Rebroadcast: Psychedelics and who should be able to use them

Sign up for the On Point newsletter here.  This rebroadcast originally aired on Jan. 6, 2023.

In the 1960s, tensions rose over who should have access to psychedelics.

There were advocates who thought everyone should be able to use psychedelics. There were also researchers who thought psychedelics should stay in the lab.

But when psychedelic drugs were banned by federal law in 1970, it ended the debate over who should have access to them.

Now, psychedelics are back. They’re growing in popularity, and the tensions around access, money and research are back, too.

Today, On Point: Psychedelics and who should be able to use them.

Amy Lynn McGuire, professor of biomedical ethics. Director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine.

Sandor Iron Rope, board member of the Indigenous Peyote Conservation Initiative, president of the Native American Church of South Dakota.

Brom Rector, founder of Empath Ventures, a venture capital fund that invests in psychedelics.

Brian Pilecki, clinical psychologist based in Oregon, psilocybin facilitator in-training.

Melissa Lavasani, CEO of Psychedelic Medicine Coalition, chairwoman of Decriminalize Nature D.C.

Part I

TIMOTHY LEARY [Tape]: Turn on. Tune in. Drop out.

MEGHNA CHAKRABARTI: By the time Timothy Leary uttered those famous words in San Francisco in 1967, the former Harvard psychology professor was already well known as the “high priest” of the psychedelics movement.

Leary, and the rapid expansion in the popularity of psychedelic drugs, had captured the world’s attention by the mid 1960s.

In this moment from a British documentary series called “World Tomorrow,” Leary describes an LSD trip. He’s seated, cross legged on the floor, as a child wearing beads toddles by.

LEARY [Tape]: There's a sense of being in communion with powers greater than yourself and intelligence, which far outstrips the human mind and energies which are very ancient. You have a sense of a veil is pulled away, and for the first time you see how things really are. 

CHAKRABARTI: Not everyone was along for the ride. The movement to bring psychedelic drugs to all was met with great resistance from the federal government, of course, which had first secretly, and illegally, experimented with psychedelics in projects such as the CIA’s MKUltra program.

The federal government later pivoted to viewing psychedelics as a threat as their public use spread.

Researchers also expressed serious reservations. Scientists, such as Dr. Stanley Krippner at Maimonides Medical Center in New York believed psychedelics showed strong promise as a treatment for a wide range of conditions — but only under controlled circumstances. He was featured in that 1967 British Documentary “World Tomorrow.”

STANLEY KRIPPNER [Tape]: LSD could be integrated into the general fabric of American society, but we will need additional research to indicate how best this should be done. We want to have research to indicate how it affects the educational process, whether or not it should be used in schools, universities and colleges. We will need research to indicate what types of mental illness it's most effective for. 

But the controlled, meticulous roll out of psychedelics research was not what Leary and others had in mind when they envisioned integrating the drugs into American life. In 1966, Leary appeared on the Merv Griffin show. He told Griffin he’d already taken LSD 311 times - and predicted one day, you would too.

LEARY [Tape]: And I'll say to your viewers, within ten or 15 years, psycho chemicals which expand consciousness and accelerate the mind and open up the wisdom that's inside will be just as common as books are today. When your kid comes home from school, you won't say to him, What book did you read today?

You'll say, Which molecule did you use to open up? Which Smithsonian Institute or which Library of Congress existence as your mind? I know that sounds far out, but everything, every new advance in science just seems impossibly. How can you use drugs to open up your mind as an educational tool?  

CHAKRABARTI: Enter, President Richard Nixon.

PRES. NIXON [Tape]: America's public enemy number one in the United States is drug abuse. 

CHAKRABARTI: June 17, 1971, Nixon announced the federal government’s hundred-million-dollar war on drugs abroad … and at home. His administration passed the Controlled Substances Act, which included making all psychedelics a schedule one drug – making them both illegal, and effectively banning all research using the drugs.

And that would be it. For almost 50 years. Scientists who wanted psychedelics to stay in the lab, and Timothy Leary, who wanted the drugs out in the world … both shut down to the enforcement power of the federal government.

Well, a half century later, the times, they are a changin'.

