Since the early 1970s, a vast majority of psychedelic substances have been classified as having no recognized medical value and a high potential for abuse. However, “psychedelics” is a term that encompasses a wide variety of substances. For example, while LSD, which was first derived from the Ergot fungus (a close relative of the Cordyceps fungus featured in the HBO series The Last of Us), remains a Schedule I drug along with fellow psychedelics; psilocybin, ibogaine and peyote (as well as cannabis), not all psychedelics are Schedule I drugs. Some psychedelics, such as ketamine, are listed in Schedule III, meaning that they have some currently accepted medical use and a lower potential for abuse.
More recently, many psychedelics (including LSD) have been recognized as having therapeutic value in treating certain mental illnesses, such as depression and post-traumatic stress disorder. As a result of headway in psychedelic research, the U.S. Food and Drug Administration designated psilocybin — the main psychoactive compound of hallucinogenic mushrooms — as a breakthrough therapy in 2018. The FDA had already drawn the same conclusion for MDMA in 2017.
Following this, in 2020, JAMA Psychiatry published a study demonstrating promising outcomes of treatment with psilocybin for various forms of depression. Then, a 2021 study published in Nature Medicine identified MDMA-assisted therapy as a potential breakthrough treatment for PTSD.
Similarly to cannabis, an acknowledgment of the various legitimate medical uses for these substances has resulted in legislative action on the state level across the country. Currently, at least 31 states have either passed or are considering legislation to legalize, decriminalize, authorize therapeutic use, or encourage further research of psychedelics.
While it remains to be seen whether states’ legalization or decriminalization of psychedelics will be as widespread as it has been for cannabis, the rate at which states are introducing psychedelic reform bills is happening much quicker than we saw for cannabis.
Nonetheless, like cannabis, the decriminalization or legalization of psychedelics at the state level does nothing to affect its federal illegality.
So why might psychedelics become federally legal well before cannabis?
Principally, for three reasons.
Because ketamine, an anesthetic with psychedelic properties, is currently classified as a Schedule III substance. Although it has a checkered past, often referred to as “Special K” when used illegally in rave circles, and having been known as a “horse tranquilizer” since its primary clinical use was as an anesthetic in both human and veterinary practices, ketamine treatment programs have been popping up all across the country. Ketamine is now considered a life changing therapy which can effectively treat illnesses such as treatment resistant depression and PTSD. As a result of its proven efficacy and clinical availability (even though most ketamine therapies are technically “off-label” or unapproved for such use), ketamine has already achieved a degree of mainstream acceptance.
The FDA has already recognized that schedule I drugs like psilocybin and MDMA are what is described as “breakthrough therapy,” meaning that preliminary clinical evidence indicated that the drug may provide a substantial improvement over other available therapies. This breakthrough therapy designation allows for expedited review and drug development. The significance of this from a federal legalization standpoint is that the FDA has already acknowledged the medical potential of certain psychedelics, which is more than half the battle.
Unlike cannabis, the use of some psychedelic substances, like peyote, is permissible in the context of legitimate religious ceremonies under the American Indian Religious Freedom Act of 1978 (AIRFA) (42 U.S.C. § 1996). The federal recognition of protected uses for psychedelic compounds means that general acceptance at a federal level may come easier than for cannabis. Despite many having claimed religious use of cannabis, such as the Rastafari, no such use has been recognized at the federal level.
Taking these factors into account, we believe there is a significant possibility that psychedelics, at least on some level, will be made federally legal before cannabis.
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here were high hopes that MDMA-assisted therapy would be approved by US regulators in 2024. The data showed that the drug-therapy combo significantly reduces post-traumatic stress disorder (PTSD) symptoms, or even eases them completely — despite a strong placebo effect in the trials, which involved well under a thousand participants. When the study data was published in September 2023, the New York Times reported that MDMA-assisted therapy was “inching closer to approval.” But in an August ruling that came as a wake-up call to figures in the nascent psychedelic industry as well as an underlying psychedelic movement made up of a hodgepodge of campaigners, the Food and Drug Administration (FDA) declined to give the green light, citing a lack of convincing clinical evidence and issues with the studies. The FDA requested further data from a new study, which would take several years, marking a significant setback for the prospect of medical psychedelics.
As early as 2026, however, the FDA will likely have another opportunity to approve another psychedelic drug for Americans with depression — psilocybin, which is derived from magic mushrooms — depending on the results of late-stage research. Even if it does pass, the therapy will likely not be immediately covered by insurance and so will remain beyond the reach of most Americans. This reality, plus the fact that psychedelics are meant to make you feel more interconnected (and thus perhaps less likely to want to squeeze profits from your peers), raises an intriguing possibility: that the psychedelics industry could be nationalized for the public good.
