Few issues related to the pandemic have pushed both Democrats and Republicans to favor reducing the role of government. Yet, currently, there is such an issue: legalizing psychedelics to treat mental health is enjoying a rare bipartisan moment. It is also creating a groundswell of support for an unabashedly libertarian policy.
In 2019, firebrand Congresswoman Alexandria Ocasio-Cortez (D-N.Y.) introduced a bill to remove restrictions on the scientific study of psychedelics. Soon after, former Texas Gov. Rick Perry came out of political hibernation to lobby his state’s legislature to pass a bill permitting the study of psychedelics to treat mental illness in veterans. Perry was championing a measure introduced by state Rep. Alex Dominguez, a Democrat.
Last year, the free market-friendly think tank the Goldwater Institute joined a lawsuit against the Drug Enforcement Agency defending a Washington state doctor’s desire to prescribe magic mushrooms for a terminally ill patient. The suit is based on a healthcare deregulation law called “Right To Try,” which was signed by President Trump. Democratic Rep. Earl Blumenauer recently joined the cause and publicly requested that the DEA approve the treatment.
Those who advocate for the use of psychedelics, like those working on any political issue, are not monolithic. Folks have their disagreements. But here, too, the movement defies stereotypes. For instance, there are two potential competing ballot initiatives in Colorado to legalize psychedelics. A more politically moderate group aims to allow the use of psychedelics, but only if overseen by certified professionals and with strict limits on the quantity of the drug someone can possess. Meanwhile, the ballot measure championed by a more left-aligned group wants less government interference, arguing that there should be no limits on the amount of psychedelics someone can legally possess.
And while conservatives might have traditionally avoided drug reform for fear of being branded as fringe hippies, there’s been no noticeable political backlash against anyone on the right who champions the issue. Many major outlets run broadly favorable coverage, from Fox News to The New York Times.
So, for free-market folks unfamiliar with the issue and perhaps used to being a political minority, it might be natural to ask, “What is going on here?!”
Over the last decade, dozens of peer-reviewed studies have consistently found that psychedelics are among the most effective mental health treatment for a wide variety of illnesses, from depression to opioid addiction. MDMA, more widely known as the club drug ecstasy, is 2-3 times more effective with severe, treatment-resistant PTSD than any best-in-class mainstream pharmaceutical alternatives. The effects have been so extraordinary that the FDA granted MDMA a rare “breakthrough” status to accelerate its adoption. Indeed, doctors all over America will likely be able to prescribe MDMA in the next 1-3 years once it passes the final FDA phase, for the simple reason that it works.
Veteran Jonathan Lubecky recounts how an MDMA-assisted therapy clinical trial saved him from suicidal attempts. “I started talking and I was able to talk about things I had never brought up before to anyone. And it was OK. My body did not betray me. I didn’t get panic attacks,” he told the “Today Show.” (Lubecky is now a Washington D.C.-based advocate for the Multidisciplinary Association for Psychedelic Sciences, a nonprofit that conducts clinical trials and does drug reform advocacy.)
Given the mental health and substance abuse crisis, it’s hard to imagine a more important healthcare innovation. Psychedelics could touch tens or hundreds of millions of new people in a few years.
No one quite knows why they’re so effective, but the theory I like best is that psychedelics strengthen parts of the brain responsible for emotion. This is the opposite of typical anti-depressants, such as Prozac, which can be mildly effective in muting distressing emotions.
By contrast, psychedelics often intensify emotion and make it quite difficult to ignore the very intrusive thoughts that are the source of severe mental illness. Indeed, distractions are deliberately removed. Patients are given an eyeshade and headphones so that they can laser focus on the hallucinogenic manifestations of sometimes extremely distressing memories, fears and visualizations. And through this head-on confrontation, patients learn how to cope with ideas that they otherwise ignore (what psychologists call “experiential avoidance”).
To be sure, psychedelic-assisted therapy isn’t casually dropping a fistful of mushrooms and giggling with friends in Golden Gate Park. It can take weeks to mentally prepare a patient for therapy; therapists themselves often train for years and specialize in the unique psychic experience of a particular psychedelic. It’s intense.
There’s not a lot of research distinguishing the different benefits of each psychedelic. The most common types—psilocybin (the active ingredient in magic mushrooms), MDMA, ayahuasca (a South American tea), LSD and peyote—have been studied for different treatments. Efficacy, too, varies. Psilocybin is about as effective as anti-depressants for moderate depression but twice as effective for treating smoking dependence compared to the standard treatments.
We know even less about how and when psychedelics work. Everything from genetics to different types of music is being explored as possible factors.
As a result, there is now an entire cottage industry of venture-backed psychedelic companies. Many are pursuing traditional drug discovery and FDA approval. For example, Ketamine, a dissociative anesthetic, is currently legal and shows promise for treating mental health; some venture-backed providers are using Ketamine clinics as a first step in building out the infrastructure for facilitated psychedelic centers that would offer a broader range of treatments.
On top of the medical benefits, psychedelics are (very) popular among the tech crowd, who use them for workplace stress, spiritual exploration and to improve creativity. Steve Jobs famously said that doing LSD was one of the most important things in his life.
Advocacy for psychedelics has ended up being a boon for the libertarian movement because it is entirely held back by regulation. Restrictions on early scientific research began after the Republican war on drugs swept up many compounds, including those with medical promise, under the Controlled Substances Act’s highest category, Schedule 1—those substances that supposedly have no medical value.
As I’ve written before for Discourse, getting psychedelic therapy through the FDA’s gauntlet is extraordinarily expensive and time-consuming. Psilocybin is safely used all over the world, and there are stacks of evidence confirming its effectiveness. Yet, the FDA still requires a traditional clinical trial.
As a result, states have taken aggressive steps to legalize these substances outside the FDA approval process. Last election, for instance, Oregon voters approved a ballot initiative to legalize psilocybin, and it explicitly says the law must allow non-medical use. Oregon is now in the process of creating an entirely new healthcare category of subclinical service providers that will be able to dispense psychedelics.
For free-market fans who worry about occupational licensing burdens (overly restrictive education and job standards), Oregon will be a fascinating case in deregulation of an industry normally heavily regulated with certifications that can take years to get.
Across the board, psychedelic legalization is bipartisan. Not only is it supported by top health experts of different political stripes, but it has also rallied unusual political bedfellows around less government interference. And it is a rare case of both sides largely looking to libertarian solutions to make things better.