Hallucinogens have found their way into the mainstream: They are infiltrating modern psychotherapy and sparking revelations about mental health treatment.
Compounds from psilocybin mushrooms and MDMA are being tested against cases of depression, PTSD, fibromyalgia, and irritable bowel syndrome in Boston clinical trials. Launched in 2021, the Center for Neuroscience of Psychedelics at Massachusetts General Hospital has spearheaded research into the effects of psychedelics on neuroplasticity and brain function. Participants ages 18–55, with failure to respond to two to four previous pharmacological treatments for their current episode of depression, are considered for studies using psilocybin.
The majority of Massachusetts, about 56%, voted no on Question 4 in November 2024, disapproving the proposed law that would allow those over the age of 21 to grow, possess, and use “certain natural psychedelic substances” in “certain circumstances.” Those in favor of Question 4, including mental health counselor and Lieutenant Sarko Gergerian, recognize the benefits of the proposed law.
“For many people who are suffering, daily medications and other standard treatments aren’t working. Over 6,000 veterans die by suicide annually, and countless more struggle from service-related trauma. Natural psychedelic medicine can also offer patients with a terminal diagnosis relief from end-of-life anxiety and help them find peace,” wrote Gergarian in an argument urging constituents to vote yes on Question 4.
Those against Question 4 are staunchly opposed to decriminalization, including MGH surgeon and Associate Professor of Surgery at Harvard Medical School Dr. Anahita Dua. In an argument urging constituents to vote no on Question 4, Dua argued that a black market is inevitable with the amount of home growth permitted by the proposed law.
“The centers aren’t required to be run by medical professionals, cannot provide critical care during adverse reactions, and aren’t prohibited from giving psychedelics to high-risk patients like those with schizophrenia, bipolar illness, and pregnant or breastfeeding women,” wrote Dua.
While the future of decriminalization for recreational use of psychedelics is uncertain in Massachusetts, psychiatrists, professors, and spiritual chaplains explain the unfolding future of implementing psychedelics in the world of medicine.
“There’s no way to capture how challenging it is,” Franklin King, a Harvard psychiatry professor and director of training and Education at the Center for Neuroscience of Psychedelics, told The Beacon in an interview. While these substances seem to be changing the landscape of healthcare, the research is still in its infancy and prone to limitations.
“It takes a very long time to get a study up and running,” said Jerry Rosenbaum, leading psychiatrist at MGH and director of CNP. “Lots of approvals that have to be obtained not only locally from IRB and safety committees, but also through the Drug Enforcement Administration.”
Not only is it hard to physically acquire the actual substance and get it delivered, King and Rosenbaum explained, but the general stigma surrounding illegal substances in the federal government has made research slow and exhausting.
“Psychedelics run against the grain of modern healthcare,” said King, who leads clinical trials to observe the effects of psilocybin on gastrointestinal health. “According to the federal government of this country, there are no medical benefits, and they’re highly addictive, and have high abuse potential.”
King is referring to the policies of the Federal Drug Administration and Drug Enforcement Agency of the United States. Following the growing recreational use of psychedelics in the 1950s and 1960s, the federal government banned LSD and psilocybin in the Controlled Substances Act of 1970. Psychedelics, which were once associated with hippies, stoners, free love advocates, and countless other strains of counterculture, have now become medicalized in a radical way.
Many college students take some form of antidepressant, anti-anxiety medication, or stimulant. According to a 2023–2024 study conducted by The Healthy Minds Network, 33% of students reported taking prescription medication for depression with positive depression screenings, and 16% of students reported taking medication for anxiety with positive anxiety screenings. Roughly 5% of the U.S. population struggle with symptoms of PTSD. Western medicine, which has largely condemned illegal drug use, is introducing what are still considered Schedule I substances, or drugs with “no medical use” and high potential of abuse (including MDMA and psilocybin), and Schedule III substances, meaning drugs with high potential of abuse or dependency (including ketamine) into its realm of possible treatments.
A clinical trial session for psilocybin therapy lasts eight hours. Before the session, there is plenty of preparation, including a screening to make sure the subject is right for the study.
“First is a screening to make sure the subject meets the inclusion and exclusion criteria for the study, typically meaning not using alcohol or
“Usually they’re left alone, unless they start to have challenging experiences, in which case somebody might intervene to be reassuring. After a period of time, depending again on the agent and how long it lasts, a person can go home, but they tend to come back and reflect with somebody on what emerged and what they experienced,” said Rosenbaum.
The experts spearheading psilocybin mushroom research agree that the War on Drugs, a global anti-drug campaign that has raged for decades in the U.S., has changed what the larger population perceives as safe or legitimate for medicinal use. Because illegal drugs have so long been associated with crime, overdose, and addiction, many are hesitant to accept their medicinal benefits.
Jeffrey Breau, a program lead for Psychedelics and Spirituality at the Harvard Center for World Religions and a researcher of contemporary psychedelic churches, said he advocates for and believes in the clinical use of psychedelics, but is wary of the blind spots.
“Outside of clinical trials, there is no way to get legal, above ground psychedelic assisted therapy,” Breau said. “Even from the medical picture, all of cannabis, or not on other drugs,” said Jerry Rosenabum, leading psychiatrist at MGH and a director of the Center for Neuroscience of Psychedelics, in an interview with The Beacon.
Rosenbaum described the setting as “non-clinical; it’s comfortable.” In other words, the psilocybin-assisted therapy session doesn’t take place in a typical doctor’s office with the sterile glow of fluorescent lights. The patient usually wears eye shades and sits in a room with low light. Music may be playing. Then, the patient is administered a 25 milligram dose of psilocybin.
this [research] is interwoven with certainly longstanding indigenous use, but also rave use and club use. All of that underground use was informing the clinical trials that exist today.”
Although psychedelic-assisted therapy has the potential to transform modern healthcare, there may be a dark, unregulated side to these therapies. Because psychedelic-assisted therapy is so new, there is concern that underground practice may occur. The surge in psychedelic-assisted therapy has raised concerns in the medical community about abuse, misconduct, and ethical violations of patients in altered mental states. One of the leading researchers of MDMA-assisted therapy, the Multidisciplinary Association for Psychedelic Studies, has been accused several times of misconduct. They published a statement in 2021 claiming that the incidents of inappropriate sexual behavior were independent from MAPS-sponsored trials.
“There’s a lot of inappropriate behavior and, occasionally, exploitation of people who are seeking out psychedelic treatments” in underground settings, King said.
Many experts believe the U.S. is experiencing a “psychedelic renaissance” despite the nation’s shaky history with drug policy. MDMA, ketamine, and psilocybin are still seen as controlled substances on a federal level and are only legal for use among registered healthcare practitioners.
“If something is too different, like peyote, or morning glory seeds, or psilocybin mushrooms, they can’t be incorporated into the culture, and they’re rejected for medicine, popular use, and religious use,” Paul Gillis-Smith, another program lead for Psychedelics and Spirituality who works alongside Breau at the Center for World Religions, said to The Beacon.
Counterculture and indigenous use of psychedelic substances have directly informed and influenced medical opinion, but have been historically undercredited, underreported, and erased from history.
But Gillis-Smith wouldn’t call it a “renaissance”—it implies there was a “dark ages” of psychedelic research and experimentation. There never was, according to experts such as Gillis-Smith and Breau.
These substances have been used for centuries, it’s just a matter of who was using them. One thing is for certain, according to Rosenbaum: “Psychedelics will very much be part of the toolkit for psychiatrists in the future.”
