There are few medical doctors trained in the proper or updated use of therapeutic psychedelics, even as a general course, and most still apply old and out-of-step information about the human body for treating pain and other physical conditions, even as more and more data about psychedelics is accumulating and available.
Patients are beginning to push back on the old and dangerous opioid treatments and other pharmaceuticals to treat depression that have bad side effects. But can doctors – and the schools that teach them – understand the value and importance of the new psychedelics renaissance?
Psychedelic science and medicine are important emerging areas not just in psychiatry but also in neuroscience and pain management. Clinical studies show significant potential for psychedelic-assisted psychotherapy to treat a range of neuropsychiatric conditions.
Doctors in medical schools want this education, according to researchers at Yale. But there are few low-cost, high-quality educational opportunities available.
However, the Yale School of Medicine is attempting to present that educational material, in part as a result of their psychedelic medicine seminar held in the fall of 2020. Researchers note that creating thoughtful, nuanced, and critical educational initiatives on psychedelic medicine is challenging given the controversial history that surrounds the category, as well as the multiplicity of discourses through which the uses of psychedelics can be understood, including:
There are some treatments that likely will be approved for medical use within the next two years. Researchers and clinicians need to have a well-rounded understanding of these substances, including the challenges in studying them and using them in clinical practice, their indigenous origins, and their ethical challenges.
A new structure has been proposed to deliver psychedelic medicine, where physicians will act as the head of a medical team. They will make the decision to incorporate psychedelic therapy into a patient’s care plan. As the prescriber, the physician will also diagnose and evaluate patients for appropriateness in therapy. The doctor may prescribe psychedelics but will not necessarily be present for active psychedelic sessions.
Doctors in this new structure help put together the clues from patient assessments to form the full picture of an accurate diagnosis. This skill will be especially critical when determining if a patient could benefit from psychedelic therapy. Doctors will monitor patient status and outcomes after psychedelic therapy.
Measuring outcomes is especially important in psychedelic medicine since these treatments are being newly understood in the context of mental health. Physicians will be responsible for documenting their patient outcomes and bringing important findings to medical associations.
For now, medical schools are slowly beginning to step up to the challenge.
Stanford Medicine offered a basic psychedelics speaker series last year, but it has broadened that introductory course for the winter quarter 2022, describing this second introductory course as just touching the tip of the iceberg: “Given the constraints of time, this will not be an exhaustive introduction to the field, but rather will survey the current range of clinical applications and scientific investigations of psychedelics, as well as touch on the historical, legal, and cultural aspects of psychedelic medicine.”
One of their objectives at Stanford will be to “critically evaluate the limitations of psychedelic-assisted treatment, the medical concerns associated with treatment, and the issues of safe use including consideration of contraindications, adverse effects, and harm reduction.”
Stanford went on to added a disclaimer – almost more of a warning – that could limit true investigative learning for some medical doctors concerned about their licenses: “Neither Stanford nor any of the course facilitators condone illicit substance use; all discussion of psychedelics in this course will be in the context of sanctioned research and academic investigation.”
The New York University Center for Psychedelic Medicine is offering training opportunities for the next generation of scientists and clinicians in the field with their Psychedelic Medicine Research Training Program, launched in 2020, focused on psychedelic and psychedelic-inspired treatments of psychiatric and neurologic disease. They want medical doctors and individuals with doctorates in the program.
According to the website, the program will provide partial-to-full salary and benefits for postdoctoral researchers for up to five years and support for a mentored research project. The first year of each trainee’s participation will include identifying a primary mentor, developing and presenting a research project proposal, and initiating study startup activities. The remaining (up to) four years will be devoted to data collection, analysis, and presentation, as well as career development activities, including submission of a grant application to National Institutes of Health.
More universities also are adding undergraduate psychedelics courses. But it’s the medical schools that are still lagging, and it’s this level of academia that psychedelics researchers want to build up.
“It is incredibly important to have these (psychedelics courses) available,” Kim Kuypers, an associate professor of Psychology and Neuroscience at Maastricht University in the Netherlands, in an interview for the Interdisciplinary Conference on Psychedelic Research (ICPR). “I get requests from therapists and psychiatrists who did not get these types of courses in the curriculum of their educational training. … this type of education should be embedded within all levels of university education from bachelors, graduate and medical education.”
Brian Pace, a trained evolutionary ecologist with wide-ranging interests from agroecology, climate change, ethnobotany, and more, helped co-found the psychedelic watchdog group Psymposia. He teaches psychedelic studies at Ohio State University.
Pace said that where we are not with regards to psychedelics research is a very timid and late re-entry to the subject. “Psychedelic research didn’t end when the universities and governments abandoned it,” he said during an interview for ICPR. “It continued in the underground. The role of the university courses on psychedelics, well, we have a lot of catching up to do, and I think that should be done with humility.”
Some doctors have sought reliable information on their own, according to Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS), in an editorial piece for the L.A. Times in 2021.
“Medical school students at Harvard, Stanford, Yale, and elsewhere have formed psychedelic education groups. Advocacy and educational organizations have created psychedelic training programs. But momentum for such training has not yet reached executives and administrators of hospitals and healthcare systems, who will play a critical role in standardizing credible provider information, including – perhaps especially – for those who are least informed about and most opposed to psychedelic treatment,” he wrote.
“It’s not a question of whether people will use powerful psychedelics in pursuit of mental health. They do and they will. Let’s hope patients feel comfortable talking to their healthcare providers about it. When providers face that moment, they should know how to keep patients safe – and they should know better than to stand between ill patients and promising treatments.”