Deep in the forests of Yunnan Province in southwest China, wild mushrooms push up through the soil each rainy season, and local families climb steep, pathless mountains to find them. Among them is a mushroom called Jian Shou Qing, a type of bolete that can be psychoactive and is known to provoke visions of little people. For generations, this foraging culture has shaped how communities in the region eat, earn, and gather. April Fan, a filmmaker and recent MFA graduate from Duke University’s Experimental and Documentary Arts program, returned to her mother’s hometown in Yunnan to film Mushroom Mountain, an ongoing observational and experimental documentary that brings together anthropology, political economy, and sensory experience to examine life on the mountain. Her project received a 2025 Mycoskie-UC Berkeley Psychedelic Documentary Fellowship.

The Microdose spoke with her about fungi, foraging, and the story that called her back to her mother’s home.

Can you tell me a bit about your film, Mushroom Mountain?

This film is about my mom’s hometown in southwest China, Yunnan Province. It’s a very remote mountain area. She left Yunnan when she was in her early twenties, but she always dreamed about returning. She had a very tragic childhood, but every time you see her, she’s smiling, talkative, open and honest. She can go through every tough time because there’s always strength in her soul. I always wanted to know where that strength came from, and I thought I could find the answer in her hometown.

Then when I came to the U.S. to pursue my MFA, I heard that psychedelic mushrooms were such a hot topic here. It reminded me that there are magic mushrooms in Yunnan. I had never paid attention to them before, but I thought, this is a good reason to go back. And I think deep in my heart, there was something calling me back anyway.

The mushroom is just an entry point in Mushroom Mountain. I want to challenge the Western psychedelic narrative and tell a mushroom story from the eastern world. This journey really opened my horizon. Before, I just cared about my family history, but this time, because of the mushroom, I followed three local families foraging in the forest. They are to some extent my relatives, because after my mom became an orphan the whole village raised her. When you go into this story, you find it’s a touching story about return, about home and about love.

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What was it like to film in the mountains of Yunnan?

At the very beginning, the foragers didn’t allow me to follow them into the mountain because it could be dangerous and they knew it would be hard for me. They worried about me and didn’t think I could do it. So I stayed and worked around the village for two weeks. They realized how determined I was, and let me try to go with them to the mountain.

The first day I followed them, it was really hard. There’s no road, so they just climbed the mountain. It was so high, basically vertical. In the forest, it’s so wet and so hot, and there’s all kinds of mosquitos, snakes and bugs around you. They walk so fast because they want to find as many mushrooms as they can, otherwise the mushrooms will be picked by other people. It’s almost like a competition. I can’t walk so fast because of physical weakness, and at the same time I have to hold my camera, observe the whole environment, and make judgments in my mind about how to tell the story. I tried my best and the local people helped me a lot.

What types of mushrooms do the local people forage?

The most popular type is called the Honggu, a red mushroom also called Red Russula. They also pick psychoactive mushrooms called Jian Shou Qing. The types of mushrooms found depends on the local area, environment, and climate. There are lots of factors to decide if you can pick them. The foragers pick the mushrooms to sell them and earn money to improve their lives, but they also eat them. In recent years, because mushroom prices are so high, they’ll just eat a very small amount of the not very good looking mushrooms, and sell the very high quality mushrooms.

As you mentioned, one of the mushrooms foragers look for is the Jian Shou Qing. This bolete is known to produce what researchers call Lilliputian hallucinations. Tell me about how you visually depicted altered states of consciousness in your film?

I looked at lots of Western psychedelic documentaries and videos and did lots of scientific research to understand how the psychedelic process affects people’s perception. Initially, I added a lot of effects, like twisting the visuals and enhancing the colors, but I gradually realized it wasn’t quite right. I did a lot of oral history with the local people. I asked them what their experience was like when they were hallucinating, and they told me very magical things. They told me they would see little people or some weird things. It’s very different from the Western psychedelic narrative. So I wanted to create something from another world.

My visual style came out of my perception when I was filming on the mountain. I found that the rain wasn’t just something that suddenly happened. Before the rain, the temperature and humidity changed, the light changed, and the feeling in my body changed. So in my film, I don’t just enter the hallucination suddenly. Instead, I describe how the mist gradually moves on the mountain, how the light becomes darker, how you can hear the birds singing. It’s very sensitive. You can see perspective from the plants, the insects, the environment, and through that, you realize that something is changing, and that you’ve entered a different world. It’s just like the process of rain. At one point, you will know it’s happened, but before that, you already have a feeling it will happen.

What did you learn from the mushroom foragers?

I learned a lot about the local knowledge system. I’d always ask them, “How do you know where you can find the mushrooms?” And they would tell me, “You can only remember by your feet.” They said you have to walk the mountain again and again, and then you will know where they are. Some people knew where to find the mushrooms from childhood, they would follow their parents into the mountain. It’s a knowledge passed down from generation to generation.

Before picking the mushroom, they would gently tap the top of it first. I asked why they do this. They said, “To leave the spores in the land, so next year it will grow in the same place. If every time you pick the mushroom you exploit the resources, then the resources will run out. But if you know the balance, if you leave the spores, they protect the land and the whole ecosystem and then next year they will still grow.”

Will you try to show this film in China when you go home?

When I showed excerpts of the film over video call to the locals, the first thing they said was “It’s so real, April.” I asked them how they felt, and they said at the very beginning they were a little shy and embarrassed, but then they said it’s our real life, it’s the real me. They were excited and curious to see how their story was told and how they are seen in the film. So I will take my film to the local community and do a community screening. I think my journey is not only about making a film. I also want to really return to this community. I’m always thinking, what can I do for them? I want them to know their stories deserve to be seen and heard.

As an international artist and filmmaker, I’m also developing an international language to tell this story. I’m not only an outsider observing something from that area, but I’m not only an insider from that place either. My identity is complex, and I think that means I can provide a very special perspective on this mushroom culture in Yunnan.

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In the best-selling 2025 memoir, The Tell, Amy Griffin, a billionaire venture capitalist, wrote that after MDMA-assisted therapy, she recovered memories of rape by her middle school teacher. “I knew that these memories were real,” she wrote. “My body knew what had happened to me.”

After praise from celebrities like Oprah Winfrey and Gwenyth Paltrow, the New York Times published a story raising doubts about the memories that emerged during Griffin’s therapy. The Times interviewed one of Griffin’s classmates who said that she was the victim of abuse that sounded oddly similar to Griffin’s. The classmate went to sue Griffin for allegedly appropriating experiences from her own life for the book. This month, Griffin countersued her classmate for defamation, denying the claim.

At the heart of this controversy is a question about memory that has come up in psychology in decades past: can a traumatic incident be completely repressed, and then recovered again? During the so-called “memory wars,” in the 1980s and 1990s, some high-profile patients initially said they had retrieved memories, but then later recanted, such as a woman with “multiple personality disorder” known as Sybil, who remembered sexual abuse and torture by her mother, but was later found to have had false memories encouraged by a therapist. Researchers including the psychologist Elizabeth Loftus showed in experiments how it was possible to induce such false memories. The high profile and litigious story of Amy Griffin’s The Tell brought the memory wars to psychedelics-assisted therapy, and prompted people to ask how and if psychedelics might play a role in memory retrieval, both real and imagined.

Samuli Kangaslampi, a clinical psychologist and university lecturer in clinical psychology at Tampere University in Finland, became interested in psychedelics and memory while reading about LSD-assisted therapy from the 1950s. “It continuously caught my attention, how much memory experiences and recalling your past, especially your childhood and traumatic events, featured in all those papers,” he told me. He wondered how common recovered memories were in psychedelic-assisted therapy today, and how clinicians should regard those memories.

Kangaslampi recently received roughly $800,000 in funding from the Research Council of Finland to study just that: Can psychedelics bring back memories, and if so, can those memories be false? The Microdose talked to Kangaslampi about how to test what psychedelics do to memory, and why we should care about whether memories are “real.”

Why do you think the discussion of false memories and psychedelics hasn’t been at the forefront during the resurgence of psychedelic research?

One of the big reasons why I got interested in this is I was reading all this LSD research from the 1950s and 60s. It was considered one of the main effects of LSD— that it makes it possible to recall events, and that was one of the major categories of experiences that people have. There was a whole section of the clinical work that focused on the question of how does LSD make it possible to remember repressed memories, and how do people get therapeutic benefits out of that catharsis.

In contrast to that, people talk very little about effects on memory or memory experience in modern research. There’s the idea that these more personal experiences, autobiographical experiences, are an initial step that you go through in order to get to the really therapeutic and important part: transcendental or mystical experiences.

My interest initially was the therapeutic potential of these memory experiences, when people recall their life and process those memories. But the more and more I looked at it, the more I also realized the potential problems. It started to remind me of the memory wars of the past, and all this discussion in the trauma field about whether people can recover memories of abuse, and if they do, whether they’re false memories or not.

The “memory wars” are an important context here, can you explain what those were?

People who get more scientifically trained in the topic of trauma and trauma-focused treatment will generally be taught that the memory wars were settled, and we have all come to the conclusion that repression is not a valid scientific concept or a process that we should worry about. If people come up with memories that they didn’t have before, we should be very careful about that. We should definitely not try to actively get people to recover memories that they don’t currently have. But in reality, these memory wars are not over.

Clearly it happens that people have the experience that they now recall some important event of their past. In this context, it’s typically a traumatic event, and most commonly memories of childhood abuse. It happens spontaneously, but especially happens in therapy. The debate was: are these memories real, and if they are, what was the status of these memories before? Were they somehow repressed or dissociated? Was this person truly incapable of ever remembering this, and now suddenly they can? Or are these memories likely to be false, inaccurate?

Recovered memory cases are topics of scientific debate, they can be personally important to people, and they can also be legally important. Experts acted as witnesses in court cases, and their positions got polarized and sort of simplified. There was this perception that some people believe that all recovered memories are always true, and we should always trust them, others think that they’re always false, and it’s impossible to recover memories. Maybe some experts did hold these extreme views. Maybe it was a bit more nuanced, but that’s how it was represented in the court system.

Coming back to today, there’s the perception that this issue is settled, but when people do survey work, they realize that there’s actually still a very big chasm between practicing clinicians, especially in some areas of trauma therapy and memory researchers. A lot of clinicians who practice different types of trauma therapy still believe in this idea of repressed memories and the ability to recover those memories, whereas most memory researchers don’t.

Some psychedelic-therapists, including the Czech-born psychiatrist Stanislov Grof, explicitly mentioned recovered memories. In fact, Grof talks about re-living your birth. Other modalities that psychedelic therapists use, such as the form of therapy called Internal Family Systems, can refer to parts of childhood becoming uncovered or newly recognized. Given that, what exactly are you going to be tracking when it comes to memory and psychedelics?

There are two lines of inquiry that I’m concentrating on. First, how much does this even happen? Is it even a major problem? We don’t have basic numbers on this. There are a lot of anecdotes, and it seems to be going on more in certain circles—maybe outside the strict clinical context—but we don’t really know.

I would like to find out how many people have these kinds of experiences, and what do they think about them afterwards? Are they really convinced by these memories, and do they really struggle with whether they’re real or not?

And to get the clinician perspective, as you said, many people working with psychedelics may be working with therapeutic frameworks where they are more open or accepting of the possibility of recovering memories. They may explicitly endorse that as a part of their therapy. I’d be interested to see what clinicians and people running clinical trials think of the phenomenon? How do they deal with it?

The other side is: do psychedelics have some characteristics or qualities that make it more likely that people might have false memories, or that they might believe a memory like experience is true regardless of whether it is or not?

There are a lot of indirect reasons to suspect that that might be the case, but we don’t have any good research on whether that happens or not—whether susceptibility to false memories is increased or not in a person on a psychedelic. But especially as psychedelics increase or seem to increase suggestibility, and the feeling of realness or truth, we could imagine that this could lead to increased susceptibility to false memories.

Experimentally, how do you test these questions? It seems hard to test if a memory is true or not.

There are false memory paradigms that use word lists or pictures; you can show people pictures, and then see whether they develop a memory of having seen a picture that they actually did not. If they not only think that they saw it, but they feel like they remember seeing it, then you can think of that as a false memory.

Of course, paradigms like that are fairly far removed from our real lives and our autobiographical memory, which is specifically about important memories that happen to us, experienced from the first person. When we study autobiographical memory, the problem usually is that we can’t verify whether it’s real or not. If they feel like it happened, then how do we verify that?

One approach that has been used with other psychoactive substances, but not yet with psychedelics, are virtual reality scenarios. A person can have a first-person experience of a scenario, see something happen and interact with their surroundings, and then later on we interview them about that event. Then we can see whether they formed false memories. Because it’s a virtual reality scenario, we know exactly what happened.

Another option I hope to be using, which is a little bit more complicated, would be a diary-based method— having people record events of their lives, true and false, and then months later, seeing whether they feel like they remember some of the events that were not true. We would know from those diary entries whether they were actually true or false.

Why does it matter if a recovered memory is true or false?

You could say from a therapeutic perspective, that if a person has this experience of remembering something and it’s therapeutic for them, they feel better afterwards, they feel like they’ve dealt with something, then does it matter whether that memory was veridical, whether the event actually happened or not? From the perspective of “this person is feeling better,” maybe it doesn’t. A lot of the time, if a recovered memory is not about something as important and painful as abuse, then maybe it doesn’t matter.

But if it is about something very important that could have happened to that person, and even more so if there’s a perpetrator in that memory who did something, I think there are very large personal and even legal repercussions. So we do need to care, and we do need to be careful.

There’s also a question of whether it’s ethical to get someone to believe something that’s not true. In the context of psychedelics, we’ve often talked about this in relation to introducing metaphysical beliefs or spiritual beliefs. Is that an ethical problem? I think it is, and similarly, if psychedelic treatment gets someone to believe something about their life that’s not true, that did not happen, I think that is a pretty big ethical problem as well.

A lot of time, the person themselves can end up struggling with wanting to find out whether it’s true or not, and that seems to be a big part of their suffering. They are not able to accept that they don’t know, and become fixated on that.

There is clearly a very strong sort of cultural belief that we’ve developed, that there must be a source of my suffering, and it probably has to be located in my past. Something that’s happened. In my opinion, this is not often the case. Maybe there were some things that happened, or several things, but that’s not the only thing to figure out in most people’s cases—nice as it would be, in some sense, to find it. But if you go searching for it, you can find something. People sometimes joke that in therapy it’s never too late to have a happy childhood, but similarly, perhaps it’s never too late to have a traumatic childhood if you really go looking for it.

This interview has been edited and condensed for clarity and length.

Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.

Definium releases LSD for depression Phase 3 results

On Monday, New York-based psychedelics company Definium announced topline results from its Phase 3 study using a single dose of DT120, the company’s formulation of LSD, in the treatment of major depressive disorder.

In the study, 149 participants received a 100 microgram oral LSD dose or an inert placebo. Researchers tracked changes in participants’ scores on the MADRS, a standard depression assessment, from before the study to six weeks after. Participants who received LSD showed a significant improvement in depression symptoms; on average, they scored 13 points lower on the MADRS at six weeks after dosing. (Higher scores represent more severe symptoms, and a decrease of 6 points is often considered a clinically significant reduction in symptoms.) Those in the placebo group also saw improvement, but less so; on average, people who received placebo scored 5.2 points lower on the MADRS at the six-week point.

