Psychedelic or ecodelic medicines (e.g., psilocybin, ayahuasca, iboga) for the care and treatment of addiction, post‐traumatic stress disorder, cancer, cluster headaches, anxiety, and depression have surged to the forefront of discussions about mental health in the US, leading to the emergence of well‐capitalized biotech companies offering multimillion‐dollar IPOs. Venture capital website Pitchbook reports “continuing investor interest and growing acceptance of what until recently was seen as a fringe area of medicine.” As scholars, activists, and practitioners who have been healed by (...) these medicines and applaud the recent wave of decriminalization after a long, strange trip of mass incarceration and widespread dangerous misinformation, we look forward to a culture that makes these medicines available in a safe and affordable way that respects the lineages of the knowledges that are essentially and not accidentally bundled with these plants—Indigenous and counterculture wisdoms for whom these medicines were never “fringe,” but always foundational. In place of corporadelia's pursuit of standardization, we emphasize the care and wisdom of the Indigenous and countercultural teachings—traditions that have made psychedelics available to the emerging corporate/research partnership in the first place. These knowledge traditions offer foils to the ongoing translation of university peer‐reviewed research into market copy, technical articles, and IPOs, and the concomitant emergence of psychedelic pundits. In particular, we examine instances where prominent researchers have overstated the findings of existing clinical trials in public‐facing representations of the field. We argue that these corporate priorities and tactics are being aided by a new wave of psychedelic “thought leaders” who seek to delegitimize non‐hierarchical approaches to knowledge production and community support within a psychedelic commons. While prominent psychedelic psychiatrists and behaviorists are focused on rooting out and transforming individual habits of mind, we argue that there is another, latent potential for psychedelics to draw attention to—and transform—the invisible, hegemonic infrastructures and ideologies that subtly naturalize and perpetuate deeply unequal societies. (shrink)

ABSTRACT:While the literature on psychedelic medicine emphasizes the importance of set and setting alongside the quality of subjective drug effects for therapeutic efficacy, few scholars have explored the therapeutic frameworks that are used alongside psychedelics in the lab or in the clinic. Based on a narrative analysis of the treatment manual and post-session experience reports from a pilot study of psilocybin-assisted treatment for tobacco smoking cessation, this article examines how therapeutic frameworks interact with the psychedelic substance in ways that can (...) rapidly reshape participants' identity and sense of self. We identified multiple domains relating to identity shift that appear to serve as smoking cessation mechanisms during psilocybin sessions, each of which had an identifiable presence in the manualized treatment. As psychedelic medicine becomes mainstream, consensual and evidence-based approaches to psychedelic-assisted identity shift that respect patient autonomy and encourage empowerment should become areas of focus in the emergent field of psychedelic bioethics. (shrink)

ABSTRACT:Psychedelics have again become a subject of widespread interest, owing to the reinvigoration of research into their traditional uses, possible medical applications, and social implications. As evidence for psychedelics' clinical potential mounts, the field has increasingly focused on searching for mechanisms to explain the effects of psychedelics and therapeutic efficacy of psychedelic-assisted therapy (PAT). This paper reviews three general frameworks that encompass several prominent models for understanding psychedelics' effects—specifically, neurobiological, psychological, and spiritual frameworks. Following our review, the implications of each (...) framework for ethics and professional competencies in the implementation of psychedelics as medicines are explored. We suggest that interdisciplinary education may be necessary to improve communication between researchers, develop models that effectively incorporate multiple levels of analysis, and facilitate collaboration between professionals with diverse backgrounds in the implementation of psychedelic medicines. We also address pitfalls associated with overemphasis on neuro-mechanisms, risks associated with instigating vulnerable states of consciousness, and hurdles associated with the integration of spiritual frameworks in medicine. Ultimately, as psychedelics push the boundaries of explanatory frameworks focused on one level of analysis, developing new and more useful models to reflect knowledge being produced in this field should be a central aim of psychedelic science going forward. (shrink)