Are psychedelic drugs about to begin a long, strange trip toward use in a clinical setting? Or do the challenges of studying psychedelics, and the ethical risks of therapy, raise too many questions to introduce them into mainstream medicine?
Dominic Sisti, an associate professor of medical ethics and health policy in the Perelman School of Medicine, is part of a group of nearly 30 experts including bioethicists, psychiatrists, Indigenous scholars, researchers, and others to begin charting a path toward crafting guidelines for the ethical use of psychedelics. The group’s work is published in JAMA Network Open, setting the stage for the next phase of psychedelics in psychiatry.
As debate continues if—and how—psychedelics should be used, a Food and Drug Administration advisory committee recently voted down a proposal brought by a drugmaker to use MDMA to treat post-traumatic stress disorder (PTSD), in combination with talk therapy. The committee recognized the promise of psychedelics but raised serious concerns about the science and the ethics of psychedelic treatments.
However, the FDA can still eventually approve its use. If so, there is a growing movement of cross disciplinary experts crafting guardrails for how psychedelic drugs should be used.
Though popular culture often depicts psychedelic drug use as a product of 1960s counterculture, mind-altering drugs have been used by humans in some form for millennia. In 2008, archeologists at a 1,000-year-old site in Bolivia discovered psychoactive botanical substances found in a hallucinogenic cocktail known as ayahuasca.
According to Sisti, recognizing history like this was a central theme of his group’s work examining the potential for psychedelic use in modern medicine.
“Just imagining that if psilocybin is commercialized—should shamans in Mexico and Central America, where some of these medicines originated, receive some sort of direct benefit from the research?” Sisti says. “It’s an issue at the intersection of ethnobotany, colonialism, research ethics, reciprocity, and respect.”
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