The idea of psychedelics conjures up many different images amongst mainstream audiences. It may be the hippies who brought them to mainstream recognition, Hunter S. Thompson’s surreal, drug-fuelled novel Fear and Loathing in Las Vegas, or ravers high on acid and molly at music festivals, but it is rarely medicine that is the first thing that comes to mind. In fact, if my experience is anything to go by, people more often are taught that psychedelic substances as highly dangerous to people’s mental health, being told that it is not uncommon for people to be driven insane after one bad “trip”.

When I was first introduced to the science behind psychedelic medicine a year ago however, I began to realise how wrong this picture was. As I’ve dug deeper, I’ve realised the importance of reconsidering society’s relationship with these powerful compounds and a need to recognise them as the truly groundbreaking medicines that they have already proven to be. When I have spoken to people about my passion for psychedelic medicine however, I’ll often get a raised eyebrow and a sceptical look, at which point I talk them through the reams of research that is actually backing my interest. This article is intended to be an introduction to that research, and hopefully, initiate some further interest among readers.

The word “psychedelic” - from the Greek, meaning “mind revealing” - can refer to many compounds, from LSD and magic mushrooms to peyote and ayahuasca. There is also some debate as to what fits within the definition: MDMA for example many consider to not be a “true” psychedelic. Each of these have their own properties, their own areas of study, and their own classifications of legality: ketamine, for example, is already in use in therapeutic settings in many jurisdictions globally. Consequently, it is difficult to make sweeping statements which apply equally to all of them. Therefore, for the purposes of this article, when I say “psychedelic” I am primarily referring to LSD, MDMA, and psilocybin - the active compound in magic mushrooms - even though many of the statements and research apply equivalently to other compounds.

Decades of peer-reviewed research has clearly established multiple benefits of psychedelic compounds

Despite being classified as a “schedule one drug” or the equivalent by many countries – a classification which states that it has a high potential for harm and no medical purpose and the same classification as heroin and crack cocaine – some particularly eager researchers at globally respected universities and non-profit research organisations have pushed through the extensive bureaucratic legal processes to be able to conduct research on their impacts. This research consistently shows considerable medical benefits that these compounds can provide when provided in a clinical environment. There have been multiple research studies (see here, here, and here, to show just three) showing the effectiveness in psilocybin in treating treatment-resistant depression, and how much more effective it is than traditional anti-depressants. In one study, over half of study participants were in remission from their depression symptoms 12 months later after only two doses. Psilocybin has been shown to be effective in treating nicotine addition: an example of an illegal drug having medical benefits in treating a damaging side effect of a legal drug. LSD has had similar studies with similar results on anxiety. MDMA, also known as “molly” and the active ingredient in ecstasy, has been shown to be highly effective in treating PTSD by enabling sufferers to undergo therapy and confront trauma in ways that would otherwise be too difficult.

The list of research showing their benefits is far too long to list them all here, but a simple Google Scholar search by compound will give you a picture for how much is out there. One thing is for certain: there is too much to simply dismiss this as a quirky fad.

There is more research showing the effectiveness of psilocybin in treating depression than there was for SSRIs when they were approved for medical treatment

SSRIs and other anti-depressants are seen as the safe way to treat depression, and in terms of the history of mental health, they have been truly ground-breaking and have saved countless lives. It is worth noting however, that Fluoxetine or Prozac, the first SSRI, had three studies on humans followed by three clinical trials before it was approved for medical use. Consider the lives that SSRIs were able to change because they were allowed to be used for medical purposes, and consider that psychedelics not only have considerably more than that amount of research to demonstrate effectiveness, but the research shows how much more effective they are than SSRIs. What is the justification for not making them available?

It isn’t that they are dangerous to use.

Psychedelics are recognised by researchers as being among the safest drugs in existence

In the late 2000s, a group of scientists, researchers, and industry experts gathered together under the leadership of Professor David Nutt, the chair at the time of the UK Government’s Advisory Council on the Misuse of Drugs, to assess the relative harm of various drugs by various different factors. The ultimate research study, after several iterations and feedback from other researchers, ended up assessing harm on 16 different factors, and the paper published in 2010.

