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Hallucinogen Restriction and Promise

Psychedelics have a history of representing liberal, anti-war, and anti-authoritarian social

change in the United States and elsewhere (Gearing & Devenot, 2021; Manzano, 2018). It is no

secret that the War on Drugs that followed the 1960’s “hippie” counterculture, President

Kennedy’s assassination, and the Vietnam War resulted in substantial racial and gender

disparities (Kalmbach, 2021). Hallucinogen use was heavily integrated into the countercultural

movement of the 1960’s which emphasized love, connectedness, freedom, and peace. Though

advertised as being motivated by public health concerns (Kalmbach, 2021), there were almost

certainly political motivations to the War on Drugs (Begun, 2019; LoBianco, 2016). The impacts

of this on women and people of color have been profound, leading to mass incarceration in the

United States, a punitive approach to addiction, and lasting stigmatization of minority

communities (Kalmbach, 2021; Begun, 2019; Earp et al., 2021). Government officials have

reportedly admitted to maliciously integrating substances into communities they had deemed as

“enemies” and proceeding to criminalize them heavily as part of an intentional political assault

(LoBianco, 2016). Hallucinogens may have been seen as a threat to the status quo due to the

mystical and spiritual experiences they promote and their role within the counterculture

movements, likely contributing to their Schedule I status assignment under the Controlled

Substances Act of 1970. This scheduling and negative governmental prerogative regarding

psychedelics resulted in nearly all research and clinical trials halting for decades. We still feel the

effects of these restrictions today, with limited access to legitimate substances and funding for

hallucinogen research remaining sparse (Garcia-Romeu & Richards, 2018; Bornemann, 2020).

Despite these restrictions, there has been a renewed interest in hallucinogen research, and

many psychedelic substances from these modern studies have shown considerable promise in the
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treatment of ailments such as posttraumatic stress disorder [PTSD], treatment-resistant

depression, anxiety disorders, substance use, and end-of-life stress (Garcia-Romeu & Richards,

2018). Contemporary studies have examined the role that substances such as psilocybin can play

in assisting traditional psychotherapy, reducing suicidality, promoting happiness and quality of

life, encouraging cessation of substance abuse, improvements in standard and treatment-resistant

depressive disorders, decreasing physiological concerns such as chronic pain and migraines, and

improving productivity and cognitive efficacy (Altman et al., 2022; Garcia-Romeu & Richards,

2018; Bornemann, 2020; Griffiths & Grob, 2010). Lifetime hallucinogen use has even been

shown to be linked to decreased recidivism, lower odds of arrest, and decreased likelihood of

intimate partner violence, even when controlling for antisocial personality traits, ethnicity, and

symptoms of alcohol dependence (Walsh et al., 2016). 3,4-Methylenedioxymethamphetamine

[MDMA] as a possible treatment for PTSD is currently in Phase 3 clinical trials, anticipated to

be available to non-research patients as early as 2023 (Garcia-Romeu & Richards, 2018).

Though their previous reputation as dangerous and unpredictable may have been

unwarranted (Dyck & Elcock, 2020), they are not free from contraindication or risk. Though

significant adverse outcomes are relatively rare, one of the more common negative consequences

of hallucinogen use is a so-called “bad trip” where one experiences an intense manifestation of a

negative or painful emotion (Garcia-Romeu & Richards, 2018; Bornemann, 2020). Bad trips can

occur in controlled or uncontrolled environments and feelings can include things like confusion,

isolation, fear, anxiety, panic, grief, or even physical discomfort. It is worth noting, however, that

while bad trips are often cited as challenging experiences (Smith & Appelbaum, 2021), it is

frequently possible to reframe them in subsequent therapy sessions to still deduce constructive

meaning (Garcia-Romeu & Richards, 2018; Dyck & Elcock, 2020). Other negative consequences
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may include headaches, increased anxiety, panic attacks, flashbacks, insomnia, and increased

heart rate (Bornemann, 2020). It is noteworthy that one study by Anderson et al. (2019) pointed

out that nearly every experience that participants listed as a positive consequence was also listed

as a negative consequence for others. This emphasizes the criticality of proper preparation, a

comfortable environment, and feelings of safety for minimizing the risk of negative experiences

(Trope et al., 2019; Garcia-Romeu & Richards, 2018; Vargas-Perez et al., 2022).

