Voices echoed off the walls of the auditorium as people shouted the names of people they have lost, and with each name spoken it is a reminder of the reason we were all gathered in this special place.
The International Drug Policy Reform Conference was held this past month in the Gila River Indian Community where folks came together to discuss the state of the world and how the hell we can fix it. While the topics remained broad and multidisciplinary, from discussing socioeconomic reform to psychedelic commercialization to centering indigenous voices to defunding the police and funding communities, the main takeaway is that the war on drugs in a war on people and we must use radical inclusivity and radical love to press forward.
With all of the amazing sessions that happened, there is something I think needs to be discussed on this platform, in a space that is seen by many involved in the psychedelic community and that is psychedelic exceptionalism.
As a psychedelic researcher, sometimes I find myself in the midst of the hype (yes, even me) around psychedelic policy and the freight-train that is this “movement.” There is so much swirling around us and the attempt to keep up with the science, the policy, the patents and the complaints is overwhelming. It seems the same arguments are made over and over, without any resolve and without any resolutions for the future.
The Reform conference had two main breakout psychedelic sessions and some smaller discussions in the form of community sessions, and within all of these sessions I kept finding myself wondering why we keep arguing, why the harm reductionists find the psychedelic people elitists and why the psychedelic people thing taking psychedelics makes them better than someone who takes other drugs. It’s exhausting, but these things are important for us to sit with. In the next few sections, I’m going to highlight some key takeaways I got from these sessions and leave you, the readers, with some hopeful food for thought.
The Healing Rhetoric
Psychedelics will rewire your depressed brain, expanded consciousness for all, spiritualized humanity, collective healing with psychedelics, and the ever so co-opted phrase plant medicine, are just a few slogans floating around following this renewed psychedelic renaissance.
Psychedelics are often touted as a cure to all suffering and a way to expand consciousness to become a better version of yourself or to heal, while other drug use is thought to be chaotic, dirty and only puts you in a dark place. The psychedelic movement has lent itself to exceptionalism, where the same social constructs for other drug use need not apply. This is problematic because it reduces psychedelics to being the “good drug” and anything else “the bad drug,” which is something that was seen with the rise of cannabis.
The truth is, people have different relationships with substances, and those relationships and these relationships i) don’t make anyone less of a person for their relationship and ii) is none of anyone’s business unless that person wants to share their experience. In the psychedelic space people tend to discuss how they were able to wean themselves off their pharmaceuticals like adderall or SSRIs using psychedelics and openly encourage others to do so, ignoring the fact that some folks have a positive relationship with their pharmaceuticals and demonizing them for choosing to take these “bad drugs” and not the “good drugs.”
In the first psychedelic session of the weekend, Psychedelic Decriminalization: Gateway or Hurdle to All-Drug Decriminalization, Betty Aldworth (director of communications for MAPS, formerly worked with SSDP and cannabis regulation) brings to the attention of the attendees that the drugs in and of themselves are just drugs and that it’s important to focus on the language we use to talk about these things. If we aim to educate people about any drug, we need to be expansive, not restrictive.
What I appreciated most about Aldworth is her desire to use her position at MAPS to educate people about all drug use and further reform for all drug policy, not just psychedelics. She even did air quotations around the term plant medicine. The use of plant medicine as a phrase is not only problematic from an overall harm reductionist viewpoint, but it’s also co-opting this phrase from indigenous groups (we’ll get to that next).
We need to put an end to this idea that if you are someone who uses psychedelics or plant medicines, therefore you are better than someone who does other psychoactive substances, this idea that psychedelics are “harmless” and promote “healing” while someone who uses heroin for example (also a plant medicine) is a drug user and cannot have a positive or healing relationship with their drug of choice. It also feels necessary to point out that not all psychedelics are even plants/fungi and these still have profound effects on people, for example synthetic psychedelics are being researched as anti-inflammatory agents to help those with asthma or pain.