NEWSCAST: When it comes to psilocybin in Oregon you could call us trailblazers, or guinea pigs or maybe both. The beaver state has the nation's first regulatory framework for legal psilocybin services. And that's thanks to Measure 109 that was passed by voters back in 2020 with 55% of the vote.

CHAKRABARTI: The movement to decriminalize psilocybin, or magic mushrooms, began in the last decades and several cities have decriminalized its use. And on January 1st of this year, Oregon became the first state to allow adult use of psilocybin. And those psychedelics remain Schedule 1 drugs. In 2014, a group at Johns Hopkins University was the first in the country to obtain regulatory approval to conduct psychedelic research on healthy volunteers.

And since then, other research groups have also received federal approval. So that brings back to mind those tensions from the 1960s. The divide between people who want psychedelics for all, and scientists who believe in restrained use only in the lab. Will we relive those tensions? Or could things get even more complex? Because in the 21st century, when legalization is on the horizon, big money investors aren't far behind.

How could they influence the renewed use and slow spread of psychedelic drugs? That's what we're going to be talking about today. And we're joined by Amy Lynn McGuire. She's a professor of biomedical ethics and director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine.

She joins us from Houston, Texas. Professor McGuire, welcome to On Point.

AMY LYNN McGUIRE: Hi, thank you so much for having me.

CHAKRABARTI: I first wonder if you might describe what precipitated this resurgence in both the public and scientific interest in psychedelics about a decade or so ago.

McGUIRE: Yeah. So as you mentioned, the research use of psychedelics and study of psychedelics really began again in the 1990s. And there have been a couple of groups that have really spent quite a bit of time researching the therapeutic potential of different psychedelics, primarily largely in psilocybin, but other psychedelics as well to treat mental health disorders. pain, cancer, end of life care, things like that.

And in 2017 and 2019, respectively, the FDA actually named both psilocybin and MDMA breakthrough therapies for treatment of both post-traumatic stress disorder and treatment resistant depression.

CHAKRABARTI: So those were, that's a really major change then from the federal government's viewpoint, isn't it?

McGUIRE: It is, I think it's following the early data, the early evidence suggesting that these substances, when used therapeutically, could have really profound impacts on people's lives, people who have been suffering for a very long time with mental health disorders.

CHAKRABARTI: Yeah. We're going to talk about public interest in psychedelic drugs in just a second. But tell me a little bit more about that period in the late '90s, early 2000s, because from my understanding, after psychedelics were made Schedule I drugs, almost all, if not all scientific research into the drugs stopped for decades, right?

But was there a connection between the kind of research that had been done in the '50s and '60s? And the kind of research that was renewed in the late '90s? Was there a connection between those two?

McGUIRE: I think there were still some scientists who were really very committed to trying to study the therapeutic potential. Because remember in the '50s and '60s, the research that was being done, the legitimate research that was being done was really quite promising. And tens of thousands of patients received psychedelics through clinical trials.

There was a lot of research that was done both in the United States and Canada on the treatment of alcoholism and other substance use disorders that showed great promise for the potential of this to really transform people's lives. So they're, it didn't, the interest in that and the enthusiasm about it from a scientific perspective didn't die when these laws passed and there were some committed researchers who were really continuing to try to do the research.

And in the 1990s, the Drug Enforcement Agency loosened its hold and allowed some research to begin. Because they're still Schedule I substances though it's quite difficult to conduct research. And so you have to have certain special licenses and access to the substances.

That has slowed down the progress of research quite a bit. And if the DEA were to loosen its or reschedule these substances, I think it would open up the research field in important ways.

CHAKRABARTI: Reschedule, meaning making it a different level of controlled substance.

McGUIRE: Yeah. So Schedule 1 means that it has a high potential for abuse and no therapeutic potential whatsoever. So the more that the research happens and that there's a building evidence base that there could be some therapeutic potential, I think the harder it becomes to continue to justify these substances being scheduled as Schedule 1 substances. And so they would, the DEA would need to reschedule them as schedule 2, which means that they're more easily accessible for research purposes.

CHAKRABARTI: Do you think that could happen? Because it seems to me to be surprising the rapidity with which both public interest and even public activism, and then research interest in psychedelics has grown in the past 10, 15 years, 20 years maybe.

McGUIRE: Yeah. So there is quite a bit of interest in it. There's a confluence of things that are happening now that I think that make rescheduling these substances much more likely in the near future. So on the one hand, there is a lot of speculation including by the Biden administration that the FDA will approve the first psychedelics for therapeutic use in the coming two years.

