with PTSD.

Perspectives

Psychedelics aren’t a miracle cure but could soon be a powerful mental health tool

“No single group of chemicals can solve the complexities of mental health, which extend beyond the individual mind to include social and political elements. But if recent research holds course, psychedelics may well provide much-needed relief while inspiring entirely new approaches to psychiatry.” — Oshan Jarow, Vox

It’s still far too early to know how transformative these treatments can be

“Psychedelic research, for all its promise, is still at the embryonic stage. Trials so far have been small, and while results … suggest that certain substances could be useful, findings don’t support any claims of these drugs being able to cure mental health conditions.” — Grace Browne, Wired

Psychedelics make patients far more receptive to the things that make therapy work

“Therapy is a social pursuit: a good therapist provides not just insight and tools but a relationship in which it’s possible to change. When someone takes MDMA in the presence of a therapist, they might feel more supported and secure in this bond, and more able to dredge up painful feelings or hard memories without being overwhelmed by fear or shame.” — Rachel Riederer, New Yorker

It would be irresponsible to move too quickly out of desperation

“I understand how desperate many long-suffering patients and their loved ones are to find relief and get their lives back. However, it is urgent that we proceed with caution because, in my opinion, we didn’t do that with marijuana research over the last 10 to 20 years. … we’re finding out about some of these serious marijuana risks after the fact. After the horse had already left the barn.” — Lantie Elisabeth Jorandby, Psychology Today

The drugs will be most helpful for those who need relief the most

“People taking psilocybin often have experiences of significant insight into aspects of their lives, their relationships, and their sources of meaning — who they are as a person and how that has shaped their lives. That kind of experience is an important component of treating people with depression.” — Benjamin Lewis, University of Utah psychiatry professor

Overselling the benefits can cause serious harm

“I think there have been some serious methodological questions about the work being done by leaders in the field and a lot of outrageous and unsupported claims about what psychedelics might do. … I think this can set up potential trial participants (and future patients) for disappointment, especially if they’re seeking out this intervention because nothing else has worked. … That kind of disappointment can be significantly harmful.” — Emma Tumilty, bioethicist, to Women’s Health

Experts can’t allow the idea to take hold that the drugs alone are a solution

“The greatest threat to a healthy psychedelic future is the fetishising of just the drug alone. Whether plant, or synthesised compound of one, there is a narrative that all you need to do to change your mind is eat something.” — Rosalind Watts, clinical psychologist and psychedelic researcher

There needs to be a variety of options for people to find what works best for them

“Choosing one ‘right’ path to providing safe, accessible psychedelic therapy is impossible. Everyone can be better served by having options and choices. … Some patients may require a clinical approach or a trained therapist, while others would be fine working with a friend, family member or tripsitter.” — Robert Johnson, Rolling Stone

Psychedelic therapy won’t be a game changer if only a privileged few can access it

“For those with treatment-resistant depression or PTSD, psychedelics could indeed be a lifeline. The trouble is most people with mental health problems are unable to access psychedelic therapy under medical supervision.” — Jules Evans, The Guardian

We need more doctors, support staff and facilities to realize the potential of psychedelic therapy

“These scientific, political and social developments will soon outstrip the capacity of the infrastructure needed to deliver on the promise of psychedelics and, perhaps more importantly, to mitigate the risks of use outside of clinical and community support settings. Leading psychedelic therapy organizations … are predicting a critical shortage of mental health providers trained in psychedelic-assisted therapy.” — Megan Meyer and Victor Cabral, Baltimore Sun

Illustration by Alex Cochran for Yahoo News; photos: Oscar Wong/Getty Images, OsakaWayne Studios/Getty Images, Bloomberg Creative via Getty Images, Yagi Studio/Getty Images, and Javier Zayas Photography/Getty Images