Compared to previous Phase 2 and 3 psilocybin and 5-MeO-DMT clinical trials, Definium’s reported results show some of the largest decreases in depression scores. Beckley’s BPL-003 (5-MeO-DMT) Phase 2 trial found that participants who received the largest dose of the drug showed, on average, an 11-point reduction in MADRS score four weeks after dosing, while those in the placebo group showed only a 6-point reduction. Clinical trials for psilocybin have been more mixed; while the non-profit Usona Institute’s Phase 2 psilocybin trial decreased MADRS scores by a whopping 20 points, psychedelic company Compass Pathways’ clinical trials with COMP360, their formulation of psilocybin, were less splashy: a Phase 2b study found that psilocybin decreased participants’ MADRS scores by an average of 12 points, while their more recent Phase 3 results found that psilocybin decreased MADRS scores by a modest 3.8 points compared to a placebo. (The difference between placebo and LSD in Definium’s trial was around 8 points.)

Topline results are, by definition, the highlights put forth by a company. More details about Definium’s study will be available once it is peer-reviewed by an academic journal.

The results appeared to excite investors. Definium’s stock price was up 46% the day of the announcement, and 83% over the week (as of Thursday afternoon).

Definium rebranded from MindMed at the beginning of the year, and it appeared to be a contender for one of the Trump administration’s priority vouchers for psychedelics. In the days after the president signed an executive order authorizing the release of new vouchers for psychedelics, the FDA initially posted — and then deleted — on X announcing that one of the vouchers would support research for “LSD for GAD” (generalized anxiety disorder). Definium ultimately did not receive a voucher.

Survey suggests most veterans support VA-funded psychedelic-assisted therapy

According to a new report by the thinktank RAND Corporation, about half of veterans supported the Department of Veterans Affairs providing or paying for psilocybin-assisted therapy. The report surveyed more than 1300 veterans about their attitudes and use of psychedelics. From those responses, the researchers estimated that roughly one in four US veterans — around 4.8 million — have tried psilocybin mushrooms, LSD, or MDMA in their lifetime, and that they were more likely than nonveterans to have used LSD or mescaline.

Given the federal government — and specifically, the VA’s — recent moves to bolster support for psychedelic research, RAND’s report provides perspectives from a key group that those initiatives intend to support. And yet, veterans surveyed by RAND were largely unsure whether asking VA doctors about psychedelics was sanctioned. When asked if they thought a veteran would be at risk of losing VA benefits if they spoke with a VA provider about their use of MDMA or psilocybin, around 50% of respondents said they were not sure, while between 15 to 20% of respondents said they believed they would lose benefits for bringing up psychedelic use. RAND also asked veterans if they thought the VA should provide psilocybin- or MDMA-assisted therapy to veterans, if it were approved by the Food and Drug Administration. While the most common answer was “I’m not sure,” 54% of respondents thought the VA should pay for psilocybin and 45% for MDMA, either via VA providers or community providers.

In the last couple of years, veteran-centered psychedelic advocacy groups and allied politicians have become increasingly enthusiastic about ibogaine, a once obscure psychedelic that comes from plants such as the iboga bush. (In 2023, just 12% of Americans reported having heard of the substance.) In RAND’s survey, just 0.3% of veteran respondents said they’d used the substance; for comparison, the most commonly used drugs were psilocybin (18.6%) and LSD (19.6%).

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Colorado activists fight recent bill’s amendments to sharing psychedelics

Recently, Colorado lawmakers passed House Bill 1325, which lays the groundwork for an ibogaine research program in the state. But the bill also amended the state’s policy on the personal use of psychedelics, which was established in 2022 after Colorado voters passed a ballot initiative creating the state’s “Natural Medicine” program. The measure decriminalized “natural medicines” like psilocybin, and included the right to gift them to others. Last year, journalist Chris Walker described the “burgeoning grey market” growing around Colorado’s psilocybin gifting economy — and HB 1325 is an attempt to crack down on that grey market, as well as on unlicensed growing, manufacturing, and administration of psychedelic substances.

Some Colorado psychedelic activists are pushing back against those changes by signature-gathering for a referendum to challenge that aspect of the newly-passed bill. The group, which calls itself Coloradans for Natural Medicine Rights, wishes to leave the rest of the bill untouched, they write on their campaign website, but wish to reverse recent changes that “narrowed what ‘share’ means.”

Given the high costs of natural medicine via the state’s regulated program — the average session can cost upwards of $3500 — those leading the referendum are concerned that psilocybin mushrooms will no longer be accessible via sharing and gifting. Jacob Marlega, an organizer behind the referendum, is a mushroom grower and runs a harm reduction and education services program.

Psychedelic research funding bills and a move towards psilocybin legalization in Canada

In May, North Carolina senators Sophia Chitlik (D) and Bob Brinson (R) introduced Senate Bill 1018, which would earmark up to five $1 million psychedelic research grants to be given out through the state’s general fund. (North Carolina’s legislative session began in April, as many other states’ sessions were wrapping up; it runs through August.) According to the North Carolina Newsline, another legislator tried to pass similar legislation in 2023, but it stalled in committee.

In late 2023, then-President Joe Biden signed a bill called the National Defense Authorization Act (NDAA), which established appropriations for the Department of Defense. That bill included $10 million for funding psychedelic clinical trials, and last week, members of U.S. Congress — including Lou Correa (D) and Jack Bergman (R), co-chairs of the Congressional Psychedelics Advancing Therapies (PATH) Caucus — filed an amendment to the 2027 version of the bill, which would extend that funding through 2033.

Corey Tochor, a conservative member of Canadian parliament, introduced a bill last week that would allow physicians to prescribe psilocybin and psilocin, the active metabolite of psilocybin. The country has a psilocybin access program through Health Canada, its health authority, but doctors must apply on behalf of patients, and the process can take months. A Health Canada spokesperson told CBC that the agency had authorized 354 participants since its Special Access Program launched in 2022.

• New York State Police announced the arrest of a 30-year-old Brooklynite who was charged with possession of psilocybin mushrooms after he and his friends got lost on a hike in Harriman State Park, near the town of Tuxedo. The man allegedly got into a fight with his friends, then “became overwhelmed and ran through the woods” — he called for help and police say he was found with 45 grams of psilocybin mushrooms.

• Harm reduction organization DanceSafe is teaming up with The Shulgin Foundation to sell pieces of art using broken glassware from the famed psychonaut Sasha Shulgin’s lab. The proceeds from the sales will be split evenly between the two organizations.

• CBC released a new documentary called Prophet of Ecstasy, which follows longtime MDMA dealer Michael Clegg’s journey from “Ecstasy Kingpin” to prison and the spiritual awakening that he experienced behind bars.

• According to ABC, venture capitalist and author Amy Griffin is now suing her classmate for defamation over the classmate’s allegations, detailed in a New York Times piece, that Griffin used the classmate’s experiences of sexual abuse as her own in her 2025 memoir The Tell. In the memoir, Griffin says her memories of sexual assault were awakened by MDMA-assisted therapy. The Times piece also mentions Griffin’s close ties to powerful psychedelics organizations: her husband, hedge fund founder John Griffin, has donated $1 million to MAPS, and the couple holds a 15 percent stake in Resilient Pharmaceuticals (formerly known as Lykos Therapeutics). Griffin was introduced to her MDMA therapists by MAPS founder Rick Doblin.

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Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.

Is the boom in toad-derived 5-MeO-DMT built on a false history?

In a paper published in Psychedelics, researchers reference historical scholarship and contemporary accounts to argue that current claims stating that 5-MeO-DMT is an “ancestral toad medicine” are in fact fabricated. The researchers call this a case of “fabricated ancestrality.”

5-MeO-DMT is a powerful psychedelic, known for its rapid onset and short duration. Synthetic versions of 5-MeO-DMT are made in a laboratory but 5-MeO-DMT also exists in nature and can be extracted from certain plant species and the glandular secretions of the Incilius alvarius toad (formerly known by the scientific name Bufo alvarius).

Plant derived 5-MeO-DMT is well-documented, including in preparations made from Anadenanthera peregrina, also known as the yopo tree. The authors point to historical uses dating back to the 15th century, including by Indigenous Caribbean and South American communities, some who used long bamboo or hollow bird bones to administer snuff. But early evidence regarding the use of toad-derived 5-MeO-DMT is missing, and the authors argue that the narrative of toad medicine as an “ancient tradition” has been fabricated to establish cultural legitimacy motivated by monetization. The rising demand for toad-derived 5-MeO-DMT, the authors say, has put pressure on a vulnerable toad species.

“If ancestralization confers legitimacy, then ethical reflection must confer restraint,” the authors write. “The future of 5-MeO-DMT need not depend on the continued extraction of a wild species. Whether the psychedelic field aligns itself with conservation or continues practices that contribute to depletion will shape not only the fate of Incilius alvarius, but the moral coherence of the psychedelic field itself.”

Colorado’s new law lays groundwork for ibogaine access

Colorado’s Natural Medicine Act (HB 26-1325) was signed into law this month by Governor Jared Polis. The law establishes an ibogaine pilot program under the state’s Behavioral Health Administration (BHA) and lays the groundwork for ibogaine to be included in the Natural Medicine Health Act that Colorado voters passed in 2022.

Colorado is now facing a $1.5 billion budget shortfall. Rather than allocate public state dollars, HB 26-1325 created a path for agencies to obtain funding, such as grants, opioid settlement dollars, federal research funding, and private philanthropy. If the state can raise at least $150,000 by January 1, 2028, the pilot program could move forward to raise the additional required funds and the health agency could select up to five pilot sites to conduct research or offer ibogaine treatments under the Right to Try law. The pilot sites would need to operate with federal approval, and they could collaborate with other states that have already committed public funding for ibogaine research and drug development.

The law differs from ibogaine legislation in other states such as Texas and Arizona by creating a pathway for ibogaine to be administered in Colorado’s healing centers with licensed facilitators. That means people in Colorado could potentially access state-legal ibogaine long before the drug could make its way through the Food and Drug Administration approval process, according to Joshua Kappel, an attorney and co-author of the ballot measure that created the psychedelics access program and decriminalized certain psychedelic drugs in the state.

Due to ibogaine’s serious health risks, including cardiotoxicity, regulators would have authority to require more rigorous medical screenings beyond what is required for psilocybin. If ibogaine is included in the regulated program, the definition of natural medicine would change to enable laboratory produced forms of “semi-synthetic” ibogaine derived from the iboga shrub. Currently, no synthetic forms of psychedelic substances are allowed in Colorado’s state program. Under the new law, providers would have to consult with Indigenous communities traditionally connected to ibogaine or iboga, and commit to a benefit-sharing plan.

Colorado’s new law also adds civil malpractice liability to shield practitioners from having to pay for damages related to potential psychological or physical injuries that might occur while administering ibogaine, excluding intentional misconduct and gross negligence. “The idea is not to protect bad actors,” explained attorney Barine Majewska during a webinar about the new law. “The hope here is that if we have this kind of protection, it will attract more qualified practitioners to provide these services.”

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Study finds personality traits may shape the intensity of psychedelic sensory experiences

In a study published June 10 in Drug and Alcohol Review, researchers surveyed 426 psychedelics users in New Zealand to learn how personality traits may influence the intensity of sensory effects (i.e., hallucinations and distortions) experienced during altered states of consciousness.

Researchers at the University of Otago used an online survey to examine the “Big Five” personality traits (neuroticism, extraversion, openness, agreeableness and conscientiousness) and 20 sensory effects, such as visual trails, objects ‘breathing’, out‐of‐body experiences, field of vision changes, experiences of other dimensions or worlds, and synesthesia, a type of sensory crossover, such as feeling sounds or tasting colors.

The survey participants were adults who had previously taken DMT, LSD, psilocybin, mescaline, Salvia divinorum or synthetic drugs that are structurally similar to mescaline. Participants shared demographic data and information about their drug-use, such as where they used psychedelics. They also rated their association with the Big Five personality traits and responded to true/false questions about the personality trait the researchers call absorption – or how deeply they were immersed in aesthetics and vivid mental imagery during their psychedelic experiences.

The study’s key takeaway is that absorption is associated with increased sensitivity to sensory effects, which, according to the study authors, is consistent with previous research. Absorption was associated with 18 of the 20 sensory effects — and of those associations, four were at least moderate in strength.

The study authors said there were several unexpected findings, including that the personality trait of openness lacked significant associations with heightened sensory effects, which is inconsistent with previous research. The personality trait of conscientiousness was negatively correlated with the intensity of disgusting visual experiences. “Here, it may be that conscientious individuals are more likely to engage in harm reduction behaviors that facilitate a positive psychedelic experience and thus are less likely to experience negative sensory features such as disgusting visuals,” speculated the study authors.

Overall, the study shows evidence of significant associations between personality traits and the intensity of sensory effects of psychedelics, but the study authors said the correlation is likely weak compared to other factors, such as set, setting and dosage. Nevertheless, the authors suggest that personality traits that are relatively easy to measure, particularly absorption, could be incorporated in tools used to predict acute reactions to psychedelics that might help improve therapeutic outcomes.

• Residents of Philomath, Oregon (population 5,838) voted to allow psychedelic mushroom businesses to operate in town by 16 votes. In 2020, Oregon voters passed a ballot measure to establish the nation’s first regulatory framework for the legal manufacturing and therapeutic use of psilocybin. Some municipalities opted out of the program, including residents of Philomath. Now they’re opting back in after a continuation of the ban failed to pass by a tiny margin.

• What will President Trump’s new acting attorney general Todd Blanche mean for psychedelics and marijuana? In the National Law Review, attorney Whitt Steineker, who represents cannabis industry clients, weighed in.

• In a podcast episode with The Jerusalem Post, Anna Harwood-Gross, a researcher at Israel’s Ariel University, spoke about her team’s MDMA trial with Israeli soldiers that was put on hold when the war broke out in 2023. At the time, she questioned the ethics of testing psychedelics on traumatized soldiers during an active conflict, but as PTSD cases surged, she and her team changed their minds and proceeded with the study.

• In The Atlantic, journalist Ross Andersen shares ways that researchers are “looking for ways to engineer better mind-altering therapeutic experiences” with shorter, less intense trips, to remove cardiovascular risks, and to enhance sensory perceptions. Andersen himself wonders whether engineering the “perfect trip” is possible — or could even be measured — considering the diversity of human consciousness.

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But when P. cubensis, or cubensis for short, first entered the canon of Western science with an official name and description, the person who found it would never have imagined that the little brown mushroom he scooped up would one day be a global sensation.