Part II

CHAKRABARTI: Professor McGuire, you were saying about how there's speculation that in the next two years, the Biden administration may approve the first legal medication of psychedelic drugs.

Tell me more about that.

McGUIRE: So it wouldn't be the Biden administration approving it, but the Biden administration has come out and speculated that the FDA may approve the first psychedelic drugs within the next couple years. And so they're starting to prepare for that. There's been talk about establishing.

I don't know if it's been established yet, but a federal task force to think through what would be the implications if FDA were to approve a psychedelic for therapeutic use. You were talking about the tensions between the personal nonmedical use of psychedelics and the research or medical use or, research into the medical use of psychedelics that we saw in the 1960s.

And I do think that there's similar parallels that we're seeing now. It's a really complex sort of legal and social environment going on right now.

CHAKRABARTI: Yeah, and that's, there's all different, there's a bunch of different threads within that complex set that I want to explore with you. But before we leave what's happening inside the lab, I just want to check something. Because I've been reading some reactions and papers from the early research again, as you mentioned, into various psychiatric disorders to mental health issues, alcohol use disorder. I believe even there are potential research projects in oncology. So a lot of different areas of interest here, but some folks are saying that the early results are, they're not saying it's miraculous, but they're describing it as ultra promising.

What do you make of that? Is that just like the excitement of being able to do this research again, or is this really could be groundbreaking efforts here?

McGUIRE: So I think there are some really promising early studies, but most of them are early, right? So they're small sample sizes.

They're potentially not super generalizable. We don't know long term effects, those sorts of things. So there has been a lot of discussion of are we over hyping this as we tend to do with new, exciting innovations or is this excitement really justified, and I think it's probably a little bit of both.

I think that the media has become interested in this and as you get media attention related to things, you get big headlines and there tends to be a little bit of overhype of the potential findings that we have right now. But on the other hand, I do think that there are some promising early studies that should really encourage us to continue this research and to make sure that we're building a solid evidence base to really understand how, and when and under what circumstances these substances can be most useful.

So let's switch over to another sort of quadrant of this new world of psychedelics in the United States.

As we mentioned, on January 1st, Oregon became the first state to allow the legal use of psilocybin. So we spoke to Brian Pilecki. He's a clinical psychologist based in Portland, Oregon, and he's training to be a psilocybin facilitator. And he says, psychedelics really blow up the traditional medical model.

And it's important to be intentional when using them for mental health treatment.

BRIAN PILECKI: They don't quite fit in therapy. They don't quite fit in medication or psychiatry. There's a spiritual aspect to them. Psychedelic experiences are very dependent on the set and setting, what you do to prepare a person in the days and weeks leading up to an experience, that matters. How you construct the environment and show up as another person in the room, that matters. How you encourage a client to respond to their experience, whether some challenges came up or something really positive came up. That matters, too.

CHAKRABARTI: Professor McGuire, first of all, what did you think when Oregon voters, actually I should make that clear, it's Oregon voters who first voted to allow legal adult use of psilocybin. What did you think about a statewide change like that?

McGUIRE: Yeah, so I don't think it's very surprising, given our current sort of political environment and what we've seen happen with other controlled substances like cannabis.

And I think this is, psychedelics are the next generation from a legal perspective of what we're seeing with regard to the legalization or decriminalization of cannabis.

CHAKRABARTI: But it still seems cannabis and marijuana advocates had to fight a long and hard road.

Is that a similar battle that's happened for advocates of psychedelics?

McGUIRE: Maybe not quite as openly. I think that things have been happening behind the scenes, but I also think that cannabis laid the foundation that made it easier and more acceptable for psychedelics to go this, go on this path.

CHAKRABARTI: I just wonder what you think of the fact that what states like Oregon, the state, and other local jurisdictions when they have effectively decriminalized psilocybin, what they're saying is that adults can just casually use it. Does that evince an appropriate understanding of what these drugs actually are and what they can do to a person?

McGUIRE: You've uncovered quite a few tensions, right? So there is this tension between sort of the federal government and the gatekeeping role that they have over these sorts of substances. And the states and their desire to act independently in terms of whether they criminalize or decriminalize.

