As the tides of public opinion continue to shift, the movement for the legalization and decriminalization of psychedelic substances has gained significant momentum in recent years. A notable example of this shift in perception in the United States is the decriminalization of Cannabis. As more states move to legalize cannabis, both for medicinal and recreational use, other previously taboo substances are being reevaluated for their therapeutic potential. In this article, we will discuss the current landscape of psychedelics and their potential future with regard to decriminalization and medicinal use.
The Multidisciplinary Association of Psychedelic Studies (MAPS) has been a driving force behind research into the potential therapeutic applications of psychedelics such as MDMA, psilocybin, and cannabis. MAPS has had a profound impact on the research and understanding of these substances by working closely with the US Food and Drug Administration (FDA) and other government entities to help redefine formerly negative perceptions.
A significant milestone was reached in November 2016 when the FDA granted Breakthrough Therapy Designation to MDMA-assisted psychotherapy for the treatment of post-traumatic stress disorder (PTSD). This decision was based on compelling evidence from clinical trials that demonstrated MDMA’s efficacy in treating PTSD when combined with psychotherapy. In fact, Phase 3 clinical trials are currently underway, with the potential for FDA approval of MDMA-assisted psychotherapy for PTSD as early as 2023.
In addition to MDMA, the therapeutic potential of psilocybin, the active psychoactive compound in “magic mushrooms,” has been investigated for a variety of mental health conditions such as depression, anxiety, and alcohol and drug addiction. In 2019, the FDA granted Breakthrough Therapy Designation to psilocybin therapy for treatment-resistant depression, bolstering the growing body of evidence supporting its potential as a mental health treatment option.
There are multiple organizations, such as MAPS, leading the charge for the decriminalization of psychedelics. For example, in the United States, the cities of Denver, Oakland, and Santa Cruz have all decriminalized possession of psilocybin-containing mushrooms, and similarly, the state of Oregon became the first to legalize the therapeutic use of psilocybin in 2020.
Beyond the United States, other countries have decriminalized or are revisiting their position on drug policy. Portugal decriminalized the possession of all drugs in 2001, and since then, drug use has decreased, and treatment and rehabilitation programs have significantly improved. The Netherlands has long been known for its lenient drug policies, and the Dutch city of Amsterdam is famous for its “smartshops” where psilocybin-containing truffles are sold legally.
Even at the United Nations, member countries such as Canada, Colombia, and Uruguay are pushing for reforms to the global Narcotic Drugs treaty, with Uruguay becoming the first country to legalize recreational cannabis in 2013, followed by Canada in 2018.
These sweeping changes in drug policy around the world have opened the doors to increased research and understanding of the therapeutic potential of psychedelics and, combined with successful clinical trials, are providing a pathway toward FDA approval and broader cultural acceptance.
Regarding the future of psychedelics, there are three realistic scenarios. The first may see a steady continuation of the current trend: increased decriminalization efforts, rigorous scientific research, and the eventual FDA approval of psychedelics for specific therapeutic uses. This possible future would be characterized by broad public support, analogous to the path of cannabis.
A second potential future could involve government pushback, where psychedelics become a political issue, and regulatory barriers are erected. This would result in delays or stagnations in research, approval, and decriminalization.
Finally, a third trajectory would see a paradigm shift, where psychedelics are embraced for their therapeutic potential and become widely available, much like over-the-counter supplements like melatonin or St. John’s wort.
While predicting the future is inherently uncertain, it seems clear that support for the decriminalization and therapeutic use of psychedelics is growing. With scientific evidence mounting, the potential for the legalization of these substances is more feasible now than at any point in the past and could revolutionize the way we approach mental health treatment.