The mushroom was collected and first given a scientific Latin name in Cuba in 1906, the same year the U.S. government began occupying the island following a contested presidential election. The man who found and named it was U.S. citizen Franklin Sumner Earle, who had moved to the island nation two years prior to direct Cuba’s Agronomical Station. Earle’s interest in fungi was the “distinctive feature of his early life,” according to his colleague Carlos E. Chardón, a trailblazing Puerto Rican mycologist. But at the turn of the 20th century, fungi were poorly understood and often studied only when they showed up as a risk to human health or crop yields, so Earle did what any fungi-lover trying to make a living would do: he levied his mycological interest into a job as a plant pathologist. His career included stints working in that capacity for the U.S. Department of Agriculture, as well as serving as a biology professor at the Alabama Polytechnic Institute, and overseeing the mycological collections at the New York Botanical Garden (NYBG).

It was while at NYBG that he received the offer to begin directing the Agronomical Station in Cuba, and though he left his post in New York to begin a new life in Santiago de las Vegas, he maintained a relationship with his old colleagues. Once on the ground in his new home, he continued to send interesting letters and specimens back to the Garden in New York, where his findings were added to the ever-growing herbarium. Among them was a collection of two tawny brown mushrooms that Earle dubbed “Stropharia cubensis.” The genus Stropharia would later be swapped for Psilocybe by the mycologist Rolf Singer, but Earle’s moniker “cubensis” — named for the fact that the specimen was found in Cuba — has stuck ever since.

I found myself wondering if Earle had any idea that this mushroom was special; so special, in fact, that it’s the reason we’re still talking about him a century later. So one sunny day in April, I hopped on the train from Brooklyn and headed toward the Bronx, where Earle’s letters were filed away in the library archives at the New York Botanic Garden.

Thumbing through his hundred-year-old correspondences with colleagues, I came across staffing and interpersonal queries, and evidence of Earle’s salary (in 1904, before he took the position in Cuba, he had been making $1800 a year at the Botanic Garden, equivalent to about $67,352 in 2026 dollars; he wrote later that year asking for a raise to $2500, or the equivalent of about $93,545 today, before accepting the job in Cuba). Once in Cuba, the letters document a shift in his relationship with Cuban authorities — from “my relations with the government continue to be eminently satisfactory” in 1904, shortly after he arrived, to a proclamation that he’d lost a “long drawn out fight” with the Cuban Secretary of Agriculture by 1906. Later that year, he would resign from his post, though he stayed in Cuba and continued to work on agricultural issues.

But nowhere in his letters are there any mentions of cubensis, or any hint that Earle knew what powers it might possess.

Was it possible that these mushrooms were culturally significant, and Earle had missed that significance entirely? He was, after all, a U.S. scientist focused on pathogenic threats to sugar cane. Or was it that Cubans at the turn of the century weren’t seeking altered states of consciousness via these mushrooms? Were they even doing so now? I reached out to some Cuban mycologists to find out.

According to Lázaro Castro Hernández, a Cuban doctoral candidate in ecology in Chile, Earle’s oversight is not surprising, because Cubans themselves didn’t know about the mushroom’s psychedelic properties. Most still don’t. “Although this species is present in Cuba, the majority of the population is unaware of its potential as a psychedelic mushroom,” Hernández told me via email. “Consequently, it is not integrated into Cuban traditions or medicine.”

To Milay Cabarroi Hernández, a Cuban mycologist who worked for more than a decade at the National Botanical Garden of Cuba and at the University of Havana before moving to the University of Guadalajara in Mexico, where she now works, that resonates. “There is no strong evidence of an Indigenous Cuban mushroom tradition,” she noted. Hernández was never exposed to fungi until university, where she fell in love with them on her very first day of class. But when she told friends and family that she intended to study mushrooms, they told her she was “crazy.”

“Cuba is generally considered a mycophobic country,” she explained. “Mushrooms are not widely consumed, nor are they well known among the general population.” In college, she met a few students who experimented some with psychedelics, but most of it stayed underground and infrequently documented due to Cuba’s strict drug laws.

The Cuban government restricts not just the possession and use of psychedelics, but information about them as well. When Hernández was serving as advisor for a student investigating fungi that grow on manure, a category that includes psilocybin-containing mushrooms like P. cubensis, they decided not to publish that research because of what Hernández described as “possible legal implications.” The fear was that the report might make known the growing locations of P. cubensis when the Cuban government considered it a harmful drug. “Research involving psychedelics in Cuba is a complicated subject,” she told me.

If there is current academic interest in P. cubensis within Cuba, I couldn’t find it. When Hernández tried to facilitate interviews for this story with her mycology colleagues still in Cuba, she was told that there would be prohibitively cumbersome paperwork required for any of them if they wanted to give an interview to a foreign journalist, “especially someone from the U.S.” Even if they had been able to get the permissions required, it’s understandable they might have had other priorities: the country is facing blackouts and a deepening humanitarian crisis due to the U.S. government cutting off the oil supply and imposing an ongoing economic blockade.

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So how should we make sense of the world’s most famous “magic” mushroom being named after a country that doesn’t have a deep cultural relationship with it, especially when neighboring countries like Mexico have much longer and more established traditions of psilocybin use?

One part of the answer is, of course, that a species being entered into scientific literature has very little to do with when that species first became known to humans. The people Indigenous to any given landscape have often been using local flora and funga for millennia before a scientist “discovers it,” giving it a Latin binomial name and sticking a specimen in an herbarium. Looking at the long history of use of psilocybin-containing mushrooms in nearby countries like Mexico, it would be tempting to assume that those populations were intimately familiar with P. cubensis even if Cubans weren’t, and that if Earle had happened to be stationed in Oaxaca rather than Santiago, he might have found the same mushroom, recognized its significance to local populations, and named it after Mexico rather than Cuba.

But the truth is that even in places like Oaxaca, Mexico, where P. cubensis is frequently used now, it likely wasn’t a commonly used psychedelic there at the time of Earle’s finding. Alexander Bradshaw, who has been researching psilocybe species as an evolutionary biologist, said that on his visits to Oaxaca, he was told many times that there’s not a strong historical tradition around P. cubensis the way there is with other psychedelic mushrooms. This anecdotal evidence seems to check out: the psychedelic mushrooms from which psilocybin and psilocin were first crystallized, which were brought back from Mexico by Gordon Wasson in the 1950s, when “magic” mushrooms first burst into the U.S. spotlight, were not cubensis, but the species that would come to be known, fittingly, as Psilocybe mexicana.

Bradshaw’s theory is that P. cubensis was first introduced to the Americas (likely via cattle dung, as first proposed by Mexican psilocybe expert Gastón Guzmán), perhaps after originating in Asia. Earle’s finding of the type specimen is likely from this first dispersal. But after that, Bradshaw noted, there’s a bit of a gap in the historical record — cubensis doesn’t really show up in herbarium collections after that for decades, which is odd considering that “if you’re in a cow field and they’re occurring there, they’re extremely obvious,” Bradshaw told me. If they had been widely present, “these things would have been found,” he believes.

And then “all of a sudden, post 1970s, they seemed to be everywhere,” showing up in the fungarium collections of museums all over the world. One example he pointed to is in Fiji, where museum collections specifically note that they had never had samples of P. cubensis before, but they believe the mushroom was brought into the nation by Peace Corps volunteers. Since the Peace Corps only operated in Fiji from 1969 to 1973, that seems to fit Bradshaw’s theory that cubensis’s most significant dispersal came not from cattle or ancient sacred usage in Mesoamerica, but from the much more recent “shroom boom” of the hippie era, propelled by U.S. counterculture types.

“There was definitely at least secondary or even tertiary spread via those populations,” he said. Why cubensis rather than other species of psychedelic mushrooms, like P. mexicana? “I think people latched on to [cubensis] because it was very easy to grow,” he said.

If that’s the case, then perhaps Earle’s lack of recognition that he’d found something special in cubensis at the beginning of the 20th century makes sense: not only was it not used by Cuban populations as a psychedelic, but even nearby people in neighboring countries that did use psychedelics more regularly weren’t using P. cubensis at that point. The mushroom was just biding its time, waiting for its turn in the limelight.

Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.

An Amanita mushroom poisoning outbreak in California

A May 28 report from the Centers for Disease Control and Prevention describes nearly 40 cases of Amanita mushroom poisonings in northern California from November 2025 through March 2026. The poisonings resulted in three liver transplants and four deaths. “This is the largest reported outbreak of mushroom-associated hepatotoxic poisoning in California history and the largest in the United States in several decades,“ the report authors write.

The Amanita genus contains about 600 species of fungi. Some are toxic, with ‘amatoxins’ responsible for about 90% of mushroom poisoning deaths worldwide. Others, including Amanita muscaria, are increasingly being ingested in various forms including in tinctures and gummies. A. muscaria has psychoactive effects that can cause unpleasant trips, and the mushroom’s iconic red cap with white dots is featured in popular media from Super Mario Bros. to Alice in Wonderland. On the other hand, toxic all-white Amanita species A. phalloides and A. ocreata, are responsible for poisonings like those in northern California.

The CDC report authors say distributing educational materials in languages other than English during seasons when toxic mushrooms fruit could make a big difference in preventing poisonings. Patients from the northern California poisoning outbreak spoke Spanish, Ukrainian, Russian, Mandarin Chinese, and Mixteco and Mam Indigenous languages from Latin America. Some reported the mushrooms they consumed resembled edible types in other countries.

While foragers are unlikely to confuse red-capped Amanita muscaria with white, toxic, Amanita phalloides and Amanita ocreata – A. muscaria is rising in popularity.

Whereas psilocybin is a federally controlled substance, muscimol, the psychoactive alkaloid found in Amanita muscaria, is not. A 2025 RAND Corporation survey estimated about 3.5 million U.S. adults used A. muscaria mushrooms in the past year. According to RAND, Amanita muscaria was one of the most popular psychedelics used that year. “Amanita muscaria is not the same as psilocybin-containing mushrooms, and it acts on different receptors in the brain,” emergency physician and columnist Leana Wen told CNN. “Yet mushroom products are often marketed together under broad wellness or psychedelic themes, which can create a lot of confusion.”

A recent case study reported a reversal of Alzheimer’s disease symptoms following a high psilocybin dose

In a buzzy case report published May 27 in Frontiers in Neuroscience, researchers in São Paulo, Brazil describe a woman in her 80s with advanced Alzheimer’s disease. After about 10 years of Alzheimer’s-related decline, she displayed symptoms including urinary incontinence and mostly speaking in single syllable words. After giving the woman a large dose (5 grams) of the Enigma strain of psilocybin-containing Psilocybe cubensis mushrooms, researchers noticed improvements such as the return of urinary continence and spontaneous recounting of personal memories in the days that followed. The patient also began to dress herself and have sustained social interactions. During a second dose of psilocybin mushrooms (3 g), a month after the first, the patient described surfing with her son on a peaceful island, the study reports.

“The findings do not imply disease reversal but suggest that residual functional capacity may persist in late-stage neurodegeneration and may become transiently accessible under specific neuromodulatory conditions,” the authors write. “Causality cannot be established, and spontaneous fluctuations inherent to neurodegenerative disease cannot be completely excluded.” Still, many online were quick to hype the report’s findings. Longevity influencer Bryan Johnson went so far as to call the case “biblical” on X.

Studying psychedelics in dementia cases is not a new idea. An ongoing trial at Johns Hopkins University is testing whether psilocybin improves quality of life and/or depression for those with early Alzheimer’s disease. However, such research comes with questions and debate about informed consent. “This case publication raises several ethical red flags, and violates several of the requirements that make clinical research ethically acceptable,” Dominic Sisti, a medical ethics professor at the University of Pennsylvania told The Microdose on June 9. “What was the purpose and rationale for dosing this particular patient? Was it just out of curiosity that they exposed this woman with dementia to an unknown level of risk?”

The case report describes that after the first psilocybin dose, the Alzheimer’s patient experienced “hyperthermia, profuse sweating, and a prolonged deep sleep-like state.” The case report’s ethics statement says approval for the study wasn’t required because it was conducted in “routine private clinical practice, in accordance with local legislation and institutional requirements.” The authors add that they obtained informed consent from the patient’s legal guardian for publication of the case report. However, there is no clear evidence of consent for the intervention itself, Sisti said.

Johns Hopkins psychiatry and behavioral sciences professor Albert Garcia-Romeu, who has worked with most of the participants in the university’s Alzheimer’s trial, agrees the case raises a number of ethical concerns. He said thus far, his observances of psilocybin’s effects on trial participants with early Alzheimer’s have not shown “any responses of this sort.” He also had methodological concerns about the paper, such as the patient not having brain scans to better understand the Alzheimer’s diagnosis. Also, the case report did not mention whether improvements persisted beyond a few weeks of follow up.

“We risk sensationalizing anecdotal reports and potentially encouraging people who are desperate and suffering to do things that could put their loved ones at serious risk without clear rationale or safety protocols in place,” Garcia-Romeu told The Microdose on June 10. “We currently have no rigorous evidence for clinical benefits of psilocybin or other psychedelics in patients with dementia and need to proceed accordingly until we have more data.”

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Risk of psychedelic-induced mania is low in clinical trials and higher in unsupervised settings

Researchers often exclude participants with diagnoses or family history of bipolar disorders from clinical trials testing psychedelics. The drugs have been documented to induce psychotic and manic symptoms, according to a recent review published in Nature’s Molecular Psychiatry.

“Given the increasing use of psychedelics outside clinical research—often in unregulated, unsupervised, or recreational contexts —better characterization of bipolar-relevant adverse outcomes, particularly treatment-emergent dysphoria/euphoria, mania, and hypomania, is needed,” the study authors write.

In their review, researchers examined over 20 studies that tracked symptoms of mania following psychedelic use – including psilocybin, LSD, DMT, ayahuasca and MDMA. They found rates of dysphoria, euphoria, hypomania, or mania associated with psychedelics varied greatly, depending on study format. For example, rates of such symptoms were about 6% in controlled trials testing psilocybin for depression disorders. Meanwhile, rates could be as high as about 30% in naturalistic studies of people with self-reported bipolar disorder.

The review, led by a research team in Switzerland, concluded that hypomania and mania symptoms following psychedelic use occurred mainly in people with bipolar I, or those who had a genetic predisposition to the disorder. The authors didn’t find evidence of psychedelics inducing bipolar disorder in participants without a previous diagnosis or predisposition. They also described the instances of mania as acute and resolving on their own. “Psychedelic use is associated with a low but clinically relevant risk of manic or hypomanic symptoms in individuals with bipolar vulnerability, particularly in naturalistic or unsupervised settings,” the authors conclude.

Legislative sessions wound down in May, and a final picture of this year’s psychedelic legislation is appearing.

Psychedelic Alpha reports psilocybin measures led state enactments this season, and the success rate of ibogaine-related bills was nearly 25%. Over all, 17 of the 115 psychedelics-related measures tracked by Psychedelic Alpha were signed into law, while around 50 are still pending.

Even in the slow season, some legislative efforts are still marching forward, including a new federal ‘clarification’ act on controlled substances introduced by Tennessee Congressman Steve Cohen (D) this week. The ‘Controlled Substances Act (CSA) Clarification in Sciences Act,’ would not re-schedule substances like psilocybin or MDMA, but instead would help define terms like ‘abuse potential’ and ‘currently accepted medical use’ that are part of the criteria used to schedule drugs at the federal level.