“Psychedelics, like pharmaceutical products, are just going to be inaccessible to many, many people,” says Professor Susi Geiger, a patent expert from University College Dublin. Step one to ensuring equitable access, and giving hospitals some respite from the straightjacket that often forces them to pay well over the odds for drugs, is reforming a patent system that enables Big Pharma to hike prices on existing drugs cartel-style thanks to the monopolies they enjoy over their products. To prevent the far-out possibility of Google founder Sergey Brin controlling the price of certain psychedelic therapy protocols, Geiger suggests a complete moratorium on private patents over psychedelics. “That’s the equivalent of nationalizing it at the source and keeping it as a public good.”
The idea may sound utopian and raise more questions than it immediately solves, even if the US patent office got on board and Congress created a European-style semi-socialized health care system, free at the point of use. “How can we trust exclusive access through a national health service when the state has only previously handled access [to psychedelics] through prohibition and religious censorship?” asks Chris Byrnes, a patent attorney at CalyxLaw. Matt Brockmeier, counsel at Antithesis Law, says less charitably: “I don’t trust the federal government — this or any other administration — to oversee something as monumental as our collective consciousness. Their track record is abysmal; they ruin everything they so much as look at because of the influence of special interests, fraud, waste, abuse, outright corruption, and general incompetence.”
Members of U.S. Customs and Border Protection said they are continuing to investigate after several shipments of chocolate bricks filled with magic mushrooms were found at the Peace Bridge warehouse at the Port of Buffalo, New York.
In a news release, U.S. CBP said officers discovered “multiple commercial shipments” containing psilocybin, the chemical compound found in magic mushrooms, at the warehouse over the past 30 days.
The shipments were coming from Canada to the U.S.
“CBP officers working in the Peace Bridge cargo facility discovered multiple shipments manifested as ‘chocolate and other food preparations,’” the news release read.
“Upon further inspection of these shipments, it was discovered that the chocolate bricks contained psilocybin, a schedule 1 controlled substance.”
The chocolate bricks were “field tested” by officers and the substances tested positive for the “properties of psilocybin.”
According to the release, there were a total of 15 seizures with a weight of about 10 kilograms in the last 30 days.
The estimated street value of the drugs, officers said, is believed to be US$165,000.
Psychedelics are experiencing a resurgence in the field of mental health care. Once relegated to the fringes of both medical practice and legality, compounds such as psilocybin, MDMA, LSD, and ketamine are now being re-examined for their therapeutic potential. A recent survey reveals that a significant portion of mental health professionals are open to incorporating psychedelic-assisted therapy into their practices—on the condition that these treatments are legalized and regulated. This shift in attitude reflects both growing scientific evidence for psychedelics’ efficacy and increasing awareness of their ability to address treatment-resistant conditions like depression, anxiety, and PTSD.
Psychedelic Therapy: A Re-Emerging Field
In recent years, research on psychedelics has surged, leading to promising results in the treatment of mental health conditions that often prove resistant to conventional therapies. The Multidisciplinary Association for Psychedelic Studies (MAPS) and other research institutions have been conducting clinical trials on substances like MDMA for PTSD, psilocybin for depression, and ketamine for treatment-resistant depression and suicidal ideation. These studies demonstrate that psychedelic substances, when combined with psychotherapy, offer rapid and sustained relief from symptoms with minimal side effects when administered in controlled environments.
A surveyconducted among mental health professionals, including psychiatrists, psychologists, counselors, and social workers, has provided valuable insight into their perspectives on psychedelic therapies. While many respondents expressed enthusiasm about the potential of psychedelics, the key barriers identified were the current legal status and regulatory uncertainty surrounding these substances.
Survey Results: Mental Health Professionals Support Psychedelics Under Regulation
The survey revealed that 69% of respondents were willing to use or recommend psychedelic-assisted therapy for their patients if it became legal in their jurisdiction. Mental health professionals are particularly interested in the use of psychedelics for treatment-resistant conditions, such as major depressive disorder (MDD) and PTSD, where traditional treatments have often been insufficient.
Despite this enthusiasm, concerns remain about the need for proper regulation and oversight. Professionals emphasized that legal frameworks would need to ensure that psychedelic therapies are delivered safely and effectively, with clear guidelines for dosing, set and setting, and professional training. There is also a push for psychedelic therapists to receive specialized education, much like those working in other areas of pharmacological therapy.
Legal and Ethical Considerations
Currently, most psychedelics remain classified as Schedule I substances in the United States under the Controlled Substances Act, meaning they are considered to have no accepted medical use and a high potential for abuse. This legal status poses a significant barrier to their use in clinical settings, despite mounting evidence to the contrary.