Then there's the tension also between the medical use and the non-medical use. And so Colorado has now also passed an initiative to decriminalize psilocybin. And both Oregon and Colorado are playing with this medical, non medical boundary of, is it going to be acceptable?

And again, this is following in the lead of cannabis where we saw initially medical marijuana laws being passed, where you could use it for medicinal purposes. And then it got expanded to personal use and you have dispensaries that are not for medicinal purposes that people can access through.

So I think we're seeing the same tension playing out, and it raises some concerns primarily from the perspective of people who think they're using this recreationally, but they're really, or claim to be using it recreationally or obtaining it recreationally.

But then using it for medicinal purposes or they're self-diagnosing and self-treating and I think that can, potentially have some safety concerns associated with it if there's not appropriate oversight by a medical professional or somebody else.

CHAKRABARTI: Yeah, you know what's so fascinating to me Professor McGuire is in preparing for today's conversation, I watched that entire 1967 documentary I referenced at the top of the show, "World Tomorrow," where they featured conversations with Allen Ginsberg, Timothy Leary, other researchers and researchers from the '60s.

There's also a totally wild scene in the middle of it. Of a Colorado, speaking of Colorado, of a Colorado mom in 1967 with three children who like was regularly taking LSD every two weeks, in fact, she and her husband. And it was really helping them deal with not only the tensions of their current life, but unresolved things from their past.

But I point this out because she also mentions that her youngest child had gotten ahold of the equivalent of six adult doses of LSD and took it. And was this tiny kid on a trip for half a day. And she seemed okay with it. But it got me thinking, we're seeing, in 2023, there were just a bunch of reports that came out about the rise in children being admitted to hospitals for having taken edibles of cannabis when they shouldn't have.

Do you have thoughts about when these things become more accessible, that it's not just the adults, but we have to also think about other people who might get their hands on it.

McGUIRE: Yeah. So absolutely. That's very concerning. I do think we need to have protections in place and obviously that's true with all pharmacologics, right?

You don't want children getting their hands on any type of substance. And taking a bunch of pills or something like that. But it's interesting that you mentioned that. Because there's actually been a couple of news articles that have come out over the last year or so that have talked about these more mainstream uses of psychedelics even now.

So there was one article that talked about how young mothers are micro-dosing to try to deal with the stressors of having little kids and then there was an article talking about how Silicon Valley companies may be encouraging psilocybin retreats for their employees in order to expand creativity or enhance creativity.

And there's a lot, of course, issues associated with that in terms of the workplace and things like that. But so I think there is some enthusiasm for using these in a more mainstream way. Using these substances to deal with everyday stressors and it does harken back to those stories from the 1960s and raises some similar concerns.

CHAKRABARTI: So microdosing moms and Silicon Valley bros, we're going to come back to that thought a little bit later, a little earlier, you said that there's enthusiasm and hope behind the research potential, the renewed research potential of psychedelics, especially if some of them make their way to actually being FDA approved drugs.

And I would say that part of that enthusiasm also comes from the investment potential of a whole new class of drugs that could be developed. So I'm thinking that they're, just like with cannabis and the supposed green wave of investment, that followed it, will we see, or are we at the beginning of seeing something similar with Psychedelics, Professor McGuire?

McGUIRE: Absolutely. Yeah. There's been some estimates that the U.S. market for psychedelics will reach almost $11 billion by 2027. So there's a ton of potential for companies to invest and make money, and I think people are recognizing that and they're trying to be very creative in the ways in which they can start to position themselves to be leaders in that sector.

CHAKRABARTI: $11 billion in the next four years.

McGUIRE: That's one of the estimates that I've seen in print, so yeah.

CHAKRABARTI: Okay, wow. So that's what makes this sort of 2023 version of those 1960s tension even more interesting to me, right? Because now we have investment dollars, venture capital and a lot of people who see this as a way to make money as part of the picture. And we spoke to one of those folks, Brom Rector. He runs an investment fund called Empath Ventures. He founded it in 2021. And Empath Ventures invests only in businesses related to psychedelics. Their goal is to raise $10 million, and Rector says they're halfway there. And they've invested in 12 companies so far.

BROM RECTOR: Some of those are basically what you might characterize as pharmaceutical companies that happen to be working with psychedelics. These are companies that are trying to get psychedelics that we all know and love approved by the FDA as treatments for things like depression and anxiety and PTSD.