“Therapeutic progress depends directly on the ability of physicians and researchers to study substances of interest,” said Cohen in a statement. He said the act’s updates will make sure “the evaluation of controlled substances is made on the best scientific evidence of today, not decades-old processes and outdated knowledge.”

Gina Giorgio with the organization ‘Students for Sensible Drug Policy’ told The Microdose the move is long overdue. “For decades, outdated and imprecise language in the Controlled Substances Act has created unnecessary barriers for researchers, delayed promising therapies, and cost us irreplaceable scientific progress,” Giorgio said.

On the state level, Connecticut’s SB 191 was signed into law on June 4 by Democratic Governor Ned Lamont, expanding access to the state’s psychedelics pilot program. Previously, the pilot program was limited to veterans, retired first responders, and health care workers. In Louisiana, lawmakers sent SB 43 to their governor – the legislation would use opioid-settlement dollars to create a psychedelic-assisted therapy program for trials of psilocybin, ibogaine and MDMA. Michigan lawmakers are debating whether to advance HB 6020, an ibogaine bill that would award grants to researchers within the state conducting drug development trials. New Hampshire’s ibogaine bill HB1772 awaits a final vote. Meanwhile, Colorado’s ibogaine research pilot program HB26-1325 was signed into law on June 4.

• President Trump’s executive order will not only accelerate research on psychedelic treatments for adults – but potentially also for children, Scientific American reports.

• German biotech entrepreneur Christian Angermayer, who founded psychedelics company atai Life Sciences and co-founded Compass Pathways, went on The New York Times podcast “Interesting Times” to discuss humanmaxxing, psychedelics and God.

• This week, Hunter Biden shared his psychedelic use in addiction recovery. In an X post reflecting on recovery, he shared “I have done ibogaine, ayahuasca, ketamine infusion therapy, 5 MEO-DMT, and a few others. All with the intention of “fixing” me, but without doing the work that comes along with realizing that intention. I have seen amazing results in others though and I am completely open to people seeking their own path to recovery,” Biden writes.

• A new collective bargaining agreement between the WNBA and players makes key changes to its banned drug list. For example, the updated agreement moves marijuana off the banned list, while also prohibiting use of ketamine, ibogaine, psilocybin, MDMA and synthetic cannabinoids such as delta-8-THC.

(Editor's note: An earlier version of this post did not make clear that the Amanita mushroom poisonings in northern California from November 2025 through March 2026 described in the CDC report were due to toxic all-white Amanita species A. phalloides and A. ocreata. Not to be confused with red-capped Amanita muscaria. We have updated the post for clarity.)

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After three packed days, my brain is buzzing from everything I’ve seen and heard here in Haarlem, at ICPR, one of Europe’s biggest psychedelics conferences. The program certainly lived up to the promise of being “interdisciplinary.” As I mentioned in my first dispatch, the conference didn’t shy away from difficult topics, while also highlighting psychedelic research from many fields. In practice, however, it’s not always easy to be critical, and at some points I got the sense that Joost Breeksema, the executive director of the OPEN foundation, was right when he determined that the psychedelic field is in its awkward teen years. Here are some takeaways and interesting tidbits I gleaned from a few different talks.

On Friday morning, I went to a symposium called “Negative clinical trials in psychedelic research: Lessons learned and future recommendations”, where three researchers talked about negative findings from studies they had conducted. A negative result means that an expected effect, relationship, or treatment outcome was not found. Scientific conferences usually highlight what went right, and negative findings are often left unpublished, or talked about with shame. As the moderator mentioned, such negative trials contain information about the limits of certain treatments, which populations may not be the best responders, and how clinical trial designs may be clashing with real-world experience. Jurriaan Strous, a Dutch psychiatrist at the University Medical Center Groningen, began the talk with a study on ketamine for suicidality that found no difference between a group given ketamine compared to a group given midazolam, a benzodiazepine. The trial ended early with 54 patients when a safety monitoring board said it would be unethical to continue since it seemed there was no effect at all. Strous pointed out that these were patients who he and his colleagues saw in the midst of crisis, and so the researchers didn’t advertise for the trial. Therefore, these patients may have had less expectations about ketamine. In fact, some had never heard of it. When they tested for blinding, the number of study participants who guessed which group they were in was the same as chance, suggesting that they may have successfully concealed who got which drug, which has proven to be particularly difficult in studies involving psychedelics. Strous showed the audience a graph of how the participants in each group rated on various scales, including the Beck Suicidal Ideation Scale. “You see no difference whatsoever,” he said. He added that he started off as a real believer back in 2014,” but after this study, “I was able to get a more neutral stance towards ketamine.”

Another panelist, psychotherapist Lea Mertens presented on the EPIsoDe study, a randomized clinical trial of psilocybin for Treatment Resistant Depression shared how, because they didn’t meet their primary endpoint of a 50% reduction of a certain depression measurement—the Hamilton Depression Rating Scale—their study was considered a negative finding. But she shared how in their long-term follow up, some participants still showed a reduction in depression. She wondered aloud how clinicians should make sense of that. Compass Pathways’s Phase 3 trials had similar results as the EPIsoDe study, but had a different predetermined end point, and so were considered positive outcomes. Mertens said it might be “a bit too simple to declare a study positive or negative based on one P-value.”

The negative findings panel was very thought-provoking. There has been research from Stanford University’s Boris Heifets and colleagues suggesting a role of expectancy on ketamine outcomes, and so these negative trials—where blinding was seemingly achieved—could help fill out that picture. But in the Q&A, some audience members pushed back, especially on the ketamine trial. One psychologist asked if there might be an anti-anxiety effect of midazolam that masked ketamine’s effects. Strous mentioned this in his talk, but said for suicidality, research on midazolam was scant. He said one explanation might be that suicidal people naturally drifted back to a less depressed baseline.

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Later on Friday morning, I went to “Living with guilt: Interview on stage between Garik Rober and Peter Gasser.” Gasser is a recent president of the Swiss Medical Society for Psycholytic Therapy and Rober is a former doctor and therapist who led an illegal group psychedelic session in which two people died. Rober explained that before leading the group session, he himself took 30 to 40 micrograms of LSD; a dose slightly higher than the typical microdose of 5 to 25 micrograms. He did so because he said he “knew all of the patients and expected tensions between them,” and thought that taking LSD would “open” him up to being better equipped to manage the participants. The group first took methylone, a synthetic drug with stimulant properties, and then MDMA. When Rober left the room to measure out the MDMA powder, he said he had trouble reading the scale and accidentally gave each person 10 times the expected dose. When certain participants started openly responding with agitation and distress, he gave one man diazepam, a drug that can relieve anxiety. A few minutes later, the man turned blue; Rober administered CPR while asking his wife, who was co-leading the session with him, to call emergency responders. The man died, as did another young man in the session. Rober was sent to jail that same day. He was ultimately charged with negligent homicide, and served three years in prison. (Despite his lifetime ban on practicing medicine or therapy, I noticed on his website that Rober still offers “coaching” by donation.)

It was a harrowing story, but if the purpose of the panel was to provide cautionary lessons to other facilitators or therapists, the interview fell short in significant ways. A number of key mistakes in the narrative weren’t addressed: like, why did Rober think that LSD would make him a better leader of a group of impaired and vulnerable people? Does that kind of thinking still exist in psychedelic circles—above or underground? When Rober doubted his MDMA measurements, he considered asking for help from his wife, but ultimately didn’t because they had had a small argument that morning. This could be a warning against spouses or people with personal relationships leading together if they let their personal lives interfere, but that wasn’t commented on either. Also, the question of training wasn’t acknowledged. Rober said he was trained by Samuel Widmer, a controversial therapist who died in 2017 whose permit to use psychedelics for research was banned by the Swiss Federal Office of Public Health. Widmer started the Kirschblütengemeinschaft, or the Cherry Blossom Community. This group of adults and children has been described in European news media and testimony from former members as cult-like, and dangerous—where alleged sexual abuse took place between patients and therapists and within families, and people died of overdoses. Did training with Widmer influence Rober’s decision-making and general attitudes towards guiding others during psychedelic trips?

In the Q&A, one person asked a good question about how therapists working with psychedelics often use psychedelics themselves. The audience member asked Rober if his own drug use led him to “erroneous ideas” and “narcissism?” Rober acknowledged that his psychedelic use supported his views at the time. “What can you learn out of my case?” he said. “How important, how necessary is supervision, intervention, being in contact with colleagues, and being honest with whatever happened.” But Gasser said, “I think we have to differentiate between taking psychedelics while being in the treatment of patients or taking it outside in a special setting for your training and self exploration. I mean, here it was clear LSD does not help managing any tools,” meaning the scale. The audience laughed. The question asker raised their voice to add, “They both have risks!”

The next day, on Saturday, I sat in on a talk called “A decade of clinical Insights: real-world evidence from European ketamine clinics.” Four experts shared their experience opening clinics that offer ketamine-assisted therapy in the Czech Republic, Germany, Norway and The Netherlands. It seems like a big undertaking to open a clinic, but my takeaway from this panel was how wildly different ketamine clinics (though likely not all of them) could be in Europe compared to the United States. Off-label ketamine clinics in the United States have faced their fair share of criticism; the industry was called in one paper the “wild west.” Clinics rarely take any form of insurance, and people might receive ketamine infusions without psychotherapy, with same-day appointments, or even get intravenous ketamine injections mailed to their home. This is radically divergent from what I heard from the European panelists who all described how ketamine was embedded in rigorous therapy programs that in some cases also involved art therapy, music, and even kayaking. “I can’t imagine giving ketamine to people… to just leave people in a room,” said Rutger Engels, a professor in Developmental Psychopathology, at the Erasmus University Rotterdam and co-founder of a clinic called Senz in the Netherlands. I admit that my American brain kept thinking, This sounds expensive! But then, each expert also described how most or all of their clinics were covered by insurance, and often with state-funded healthcare. In Norway, for example, at the Axon clinic, they use an Acceptance and Commitment Therapy-based approach in combination with generic ketamine, for which the country has approved nationwide reimbursement for treatment-resistant depression. Each panelist also shared how they discern who is the best fit for ketamine-assisted therapy —it’s not a given that any person will be administered the drug.

Later on Saturday afternoon, I went to a talk called “Patient perspectives and experiences of a novel psychedelic treatment for postpartum depression.” The talk covered findings from an interesting survey of women who participated in a postpartum depression study funded by the company Reunion, using RE104, a novel compound similar to psilocybin but with a shorter trip duration. University of South Florida epidemiologist Amanda Elmore was not involved in the original study but interviewed seven participants from one trial site about what it was like. All the people she talked to who got the active higher dose experienced remission in their depression, and said they felt more present with their babies after, and that their confidence as mothers was boosted. Getting insights from participants is invaluable. For example, the women did not bring up concerns around having to stop breastfeeding during the study, though they did express wishing for more counseling and support after the trial. One woman complained about only meeting with her counselor once. In the active group some people had positive drug experiences, while others were distressed: “My brain was just splitting open… I was so angry during it…very chaotic… not a moment of it was pleasant.” Yet both kinds of experiences still could lead to good outcomes. One person in the low-dose placebo group also had similar remission levels in depression scores. But for another woman who was aware that she was in the low dose group, the trial didn’t seem to manage her disappointment well. She told Elmore, “I’m back at square one… if I didn’t have the treatment then it’s like well what now? Where do I go? What do I do?”

Looking to the future psychedelic applications, in a talk called “Can psychedelics ever be given in the clinical setting to someone who does not have capacity to give consent?” Caroline Hayes, a psychiatrist based in Newcastle-upon-Tyne, UK spoke about a 2025 case report in which a woman in a minimally conscious state was given a dose of psilocybin. “This made me feel a little bit uncomfortable,” she said. I thought about Jonathan Moens excellent National Geographic piece on this topic about a husband who grappled with giving his minimally conscious and vegetative wife psilocybin. Hayes’s main message, bolstered by the legal concepts of capacity and consent in the UK, is that the research wasn’t far enough along to justify giving minimally conscious patients psychedelics. A person wouldn’t be able to receive preparation before their experience, or integration after—which are known to be helpful. And their experiences may be quite different than we are able to grasp. In a recent case report, a woman with a significant brain injury woke up from a 20-day coma and reported that she had had a traumatic near death experience without any drugs at all; this shows it’s possible to have a challenging experience, even in different brain states. “Patients with disorders of consciousness have no way of communicating that the experience that they’re having is challenging,” she said. During the Q&A session, Hayes said her views also extended to dementia cases, in spite of anecdotal cases where people with dementia gain some function for a short time after taking psychedelics. A person commented that in the Netherlands, patients could give prior consent to euthanasia, and asked whether such consent could apply in these cases too. Again, Hayes was wary. “Your opinion might change, you know, the version of you that signed that form isn’t the version of you that is experiencing that later stage.”

Throughout the entire conference, there was some good psychedelic fun to be had as well. Some of my favorite moments included cognitive scientist Christof Koch’s face projected on the overhead screen while calling in virtually, looming over the other panelists in the consciousness debate, demanding of neuroscientist Anil Seth: “Have you ever had the experience of becoming ‘one’?” Or University of Fribourg philosopher, Jason Day, breaking down the psychedelic experience into phenomenological categories that included, “What the f*ckness.” Drug historian and sociologist Ido Hartogsohn gave a spirited talk on non-hallucinogenic compounds, comparing them to diet soda that force us to define the value of a psychedelic experience.

A tradition of the closing session is that a random group of speakers is brought onto the stage with little notice and asked to reflect on the conference. Adana Omagua Kambeba, an Indigenous Brazilian medical doctor shared that at ICPR two years ago, there was only one Indigenous representative from Brazil (there were three in total), and this year only five. “The vast majority are scientists, researchers, and people connected to pharmaceuticals, but where are the guardians of these medicines that here are called psychedelics?”

Her comments led to applause, and then the other chosen panelists shared more groups they felt were underrepresented. Grace Blest-Hopley wanted the focus on women’s health to continue, while sociologist Joanna Kempner mentioned the cluster headache community—which is sometimes ostracized because they don’t necessarily prioritize the psychedelic experience in and of itself, but are seeking relief from debilitating pain. Psychedelic Alpha’s Josh Hardman said that as medical psychedelics become more available, the need to have patient representation will increase.

There have been similar calls for more inclusivity at many psychedelic conferences, for Indigenous representation, but also other groups: a greater diversity of socioeconomic classes, people of color, or those with serious mental illnesses that are often excluded from studies. I reflected on something that anthropologist Manvir Singh said in the closing panel about how the psychedelics community is now crystallizing into a proper field. There’s much to gain from that—unified questions and definitions—but things can be lost when an interdisciplinary project becomes a “field.” It risks becoming self-referential, and the questions asked become informed by only other people in the group. “How can psychedelics continue to benefit from interdisciplinarity and new ideas flowing in, while not being subject to the limitations that come as a field develops, which can close it off from other conversations?” Singh asked.

A part of the urgency around inclusion may be a response to what Singh is talking about: that the “psychedelic field” is being defined in real time, before our eyes. There’s fear that the gates will be closed, and only the people inside its borders will be able to participate and contribute. I still think that Breeksema was onto something with his metaphor around development—psychedelics are growing up. I welcome that maturity whole-heartedly, but maybe in some instances, the community should be careful about growing up too fast.