Epidemiological Overview

Prevalence and Demographics

Classic psychedelics (such as psilocybin, lysergic acid diethylamide [LSD], ayahuasca,

N,N-dimethyltryptamine [DMT], and mescaline) are reported to be used by approximately

13.5% of United States adults in their lifetimes (Simonsson et al., 2021). This rate may be on the

rise, as Yockey et al. (2020) found that the lifetime prevalence of LSD use in US adults has

increased in recent years from 0.55% in 2015 to 0.86% in 2018. Though some studies vary, the

literature generally indicates that psychedelic users are White, male, and relatively young

(Simonsson et al., 2021). Microdosing, or the act of taking smaller doses of a psychedelic

substance on a frequent and scheduled basis, appears to be relatively common with

approximately 13% of surveyed adults indicating that they have microdosed at some point in

their lives (Cameron et al., 2020). Microdosing also appears to be more common among veterans

than the general population. Finally, research on therapeutic potential may specifically be over

representative of individuals with disabilities, as much of the recent literature has explored

populations with chronic illnesses such as cancer, treatment-resistant mental illness, end-of-life

anxiety, acute PTSD, and obsessive-compulsive disorder. Demographic numbers in research may

be skewed due to substance illegality, limited availability of research, and sampling bias.
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Vulnerable Groups

Estimates of arrest and incarceration rates specifically related to psychedelic drug use are

difficult to obtain. However, 45.3% of current inmates in the United States are incarcerated on

drug-related charges (Federal Bureau of Prisons, 2022). It is also estimated that 14% of overall

arrests are for drug-related crimes, and recidivism rates for drug offenders are quite high at an

estimated 76.9% (Hendricks et al., 2018). Black Americans are more likely to suffer in these

scenarios, as they are more likely to be arrested and incarcerated for drug-related issues (despite

using at rates similar to those of White offenders), receive harsher punishments than comparable

White offenders, and face longer sentences (Hinton & Reed, 2018; George et al., 2019). Clearly,

the weight of the nation’s War on Drugs falls disproportionately upon minority Americans,

specifically Black Americans.

Americans with disabilities may also be disproportionately affected by the

criminalization of psychedelics. As previously discussed, there is significant promise for

hallucinogens in the treatment of a variety of chronic health issues that could be cause for

receiving disability compensation. Legislation and lack of financial incentive for pharmaceutical

companies to engage in studies prevents effective and timely research for these potential

treatment options, and Americans with these chronic health issues continue to suffer as they wait.

Traditional treatments for many of these conditions are either subpar or fraught with their own

side effects (Altman et al., 2022; Bornemann, 2020). The tight restrictions on these substances,

lack of avenues for research, and lack of financial motivation to study and employ their use

suggests that it will be some time before many of these substances are viable as treatment

options. From this perspective, the public also suffers in that the employment of less effective

treatment options means that individuals remain sicker for longer, thereby increasing demand on
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the country’s healthcare system, keeping individuals on disability benefits for longer periods of

time, and reducing their ability to contribute productively to society.

Institutions Involved and How Regulation has Changed Over Time

Psychedelics are tightly controlled, but many different systems work to address the

regulation of hallucinogens. Government bodies may have the most influence, as agencies such

as the National Institute of Health and the Centers for Disease Control and Prevention offer

much of the grant money that funds drug research. The Drug Enforcement Administration [DEA]

sets the national tone for enforcement of substance laws. Approval for clinical use of

psychedelics must be given by the Food and Drug Administration [FDA]. Legislation, too,

defines behaviors that constitute substance crimes and instructs local law enforcement and judges

in how to enforce and sentence offenders. Collectively, these governmental bodies have worked

together to limit the availability of legitimate substances for research, limit the quality and

quantity of research being conducted, impose narratives indicating that psychedelics are so

dangerous that the only solution for safety is complete embargo, to brand substance use and

abuse as a moral failure, and to heavily police and punish those involved in drug-related offenses

(Gearing & Devenot, 2021; Blainey, 2015).