Some of these companies are trying to invent new psychedelic drugs. We invested in a clinic down in Mexico that is using psychedelic therapy to help people break their opiate addiction. We invested in a company that makes music to accompany psychedelic therapy and ketamine therapy. Obviously, we expect to make some kind of positive return.

CHAKRABARTI: And Brom Rector also told us that he believes psychedelics offer way more investment potential than even cannabis.

RECTOR: The world of psychedelic molecules is massive. Rather than betting on the success of a single plant, it's almost like using the investing analogy.

It's almost like psychedelics is a portfolio of different molecules. If it turns out that one of these drugs ends up not being popular, there are still hundreds of other ones that have a chance at becoming adopted broadly.

CHAKRABARTI: So that's Brom Rector who runs an investment fund called Empath Ventures.

Professor McGuire, what impact do you think investors could have on the research and development of the use of psychedelics?

McGUIRE: Huge impact, right? Commercial interest always has a large impact on the way that things evolve because there's a lot of power and there's a lot of motivation when you're dealing with money.

I think it's interesting because there's two potential ways that this could go forward. And this harkens back to that tension between state regulation and legalization, and widespread sort of social distribution of these substances and more controlled clinical trials for therapeutic use.

So the tension there is that the more widely available these substances become, the more difficult it becomes to conduct these controlled clinical trials to better understand their therapeutic potential. Because it's difficult to enroll people into randomized clinical trials, for example, if they can just go to their local dispensary and get access to a drug, as we said earlier.

And that sort of compromises our ability to build a solid evidence base. So the two sort of areas of commercial potential deal with FDA approved drugs and pharmaceuticals, which is a huge market, right? So if you have FDA approved drugs for treatment of mental health disorders, which one in five Americans suffer from now, then that's a huge potential from a therapeutic perspective.

There's also commercial potential associated with more mainstream widespread access through local dispensaries that's nonmedicinal. And it'll be difficult for both of those sectors to develop at the same time for the reasons that I stated before, but I think there's investment in both sides.

CHKRABARTI: Yeah, you were just saying what I was about to add, that there's big money on both sides pushing equally on the research side. We just got 30 seconds before our next break. Those investors don't have a ton of tolerance for super long timelines for new drug development. Do you think that could have an impact on the kind of research or the pressures that the researchers feel who are reentering the world of psychedelics?

McGUIRE: Yeah. It's really expensive to bring a new drug to market, right? And it does typically take quite a long time. So there's a lot of pressure to move things quickly and to make sure you're picking the right targets.

Part III

CHAKRABARTI: Now Professor McGuire, as you well know, there's an extremely important group that we haven't yet discussed or brought into this conversation about the resurgence of use in psychedelics.

And that, of course, are the indigenous peoples of the Americas who have been using psychedelics for thousands of years.

Colonization and extermination ripped away their right to use psychedelics for generations.

On Jan. 1st, the state of Oregon became the first state to allow legal adult use of psilocybin, a.k.a. magic mushrooms. It's only the latest in a big boom in non-medical and investor interest in psychedelics, even though psychedelics remain a Schedule one federal drug.

MEGHNA CHAKRABARTI: There's one group that's been looking on in dismay. The Indigenous peoples of the Americas have been using psychedelics for thousands of years. Colonization and extermination ripped away their right to use psychedelics for generations. Slow change began in the 1970s.

SANDOR IRON ROPE: We were given the American Indian Religious Freedom Act of 1978, 1978. So in 1978, my dad was born in 1928. He passed away in 1977. And he served the United States Army in the Korean conflict. Yet he served the United States Army. He was not free to practice his way of life legally until 1978. Imagine that.

CHAKRABARTI: This is Sandor Iron Rope. He is Lakota and lives in South Dakota. He's the chair of the Native American Church of South Dakota and a founding board member of the Indigenous Peyote Conservation Initiative. Sandor says it took almost 20 more years of advocacy and legal battles for Indigenous peoples to reclaim their right to use the peyote cactus in religious and spiritual ceremonies.

IRON ROPE: And so peyote was given, you know, it was allowed by federal policy In 1994. The amendments to the American Indian Religious Freedom Act of 1994. So when you look at this, this particular it was fought for to be able to utilize it in a way in freedom, the freedom to pray.

