When a person is diagnosed with a mental illness like an anxiety disorder, depression, or PTSD, a therapist's first recommendation is typically to try a traditional form of therapy like cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), which focus on regulating emotions and developing skills to reframe negative thought patterns and behaviors. Although many people benefit from therapies like CBT and DBT, they're not effective for everyone — and that's when individuals may begin to consider nontraditional treatment methods like psychedelic-assisted therapy.
What Is Psychedelic Therapy?
"Although the term may conjure up images of drug use under the guise of self-care, psychedelic therapy is evolving as a recognized medical practice," Bryan Bruno, MD, medical director at Mid City TMS, a New York City-based medical center focused on treating depression, told POPSUGAR. He explained that the process involves taking a small dosage of a drug, such as LSD, while under a therapist's supervision. "The patient is encouraged to not repress any negative emotions, such as grief or anger, and to discuss their experiences aloud with their therapist over several sessions," Dr. Bruno said.
Gail Saltz, MD, a Manhattan-based psychiatrist and associate professor of psychiatry at the New York Presbyterian Hospital, Weill-Cornell Medical College, noted that it's important to understand that the treatment isn't simply taking a psychedelic. Rather, it's a specific regiment of psychotherapy that takes place in the safe confines of a therapist's office.
How Can Psychedelic Therapy Be Legal?
At the moment, it isn't, because while there's been a resurgence of research using substances like MDMA and LSD, they're still classified as Schedule I drugs by the United States Drug Enforcement Administration. Rudy Lugo-Rios, PsyD, told POPSUGAR that whether or not the practice will become legal is a complex question. "One has to keep in mind that state governments and the federal government are two separate entities," Dr. Lugo-Rios explained. "Something may be decriminalized but is still technically illegal or entirely legal but so socially taboo that it might as well be illegal." According to Dr. Lugo-Rios, what's most likely to happen is that psychedelic therapy will continue to be researched and implemented in particular clinics — meaning, it will be available for people who have access to those clinics and are willing to try the treatment despite its potential risks.
So, Is It Safe to Use Psychedelics as Therapy?
A potential danger associated with psychedelic therapy is people attempting to self-treat with psychedelics. Under no circumstances is this a type of treatment that you should try at home; it must be done under a doctor's supervision. "There is zero evidence that randomly taking a psychedelic on your own treats a psychiatric diagnosis," Dr. Saltz told POPSUGAR. "In fact, a frightening 'trip' can be traumatic. Nonregulated drugs can be contaminated, and overdose is possible." However, she looks forward to the results of rigorous studies that are conducted at reputable medical centers.
While clinical trials have shown promising evidence that psychedelic therapy can be an effective treatment for a variety of conditions, and it certainly warrants further investigation, Dr. Bruno cautioned that even in a medical setting, there are risks associated with the use of psychedelic drugs. "While studies so far have shown a positive correlation in using psychedelic therapy for anxiety, for instance, drugs such as LSD have been known to produce great anxiety and panic attacks in those who do not regularly present with anxiety," Dr. Bruno explained. "Further research is needed on what constitutes a properly controlled setting for psychedelic therapy before legalization occurs."
Additionally, due to safety concerns, a patient should go through a rigorous screening process before beginning psychedelic therapy. For example, Dr. Bruno noted that it's important to be screened for certain conditions like schizophrenia that could potentially make the treatment dangerous.
As of today, psychedelic therapy is typically used as a last resort when traditional therapy options have been exhausted. Dr. Lugo-Rios pointed out that, although there appear to be promising short-term effects, it's still unknown if they will last beyond a few years. He also has other concerns. For example, if a person who uses psychedelic therapy to treat PTSD experiences another traumatic event after their initial treatment, it's unclear how they'll react. Although they may remain resilient, he pointed out the effects of the trauma could be more intense. "[And] of course there are medical and neurological questions to be asked as well, [such as] what effects emerge after this 'macro dosing?'" he said.
For these reasons, it's highly unlikely that psychedelic therapy will become a replacement for traditional therapies anytime soon. Rather, it will remain a last resort for people who are comfortable using a form of therapy that hasn't been studied as extensively as others. Psychedelic therapy appears to be safer than many of us may initially assume, but it's crucial to work with a reputable therapist and go through all the necessary screenings before pursuing it further.