Further, when psychedelics are constantly called healing drugs the potential negative side effects are significantly ignored, reduced or forgotten. These are powerful, mind-altering substances that just like any substance can be used chaotically or for non-healing purposes. There is plenty of evidence that psychedelic use by people who are uninterested in this healing rhetoric have no changes in their belief systems, or further validate their current belief systems which can be problematic to society and perpetuate the war on drugs. In addition, psychedelics have been used for centuries in different ways including recreationally where people have no interest in using them medically or ceremonially.
From a policy perspective, as it was pointed out by Ami Kachalia from ACLU in New Jersey, when psychedelic reform is discussed the lead is always from the healing/medicinal viewpoint, similar to medical cannabis. Not only does this reek of psychedelic exceptionalism, it also makes it difficult for other drug policy reform bills to be seen as important when they aren’t focused on healing or curing anyone. Psychedelic reform doesn’t lead with the drug, it leads with drug indication which perpetuates medicalization. In the eyes of policymakers, this may make them a little more comfortable lifting the restrictions and introducing new drug policy, but these bills often leave behind non-psychedelic substances.
In Aldworth’s response to the policy goals of psychedelics versus other drugs, she was the first to admit that psychedelic policy is not inclusive or deserving at this point. For example, psychedelic bills are focusing on only de-prioritizing mushrooms or trying to convince policy makers on their medicinal value when the time and effort could be going into bills that focus on safe drug supply for ALL drugs, decriminalization of ALL drugs, and working to free people who are wrongly incarcerated and dying in prison for personal drug use. There is some light in the convoluted policy tunnel: a bill in Denver that passed that will train 4,000 first responders on how to respond to a psychedelic-related crisis, which is typically a mental health-related crisis. The training here can be applied to a variety of other non-psychedelic situations, which hopefully leads to de-escalation and less harm caused by ill-trained responders.
As Aldworth said, “It's important to plant our seeds to bring in others on overall drug advocacy.”
Models of use
A continuation of thinking about the language used to describe psychedelics is the use of language to describe the models in which they are employed. The big three include medical, spiritual, and recreational.
Medicalization of psychedelics probably produces the most conversation, as it is a goal for several drug companies (MindMed, Atai Lifesciences, Compass Pathways, Cybin, etc.) and special interest groups (MAPS) to provide a legal way for people to access psychedelics for medical use. What is not often thought of, as Ifetayo Harvey of POC Psychedelics Collective, is how medicalization is used as a justification for drug reform even though the medical system has treated people who use drugs poorly for a long time, especially the POC and indigenous folks that have been systematically targeted. She so eloquently points out: If we keep trying to integrate psychedelics into the burning house, they will take on the issues of the house.
The medical system has its flaws, both major and minor, which would only be exacerbated by adding psychedelics into the mix. The medicalization of psychedelics can be two things i) the use of these substances as an “assisted therapy,” known as P-AT and ii) the configuration of a psychedelic into a pill that does not induce hallucinations and can be taken like any other pharmaceutical. The P-AT model typically consists of an on-call physician, two therapists (one must be licensed), and other staff. Sessions include preparation sessions, psychedelic sessions and sometimes integration sessions. Therapy alone is already shown to be unaffordable for a large majority due to issues with insurance coverage, premiums and general accessibility. For example, a clinic in Oregon touted a plan for “medical P-AT” that would cost people thousands of dollars and the center wouldn’t even legally be able to provide therapy, just essentially an overpaid babysitter.
So, how would this model allow access for the people who might benefit from it most if they wouldn’t be able to afford it financially or afford to spend the time? Some would argue that for psychedelics to truly work, one must be open to spending the time healing, but not everyone is equipped to quit their day job and embark on a spiritual journey. Several people who could benefit from psychedelics would benefit even greater from access to stable income, education, housing and food and some would argue that is what these organizations should be aiming to fund alongside their treatments.
This leads into the second medical model: the pharmaceutical formulation. Several companies have poured millions of dollars into attempting to isolate the therapeutic effects of psychedelics without inducing “side effects” like hallucinations, which some would argue are the effects. While this point remains important, some folks who believe the subjective effects are necessary fail to see the potential positive outcomes of pharmaceutical adaptations. For example, while cost still may remain an issue for some it would be significantly less expensive in comparison to P-AT and people would most likely be able to access medications more readily than if they were going to be going through an entire psychedelic experience. If the goal of psychedelic medicine is to truly heal people, then formulating them in a way that provides more opportunities for treatment should be welcomed.