CHAKRABARTI: So what does Sandor think about the growing numbers of suburban moms and Silicon Valley tech brothers who are microdosing psilocybin and the investors and researchers who are part of the major resurgence in psychedelics popularity?

IRON ROPE: Peyote is many things. It has many names. ... It is the spiritual cactus, a spiritual herb, a sacrament. It hears, it sees. It's the eyes, the ears of all things. It's your grandma. It's your grandpa. It's everything to many indigenous people. And many indigenous people recognize it as one of the last medicines. You understand that there were a lot of sicknesses that were upon us. And, you know, they brought smallpox. They brought these sicknesses upon us.

And so when these sicknesses come upon us, you know, grandma and grandpa use this body as the healer, you know, And they were all night ceremonies sometimes like for night ceremonies of requesting assistance ... plants to really help heal our people. You have people that want to capitalize on psychedelics by opening up this spiritual portal and not really knowing what's going to happen and these terms that are used, you know, like microdosing ... these terms that come up because of the psychedelic movement or I don't know, they're really unheard of. I mean, okay, how many grams are we going to take?

You know, should we microdose? These babies. ... You know, I look at these researchers and practitioners and they have these credentials, this education behind them, and they're doing research, and there's more research doing here. But I look at them as babies. We've been using this medicine. I've been using this medicine my whole life. What I'd really like to see is the respect for Indigenous people and be the forefront of what is happening here. Because once again the movement is intense, like the colonizers.

And so if we do not want to repeat history and if we want to restore balance, let's start respecting indigenous perspectives. Let's give them a chance to voice them. You know, there are people that practice and use various types of medicines. Let's find out who they are. Let's bring them to the forefront and let's ask them, you know, can we do this? Is there a prior informed consent happening? I doubt it.

CHAKRABARTI: Sandor Iron Rope. He's Lakota, lives in South Dakota and is board member of the Indigenous Peyote Conservation Initiative.

Professor McGuire, first of all, respond to what Sandor Iron Rope said there about the sense that he and other others in the indigenous communities of the United States that have long been using psychedelics, they feel almost as if there's a recolonization going on as psychedelics become more popular once again.

McGUIRE: So first of all, I couldn't agree more with Mr. Iron Rope. And it's interesting, my interest in psychedelics began 30 years ago when I started taking trips down to the Amazon Rainforest of Ecuador, and studying with the Shuar nation and subsequently, the Odawa nation who use ayahuasca, which is another psychedelic plant for their religious, spiritual and medicinal purposes. And so I have great respect for indigenous populations and how they use these substances. And I think what Mr. Iron Rope said, which there's two components to this, right?

There's respect for the indigenous communities. And it's not just respect for them. There is a tremendous amount that we can learn from them. He's absolutely right that there's thousands of years of history, and experience and oral tradition that has been passed down that can be extremely informative to those who are just starting to try to understand how these plants and the properties within these plants work.

So there's respect for the communities, but there's also respect for the substances themselves. And it's important to recognize that in indigenous communities, they have a very different relationship with the plants. He talked about the plants themselves being our grandmother, our ancestors, having spirit, being a portal and they have a very different relationship to the plant.

And so when I've, in more recent years, gone down and studied with different communities in the Amazon, their response when I've talked to them about the Western use of ayahuasca and other psychedelic substances has been very similar. I think you're disrespecting the plant.

I think you're disrespecting the spirit that's sort of part of this whole culture and relationship that we have with these plants. And so I think that's very important to take into consideration.

CHAKRABARTI: And he also talked about the sense that researchers or even those folks who want to advocate more public use aren't, as you said, respecting the cultural intelligence of indigenous communities and asking for their voice or their advice or their guidance.

Do you, in any research project that you know of, are indigenous speech people involved in them?

McGUIRE: We're trying to build a research program that focuses on some of the ethical and policy issues associated with the use of psychedelics. A lot of the current research programs are actually doing research on the potential therapeutic effects.

And I'm not aware of those really actively engaging, although there may be some out there, I'm just not as aware. I will say in our research program that we're trying to build. And the couple of others that I know in my field who are trying to do work in the space, there is an active effort to make sure that there are indigenous voices at the table, and that those are taken into consideration.

