Abstract
Research exploring the potential of psychedelic-assisted therapies to treat a range of mental illnesses is flourishing, after the problematic sociopolitical history of psychedelics led to the shutdown of clinical research for almost 40 years. Encouraged by positive results, clinicians and patients are now hopeful that further interruptions to research will be avoided, so that the early promise of these therapies might be fulfilled. At this early stage of renewed interest, researchers are understandably focusing more on clinical trials to investigate safety and efficacy, than on longer-term goals such as progression to community practice. Looking to identify and avoid potential pitfalls on the path to community clinics, the authors, a group of Australian clinicians and researchers, met to discuss possible obstacles. Five broad categories of challenge were identified: 1) inherent risks; 2) poor clinical practice; 3) inadequate infrastructure; 4) problematic perceptions; and 5) divisive relationships and fractionation of the field. Our analysis led us to propose some strategies, including public sector support of research and training to establish best practice and optimize translation, and funding to address issues of equitable access to treatment. Above all, we believe that strategic planning and professional cohesion will be crucial for success. Accordingly, our key recommendation is the establishment of a multidisciplinary advisory body, broadly endorsed and representing all major stakeholders, to guide policy and implementation of psychedelic-assisted therapies in Australia. Although these challenges and strategies are framed within the Australian context, we sense that they may generalize to other parts of the world. Wherever they apply, we believe that anticipation of potential difficulties, and creative responses to address them, will be important to avoid roadblocks in the future and keep the “psychedelic renaissance” on track.
Highlights
Half a century after a range of sociopolitical factors rendered psychedelic clinical research and practice untenable, a widely touted “psychedelic renaissance” is well-underway [1, 2]
Recognizing that the step toward implementation of innovative approaches is translation, we look beyond research to anticipate potential issues and possible solutions in moving from clinical trials to community clinics
They can open an individual to strong emotions - among them fear, rage, joy, sorrow, and shame - commonly experienced during psychedelic therapy sessions, along with vivid visual images, deep memories, and powerful insights
Summary
Half a century after a range of sociopolitical factors rendered psychedelic clinical research and practice untenable, a widely touted “psychedelic renaissance” is well-underway [1, 2]. Frustration and pent-up demand for effective therapies are expressed through disappointment, even rage, upon exclusion from clinical trials based on criteria that some clearly regard as being overly conservative Countering this is a strong argument that research needs to be completed [33], and many therapists will need to be trained before community needs, let alone expectations, are met. Differences have already emerged between those pushing for rapid regulatory change and clinical rollout based on limited, even anecdotal, evidence, and those who favor a more measured approach informed by research [33] Another division has emerged between the psychotherapeutic and pharmacotherapeutic models of mental health treatment. The first step toward ensuring a patient-centered future is a commitment to Open Science and transparent translation pathways [3]
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