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This Friday, I’m reporting to you from ICPR, the Interdisciplinary Conference on Psychedelic Research, one of Europe’s biggest psychedelics conferences. It takes place in Haarlem, located just 20-minutes on the train from Amsterdam. Haarlem is the oldest city in North Holland; it’s home to the first museum in The Netherlands—a fabulous mix of fossils, scientific instruments, and Dutch art—plus all the canals, cobbled narrow streets, and gabled houses you could want when visiting this part of the world.

This is the 7th ICPR put on by The OPEN Foundation, a nonprofit that was founded in 2007 to advance psychedelic research and therapy. For the past three iterations, ICPR has been held at the Philharmonie Haarlem, the city’s concert venue. With its brick and wooden interiors, the conference setting feels warmer than those held at a convention center or a university. It also adds to its distinctly European flair. I’m attending ICPR this year in part to suss out how the European psychedelic sphere and European researchers view what is transpiring in the field in the U.S. Before I’d even begun talking to people, I could tell the vibe was different; more dress shirts and slacks and fewer of the giant Amanita muscaria hats and other psychedelia attire that you’d find at MAPS’s Psychedelic Science conferences.

This morning, I reflected on what it’s been like to regularly go to psychedelic conferences in the U.S. over the last seven years, as I have. Initially, some felt so intimate it was like I was intruding on small communities of people who all knew each other. A hype-y period followed, where newcomers from biotechnology, the pharmaceutical industry, and longevity space flooded in, attendance swelled, expectations crested, then fell—and ultimately became confused in the midst of political and regulatory back-and-forth.

“At the risk of generalizing, I think that Europe has approached this field with a certain moderate temperament,” Joost Breeksema, the executive director of the OPEN foundation, said at the opening talk. He acknowledged that this might feel frustrating compared to the spurts of activity taking place in the U.S. But consider how “so much of the discourse is driven by financial pressure, political volatility, opportunism, pharmaceutical companies, deep pockets, celebrities, influencers, tech bros looking for immortality,” Breeksema added. “Our sober outlook looks a little bit more like a sign of maturity.”

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Honestly, it is a relief to put the U.S. out of my mind for a few days, even if it’s a case of “the grass is always greener.” President Donald Trump’s executive order on April 18 caused a flurry of debate around whether psychedelics belong to the right or left, if the U.S. is moving too fast or too slow, while reigniting evergreen questions about cost, commercialization, and tensions between regulatory change and medicalization. The executive order “hardly plays a role here,” Breeksema told me. Attending ICPR is a reminder of the European—and global—psychedelic community that is managing its own steady growth and evolution. And they too seem to be grappling with how to make sense of the forward motion of the last several years.

Breeksema offered a metaphor for this sense-making, different from the concept of a “Renaissance” or the hype boom-bust cycle. He compared it to the developmental stages of becoming an adult. “In some ways, I think we’re somewhere in the middle of adolescence,” he said. “The field is growing fast, faster than many of us anticipated, or were even ready for. We are still trying to figure out what kind of adults we will grow to be, what we stand for, what we owe to the people and traditions that were here before us.” And part of embracing maturity is confronting the awkward parts of getting older.

ICPR’s program is wide-ranging, and it doesn’t have a theme. It’s focused more on the humanities than read-outs of clinical trial results. It almost exhaustively considers the experience of different demographic groups and under-addressed experiences. There’s a pervasive critical slant; for example, there are panels on negative results, erotic feelings that emerge in therapy, and the lived experience of psilocybin non-responders.

At the last ICPR I went to, in 2022, I remember the conference also dealing with complex topics. It’s where, for instance, I talked at length to researchers about issues with the limitations of placebo two years before the U.S. Food and Drug Administration listed those reasons in their rejection of MDMA for PTSD. That same year, Johns Hopkins researcher David Yaden created the Wet Blanket award, an honor given to the most “negative” presentation, to encourage psychedelic researchers to share difficult aspects of their work. In 2024, the award was given to Jamila Hokanson from Yale University for presenting on cases where OCD patients did not respond to psychedelic therapy.

I’m glad to see this ethos still stands—one that takes psychedelics’ potential as a given, and then gets into what emerges after that presumption. In the first talk I saw, a keynote by the neuroscientist Grace Blest-Hopley, whose PhD focused on how cannabinoids affect the brain. She asked why women’s health and biology hasn’t been more of a priority. Even though sex as a biological variable was introduced by the FDA in 2016, very few studies monitor sex-based differences that could emerge based on where a woman is in her menstrual cycle, or what else is going on for her hormonally—let alone the other social and psychological factors that could be unique to women. Estrogen and progesterone fluctuate throughout a woman’s cycle, interacting with the brain and serotonin receptors in meaningful ways, even before you add a psychedelic into the mix. Her non-profit, Hystelica, will be doing research in collaboration with King’s College London on psychedelics and menopause.

Continuing on the motif of narrowing in on specific groups, I heard intriguing presentations on two small research projects, one that revealed psychedelic use among Orthodox Jews, the other among Muslim women. It was fascinating to hear how the Jewish men made psychedelics “kosher,” by making changes to ceremonies that aligned with their views. In some cases, they had encounters with Jewish entities, whereas a Muslim woman interviewed, said she found her connection to the Quran deepened.

There is a very strong therapy theme I’ve picked up on here, which struck me as notable given the trend in the U.S. among companies looking to bring psychedelic drugs to market is to move away from psychotherapy and towards the more nebulous “psychological support.” I heard Dutch psychotherapist Guy Simon speak about cases when therapy doesn’t help those with extended difficulties after taking psychedelics. An interesting talk from Dutch psychiatrist Damiaan Denys asked whether psychedelics should affirm, without question, or move beyond the diagnostic categories in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, published by the American Psychiatric Association. And I spotted panels on a Foucauldian analysis of “losing your mind,” how Jungian therapy might shape psychedelic therapy, and culturally adapting therapy for Indian and Rwandan patients. Breeksema told me that the program is largely driven by what would-be presenters submit; it’s like a snapshot of what researchers are thinking about at the moment. But he has a penchant for big-picture perspectives that drive the curation.

For the rest of Friday and into the weekend, I am looking forward to a symposium on Asian psychedelia, which is something I’ve long been curious about—how cultural norms might interact with psychedelics. In anthropologist David Dupuis’ talk on Ayahuasca-induced voices, he’ll explore why auditory hallucinations are less considered than visual ones. And there’s a very striking interview that will take place with Garik Rober, a German physician and psychotherapist. In 2009, Rober led an illegal psychedelic group therapy, and two people died. He was sentenced to four years in prison for negligent homicide plus a lifetime ban on being a therapist. “Our conditions for giving this a stage were that we would neither try to absolve him or justify him, or neither try to condemn him,” Breeksema said. “Instead, honestly, exploring what could lead to such a situation, what we can learn from it, how we can prevent it from happening in other such situations.”

Finally, three big names in consciousness research—Bernardo Kastrup, Anil Seth, and Christof Koch—will debate whether psychedelics teach us anything about the nature of consciousness or reality. I love when experts in other fields highly related to psychedelics (like consciousness or neuroscience) come to psychedelic conferences and share their wisdom.

The array of perspectives, in some ways, is overwhelming. The conference is trying to acknowledge ethical breaches and the ongoing wars in the Middle East and Ukraine, as well as give voices to clinical trial patients, honor Indigenous lineages, shine light on women’s health, nod to the recreational psychonaut, and make space for various religious belief systems all at once. It’s a staunch reminder that psychedelics mean very different things to different people—and we should try to contend with all of them. How do I feel about the ability to do so? As I overheard one attendee say to another over coffee in the main lobby: “neither too optimistic nor too pessimistic.”

I’ll be back on Monday to give you a recap of what else I found at the conference!

When Gwyneth Paltrow wanted to go on a psychedelic mushroom retreat for her Netflix show, she went to Jamaica. As a country where psilocybin-containing mushrooms have always been legal and where dosing limits don’t exist, the island nation has found itself playing host to a growing crop of psychedelic retreat centers that cater to wealthy foreigners. At MycoMeditations, the center Paltrow visited, retreat prices are listed as ranging from $6,250 to $13,600, with another tier for private retreats that are “price upon request.” Meanwhile, the gross income per capita in Jamaica is around $10,000 per year.

For Maria Pinto, a Jamaican American author and mycophile who lives in the Boston area, this leads to complicated feelings. On the one hand, these retreat centers can feel to her like “neocolonial endeavors” where (usually white) foreigners come in to “extract the ‘natural resource’” of Jamaica’s permissive drug laws. On the other, she’s a person who has found psilocybin to be a medicine in her own life — often from mushrooms she’s found for free while out foraging. That first hand experience makes Pinto interested in the ways that these retreat centers spread the potential benefits of psychedelics in Jamaica by training local therapists and enabling psychedelic research.

Pinto digs into this dynamic in her recent book Fearless, Sleepless, Deathless, a meditation on all things fungi that brings together personal essay, scientific musings and cultural criticism. The Microdose spoke with Pinto, a respected figure in East Coast mycology circles, about retreats for the rich, her experiments with lesser-known psychedelic mushrooms, and the relationship between psychonauts and the broader mycological community.

In the book you write about a new wave of psychedelic retreat centers in Jamaica, and wrestle with the tensions they represent. Can you tell us a little bit about that?

Because of Jamaica’s permissive laws around psychedelics and the fact that psilocybin has never been illegal there, I knew that as soon as public will and money were behind them, there were folks who were going to go to Jamaica to do something like this. As someone who loves the fact that society is talking more about psilocybin and all of the wonderful benefits of it as a medicine, I have a very complicated relationship to seeing these centers become luxury getaways for rich folks. Because it’s the very same thing that the tourism industry does: it parcels out land, making it inaccessible for Jamaicans themselves. People are coming from elsewhere to profit. It feels very much like the same frontiersperson attitude of, ‘They’re not doing anything with it. We might as well go down and make a mint off this thing.’

In my interview with Justin, [the founder of] MycoMeditations, in the book, I did want to get him to own up to what I see as the same old VC thing — which is something like, ‘We see a way to make a lot of money, and now I’m going to spend however long it takes to make a profit out of this place.’

But it’s a complicated relationship, because there are aspects of what he’s doing that I love. I love that they’re taking some of this capital, and they’re training therapists on the island who are interested, which is very thrilling. Who knows how long it would have taken for that kind of relationship to emerge without centers like these? And they’re at the forefront of a lot of the studies, because they are doing this all unencumbered by the law. So there are benefits too.

I have complicated feelings about it. But at the heart, I’m like, ‘How is the average Jamaican gonna get a piece of this pie?’ That answer remains unclear.

What would it look like to build non-extractive and equitable access to the benefits of psychedelics in Jamaica and beyond?

Having several different kinds of models is key. I talk a little bit in the book about non-medicalized spaces that have started to emerge in the past few years that are run by Jamaicans. You pay something like $200 to basically get your set and setting taken care of, and these people who have worked in hospitality industries in Jamaica facilitate your experience. I’m interested in seeing more stuff at that level emerge, because it’s a lot more accessible.

We know how it played out here in the States with legalization around marijuana, and that’s what I don’t want to see. The cottage industries that had been around for a long time felt the hurt. [For psilocybin], there has to be something between the big guys charging thousands and thousands of dollars, and just finding someone on the beach who doesn’t even know how to tell you about dosage. There has to be a middle tier. And I fear that that won’t happen, because we’ve seen how often the big guy stamps out the little guy.

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Psychedelics are just one facet of your interest in mushrooms. Did an interest in mycology lead you into an interest in psychedelics, or was it the other way around?

So many people I know became serious mycologists because they were looking for psilocybin-containing mushrooms. But I got into foraging and the culinary aspects of mushrooms well before I considered looking for my own medicine or anything as lofty as that. I had a psychedelic experience with psilocybin back in college, but it was not at the fore of my mind when I first started foraging for mushrooms. It became extremely interesting when I realized that you could find Psilocybe ovoideocystidiata around the Boston area. I did start looking for those once I realized that their range was this far north.

Now, though, people in my life that I never even would have imagined have gotten interested in microdosing for the therapeutic aspects, to help with OCD or depression symptoms, or to be less anxious about being a new mother. It’s been quite moving to be able to point people in the direction of certain research, and say, ‘Yeah, I know a little bit about this thing that everyone’s buzzing about.’

As someone who attends lots of mycology conferences and forays, do you ever witness tension between the psychonauts and the more ecology or biology-focused fungi lovers?

Yes. It’s palpable to me, especially when you have people who are a little bit more serious and staid in their study of mushrooms, who maybe feel that there’s a tendency to make into a party this pursuit that they deem noble. Because when you tell people that you study mushrooms, the first question is generally going to be, ‘Oh, you mean the fun ones, the magic ones?’ To sort of militate against that within the community is probably just seen, for some, as self preservation.

But there’s a scientistic dislike I’ve seen of anything to do with the Spirit, and anything to do with the intangibles of this stuff that we’re studying. There can be a desire to distance yourself from the thing that looks unserious. I’ve definitely seen people scoff when there’s certain programming at one of these convergences, especially if it feels like it’s too touchy feely. On the other end, I’ve seen people being like, ‘Wow, you all are joyless grinds.’

Even within communities of people who are very much into psilocybin, there can be a divide between folks who want to be objective about it and want to speak only in terms of the usefulness of psilocybin as a drug, versus people who use terms like ‘entheogen,’ and who feel that they are communing with God. It’s easy for them to misunderstand one another or talk past each other if they feel like the other group is misrepresenting or somehow ruining the image of the mycological community.

In the chapter of your book focused on your own psychedelic experiences, you chose to focus on Gymnopilus species, aka Laughing Jims — a genus of over 200 fungi with fourteen psilocybin-containing species, which you describe as “complicated and misunderstood even by those who study fungi.” Why concentrate there rather than on one of the better-known psychedelic mushrooms?

Because these are mushrooms that grow in my neck of the woods that I was learning about in real time. There’s something so cool about going to my home woods, seeing a new spot where gyms are emerging, and harvesting them. And that came just from my noticing, from me being out in the places that I go. People have related to the land in this way for millennia. I feel like it’s this wonderful reconnection to be able to say, ‘I found the thing that helps me with my ADHD on the ground. It was free.’

One of the main ways that I became comfortable with taking them was through a poisons expert who lives in Rhode Island named Spike Mikulski. He’s a chef, but also the Amanita guy — he’s the one that people are calling for toxicology cases, so he knows the emerging science. I was watching him like a hawk, because he would make Gymnopilus lemon bars. When people were like, ‘I found this huge cluster of gyms, but they’re too bitter to eat,’ he was always raising his hand, saying ‘Shoot them my way.’ I watched that with great interest.

I saw all the oldheads on the internet talking about taking gyms at the conferences to get through boring, dry lectures. There was an openness that they had in talking about it that didn’t quite square with how people seem to feel about [them]. You know, people who say stuff like ‘Those aren’t worth it; they’re too bitter to have in enough quantity to actually experience anything.’

