Treating severe mental health disorders with psychedelic substances 

To most in our modern era, psychedelic compounds (e.g. mushrooms or ecstasy) carry negative or at a minimum, highly cautious connotations. A measure of such caution is warranted; all of these substances appear in the Federal Controlled Substances List and their use for recreational or medical purposes is prohibited at the national level. For the first time in decades, researchers are revisiting the applications and side effects of psychedelic compounds. The new goal? Medical applications for psychedelics in controlled, clinically supervised settings that minimize negative side effects

What are psychedelics?

Psychedelics can be classified into two primary groups. Entactogens (MDMA, Ecstasy) which signal the body to release familiar feel-good chemicals serotonin and dopamine, and classic psychedelics (LSD, Psilocybin, Mescaline, etc.) which can cause pronounced changes in sensory experience, like hallucinations, mystical (or spiritual experiences), and disassociations from self or reality.

What are the potential uses?

Mental Health has long been the focus of clinical treatment research related to psychedelics and progress continues to move in that direction. 

• As of December 2024, there are 75 active studies examining psychedelic use in treating "major depressive disorder, treatment-resistant depression, and alcohol use disorder."
• There is also significant interest in utilizing MDMA in conjunction with traditional talk therapy to treat post-traumatic stress disorder. For some, MDMA might also improve couples counseling outcomes by facilitating bonding and openness between partners.

What are the concerns?

Despite the potential for breakthroughs in mental health treatment, questions persist on a variety of interconnected hurdles.

• Safety: Psychedelics are powerful and the effect of such drugs cannot be 100% predicted. It is possible that patients could undergo psychotic or manic episodes – resulting in either harm to themselves or others from bursts of energy, abnormal mood swings, and inability to determine reality.
• Method of Care: These safety considerations necessitate an intensive administration model. A proposed system of administration would require multiple eight-hour sessions at a licensed therapist's office where a therapist would be required to monitor the patient almost around the clock due to the vulnerable state of the patient. So far, no estimate has been provided for the cost of such a procedure, but given such time intensity, it is reasonable to expect a high price tag.
• Provider Qualifications: The requirements to keep patients safe (practitioner licensure, governmental approval, continued regulation) also contribute to cost and by extension patient accessibility.

The advancement of new treatment methods is long and costly and the road to the FDA is littered with failed proposals (most recently Lykos). Nevertheless, psychedelics show real promise for treating mental health issues that are resistant to existing medication or treatment methods. More research needs to be conducted to better understand the body's interaction with such compounds, but studies are underway. In short, for psychedelic treatments, the road looks promising, but the trip is just getting started.