The other side of the medicalization coin is that people are being left out of the conversation. If pharmaceutical companies and special interest groups are taking over the production of psychedelics and determining their legality, how does that affect people who still want to engage in other forms of use? Is the medical model - both types - actually going to help more people or will it end up gatekeeping psychedelics from folks who aren’t interested in this version of healing? To that end, who are we letting determine the medical models of P-AT? As Daniel Garcia from POC Psychedelics Collective points out, a large majority of funding for psychedelic research specifically for PTSD and depression comes from some potentially dangerous people including the US Department of Defense, Christian Angermayer (who served as an advisor to Rwandan Dictator Paul Kagame and now runs ATAI), and a variety of silicon valley and wall street elites (who majority support TESCREALism ideals). I will be the first to admit that it is difficult to obtain funding for these studies, especially large scale human clinical trials, but does the psychedelic movement really want to be formulated and backed by the same people who perpetuate militarization, class separation and the war on drugs? If that is where the funding is coming from, the organizations receiving it could at least spend more of their time and money fighting for basic human rights that are realistic.
Coming out of this medical framework, there is perhaps the opposite end of the spectrum of psychedelic use: ceremonial. When asked who or what was being left out of the conversation when it comes to the psychedelic renaissance, several panelists had a similar answer said in various ways: the spirit of the medicine. Since the renewed interest in psychedelics, indigenous traditional knowledge has been put to slaughter against the system. The way some psychedelics were used as sacrament or for spiritual healing has been replaced with pharmaceutical interests and development of the abovementioned medical paradigms. Even the P-AT model, which still provides some preparation and integration, is really only making the drug available within the bounds of a specific setting, removing the ceremony. There have been some attempts for the preservation of some ceremonial aspects of psychedelic use in clinical practices, but then that has also begged the question of influencing patients with religious beliefs of the prescriber and whether or not that is ethical.
Further, while some organizations such as Decriminalize Nature fight for decriminalization of all natural psychedelics (including peyote) and access for all individuals, the Native American Church aims to continue to protect peyote and the environment in which it grows from people outside Native communities. There was a lot of discussion about centering indigenous voices at Reform 2023, but when it seems to come down to it many organizations claim they want input but tend to ignore requests from indigenous groups. As Garcia so blatantly stated, “Just give the f—-ng land back,” and if it’s truly healing that you are genuinely seeking then you will be let into the circle. Respect is a large part of it. There are also alternatives that can be consumed. You can experience mescaline in synthetic form or through San Pedro cactus, which leaves the teacher plant for indigenous folks. It’s respect for the culture, the identity, the ancestral knowledge behind these sacred practices and the substance being consumed. Dr. Angela Carter brought up how putting something with such a rich history and spirit behind it into a single pull removes so much that can be gained by the experience. These kinds of substances allow people to see deeply within themselves and their past/future, allowing a person to be able to take what they have experienced and do the work to become the next version of themselves. Medical models take that away, making psychedelics seem like a one-stop shop.
The largest critique of the westernization of psychedelics is that the medical models tend to ignore things that cannot be measured or quantified. There are ailments across a variety of cultures that are not recognized by western medicine but can be potentially healed in a variety of ways including herbal medicines, meditations, breathwork, ceremonial prayer and even the use of psychedelics. These things are ignored by western medicine and by taking psychedelics into this framework, what else - or who else - will be ignored if they seek to use psychedelics in a non-medical way? There are dynamics beyond the physical that makes someone who they are and influences their choices, as well as their needs. The historical indigenous use of psychedelics and the concept of healing is circular and the people who are choosing to take this route should be a part of determining their needs. Calling the ceremonial use of psychedelics a model doesn’t even seem fitting because it’s so much more than that.