One of the reasons I wanted to write about them was because I didn’t see anyone else talking about them, except people within the mycological community. We don’t know as much about gyms as we do about the traditional Psilocybe species. I wanted to be very clear that I was not telling anyone that they should experiment with them, and I was obsessively looking for papers to see what other chemicals that could hurt you might be present as well.

But I also wanted to be clear that some of these mushrooms are extremely potent. I was seeing visuals sometimes, and I had never seen that reported anywhere else. It felt exciting to be talking about something that no one else was talking about, and to watch as this little-known vessel for psilocybin was used by people who knew more about it than me.

This interview has been edited and condensed for clarity and length.

Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.

Veterans Affairs announces new MDMA clinical trial

In the Department of Veterans Affairs’s latest push to research the potential for psychedelic treatments to help American veterans nationwide, the department announced a new MDMA clinical trial on Tuesday. Study leaders are enrolling approximately 80 veterans to test MDMA-assisted therapy for post-traumatic stress disorder and alcohol use disorder. Some participants will receive 180 mg of MDMA in each of the three sessions, while others will get an “active placebo” (a 40 mg dose of MDMA). Patients in both treatment conditions will receive psychotherapy, and they will be recruited from VA health systems in Rhode Island and Connecticut, where study leaders are employed.

The department is currently participating in 19 other psychedelic therapy clinical trials, according to the notice announcing the latest trial. All VA research in this field is taking a “strict” approach to safety, leadership said. Of note, the MDMA trial has a long list of exclusion criteria for would-be study participants, including if they’re likely to be re-exposed to trauma during the trial period or don’t have a “support person” at home, presumably to avoid recruiting patients who may be at higher risk of adverse events.

In a recent hearing before the U.S. Senate Committee on Veterans’ Affairs, VA Secretary Doug Collins noted that ibogaine will likely be the next psychedelic the department focuses on, following President Trump’s executive order last month, which specifically called for more research on ibogaine. In the hearing, Senator Ruben Gallego (D-AZ) asked how the VA is approaching psychedelic-assisted therapies. “If it helps a veteran, we’re gonna look into it,” Collins replied. “We’re developing the standards right now, on how we’re going to be implementing this.” He mentioned the MDMA trial, and said ibogaine will probably be the department’s “next big one.” “It’s gonna take a little time to get that because … that’s gotta come through the FDA first.” Importantly, officials will also need to source the ibogaine, he said, “which we don’t have a costing on at this point.” Indeed, sourcing the drug for studies is “the single most important issue facing the ibogaine lobby,” journalist Jack Gorsline wrote on X.

Senator Gallego, championing the VA “Novel Therapeutics Preparedness Act,” went on to encourage Collins to “work with Congress” to close the gap between research and access to the treatments. The Novel Therapeutics Preparedness Act, introduced in late March, would establish a new office within the VA to make “implementation-readiness plans” and prepare the department to approach psychedelic treatments safely. VA leadership has voiced skepticism about the new office being duplicative of their current systems, potentially making the VA’s efforts less efficient.

Psilocybin’s antidepressant results are both rapid and long-lasting, small trial shows.

A single dose of psilocybin has a rapid and months-long antidepressant effect on people with major depressive disorder, compared to an active placebo. That’s according to results from a small clinical trial out of Sweden. The Phase 2 randomized trial found that over half of the psilocybin group was considered “in remission” six weeks after a single psilocybin dose, compared to only one of the patients in the placebo group.

The study, published in JAMA Network Open, recruited 35 participants that received either a 25 mg dose of psilocybin or a 100 mg dose of niacin, a B vitamin used as an “active” placebo because it produces skin flushing. All participants underwent five psychotherapy sessions over 17 days. Those who received psilocybin displayed a significantly greater reduction in depression scores, as measured by the Montgomery-Åsberg Depression Rating Scale, eight days after dosing. Participants’ self-rated depression symptoms showed improvement even sooner.

“Such rapid effects are comparable only to those of ketamine and possibly electroconvulsive therapy and faster than other MDD treatments, including SSRIs, cognitive behavioral therapy, and repeated transcranial magnetic stimulation,” the authors write.

The antidepressant effect persisted for over three months. However, it didn’t last up to a year, suggesting that repeat treatments might be needed, lead author Hampus Yngwe said in a press release. “This needs to be investigated in larger studies,” he added.

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Psychedelic trips leave traces in speech through vocal “jitter” and “shimmer”

Scientists recently analyzed speech patterns in participants who attended a psychedelic 5-MeO-DMT retreat. 5-MeO-DMT, which can be made in a lab and is also found in secretions from the Sonoran Desert toad, produces brief, intense psychedelic experiences. By analyzing retreat attendees’ language and vocal dynamics before and after their trips, researchers at the University College London reasoned that they may be able to predict users’ subjective experiences and even psychological outcomes.

“Language may serve as a valuable proxy for understanding and predicting mental health,” the authors write. “Vocal features,” measured by sound quality, frequency, and amplitude, they added, could also reflect changes in people’s mental states. The article, published in the Journal of Psychopharmacology on May 23, reported that participants’ speech markers indeed predicted “psychological transformation” from the 5-MeO-DMT retreat.

The researchers analyzed voice notes recorded by 29 participants for two weeks before and after their 5-MeO-DMT trip at the Tandava Retreat Centre in Mexico. The researchers used acoustic analyses to find increased “jitter” (variability in fundamental frequency of voice) and “shimmer” (irregular variation in loudness) in participants’ voice quality after the trip. Higher jitter and shimmer have been linked to anxiety but in this case “may reflect a temporary turbulent or liminal state,” the authors write. “Taken together, these findings underscore that elevated jitter and shimmer might not necessarily indicate clinical distress but rather a transient window of malleability and openness following a profound psychedelic event,” they add.

Overall, the researchers suggest that linguistic and vocal markers may serve as prediction tools for therapeutic response.

Scientists pair intravenous ketamine with drug targeting opioid receptors to enhance antidepressant effects

In the latest attempt by researchers to pair ketamine with other drugs to better harness antidepressant properties, Stanford scientists conducted a Phase 3 clinical trial testing if the medication buprenorphine could prolong ketamine’s transient effects.

Buprenorphine is frequently used to treat opioid use disorder, and it’s known as a partial agonist of the brain’s opioid receptors, meaning it can stabilize their activation. Scientists believe opioid receptors play a role in ketamine’s antidepressant action, and many are testing drug pairings to enhance ketamine’s effects and produce symptom relief while mitigating side effects.

The Stanford researchers published the results of their trial in the American Journal of Psychiatry last week. They recruited 45 participants with major depressive disorder, randomized to receive either buprenorphine or a placebo for four weeks following a single infusion of ketamine. Participants’ score on the Scale for Suicide Ideation was assessed every week from day one through day 31.

Those in the buprenorphine group had a greater reduction in suicidal ideation scores. Thus, the trial provides the first evidence that buprenorphine “sustains and enhances” the antisuicidal properties of ketamine for patients with major depression, the authors wrote. “We have a sequence of treatments that’s doable now if the field wants to adopt it,” senior author Alan Schatzberg said in a Stanford Medicine article about the study.

More states join the ibogaine push and Connecticut expands psychedelic access while Georgia ups regulation

Michigan lawmakers recently introduced an ibogaine bill that would award grants to researchers within the state conducting drug development trials. The legislation, HB 6020, would also require the state’s participation in a multi-state consortium working towards Food and Drug Administration approval and breakthrough therapy designation for ibogaine treatments. In an announcement from the bill’s sponsors, psychedelic researcher Kevin Boehnke from the University of Michigan Medical School said that while ibogaine holds promise for treating conditions like substance use disorders, “rigorous, thoughtful studies are essential to determine who may benefit, how to reduce risks, and how to build treatment models that are safe, ethical, and grounded in evidence.”

In other ibogaine news, Tennessee’s SB 2149 was recently signed into law by Governor Bill Lee, a Republican. It creates a state fund for “mental health innovation” using money from intellectual property and commercial rights that may come from ibogaine trials, along with public dollars.

In Connecticut, legislation to expand access to the state’s psychedelics pilot program has passed and was sent to the Governor on May 26. SB 191 opens eligibility to residents 18 and over who meet clinical eligibility criteria for the state’s psychedelic-assisted therapy program, which includes MDMA and psilocybin studies. Currently, the pilot program is limited to veterans, retired first responders, and health care workers.

And in Georgia, a revived HB 717 was signed into law by Republican Governor Brian P. Kemp this month. The legislation aims to regulate psychedelic-assisted therapy in the state by directing a medical board to create rules by the end of the year “to establish consistent standards, ensure continuing competency, and promote patient safety.”

• For The Atlantic, our very own Shayla Love sat down with Americans for Ibogaine co-founder W. Bryan Hubbard to learn how he rallied Republicans behind ibogaine.

• And our newest writer Robin Berghaus did a Q&A for Nature with cognitive scientist Félix Schoeller, covering his development of an artificial intelligence chatbot that could train facilitators for psychedelic-assisted therapy. His team used thousands of anonymised recordings from the Fireside Project’s psychedelic support phone line to build the AI platform, “Lucy,” with the goal of helping train facilitators using realistic scenarios.

• ABC profiled a manufacturing hub in Brisbane, Australia, that produces MDMA and psilocybin for clinics across the country. This follows Australia’s 2023 approval for authorized psychiatrists to prescribe the drugs.

• “Friends” star Matthew Perry’s assistant, who injected the actor with the ketamine that killed him, was sentenced to more than three years in prison on Wednesday, according to The New York Times.

  

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Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.

Researchers ask probing questions about methylone study

In February, the New York-based psychedelic company Transcend Therapeutics published promising results from a Phase 2 study on methylone, which is similar to MDMA, for the treatment of PTSD. Last month, the U.S. Food and Drug Administration chose the company for a coveted priority voucher to expedite review of their drug for potential approval. But this week three researchers wrote a probing commentary in JAMA Psychiatry, where the initial research was published, suggesting that the company provide more transparency about its trial methodology and data.

Transcend’s initial Phase 2 study was a double-blind, placebo-controlled clinical trial in which 65 people with PTSD were treated either with weekly doses of Transcend’s drug candidate, TSND-201 or methylone, or a placebo for four weeks. They found that participants treated with methylone showed greater improvement than the placebo group on standard scales measuring depression and PTSD symptoms, and that the adverse effects reported by participants were generally mild.

In their commentary about Transcend’s initial publication from the study, the authors — Icahn School of Medicine at Mount Sinai and Veterans Affairs psychedelic researcher Rachel Yehuda, and Stony Brook University researchers Geoffrey Russell and Apurva Parikh — ask for data that they say could “refine mechanistic understanding and inform the design of subsequent trials.” Though these questions apply to Transcend’s data specifically, they touch on broader questions that psychedelic science is grappling with, especially in light of recent efforts to fast-track psychedelic drugs. Since Transcend’s original study was published, the company received one of the U.S. Food and Drug Administration’s priority vouchers for methylone. An executive order signed by President Trump in mid-April sought to accelerate access to psychedelics, and it included an order for the FDA to issue priority vouchers to psychedelics companies that would expedite the FDA’s review of their drug candidates submitted for approval. (Later that week, then-FDA commissioner Marty Makary announced three developers — Transcend, Usona, and Compass — will receive those vouchers.)

Parikh, Russell, and Yehuda suggest Transcend needs to collect data that quantifies the psychological support received by Transcend’s clinical trial participants. (Other companies, such as Compass, another priority voucher recipient, have begun describing the oversight that facilitators have over participants as “psychological support,” in contrast to psychotherapy.) The commentary’s authors also recommend probing whether aspects of that support were associated with the study’s outcomes, and examining whether participants’ ability to guess which condition they were in — 70% of participants who received methylone correctly guessed which condition they were in, whereas 53% of participants in the placebo group guessed correctly — was associated with outcomes. Additionally, they ask whether Transcend would consider reporting a more rigorous analysis of their results, and for the company’s researchers to further articulate their theory of how TSND-201 might lead to sustained improvement in participants.

According to a note accompanying the article, “this letter was shown to the corresponding author of the original article, who declined to reply on behalf of the authors.”

The complications of psychedelics access under the Right To Try Act

President Trump’s April executive order on psychedelics included a clarification on the use of psychedelics as part of the FDA’s Right To Try policies, which allow people with terminal and life-threatening conditions to try experimental drugs that have undergone Phase 1 trials and are being considered as an investigational new drug by the agency but have not yet been approved. The executive order specifically directs the FDA and Drug Enforcement Administration to “facilitate and establish a pathway for eligible patients to access psychedelic drugs” under Right To Try.

Since 2021, Seattle-based physician Sunil Aggarwal and his lawyers have sought clarification from the federal government on accessing psilocybin for terminally ill patients via the Right To Try Act. They reached out to the Department of Justice after Trump’s executive order on psychedelics was signed on April 18, asking about next steps given the development, and were told that the authorities were “analyzing the relevant evidence and consideration,” with no estimated time for completion. In a reply sent this week by Aggarwal’s lawyer Shane Pennington, he points out that the FDA has “already twice granted Breakthrough Status” to psilocybin as an investigational drug, arguing that analysis of the evidence “has already occurred.” The delay signals the disconnect between the declarative act of a president signing an executive order and the reality of enforcing the order, which requires action and coordination among large government agencies.

Moreover, as attorney Kimberly Chew points out in a recent Law360 piece, the executive order’s Right To Try clarification might also include some new legal issues for psychedelic drug companies — especially for any ibogaine drug developer, given the administration’s recent decision to designate DemeRx’s noribogaine as an investigational new drug. “On the surface, this looks like accelerated progress,” Chew wrote in a LinkedIn post. “Underneath, it creates a regulatory collision that every ibogaine sponsor, clinical trial lawyer, and regulatory affairs professional needs to understand right now.” Noribogaine’s investigational new drug status means that technically, patients could access ibogaine under Right To Try — and, as Chew explains, those Right To Try patients could experience adverse events that drug sponsors are required to report as part of any drug application, even if the sponsor did not administer it. Physicians providing psychedelics to Right To Try patients are not required to follow any particular protocols to monitor patients for safety. “That is the control paradox: full regulatory responsibility for settings you cannot govern,” Chew wrote on LinkedIn, and went on to say in her Law360 piece that Right To Try access “could generate the adverse event data that derails development programs.”

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Maine ayahuasca church sues federal government

On Tuesday, an ayahuasca church in Maine called Pachamama Sanctuary and its leader Derek Januszewski sued several U.S. cabinet leaders in Maine’s U.S. District Court, alleging that the federal government’s seizure of “sacramental plant materials” used to make ayahuasca violated the Religious Freedom Restoration Act. Defendants include U.S. Attorney General Todd Blanche, Homeland Security Secretary Markwayne Mullin, DEA administrator Terrance Cole, and U.S. Customs and Border Protection commissioner Rodney Scott. The suit alleges Customs and Border Protection agents seized multiple packages containing plant materials between 2020 and 2022 but does not specify how many packages were intercepted, where they were intercepted, or how much plant material was seized.

