The findings highlight the value of qualitative research in the psychopharmacological investigation of psychedelics. They describe perceived connections between drug- and non-drug factors, and provide suggestions for future research trial design and clinical applications.

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This commentary considers efforts to turn psychedelics into medications that can be administered through healthcare systems as examples of “medicalization.” I draw on ethnographic research both inside and outside of university-based clinical trials from 2014 to date, together with analogous examples from psychiatry and drug research and development. Rather than taking a normative stance on medicalization, I situate it in a wider political, economic, and cultural context to better understand its logics and effects. I begin by suggesting the resurgence of psychedelic science has been concerned with medicalization from the outset, recently prompting a crisis in the “psychedelics community” over its self-identity and values. Next, against the confident public messaging surrounding psychedelics, I consider how attempts to scale up and market psychedelic-assisted therapy could end up undermining the safety and efficacy of the therapy itself. I then outline the movements to decriminalize, legalize, and minimize the harms and risks of using psychedelics in their currently illicit therapeutic and recreational modalities. Finally, I explore how working toward psychedelic medicalization over the coming years may influence the movements toward decriminalizing and legalizing psychedelics use, focusing on the underarticulated ways in which medicalization may disregard or even hinder, rather than help, decriminalization and legalization efforts. I call attention to how the cost of gaining approval for therapies incentivizes the development of diluted-yet-profitable forms of psychedelic-assisted treatments, and how frameworks developed for “proper use” demarcate what counts as “abuse” and enable those with newly sanctioned access to psychedelics to condemn afresh their illicit use.

The recent renaissance of psychedelic science has reignited interest in the similarity of drug-induced experiences to those more commonly observed in psychiatric contexts such as the schizophrenia-spectrum. This report from a multidisciplinary working group of the International Consortium on Hallucinations Research (ICHR) addresses this issue, putting special emphasis on hallucinatory experiences. We review evidence collected at different scales of understanding, from pharmacology to brain-imaging, phenomenology and anthropology, highlighting similarities and differences between hallucinations under psychedelics and in the schizophrenia-spectrum disorders. Finally, we attempt to integrate these findings using computational approaches and conclude with recommendations for future research.