Psychedelic Medicine for Mental Illness and Substance Use Disorders: Overcoming Social and Legal Obstacles
72 Pages Posted: 16 Nov 2017 Last revised: 5 Aug 2020
Date Written: November 3, 2017
Mental illness is a public health crisis. Millions of Americans suffer through their days crippled by symptoms of mood, anxiety, and substance use disorders. These conditions take large social and economic tolls on our communities. However, the medicines used to treat them have remained largely unchanged for over fifty years. Though helpful to many people, the relative ineffectiveness of traditional drugs is prompting patients and physicians to seek alternatives including psychedelic compounds such as ketamine, psilocybin, MDMA, and DMT. These drugs showed therapeutic potential in the mid-twentieth century until the U.S. War on Drugs shut down all research. Now, having few alternatives, scientists are revisiting psychedelics as treatments for mental illness. This article is the first comprehensive review of the social and legal obstacles to developing psychedelic medicines. It argues that the current mental health and opioid crises demand exploration of their therapeutic potential. With subtle modifications to state and federal drug law, psychedelics could be thoroughly studied and made available to patients under carefully controlled conditions. Possible pathways include working within the existing federal regulatory framework to gain FDA approval for psychedelics; removing psychedelics from the DEA list of Schedule I controlled substances; reducing federal restrictions on psychedelics research without changing their Schedule I status; decriminalizing psychedelics at the state level; creating state governed systems for regulating psychedelics; and implementing state-sponsored psychedelics research programs. Some approaches may be counterproductive or have counterintuitive results. Recent state marijuana reform efforts could serve as a roadmap for amending the laws governing psychedelics. Ultimately, creative solutions that promote collaboration between state and federal government may be most likely to succeed.
Keywords: Ayahuasca, Addiction, Controlled Substances Act, DEA, Depression, Decriminalization, Drug Enforcement, Ecstasy, FDA, FDA Law, Federalism, Ibogaine, Ketamine, LSD, Marijuana, MDMA, Mental Health, Mental Illness, Opioid, Opioid Crisis, Preemption, Psilocybin, Psychedelic, PTSD, Substance Use
JEL Classification: I1, I12, I18, K23, K32, H51
Suggested Citation: Suggested Citation