CHAKRABARTI: Yeah, it just, it does, I really wanted to get to this part of the conversation because we have to just draw a bright line under the fact that tribal members had to fight, they had to fight and advocate and go to court to reclaim the right to use these psychedelic medicines that they had been using for thousands of years.

And that in a sense, actually, their efforts and especially their legal efforts, helped inform the legal efforts that have come more recently as people are advocating locally to decriminalize psychedelics in local jurisdiction. Is that a fair analysis, Professor McGuire?

McGUIRE: I think that's a fair analysis.

Yeah. And I think, one of the big objections is to what we were just talking about, which is this tremendous commercialization. And the idea that how can you claim intellectual property rights over something that we have been studying and using and living with and been in relationship with for thousands of years.

CHAKRABARTI: There's one more perspective that I want to quickly touch upon here.

And because I've been mentioning local advocacy for decriminalization, or at least allowing adult use of psychedelics. And that has happened in several local jurisdictions before even the state level changes that we've discussed going on in Oregon right now.

So Melissa Lavasani is founder of the Psychedelic Medical Coalition, they're lobbying Congress for better policy around psychedelics, and she found psilocybin and ayahuasca herself as she was suffering from debilitating postpartum depression and she previously led the decriminalized nature movement in Washington, D.C., which successfully pushed a 2020 measure to reduce penalties for some psychedelic plants in the nation's capitol.

MELISSA LAVASANI: I think that people should have the right to put whatever they want in their bodies and they gotta deal with the repercussions of it, positive or negative. In the real world, I think that's a very difficult argument to make.

Because as soon as you get marked with, "Oh, you're decrim people, okay, we'll get back to you when we figure out what to do with cannabis." And even at that point, they don't want to get back. Just like that word itself is really loaded.

CHAKRABARTI: She also says that psychedelic advocates need to strike a delicate balance between pushing for reform and setting realistic goals to get lawmakers on board.

LAVASANI: We have to be sure that we ride the wave, the push and pull that's happening and ensure that what we're promoting, pushing the boundaries just enough that we make lawmakers slightly uncomfortable, but not so uncomfortable that there's this complete backlash. Because I believe that's what's happened with cannabis.

There was so much push-push on cannabis reform instead of thinking practically and incrementally what can we do now so that we can create our champions in Congress for this?

CHAKRABARTI: Professor McGuire, as we round to the last few minutes of today's conversation, how would you describe what the regulatory system around psychedelics currently is?

McGUIRE: So currently the regulatory, you mean what are the current laws around it?

CHAKRABARTI: Yeah, or is it a sensible one? As well.

McGUIRE: I think right now there's a lot of uncertainty from a regulatory perspective. I think there's this moment in time where everybody's what do we do? And nobody really has the answer.

The FDA is considering whether it ought to, but whether there's a sufficient evidence base to move forward with approval of any of these psychedelics. Meanwhile, they're illegal and considered to have no therapeutic benefit as Schedule 1 substances under the Controlled Substances Act.

As we talked about, states are pushing to decriminalize, which still does not make them legal because they're federally illegal under the Controlled Substances Act. We saw with cannabis that there was an active sort of movement from the federal government to say, we're not going to enforce either the FDCA or the Controlled Substances Act against cannabis.

And it's unclear whether they'll do the same thing. So will the federal government come in and in those states in Oregon, for example, and say, "Yeah, you've decriminalized it, but this is still illegal federally. And we're going to come in and enforce that law." So there's a lot of uncertainty with regard to that.

And there's a lot of opportunity right now to develop sensible, evidence-based policy, but we really need to get all of the voices stakeholder voices at the table, including indigenous voices, as we just discussed and make sure that the policies that we're developing make sense.

CHAKRABARTI: In the last minute that we have here, then. Circling back to where we started about those tensions in the '60s between the democratizers of psychedelics, people who wanted to keep it in the lab, and of course the federal government that shut it all down, what do you think is the most important lesson to be learned from that period? I think that I'm a huge proponent of research, and I don't just mean research into the therapeutic potential of psychedelics, but also the kind of research that I do, which is really what are all of the different perspectives?

How do we think about this from a ethically robust, conceptually robust perspective and how can we inform our policies without being, inform policies going forward without being just reactive to things that happen based on extreme cases or extreme news stories.