Progressive steps have, however, been taken in recent years to promote drug-related

justice. The research resurgence itself is evidence that the first steps for progress have been

taken. Stated previously, MDMA is in Phase 3 clinical trials for the treatment of PTSD. The

FDA has recently granted “breakthrough” status to psilocybin trials for the treatment of

depression, allowing research in this area to move more quickly. Positive information is now

presented in addition to negative information regarding psychedelics from the National Institute

on Drug Abuse (U.S. Department of Health and Human Services, 2020). Several state and local
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jurisdictions have already decriminalized the possession of hallucinogens, such as: the state of

Oregon; Denver, Colorado; Oakland, California; Ann Arbor, Michigan; and Cambridge,

Massachusetts (Smith & Appelbaum, 2021). Therapeutic use of psilocybin has been fully

legalized in Oregon (Roberts, 2020). Finally, beyond the growing movement to legalize

marijuana nationwide (which is sometimes classified as a hallucinogen), even the DEA has taken

steps to make more drug products available for research purposes (DEA, 2020).

Consequences of the Problem

Some prominent issues relating to the illegality of hallucinogens despite their therapeutic

potential have already been discussed, such as the lack of research on how people should be

interacting with psychedelics leading to bad trips and accidents, lack of control surrounding

one’s preparation and environment before consumption, increased demands on several aspects of

society, and the undertreatment of chronic health issues. In addition to these, many individuals

have reported concerns related to the purity of the psychedelic substances they procure due to

their unregulated black-market origins (Bornemann, 2020). Federal funds that are dumped into

the national healthcare system for suboptimal treatment methods are essentially wasted, forcing a

portion of the economy to be permanently allocated to less effective therapies.

Many of these issues may improve if the ability to conduct both hallucinogen-related and

overall Schedule I substance research was expanded. The lack of research on hallucinogens and

Schedule I substances creates a cyclical problem, as the purported danger and lack of medical

benefit of psychedelics has been used to justify artificial caps and unnecessary regulations on the

research that can be performed. Meanwhile, hundreds of thousands of Americans are

incarcerated on overly punitive drug sentences that are difficult to challenge because we do not

have sufficient research to support reclassification or restructuring sentencing policies. Research

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expansion can provide us with the tools and insights we need to find better ways of systemically

handling substance misuse.

It bears repeating that the criminal justice side of this issue is exceptionally noxious. The

incredible percentage of people incarcerated on non-violent drug offenses creates substantial

costs to the American taxpayers; the average state prison cost per inmate in Michigan is $35,809

(Mai & Subramanian, 2016). Incarceration often involves separation of families, thereby raising

issues related to child welfare and custody, perpetuating cycles of childhood trauma and criminal

activity, and potentially eliminating income sources for the family. Negative consequences for

these conditions on the child are likely to permeate into their life at school, increasing the

demand on already overburdened public school systems and their staff.

Policy Suggestions

First and foremost, available dollars for research on Schedule I substances, including

hallucinogens, should be increased and licenses should be made easier to access. This research

can, again, provide guidance on effectively addressing substance abuse and misuse on a societal

level, as well as help justify more appropriate classifications for controlled substances. It is

widely acknowledged that the current scheduling system is applied problematically in many

cases; however, more specific suggestions for a system overhaul and reimagining process are

outside the scope of this paper.

Second, policy changes should be implemented to increase access to and support

developing research for promising medicinal applications of psychedelics, prevent incarceration

for nonviolent drug offenses, and support ex-inmates in the reintegration process to prevent

recidivism. Potential targets for increasing access to promising psychedelics include

rescheduling of MDMA and psilocybin to Schedule IV to reflect their therapeutic potential,

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lifting production restrictions on research substances from the DEA, preventing individuals from

being prosecuted on federal charges when their behavior is within the bounds of local policy,

preventing pharmaceutical companies from patenting psychedelics and thereby capitalizing on

public illness, and passing legislation that reassigns power over drug policies to public health

officials rather than law enforcement (Marks, 2020).

It is possible that experience with hallucinogens is related to decreased recidivism. Given

the exceptionally high rate of recidivism for drug offenses, decriminalization of psychedelics

will certainly contribute to reducing mass incarceration and re-offending rates in the United

States. Reintegration efforts should be expanded to include assisting individuals with securing

housing and employment. Restorative justice elements can also be incorporated into this process

by expunging records of ex-offenders who only have histories of nonviolent drug charges,

ultimately limiting the negative ongoing consequences to individuals related to criminal conduct,

and reallocating saved tax dollars to efforts that service populations harmed by the War on

Drugs. Several benefits can be anticipated from this, including saved tax dollars, increased

employment rates of ex-offenders, drops in recidivism related to employment instability after

release, fewer fathers being absent from their families due to incarceration, and prevention of

separation-related childhood trauma.

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