In regions where decriminalization or medical use of psychedelics has gained momentum, such as Oregon and Colorado, psychedelic therapy is slowly becoming more accepted. Oregon, for instance, was the first state to legalize the supervised therapeutic use of psilocybin in 2020. Meanwhile, several cities, including Denver and Oakland, have decriminalized the possession of psilocybin and other entheogenic plants. These local efforts highlight a growing recognition that psychedelics, when used responsibly and within the right context, can provide healing opportunities for individuals who have exhausted traditional treatment methods.
However, mental health professionals have raised concerns about the ethical implications of widespread psychedelic use. They stress the need for stringent training requirements for therapists, particularly because psychedelic experiences can induce profound and sometimes overwhelming emotional responses. In therapeutic contexts, these experiences need to be properly integrated into a patient’s broader psychological framework, requiring both expertise and ethical responsibility.
Majority of Mental Health Professionals Support Psychedelic Therapy If Legal
Scientific Evidence Behind Psychedelic Therapies
The growing interest in psychedelic-assisted therapy is not simply a matter of changing societal attitudes—scientific research increasingly supports its efficacy. Some of the most promising results come from studies on psilocybin and MDMA.
Psilocybin and Depression: Psilocybin, the active compound in magic mushrooms, has shown significant potential in treating depression, including treatment-resistant depression. A study published in JAMA Psychiatry demonstrated that two doses of psilocybin, combined with supportive psychotherapy, reduced depressive symptoms in patients for up to a year. Many participants reported a profound sense of emotional clarity and connectedness, which allowed them to process deeply ingrained feelings of sadness and despair.
MDMA for PTSD: One of the most well-known psychedelic therapies is MDMA-assisted therapy for PTSD. Clinical trials led by MAPS have shown that MDMA, when administered in a therapeutic setting, helps patients with PTSD by lowering the emotional intensity of traumatic memories, making it easier for them to process these experiences. In Phase 3 trials, over 60% of participants no longer met the diagnostic criteria for PTSD after just three sessions of MDMA-assisted therapy.
Ketamine: Already approved for clinical use as esketamine, ketamine has gained attention for its rapid-acting antidepressant effects. When used in low doses under medical supervision, ketamine can rapidly alleviate symptoms of treatment-resistant depression and suicidal ideation, providing relief within hours or days, compared to the weeks or months it takes for traditional antidepressants to take effect.
Training and Certification: A Key Concern
One of the most consistent points raised in the survey is the importance of ensuring that mental health professionals are adequately trained to administer psychedelic therapies. Given the profound psychological effects that psychedelics can induce, therapists need specialized training in both the administration of these substances and the integration of the experiences that arise during therapy sessions.
Many professionals also argue for the creation of certification programs that would establish clear standards for psychedelic therapy. These certifications would ideally cover:
Dosing protocols
Managing difficult or overwhelming experiences (often called “bad trips”)
Psychological preparation and integration techniques
Safety measures for vulnerable populations, such as those with a history of psychosis or bipolar disorder
Without proper training, the risks of psychedelic therapy, including re-traumatization or psychological destabilization, could outweigh the benefits, particularly in cases of complex trauma or severe mental health disorders.
The Future of Psychedelic-Assisted Therapy
As the legal and regulatory landscape around psychedelics continues to evolve, it is clear that the mental health field is preparing for the potential widespread adoption of psychedelic therapies. The survey’s findings indicate that the majority of mental health professionals are open to the integration of psychedelics, particularly if legal barriers are removed and appropriate safety measures are put in place.
The future of psychedelic therapy will likely involve a blend of clinical trials, regulatory changes, and public education about both the risks and benefits of these treatments. Mental health professionals will play a critical role in shaping how these therapies are implemented, ensuring that they are used ethically and effectively in clinical settings.
If legalized, psychedelics could mark a paradigm shift in mental health care, offering new hope for individuals suffering from anxiety, depression, PTSD, and other psychiatric conditions that have proven difficult to treat with conventional methods.
Conclusion
The survey of mental health professionals provides a glimpse into the future of psychedelic-assisted therapy. The openness of clinicians to these treatments, contingent upon legalization, suggests a broader acceptance of psychedelics as viable therapeutic tools. As research continues to support the safety and efficacy of psychedelics for treating mental health disorders, the field is poised for significant changes. The next few years may see these once-controversial substances become part of mainstream psychiatric treatment, revolutionizing how conditions like PTSD, depression, and anxiety are managed.
Sources
Sermo Barometer Survey: 94% of Global Mental Health Professionals Open to Psychedelic Treatments. Business Wire, 2024.
Moliner, R. et al., “Psychedelic treatments are speeding towards approval,” Nature, 2023.
How Psychedelic Treatment Can Revolutionise Mental Health. Health Europa, 2024.
Lewis, C. R. et al., “MDMA and PTSD: Clinical Applications,” Frontiers in Psychiatry, 2023. DOI: (Nature).
