Psychedelics

The term psychedelic was formally introduced in 1957 to mean “mind manifesting” or “to bring to light,” but the phenomenon of seeking nonordinary states of consciousness has long and diverse roots. Psychedelic substances are associated with plants, fungi, animals, and synthetic substances that can cause changes in consciousness and hallucinations. These substances are found all over the world; some common examples include peyote cacti (containing the alkaloid mescaline), d-lysergic acid diethylamide (LSD, synthesized from ergot fungus), psilocybin “magic” mushrooms, ayahuasca (containing N,N-dimethyltryptamine [DMT]), ibogaine, and 3,4-Methylenedioxymethamphetamine (MDMA, commonly called Ecstasy or Molly). Psychedelics have been part of spiritual and healing ceremonies in many parts of the world for centuries and even millennia, incorporated into Indigenous practices and rituals. Throughout the twentieth century, pharmacologists and psychiatrists sought to examine the therapeutic potential of these “madness-mimicking” substances, also called hallucinogens to emphasize their visual and perceptual effects, believing that they may provide insight into madness or serve as a temporary conscious-expanding opportunity through self-experimentation to gain personal insight into pathological conditions. Psychedelic therapies showed early promise especially in areas of addiction, and in disorders associated with trauma. Despite their potential, researchers struggled to reach a consensus on how psychedelics should be used in therapy, finding instead that psychedelic sessions relied significantly on “set and setting”—a person’s mindset or attitude toward the experience along with its environmental, contextual, and social aspects. These extra-pharmacological factors complicated a more systematized approach to studying psychedelics, such as evaluating them in randomized controlled trials (RCTs), which became a gold standard in pharmacological research in the 1960s. Beyond the psychiatrist’s couch and the secret CIA files of MKULTRA, nonaddictive, consciousness-expanding experiences inspired adventurous and creative types, from philosophers to musicians and artists, and by the late 1960s a psychedelic cultural phenomenon transformed their association from spiritual guides or medicines to recreational drugs and countercultural catalysts. The concept of “psychedelic” itself expanded from a class of pharmacological substances to an idea, an aesthetic, and even an attitude to society and life. In the United States especially, authorities came to associate psychedelics with nonordinary ways of being, in terms of sexuality, communal living, fashion, and increasingly anti-establishment political perspectives. Throughout the 1960s, several political jurisdictions criminalized psychedelics, and in 1971 the United Nations introduced a new set of drug schedules that classified psychedelics in Schedule I: substances with a high potential for harm or addiction with no medical value. In the twenty-first century, researchers across clinical and cultural disciplines have questioned the categorization of psychedelics in Schedule I. Dubbed a “psychedelic renaissance,” researchers and civilians alike continue to insist that these substances warrant a retrial. The retrial is largely being narrated in biomedical publications, which is the scope of this entry.