Are Clinicians Prepared to Counsel Patients About Psychedelics?

Psychedelic research is in a renaissance, said Gus Alva, MD, as work that began in the middle of the last century draws renewed attention.¹ The transformative potential of these agents made the field compelling, and Alva noted that researchers are actively working on further elucidating the validity of psychedelics. Reactions to the field ranged from concern to hope, with some clinicians approaching it with caution and others with optimism. Alva noted that any patient who wanted to potentially benefit from a psychedelic required that the terrain be fully vetted for safety and tolerability.²

Attitudes toward psychedelics were often shaped by the era in which clinicians were educated, Alva said. He added that outside societal influences had created a tenor around the field through misinformation implying that problems would be encountered by everyone who tried a psychedelic, which was not accurate. Such early messaging could unconsciously suggest whether a given agent was worth pursuing, even when the question was one of evidence rather than perception.

Evidence should be the standard applied to psychedelics, as it is with any treatment, Alva emphasized. “In the space of medicine, we need to have good evidence as to whether something is safe, whether it works or doesn't,” he said. Whether an agent was safe and whether it worked were separate questions that each required answers. He summarized that psychedelics remain a field in which clinicians needed to learn more, stay up to date, and understand the data before forming a position.

Patients will continue to ask questions about psychedelics regardless of a clinician's stance, according to Alva. “We need to be educated as to how to best advise patients regarding their options and whether we feel positive or negative about it,” he said. Remaining informed was therefore important for clinicians, whether their views of these agents were positive or negative, because patient questions would arise either way.

Dr Alva is a board-certified psychiatrist and the Mood Disorders Section Editor for Psychiatric Times.

References

1. Nutt D. Psychedelic drugs—a new era in psychiatry? Dialogues Clin Neurosci. 2019;21(2):139-147.

2. Hinkle JT, Graziosi M, Nayak SM, Yaden DB. Adverse events in studies of classic psychedelics: a systematic review and meta-analysis. JAMA Psychiatry. 2024;81(12):1225-1235.