A lot happened last year in psychedelics, and 2023 promises to be even more eventful. With all that activity, what matters most? For insight Lucid News turned to Bob Jesse, who has long been a quiet, guiding force behind what he calls the “contemporary psychedelic re-emergence;” he’d prefer not to use the word “renaissance.” Jesse helped form the psilocybin research team at Johns Hopkins and has co-authored numerous influential papers in the field. We wondered what he thinks are the most important developments to watch for in the months ahead.
Surveying the landscape, Jesse noted that FDA trials for approval of MDMA and psychedelic medicines are progressing along a well-marked track, and should pave the way for insurance coverage for FDA-approved uses. “So it’s the non-FDA routes we need to watch most carefully,” he emailed. “With ballot and legislative initiatives [e.g., Oregon and Colorado] what expectations are being set? Word is getting out about the potential upsides of psychedelic use, but what about the risks? Some people don’t respond favorably, and occasionally the outcomes are negative. A few will have very bad outcomes. Our culture has developed intuitive understandings of activities that carry risks, like riding a bike, driving, and rock climbing. They’re usually quite safe — except when they aren’t. Western culture doesn’t yet have that kind of understanding, including risks and risk reduction, of psychedelics. We’re in an adolescent stage at most.”
Then he made a point that resonated with this psychedelic journalist: “There’s a key role for the media to play in educating about the full range of possible outcomes and contextualizing the negative ones.”
Who’s paying? Jesse also raised another challenge: will we have affordable and culturally attuned access to psychedelics in the states where legalization is being pioneered? Addressing cost, he suggested, “It may be that group-based models could serve many people, at low cost and with lasting returns in the form of community that’s not dollar-denominated. Indigenous traditions provide examples, and you can find other group-use examples in today’s underground.”
It remains to be seen, though, what form group experiences will take as restrictions ease in Oregon, as well as cities that have enacted decrim legislation. As Jesse reminds us, “groups and leaders, in the absence of adequate safeguards, can and do go off the rails. It takes wisdom and effort to prevent that.”
New research. Turning to the science, Jesse pointed to the confirmed success of MAPS’ recently completed second Phase 3 trial of MDMA-assisted therapy for PTSD as a milestone that will resonate into the new year. He hopes that Usona Institute will continue the positive trend when it publishes the results of its multisite trial of psilocybin therapy for depression.
Jesse is also looking forward to the release of another much anticipated report: “This year will see publication of a controlled study conducted at Johns Hopkins and NYU, in which religious leaders of various traditions were given high-dose psilocybin sessions and asked to report their experiences through the lens of their tradition.”
Religious use. Regarding the state sanctioned use of psychedelics by religious groups, Jesse notes that “the historical and scientific evidence is overwhelming that entheogens, used appropriately, often occasion experiences that people describe as profoundly ‘spiritual’ or ‘religious’ (both of these terms are hard to pin down). Government and the culture will need to reckon with that, whether through decrim or religious-use exemptions.”
But he expects this process will take time. “Religion, even without the entheogens, is all over the map with respect to immaturity versus maturity, corruption versus integrity, abuse versus care-giving, tribalism versus inclusion, and so on. Add entheogens and we’re likely to get more of all of the above. My hope is that things will trend positively over the long run. A promising sign is the Sacred Plant Alliance, a new self-regulating consortium of entheogenic communities.”
Inviting policy wonks. As a closing thought, Jesse suggested that the current psychedelic discussion would benefit from the rigorous policy analysis of the kind typical for established fields, like real estate and education. Considering the societal transformation that psychedelic mainstreaming could lead to, the topic is certainly worthy of informed investigation.
Jesse explains that “true policy analysis doesn’t start with a targeted outcome. Instead, it builds what-if models, based on best available evidence. It presents options and describes their likely consequences.”
Maybe this will be the year when seasoned analysts bring their expertise to modeling potential outcomes? “If one or more of the top policy think tanks addresses psychedelics, their reports would be taken seriously in legislatures,” Jesse notes.