In their suit, the plaintiffs cited previous cases with Brazilian ayahuasca churches Santo Daime and União do Vegetal which successfully fought the DEA’s efforts to challenge their ceremonial use of ayahuasca. In 2006, União do Vegetal won a landmark case in the U.S. Supreme Court which ruled that the federal government could not prohibit the group from importing and consuming ayahuasca tea in ceremony. Pachamama is a non-profit church registered with the state and has safety protocols in place. The plaintiffs are represented by Portland, Maine lawyer Alexander J Mihalov and Texas lawyer Greg Lake, one of the co-founders of the Church of Psilomethoxin.

More states pass ibogaine research bills

After recent successes in Louisiana and Tennessee, ibogaine advocates continue to gain political traction in states across the country. Last week, the Colorado legislature passed House Bill 26-1325, which creates an ibogaine research pilot program and allows the state’s licensing authority to accept gifts, grants, and donations to support the work. A similar bill in Oklahoma, passed by its legislature in early May, was signed by the governor last week.

• Adult mangrove rivulus fish are usually aggressive towards one another, but when they’re given psilocybin, they chill out and are less likely to fight, according to a new study in Frontiers in Behavioral Neuroscience.

• Psychedelic patent watchdog organization Porta Sophia launched a psychedelics legislation tracker.

• Psychedelic Alpha’s Josh Hardman reported on a recent talk given by U.S. National Institute on Drug Abuse director Nora Volkow at the American Psychiatric Association’s annual meeting. Volkow had previously said she thought it was unlikely ibogaine could ever receive FDA approval, but she’s become increasingly publicly enthusiastic about the drug’s potential. “If I can’t change my views based on evidence, then why do science at all?” she explained during her presentation.

• What happens when you feel like Jesus after taking psychedelics? Double Blind reports on the connections among spirituality, psychedelic, and psychotic states.

• Some therapists who worked on psychedelic clinical trials are increasingly concerned about the safety of participants and how the studies are being run, reports Jules Evans in Ecstatic Integration.

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In 2016, a research scientist and National Geographic Explorer, Albert Lin, was in a car accident and had his lower right leg amputated. Like many other people who lose part of their arm or leg, Lin started to feel pain where his leg used to be, a phenomenon known as phantom limb pain. For around two-thirds of amputees, the sensation is severe. Lin felt like this phantom foot was stuck in a tightly flexed position at the ankle, and felt extreme pain several times per day.

He sought the help of V.S. Ramachandran, a neuroscientist at University of California San Diego who has done research showing that when a mirror is placed so that it reflects the other limb, it creates an illusion that the amputated limb has been restored and provides relief. But the relief sometimes only lasts as long as the mirror is in position. Lin wasn’t responding to pain medications, and decided to try psilocybin mushrooms, which he had heard anecdotally could help. In a case study from 2018, Ramachandran, Lin, and their colleagues reported that the combination of mirror visual-feedback and psilocybin led to “a striking and long-term reduction of pain.”

Lin’s success was just a case study. To figure out if psilocybin can help others with phantom limb pain, neuroscientist and professor of anesthesiology at UCSD, Fadel Zeidan, ran a small study in nine more amputees; five received psilocybin and four received niacin as a placebo. The trial’s goal was primarily to show that it’s safe to give psilocybin to amputees, yet the preliminary results were promising: those who received the drug experienced a 50 to 75 percent reduction in pain. Zeidan recently received a grant from the National Institutes of Health to do a clinical trial with a larger sample size. The Microdose talked to Zeidan about his initial study, and how he thinks psilocybin reduced this mysterious kind of pain.

How did the research on phantom limb pain and psilocybin begin?

Albert Lin is a professor and a National Geographic Explorer. He got into a really bad car accident, and they had to amputate his leg because he had an infection. This super active dude had crippling phantom limb pain, which is pain that emanates from a limb that’s missing; it feels like the limbs are basically being severed. Physiologically, it really makes no sense. It might be related to trauma, where the organism’s safety signal pain is still saying, ‘Hey, there’s something wrong.” Albert went to Joshua Tree with his girlfriend, took a massive dose of magic mushrooms, and after working with Ramachandran here with a mirror box, brought a mirror to the desert and coupled his psychedelic experience in Joshua Tree with the mirror. It essentially eradicated his pain. A case study was published on that, with a sample size of one.

My first talk at UCSD eight years ago, Albert was in the audience, and I had just come from North Carolina at Wake Forest University. He approached me after about my work on [the neuroscience of] meditation and asked me if psychedelics work on the same biological processes. After I looked around and saw there were no cops in the room, I said, “Yeah as a matter of fact, I think they do.” Because they both likely target mechanisms supporting egocentric appraisals of experience. He invited me to meet a bunch of other psychedelic researchers that had been in the underground that were working with rodents. And they got a gift from a philanthropist to study phantom limb, and we were able to carry out that work. It kind of fell in my lap.

I had heard of the mirror techniques to alleviate pain—do you think the psilocybin is enhancing its effect or doing something on its own?

Great question. I don’t know. Albert believes that the mirror was critical, and we had this dilemma: do we do this with the mirror? I didn’t want to because we still didn’t do the first pancake study, we don’t know the effects of psilocybin alone. I love Ramachandran’s work but the mirror box isn’t sustainable. It’s so cool how it works. It basically creates this illusion that your limb that’s missing is intact, which can give this exhale that tells this aberrant signal from the organism that it’s actually okay. But that’s not the truth. There is currently no cure for phantom limb pain. Mirror box has an immediate phenomenon, and perhaps coupled with the truthfulness that psilocybin can elicit, it can be uniquely efficacious.

For the small study you’ve recently completed, as you said you didn’t use a mirror. What were your results without it?

We did a phase zero basically, a safety study, of five people versus four. We did 25 mg psilocybin versus 100 mg of niacin. The main question was: is psilocybin safe for people that have amputations and phantom limb pain? And we did functional MRI before and after. We screened them, we scanned their brains, did pain assessments, we prepped them for three days, and we dosed them. The day after, they did integration. They had eyeshades and music. Not too far off from the Hopkins model, but I think we have a cooler playlist. Then we collected data two and four weeks post-dose.

We found it was very safe. In fact, the niacin group had higher blood pressure increases than the psilocybin group. In our world, 30 percent improvement in pain is considered clinically significant. And after four weeks, there was a 70 percent reduction in phantom pain. Mind you, nothing works for this disease. The same was true for residual limb pain, pain that emanates from the stump. And one of my favorite findings is that on the Brief Pain Inventory, the classic standardized chronic pain assessment, from two weeks and four weeks after the dose you can see a beautiful staircase effect. So the psilocybin is still doing its thing after the dose.

When we ran fMRI analyses, we found a greater deactivation of the thalamus, which is a central component of pain processing, and the default mode network, where there are self-referential processes. In the primary somatosensory cortex, we saw a lot of activity there too. This is a major player in phantom pain because the sensory cortex reorganizes itself to facilitate the experience of phantom pain. What we saw was that the greater the brain activity there—and perhaps reorganization rehabilitation—the greater the pain relief four weeks out. That’s the study, more or less. And three weeks ago, we landed a $4 million grant from the NIH to carry out a properly powered trial.

How do you think psilocybin reduces the pain?

As a physiologist, it doesn’t make sense that there’s pain that’s coming from an area that’s not there. Perhaps the method is to treat a hallucination with a hallucination, to push the control, alt, delete, restart buttons that allows the system to say, “Oh, we’re not in danger right now.” The brain processes that were borne out—again it’s a small sample, and I shouldn’t be over-interpreting them— suggest that there is an interaction between self-referential, low-level nociceptive input and higher level somatosensory interactions that are remediating the pain. It’s not a silver bullet. There are multiple components that are interacting with each other.

Interestingly, all of our patients said the therapists were really important, and the prep and the integration was critical. And—this was surprising to me—almost all of them said they wouldn’t have done it if it wasn’t in a clinical setting. They were stoked that they were in a clinic with a physician next door, and an ER half a block away.

Has this made you think differently in your treatment of pain for other conditions, not using psychedelics?

Yes and no. What I’ve learned from studying meditation and chronic pain, is that we have a situation in the United States where patients come in and they want their pain to go away. Physicians take that upon themselves, and say, “I’m going to remove your pain.” Let’s do surgery. Let’s do spinal cord stimulators. Let’s give you opiates. Whatever we do to remove your pain,—it’s not about changing the relationship you have with your pain. Chances are, that pain may be there forever, and the patient will start blaming themselves. I’m still in pain. It must be my fault.

What we’ve seen in our mindfulness research is that some folks still feel the pain, it just doesn’t bother them anymore. They’re not attaching this sense of, “This is who I am, I identify as a patient living with chronic pain” anymore. They find a way to integrate their moment to moment experience where the pain doesn’t contaminate it.

I feel like psilocybin can do the same thing. It can change and modify egocentric appraisals of arising nociceptive input in a way that changes the relationship one has with that experience. They can still move on with their day to day life without it becoming a self identity that dramatically worsens the feeling of pain.

This interview has been edited and condensed for clarity and length.

Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.

What might the FDA Commissioner’s resignation mean for psychedelics?
FDA Commissioner Martin Makary resigned on May 12 after speculation that President Trump planned to fire him. During his tenure, Makary clashed with lawmakers on several drug regulation decisions, and he was also accused by conservative lawmakers of stalling the safety review of mifepristone, a mail-order abortion medication. He reportedly left over concerns about the agency’s decision to approve fruit-flavored e-cigarettes despite their appeal to young people according to the New York Times and other news outlets.

In his resignation letter — sent via a text message that President Trump then shared on Truth Social — Makary highlighted his accomplishments during the thirteen months he served as FDA Commissioner. “I’m extremely proud that we reduced drug review times from a year to 1-2 months,” wrote Makary. The second thing he listed as a point of pride was having written “new guidance to advance psychedelics.”

Both of these actions were part of President Trump’s executive order, signed last month, to help accelerate psychedelic treatments. One week after the signing, the FDA issued national priority vouchers to three companies studying psilocybin for treatment-resistant depression and major depressive disorder, and methylone, a drug similar to MDMA, for post-traumatic stress disorder. The goal of the voucher program is to get drugs to market faster. Those drugs are chosen to align with national priorities, including addressing urgent health threats and unmet medical needs. After receiving a voucher, when the clinical trial sponsor completes its studies and submits its final New Drug Application, the sponsor could anticipate a review period of 1-2 months. Without a voucher, this review could take up to one year.

The FDA has had significant turnover during the past year. Health and Human Services Secretary Robert F. Kennedy Jr. fired around 3,500 FDA employees, and many others resigned their positions. Losing a fifth of its workforce means the FDA has lost institutional knowledge and subject matter expertise. The next commissioner will take over the helm during a tumultuous time for the agency; his or her opinions about psychedelics could play a significant role in determining how Trump’s executive order is implemented. “The new commissioner will have to walk a tight rope between what the administration wants — Trump and R.F.K. Jr. — and what federal law commands of F.D.A.,” Nathan Cortez, a Southern Methodist University law professor who studies the F.D.A., told the New York Times. “Historically, the expectation is someone with an M.D. or PhD and real scientific chops. It’s a lot of pressure.”

For now, Kyle Diamantas, who currently oversees FDA nutrition and food safety protocols, will take over as the new acting FDA Commissioner. Diamantas is a lawyer who does not have a medical or science background. Prior to joining the FDA, he worked as a corporate attorney, and he once defended a top formula maker against claims that its product harmed premature babies. The Microdose did not find any evidence online of Diamantas making any public statements related to psychedelics.

Ketamine infusions rapidly reduce suicidal and depressive symptoms during major depressive episodes

In a systematic review and meta-analysis published in JAMA Psychiatry on May 6, researchers from Canada, Germany, Korea, and the United States analyzed results from 26 randomized clinical trials with 1166 patients with a major depressive episode. Overall, the evidence suggests that intravenous ketamine effectively and rapidly reduced suicidal and depressive symptoms.

Patients receiving a single ketamine infusion, compared with control patients, had significantly lower suicidal symptoms 24 hours later, and after one month. Repeated ketamine infusions resulted in a similar reduction in magnitude of suicidal symptoms at the end of the treatment. Patients had significant reductions in their depressive symptoms at four hours through one week after a single ketamine infusion, and at the end of the treatment after repeated infusions.

Approximately 280 million people globally are affected by major depressive disorder. Treatment options, including talk therapy, antidepressants, and neurostimulation can take weeks to help people feel better, and there is a population for whom these treatments do not work. According to the authors of the meta-analysis, there is a need for rapid-acting treatments to reduce suicide risk and depressive symptoms, and intravenous ketamine may be effective at meeting those needs in the acute phase of depression. However, longer term outcomes on safety and efficacy are still uncertain.

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Could psychedelic-assisted therapy help improve adolescents’ mental health?

According to a review published in British Journal of Clinical Pharmacology on May 8, most participants in psychedelics trials to date were aged 25 to 65 years. The mental health conditions for which psychedelic-assisted therapy appears to be beneficial are highly prevalent in younger people. In fact, the authors write that “mental illnesses have a peak age of onset of 15 years, with 63%–75% of onset occurring by age 25 years, the opposite pattern to physical illnesses.”

The review analyzed all psychedelics research focusing on children and young people, dating back to the 1950s, as well as more modern observational research on traditional and Western non-medical use. Currently, there are no rigorous clinical studies testing psychedelic-assisted therapy for youth, but there is a growing interest, especially considering that suicide is the third leading cause of death for people aged 15 to 29.

The authors found limited existing research on young people. Despite that, the authors write, “psychedelics appear to be safe overall and may have the potential to improve mental wellbeing in young people.” They added that lifetime psilocybin use was associated with lowered rates of suicide risk, whereas LSD was associated with increased odds for suicidal thinking, planning and attempts. Adolescents who consumed ayahuasca for religious purposes reported lower levels of anxiety, body shape concerns, and attention problems, compared to adolescents from the same Brazilian school community who never used ayahuasca.

Some negative effects were reported, including that young people may be at greater risk for experiencing psychedelics-related anxiety, more likely to develop symptoms of Hallucinogen Persisting Perception Disorder (HPPD) symptoms, and tend to have difficult experiences of ego dissolution. “As the sense of self is still under development in adolescence, perhaps a disintegration or complete loss of ego might be more frightening and destabilizing for a young person relative to an adult,” the authors write. According to the study, these age-related ego dissolution challenges may indicate that researchers should consider focusing first on MDMA, which does not tend to produce feelings of ego loss.

National polling suggests a “rising tide of cautious support” for psychedelics

Researchers at UC Berkeley released the results of a second national public opinion poll on psychedelics that found that 74% of U.S. voters said they’d heard about psychedelics over the past 12 months and 57% had either tried a psychedelic themselves, or someone close to them had during the same period.

The survey was conducted by the UC Berkeley Center for the Science of Psychedelics, which publishes The Microdose but does not dictate its editorial decisions. The surveys were conducted in 2023 and again in 2025, and each polled approximately 1,500 U.S. voters from all 50 states and Washington, D.C. In the most recent poll, support for scientific research and regulated access to psychedelics seems to be increasing, with 63% of voters indicating support, up from 49% in 2023.

Those polled seemed most supportive of regulated access to psychedelics for people with depression, military veterans and people with addiction.