This medical hijacking rhetoric is something that I’ve heard in almost every single conversation I’ve been in about psychedelics, it made me think about the opposite: ceremonial hijacking. While allies, or accomplices as Sam Rivera from OnPoint NYC said it, is a great thing, I’ve seen time and time again the co-opting of ceremonial use of a variety of psychedelics. Whether they are starting their own healing businesses fully equipped with online or in-person courses for a fee, weekend getaways in jungle settings, claims of shamanism and more, it leaves a bad taste in my mouth. The preservation of these rituals is something that absolutely should be done, but maybe they should be done by the people who created and passed these rituals down for generations, not some guy on reddit that will take you to the jungle for $100 and give you their homemade Changa. (I’d like to note here that there are many non-indigenous folks who have spent several years studying and enriching themselves into the true culture and spirit of the medicines they are offering, these are not the people I’m calling out.)
We live in this society in the US where it’s so individual and so transactional that it’s very hard to picture a world where ceremonial use of psychedelics is welcomed, where people can come together as a collective and feel something other than the pressure to survive and participate in capitalism. That’s kind of the point of the argument for the necessity of using psychedelics - or any drug - in this way. It’s a human right to experience something extraordinary.
Finally, I want to discuss the use of psychedelics outside these two settings: recreational use. This type of psychedelic use tends to fall in the sweet spot between both healing indications and is actually the most popular use of psychedelics in the modern era. Most people know the history of LSD and have heard the phrase “Turn on, Tune in, Drop Out” which was famously coined by Timothy Leary in the 1960s during the height of psychedelic recreational use. Still to this day several people, mostly in their late teens to early twenties, use psychedelics in a variety of ways including just for fun. As someone from the midwest suburbs, I always found it shocking that others were shocked at these statistics. I’ve noticed that some folks who choose to partake in drugs ceremoniously tend to be surprised with the choice of people to use psychedelics recreationally. Even Bia Labate PhD, a trained anthropologist, co-founder and Executive Director of Chacruna Institute, described being surprised upon learning how people are using some drugs in a non-ceremonial way. She then points out how despite the ways they are used substances have been a building block to civilizations and cultures around the world. It’s just part of the human experience.
Running with this idea that substances are just part of the human experience, then why do some people within different sectors of drug-related movements seem to look down on folks who don’t fit into their specific ideals? Aren’t we all fighting for the same thing: the end of a war on people and their choices, the basic human right to alter our own experiences?
It seems to be that recreational use of psychedelics is looked down upon by both the medical and ceremonial camps either for being “dangerous” or for “lacking intention” but what if sometimes the intention is just to feel something …else? I’m not discounting that psychedelics can be dangerous and should be used smartly but it should be up to the person to determine how they want to use them. The important thing is that the people engaging are educated and equipped to have that experience, which brings us full circle to harm reduction practices. With the increased use of psychedelics we should be spending more time talking to people about the potential risks (as well as the benefits) and outcomes, what can be done in those situations, and how to look out for people that are just trying to take advantage of the growing use. Psychedelic use has always been recreational and will probably continue to be recreational. If psychedelics become decriminalized or legalized fully it would allow someone to decide for themselves with all the possible information at their disposal.
Something that really hit home was a statement from Labate, “There is a multiplicity of models because we are a multiplicity of people.” This statement was followed by an analogy of how drugs are like food. There is not one particular preparation that will suit everyone’s needs. We can’t expect to serve one dish to the entire world and expect them to enjoy it, or to feel fulfilled. I think it’s important to apply this outside of psychedelics as well, remembering that everyone has their human right to bodily autonomy, which includes the substances they put in it.
Another take away from this session was the importance of honesty when it comes to these different models of psychedelics by pointing out that many of the current "medical" models appearing with the recent bouts of decriminalization are not actually approved medical models and sometimes it isn't really even decriminalization.
To be honest, the psychedelic field could benefit from listening to voices outside of their bubble. If we truly want to move psychedelics forward as a means to help people, everyone needs to work together to develop better risk assessments for those seeking to take psychedelics, education on situational awareness and familiarity with the drugs and their side effects. We also need to have more conversations on who should be leading in this field, who is allowed to provide healing and who gets to decide what people deserve healing or why they can't heal themselves.
Keep a watchful eye out for Part 2 in the coming weeks which will focus on indigenous leadership and intersectionality.