Therapy and medication are currently the most powerful tools we have to treat mental health conditions like post-traumatic stress disorder (PTSD), depression, and anxiety, among so many others. But for some people—especially those who do not respond to these conventional treatments—researchers are discovering a promising new pathway to transformative mental health care: psychedelic therapy.
This isn’t the free-for-all glory days of Woodstock psychedelics that you might be imagining. We’re specifically talking about psychedelic-assisted therapy, which is practiced under the careful guidance of a trained clinician, who administers a controlled amount of a psychoactive substance to induce a person into an altered state of consciousness. In theory, this type of therapy encourages you to mentally explore the underlying roots of certain mental health issues.1
It’s important to understand which drugs fall under the psychedelic umbrella: lysergic acid diethylamide (LSD, a synthetic chemical with hallucinogenic properties),2 psilocybin (the psychoactive compound in magic mushrooms),3 3,4-methylenedioxymethamphetamine (MDMA, often referred to as ecstasy or molly),4 and ayahuasca (a mind-bending brew made from specific plants, which originated from Indigenous people in the Amazon Basin).5 Because these are Schedule I drugs in the U.S., they are illegal at federal level due to their high potential for misuse and dependence, as well as having no accepted medical uses currently.
Then there’s ketamine, a Schedule III substance that is not typically seen as a genuine psychedelic. Instead it is viewed as a “dissociative anesthetic.” Currently, ketamine is the only substance with psychedelic properties with legalized, medically-accepted uses in the U.S.6
Psilocybin is also on the path to legalization for therapeutic use, at least in Oregon, where it has already been decriminalized. Practically, that means the Oregon Health Authority will be responsible for licensing and regulating the manufacturing and sales of psilocybin products, as well as creating the country’s “first regulatory framework for psilocybin services” by January 2023.
The type of research experts have been able to do with these drugs has historically been limited—but significant strides are being made. In new and ongoing clinical trials, these substances have shown promise in treating everything from PTSD7 to treatment-resistant depression8 to substance use disorders.9
Generally, in the future, once these drugs are approved by the U.S. Food and Drug Administration (FDA) for specific mental health conditions, psychedelic-assisted therapy might be considered when other largely effective treatments haven’t worked well for a person.
“We are entering a period where we can do expanded access treatment or compassionate use,” Monnica Williams, PhD, a clinical psychologist and training director of the Behavioral Wellness Clinic in Tolland, Connecticut, and a leader in the field of psychedelic science who has published over 100 peer-reviewed articles, tells SELF. “That’s when a drug is made available in advance of final approvals to people for whom nothing else has worked.” (We’ll dive more into this below.)
The experts SELF spoke with estimate it could take between 4 to 10 years for these drugs to receive FDA approval. But you shouldn’t let that timeline discourage you. Here’s everything you need to know about exploring this type of therapy right now.
What’s the safest way to access psychedelic-assisted therapy?
There are still a lot of hoops to jump through, but you have some options.
1. Ask your doctor if ketamine may be right for you.
Ketamine is an injectable anesthetic that has traditionally been used for short-term sedation and anesthesia. But due to its dissociative and hallucinogenic effects, it’s been lumped in with other exploratory psychedelic research in the mental health space.