Whitewashing psychedelics: racial equity in the emerging field of psychedelic-assisted mental health research and treatment

Thrul, Johannes; Garcia-Romeu, Albert

doi:10.1080/09687637.2021.1897331

Cited by 38 publications

(19 citation statements)

References 30 publications

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“…As underscored by the previously mentioned moving accounts of psychedelic-assisted therapy, culturally relevant therapy is necessary for success ( 121 ). Ethically, only culturally competent practitioners should administer psychedelic compounds, particularly to Black patients who have inevitably experienced some racial trauma by virtue of living in racialized societies.…”

Section: Challenges Around Inclusive Training: a Post-hoc Case Studymentioning

confidence: 99%

The Need for Psychedelic-Assisted Therapy in the Black Community and the Burdens of Its Provision

Smith

Faber²,

Buchanan

et al. 2022

Front. Psychiatry

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Psychedelic medicine is an emerging field that examines entheogens, psychoactive substances that produce non-ordinary states of consciousness (NOSC). 3,4-methylenedioxymethamphetamine (MDMA) is currently in phase-3 FDA clinical trials in the United States (US) and Canada to treat the symptoms of posttraumatic stress disorder (PTSD). MDMA is used in conjunction with manualized therapy, because of its effectiveness in reducing fear-driven stimuli that contribute to trauma and anxiety symptoms. In 2017, the FDA designated MDMA as a “breakthrough therapy,” signaling that it has advantages in safety, efficacy, and compliance over available medication for the treatment of trauma-, stress-, and anxiety-related disorders such as PTSD. In the US and Canada, historical and contemporary racial mistreatment is frequently experienced by Black people via a variety of macro and micro insults. Such experiences trigger physiological responses of anxiety and fear, which are associated with chronically elevated stress hormone levels (e.g., cortisol and epinephrine), similar to levels documented among those diagnosed with an anxiety disorder. This paper will explore the benefits of entheogens within psychedelic assisted-therapy and their potential benefits in addressing the sequelae of pervasive and frequent negative race-based experiences and promoting healing and thriving among Black, Indigenous and other People of Color (BIPOC). The author(s) discuss the ethical responsibility for providing psychedelic-assisted therapy within a culturally competent provider framework and the importance of psychedelic researchers to recruit and retain BIPOC populations in research and clinical training.

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Section: Challenges Around Inclusive Training: a Post-hoc Case Studymentioning

confidence: 99%

The Need for Psychedelic-Assisted Therapy in the Black Community and the Burdens of Its Provision

Smith

Faber²,

Buchanan

et al. 2022

Front. Psychiatry

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show abstract

“…Unfortunately, these intensive approaches may render classic psychedelic therapies impractical for broader use within psychiatry. Indeed, it has been noted that the intensive nature of classic psychedelic therapies will almost surely render them expensive and difficult to access, especially for those living with economic disadvantage (Thrul and Garcia-Romeu, 2021). Scalable approaches that maximize patient safety and support are needed to make classic psychedelic drug therapy a more practical and affordable therapeutic alternative.…”

Section: Introductionmentioning

confidence: 99%

Safety, tolerability, pharmacokinetics, and subjective effects of 50, 75, and 100 µg LSD in healthy participants within a novel intervention paradigm: A proof-of-concept study

Family¹,

Hendricks

Williams³

et al. 2022

J Psychopharmacol

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Background: Classic psychedelics hold promise as therapeutics for psychiatric disorders, but require scalable intervention protocols. This proof-of-concept study evaluated the safety, tolerability, pharmacokinetics, and subjective effects of 50, 75, and 100 µg lysergic acid diethylamide (LSD) in healthy adults within a novel intervention paradigm. Methods: Up to three participants were administered LSD on the same day in separate rooms, each with a single attendant, after 1 day of preparation. An open-label design and a double-blind placebo-controlled design were used. Results: Ninety-one percent of participants completed the study. Thirty-two adults (mean age = 28.8 years) received 50 (n = 3), 75 (n = 7), 100 (n = 3) LSD, 50 µg followed by 75 µg LSD (n = 9) 1 week apart, or placebo followed by a 75 µg LSD (n = 10) 1 week apart. There were no serious adverse events. Twenty-eight percent of participants experienced at least one expected mild adverse event, with one expected moderate adverse event. The maximum blood plasma levels occurred between 1.2 and 2 h post-administration, with an apparent half-life between 2.8 and 4.3 h. LSD largely induced greater subjective effects versus placebo. Conclusion: In the current novel intervention paradigm, 50, 75, and 100 µg LSD are tolerable with favourable safety profiles in healthy adults, only mild adverse events during the day of drug administration, and mystical-type subjective experiences. Future studies are needed to evaluate safety, tolerability, subjective effects, and cost-effectiveness in clinical populations.

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“…Unfortunately, the intensive nature of these practices raises concerns about their implementation in the real world, where affordability is vital (Cairns, 2016). Indeed, just as esketamine has faced barriers to adoption secondary to its resource intensiveness (Wilkinson et al, 2019), it has been noted that the intensive nature of classic psychedelic therapies will almost surely render them expensive and difficult to access, especially for those living with economic disadvantage (Thrul and Garcia-Romeu, 2021). More scalable approaches are essential to allow for broad accessibility to LSD-assisted psychotherapy as an affordable treatment modality.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide in healthy participants within a novel intervention paradigm: Qualitative results from a proof-of-concept study

Hendricks

Copes

Family³

et al. 2022

J Psychopharmacol

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Background: Classic psychedelics show promise in the treatment of mental health conditions; however, more scalable intervention protocols are needed to maximize access to these novel therapeutics. In this proof-of-concept study, perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide (LSD) were evaluated among healthy participants ( N = 31) administered 50 to 100 µg LSD in a treatment paradigm conceptualized as more scalable than traditional approaches to administering classic psychedelics. Methods: Semi-structured interviews assessed participants’ expectations, experience, and thoughts on the safety and efficacy of the study design. These interviews were transcribed for thematic analysis relating to perceptions of safety, subjective effects, and beliefs about the clinical utility of LSD. Results: Most participants felt safe throughout the study, with a minority reporting concerns related to having a challenging experience that diminished over time. Participants attributed their feelings of safety to the study structure and support of their attendants, which allowed them to “let go” and immerse themselves in the experience without pre-occupation. Furthermore, participants reported transcendent, mystical-type experiences characteristic of classic psychedelics, with almost half highlighting the prominent role played by music during the acute period of drug action. Finally, participants endorsed support for the clinical utility of LSD in controlled environments, expressing the belief that LSD is safe and has the potential to help others. Conclusion: Findings provide preliminary support for the feasibility of this scalable interventional paradigm and set the stage for future critical research with clinical populations.

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Whitewashing psychedelics: racial equity in the emerging field of psychedelic-assisted mental health research and treatment

Cited by 38 publications

References 30 publications

The Need for Psychedelic-Assisted Therapy in the Black Community and the Burdens of Its Provision

The Need for Psychedelic-Assisted Therapy in the Black Community and the Burdens of Its Provision

Safety, tolerability, pharmacokinetics, and subjective effects of 50, 75, and 100 µg LSD in healthy participants within a novel intervention paradigm: A proof-of-concept study

Perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide in healthy participants within a novel intervention paradigm: Qualitative results from a proof-of-concept study

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