Highlighted several items of note: firstly, that the most harmful drug in aggregate was alcohol, by quite a large margin. Secondly, that this was not simply due to availability or legality, as tobacco was sixth behind heroin, crack cocaine, methamphetamine, and cocaine. Thirdly, psychedelic compounds were among the least harmful, with ecstasy/MDMA, LSD and psilocybin being considered respectively the fifth, third, and least harmful drugs considered. And finally, although this shouldn’t need to be highlighted considering the first three points: there is little relationship between legality and harm.

There are several reasons the study sited for psychedelics being rated so low. It is virtually impossible to die from an overdose, they cause no physical harm, and if anything they are anti-addictive as they cause an immediate tolerance which renders any further doses ineffective for some time.

Looking at psychedelics in isolation, there has also been research to identify evidence for harms, but said evidence of harm remains elusive. Research has shown that psychedelics do not appear to be linked to mental health problems or suicidal behaviour, found no link to detrimental short- or long-term effects of cognitive functioning or emotional processing, and reviews of research available has found “that medical risks are often minimal, and that many – albeit not all – of the persistent negative perceptions of psychological risks are unsupported by the currently available scientific evidence, with the majority of reported adverse effects not being observed in a regulated and/or medical context.”

So if there are harms in medical usage, nobody has observed them.

The criminalisation of psychedelics was purely a political move with no scientific backing

If there is no scientific evidence for harm, then why were psychedelics made illegal?

One is unlikely going to get a straight answer to exactly why, but public comments made by John Ehrlichman, Nixon’s former domestic-policy advisor and Watergate co-conspirator, in 1994, give us somewhat of an indication when discussing the “War on Drugs”.

“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people,” Ehrlichman said. “We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”

Nixon at the time referred to Timothy Leary, the most prominent psychedelic evangelist at the time, as “the most dangerous man in America”, and psychedelics at the time were also heavily associated with the “antiwar left”. Consequently without any research to demonstrate harm and a direct admission from one of the Nixon administration’s closest advisors that the War on Drugs was politically motivated, it seems most likely that psychedelics were prohibited in the broader “War”.

Psychedelic legalisation is moving forward in multiple jurisdictions and is increasingly supported by the public

Already in numerous countries around the world psychedelics are legalised or effectively decriminalised – The Netherlands, Spain, Portugal, Jamaica, and Costa Rica to name a few – and as more research emerges, increasingly we are seeing larger campaigns to legalise or decriminalise in the US, UK, Canada, and Australia.

Across the US, 14 cities have decriminalised the possession of psilocybin (including Denver, Oakland, Santa Cruz and Cambridge) or have made enforcement the lowest priority (including Seattle, Detroit, and the District of Columbia). Oregon from January 2023 will have a regulated framework for people to commercially grow and administer psilocybin to patients in treatment centres, and Colorado appears set to vote on Initiative 58 later this year to establish a similar model.

Elsewhere, polls are also beginning to show that the public is increasingly in support of psychedelics being made more available in research and therapeutic environments.

A 2021 poll in the UK found that 55% of the public supported lowering restrictions to make research easier. Polling conducted in Australia put that number at 61%, with 63% supporting psychedelic-assisted therapy in medically controlled environments. In Canada, where polling was focused on psilocybin use in end-of-life assistance, support was at 82%. Such end-of-life programs appear to significantly reduce anxiety with the terminally ill.

As people become more aware of the importance of mental health, they are also becoming more aware of how said health is in a state of crisis across the world due to having been ignored for so long. Yet here we have compounds with considerable evidence demonstrating groundbreaking impacts on mental health and no evidence of harm criminalised for decades. This not only keeps it away from the suffering patients that could benefit, but imposes prohibitively expensive costs on scientists who wish to study it.

Legality should be based on facts, and the facts say that we need to take these compounds seriously. The longer it is kept away from the public, the more people will suffer, and the more people will die. Psychedelic medicine is medicine that will save lives.