Psychedelics are part of many cultural traditions both historically and in the present. The recent interest in psychedelics and their potential application in mental health contexts poses several cultural issues that are important to be aware of.
First, the use of psychedelics by Western culture can involve risks of engaging in cultural appropriation, or when a dominant culture takes the practices, customs, or rituals from another culture in a way that is harmful, disrespectful, or exploitative. For example, many Westerners have traveled to other countries to “learn” about the sacred use of psychedelics by some communities in a way that is extractive and leads to problems for those communities. The most famous example of this is Maria Sabina, who was a Mexican curandero who shared her practice of using psilocybin mushrooms with an American who published about his visit in a famous magazine that then led to an influx of tourists coming into the Mexican village he visited. Maria Sabina was ousted from her community and suffered significant personal consequences as a result. Indeed, there are many examples of the destructive consequences of “psychedelic tourism” in communities throughout the world.
Second, the increased interest in psychedelics by more people has resulted in a shortage of plant medicine for many indigenous cultures. In the US, the cactus that is used in peyote ceremonies associated with Native Americans is endangered. The same is true for some plants and vines that are used to make Ayahuasca in South America and the iboga shrub in Africa.
Third, most of the research that has been conducted on psychedelics in the US has involved a lack of diversity in their samples which were mostly white, cisgendered, heterosexual participants. This means that this research has a lack of generalizability in how effective psychedelic-assisted therapy might be in people of color or individuals who identify as LGBTQIA+. Many may be surprised to hear that LSD was once researched as a potential aid for conversion therapy in the 1960’s, a harmful practice that intends to change one’s sexuality, or that LSD was also administered in abusive ways to Black Americans.
Finally, psychedelic-assisted therapy has a serious accessibility problem. First, there will be a high cost associated with these new treatments. In all of the clinical trials, two therapists have been used for all of the sessions, including preparation, dosing, and integration sessions. Since dosing sessions are typically 6-8 hours, you can see why having a licensed provider there for that amount of time is costly. It is also unlikely that insurance will cover psychedelic-assisted therapy, at least initially. As a result, psychedelic-assisted therapy may only be accessible to individuals with resources. This fact replicates all of the current systemic inequities in our healthcare system and once again fails to meet the needs of marginalized communities who also face significant barriers in accessing traditional health care. Portland Integration Network, along with many others, hopes to find solutions to these barriers and make psychedelic-assisted therapy avialable for all individuals.