Psychedelic therapy

Psychedelic therapy (or psychedelic-assisted therapy) refers to the proposed use of psychedelic drugs in mental health treatment practices. The drugs proposed to treat mental disorders and improve well-being include mescaline (peyote), LSD, psilocybin and psilocin (mushrooms), ayahuasca, DMT, 5-MeO-DMT, ibogaine and MDMA. As of 2021, psychedelic drugs are controlled substances in most countries and psychedelic therapy is not legally available outside clinical trials, with some exceptions.

The procedure for psychedelic therapy differs from that of therapies using conventional psychiatric medications. While conventional medications are usually taken without supervision at least once daily, in contemporary psychedelic therapy the drug is administered in a single session (or sometimes up to three sessions) in a therapeutic context. The therapeutic team prepares the patient for the experience beforehand and helps them integrate insights from the drug experience afterwards. After ingesting the drug, the patient normally wears eyeshades and listens to music to facilitate focus on the psychedelic experience, with the therapeutic team interrupting only to provide reassurance if adverse effects such as anxiety or disorientation arise.

As of 2022, the body of high-quality evidence on psychedelic therapy remains relatively small and more, larger studies are needed to reliably show the effectiveness and safety of psychedelic therapy's various forms and applications. On the basis of favorable early results, ongoing research is examining proposed psychedelic therapies for conditions including major depressive disorder, anxiety and depression linked to terminal illness, and post-traumatic stress disorder. The United States Food and Drug Administration has granted "breakthrough therapy" status, which expedites the potential approval of promising drug therapies, to psychedelic therapies using psilocybin (for treatment-resistant depression and major depressive disorder) and MDMA (for post-traumatic stress disorder).

Psychedelic substances have a long history of use in spiritual and therapeutic contexts, from ancient shamanic practices to mid-20th-century clinical research. After widespread experimentation with LSD, psilocybin, and other psychedelics in the 1950s and 1960s, regulatory crackdowns—including the U.S. Controlled Substances Act of 1970—largely halted scientific study, though underground therapy continued. Interest resurged in the early 2000s with advances in neuroscience and imaging, leading to renewed clinical trials. Research faces methodological limitations, ethical concerns, and issues of equitable access. Additionally, commercialization, patenting, and venture capital investment have raised debates over ethics, cultural appropriation, and potential conflicts of interest. Despite these challenges, public interest and regulated therapeutic programs—including psilocybin facilitator training in Oregon—signal a growing integration of psychedelics into mental health treatment and wellness practices.