More news from this week:

• In an opinion piece for STAT, Peter S. Hendricks, a professor of psychiatry and behavioral neurobiology at The University of Alabama at Birmingham, praised President Trump’s psychedelic executive order, but questioned whether the field is ready. Hendricks expressed the need to build a robust psychedelic health care workforce, follow rigorous clinical trial standards, create equitable access, and advance all psychedelics, not just ibogaine, which has been spotlighted recently. This article was published the same week as Hendricks’ 10-year clinical trial in JAMA Network Open, that studied psilocybin as a treatment for cocaine addiction. In an interview with Psychedelic Alpha, Hendricks explains the study findings and how his team recruited predominantly Black and socioeconomically disadvantaged participants from southern states which contrasts with other psychedelic studies that typically recruit more affluent and white participants.

• The Illinois Senate passed SB 2772, which would establish the Illinois Psilocybin Advisory Board. It’s the first step of a larger bill, the CURE Act (SB 2184), which would establish a framework for the legal manufacture, delivery, use and possession of psilocybin. State Senator Rachel Ventura (D) is leading the legislation, originally introduced in 2024. During a two-year period, the Board would advise on health and safety recommendations to agencies that would implement provisions of the CURE Act, if passed.

• The Louisiana House passed SB43 to create a psychedelic-assisted therapy program to fund ibogaine and psilocybin clinical studies for opioid and substance use disorders, and treatment-resistant mental health conditions. If signed by the governor, the bill would authorize the state’s Department of Health to seek funding from the federal government, opioid settlement funds, and other grants and gifts. []

• What is methylone? In Forbes on May 11, journalist Jessica Rendall provided background on the drug which received a National Priority Voucher to be fast-tracked through the FDA approval process.

  

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An often-shared piece of advice is to not make a huge life change immediately after a psychedelic experience. In the afterglow of a trip, it might be tempting to quit your job or move cities. It’s better to process the experience first, rather than react quickly.

And yet, people often take psychedelics because they want to introduce a big change, said Nic Carlisle, a health behaviorist at the University of Alabama at Birmingham. In clinical trials, psychedelics have been shown to induce shifts in mental health symptoms, or behaviors around using other substances, such as nicotine or alcohol. In psychedelic experiences that take place outside of a research setting, people might expect, or be waiting for, some monumental change to occur.

Researchers are increasingly trying to better understand how people are taking and experiencing these substances out in the world, outside of a clinical setting. In April, a team of researchers published a study using the relatively new “Psychedelic-related Major Life Changes Questionnaire” to survey 581 people and found that around 83 percent of respondents reported a life change after psychedelic use. But the participants were recruited online and at Entheofest, an annual psychedelic advocacy event, so the study may have been biased towards those with positive feelings about psychedelics.

Carlisle’s research focuses more generally on how social and psychological experiences shape health behavior and, ultimately, health outcomes. Earlier this year, he co-authored a paper in Scientific Reports examining the prevalence of major life changes following a psychedelic experience in a sample of people that weren’t initially told that psychedelics were the topic of the study. The Microdose talked to Carlisle about what he discovered about how likely major life changes are, and who might be the most prone to them.

How do you define a major life change? You use the phrase “quantum change,” in your paper—what is that?

We’re talking about a change that’s not just a shift in mood or perspective, but a consequential change in how someone lives, relates to others, or understands themselves.

In the paper, we were interested in changes that were concrete enough to be reported as life events: change in relationship, quitting alcohol or other substances, changes in diet or exercise patterns, leaving a job or career, changing religious beliefs—things of that nature.

The phrase “quantum change” comes from earlier psychology literature. It refers to a sudden, profound, enduring change in a person’s life or their worldview. In the psychedelic context, the idea is that an acute experience might involve powerful insights into the self, into relationships, behavior, and meaning, and that those insights can lead, sometimes at least, people to make significant changes afterward.

It’s important to say that “major” doesn’t automatically mean good. And “transformative” doesn’t automatically mean therapeutic. That was part of what motivated this study. We specifically note in the paper that whether these changes actually improve health likely depends on a whole host of things that unfortunately we didn’t have access to.

What kinds of people did you ask about life changes following psychedelics?

I think what makes this study unique is that the recruitment materials did not mention psychedelics. That helped reduce the chance that we were only recruiting people who had especially meaningful psychedelic experiences.

We used data from two samples of US adults who reported lifetime psychedelic use. The first sample was stratified to be nationally representative of US adults by age, race, race, ethnicity and sex. And so we use that sample to estimate the prevalence of these major life changes. The second data set was larger and it was more sociodemographically diverse, although it was not technically nationally representative. Then we used that to explore which demographic characteristics might be associated with reporting a major life change.

To give away the ending, in the nationally representative sample, about one in five people who had ever used psychedelics reported at least one major life change that they attributed to that psychedelic experience. The larger, more diverse sample was more like one in four. So yes, these changes do appear to occur. They’re not uncommon, but they’re also certainly not universal.

This was one of the most important takeaways: psychedelic-related transformation is real for some people, but a lot of our hype and public conversations make it sound like it is more common or even inevitable, and that’s not necessarily what the data show.

What kinds of life changes were they?

The most common changes were in relationship status, changes related to diet and exercise, and changes related to substance use—which mirrors a lot of the research happening around use of psychedelics for substance use treatment—and change in religious beliefs. Smaller proportions reported quitting a job or a career, changing their family intentions, and things of that nature.

What stood out to me is that these changes do span very different domains. Some are directly health related, like reducing substance use or changing exercise, and others are relational, existential, or identity related. I think that range matters, because it suggests that maybe psychedelic experiences don’t only operate through symptom reduction. For some people, they may prompt a broader reassessment of values and relationships and identity.

Obviously the list of changes was not exhaustive. And we didn’t measure the valence of some of those changes. Some of them are obvious from the wording of the question—quitting alcohol or substances or tobacco or other substances is inherently good. Other ones might depend on context.

Did you learn anything about the kinds of people who might be more prone to making a big life change?

That’s something I was really interested in. In the larger sample, there were three factors that were most strongly associated with reporting a major life change: those who were a younger age, higher religiosity, and had greater lifetime frequency of psychedelic use.

To dig into each of those a little bit more: Respondents who were 18 to 29 had more than three times the odds of reporting a major life change, compared to respondents who were 40 to 50. People who described themselves as quiet or very religious also had more than three times the odds compared to people who said they were not religious. And then the strongest association was lifetime frequency of psychedelic use. People who reported using psychedelics more than 20 times had about 10 times the odds of reporting compared to people who only used psychedelics once.

We have to interpret these findings sort of cautiously. This is cross sectional data, so you can’t say that the psychedelic caused the change, or that these characteristics necessarily came before the change, but I think the patterns are suggestive. Younger adults may be more developmentally fluid and in a more developmentally fluid period of their life. Religious or spiritual frameworks may help people interpret or integrate their experiences. And of course, people who have taken more psychedelics have had more opportunities to have such an experience, and they may be more likely to seek out experiences they view as transformative.

Have your findings changed how you think psychedelic therapists and other professionals should talk about major life changes, and whether to anticipate them?

It’s something we have to be careful about. The idea that everybody has a meaningful, transformative experience is in some ways dangerous, because it sets an expectation. And then—what do you do when you don’t have that experience? What kind of feelings does that elicit in the person? Perhaps feelings of failure, or feelings of loss of hope in people who were searching for an answer and searching for that experience, and didn’t receive it.

Some of that affects the way I think we should talk about psychedelics more broadly, and public health messaging. We never encourage people to self-dose. But these are substances that have been around for millennia, and people are going to use them outside the clinical, therapeutic setting. So I think being a little more realistic in our messaging and the way we talk about it is likely to be helpful for the public.

This interview has been edited and condensed for clarity and length.

Happy Friday and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.

Psilocybin changes people’s brains after their first trip, a new study led by UC San Francisco’s Robin Carhart-Harris, found. The paper, published in Nature Communications on May 5, examined how lasting psilocybin’s effects are on brain function and anatomy. The researchers gave a 25 mg dose of psilocybin to 28 healthy participants who had never tried a psychedelic before. They took measurements of participants’ brains before, during and after the dose, and also documented participants’ psychological experience and well being.

During the 25 mg trips, the researchers observed increases in ‘brain entropy,’ or signal complexity in electroencephalography measurements of participants’ brains. That entropy predicted improved well being, as reported by participants a month later.

In addition to EEG recordings during the psilocybin trip, participants had brain scans before the psilocybin dose and one month after. For these scans, the authors used functional magnetic resonance imaging (fMRI) to track blood flow between brain regions and diffusion tensor imaging (DTI) to map the brain’s white matter communication network. DTI measurements showed thinning of white matter tracts stretching from participants’ prefrontal cortex to subcortical brain regions a month after their psilocybin dose. This could mean connections between the two areas are being pruned, or new connections are being made, but aren’t yet insulated with myelin. “If verified in subsequent work, this finding may be viewed as evidence of anatomical ‘neuroplasticity’ after first-ever psychedelic use in humans,” the authors write. Further studies will need to be done to understand if the brain changes last beyond one month post-dosing.

Neuroscientist and biomedical engineering professor Alex Kwan of Cornell University told the Guardian the study results were “exciting,” but added that the study participant pool was small, and said DTI technology provides a limited and indirect view of brain connections.

Anthropologists share the first evidence of psilocybin use in traditional populations outside of the Americas

Researchers’ understanding of traditional psychedelic use comes almost entirely from documentation of Indigenous groups in the Americas. For example, Indigenous use of psilocybin mushrooms and peyote in Mexico, and ayahuasca in South America.

In a recent preprint (a draft version of a scholarly manuscript shared publicly before formal peer review) researchers report evidence of psilocybin mushroom use in southern Africa, specifically Lesotho and South Africa. The authors conducted 34 interviews with traditional healers and non-healers (often, adolescent cattle herders) from the Basotho ethnic group. The interviews revealed a majority (21) were familiar with psilocybin mushrooms (specifically, the Psilocybe maluti species endemic to southern Africa) and reported magical, healing, initiation and recreational uses for the fungi.

The authors report Basotho healers’ use of small amounts of P. maluti mushrooms in psychoactive brews likely “predate the mid-twentieth-century popularization of psilocybin.” Their findings also reinforce the belief that psilocybin was being used on a global scale and in different ways before it was popularized in the U.S.

Researchers and clinicians can learn from traditional healers who have been administering psychedelics for generations, the authors reason. For example, Basotho interviewees shared how the psychoactive brews influenced dreaming, providing a possible direction of study. Basotho healers also include other psychoactive plants in their brews, including the hallucinogenic bulb of the flowering plant Boophone disticha. “As scholars continue to consider the cognitive and therapeutic impacts of combining psilocybin with other substances, Basotho recipes suggest that the combination of psilocybin with alkaloids from B. disticha may be worthy of study,” the authors write.

As psilocybin mushrooms grow on six out of seven continents, more cases of Indigenous psychedelic use are likely being overlooked, the authors reason, adding that such practices should be documented before they disappear. “It’s generally been thought that traditional (healing/shamanic) use of psilocybin mushrooms was basically confined to Mesoamerica, but here’s the first evidence of similar traditional use (going back to at least the early 20th Century) in Southern Africa - fascinating!” neuroscientist Matthew Wall, who wasn’t involved with the research, wrote on LinkedIn.

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A pair of ketamine mechanism studies aim to “reverse engineer” the drug’s antidepressant effects.

For some, ketamine offers rapid relief from depression symptoms. In an effort to “reverse engineer” those effects, scientists recently published studies in Cell and Science Advances detailing ketamine’s molecular mechanisms in the brain, and ways to harness them.

Scientists believe opioid receptors play a role in ketamine’s antidepressant action. In the Cell report, study authors specifically examined opioid receptors on certain regulatory interneuron cells in the prefrontal cortex. They suggest ketamine targets certain opioid receptors on these cells, leading to its antidepressant effects.

Hoping to mimic ketamine with fewer side effects, the authors were able to replicate the drug’s antidepressant effects in mice by instead using small doses of three drugs that act on the same pathway. The drugs acted on glutamate, serotonin and opioid receptors. “This synergistic strategy could produce rapid antidepressant effects at much lower doses of each compound,” said lead author, neuroscientist and psychiatrist Conor Liston from Weill Cornell Medicine in a news release about the study. “By avoiding higher doses, we can avoid side effects.”

Another study, published in Science Advances on May 1, included many of the same authors and focused on ketamine’s longer-term effects. They found the TrkB and mGluR5 receptors in brain cells are necessary for ketamine’s antidepressant action. They enable “cross talk” that’s enhanced by ketamine. Involvement of the mGluR5 receptor in ketamine’s antidepressant effects is novel, author Francis Lee said.

Next, the researchers want to advance their work to clinical trials, testing if combined small doses of existing drugs can mimic ketamine’s effects in humans. Perhaps also pairing a low dose of ketamine with drugs targeting mGluR5 receptors could deliver lasting relief with fewer side effects, the authors suggest.

Trump’s executive order revives analysis into Republicans’ pro-psychedelics shift

Following President Trump’s April 18 executive order to expedite psychedelic treatments, journalists are once again reflecting on the GOP’s shifting attitude towards the drugs. After years of conservative opposition to psychedelics, leading Republicans are now at the forefront of advancing the movement to increase access to these drugs, writes Andrew Jacobs in a New York Times piece. Psychedelic users are no longer looked down on by conservative politicians as liberal degenerates and draft dodgers, Jacobs wrote. He credits Rick Doblin for focusing on veterans as a group that could benefit from psychedelic therapy. “Drug reform advocates found a highly effective proxy for persuading even the most calcified antidrug warrior: the American military veteran,” Jacobs writes.

Indeed, normalization of psychedelics by figures like Doblin and decriminalization activists in Oregon and Colorado surely paved the way for the executive order, writer Michelle Lhooq noted in a recent post on Substack. She writes the “cosmic Right” was able to achieve a political victory liberal activists spent decades working towards. “While pharma companies like Lykos and Compass have spent hundreds of millions of dollars trying to get these drugs rescheduled through the clinical-trials-to-FDA pipeline, Rogan’s influencer clout turned out to be a direct line into the President’s approval,” Lhooq writes, referring to podcaster Joe Rogan’s text exchange with Trump that apparently expedited his executive order.

In a Washington Post article, Rachel Roubein reports the order may have been in the works prior to Rogan’s text exchange with the President. She spoke with anonymous federal officials familiar with the internal deliberations. “The basic principles of an executive order were sketched out by the time Trump sought to elevate the issue, the officials said.”

More news from this week:

• Results of a clinical trial published May 7 in JAMA Network Open show a single dose of psilocybin can help people with cocaine use disorder abstain from using the drug. The trial was unique in that a majority of participants were Black and low income.

• In an opinion piece for Bloomberg, Lisa Jar­vis argues the hype around ibogaine is outpacing the science. While anecdotes shared by veterans, including those at the recent White House event, are compelling, studies of the drug are few and small, she writes. For example, the often cited Stanford study enrolled just 30 veterans. The drug also comes with potentially dangerous risks, such as fatal cardiac events. Not to mention the lengthy, sometimes 24-hour, psychedelic experience ibogaine users endure. Compared to widely studied psychedelics like psilocybin, ibogaine is more of a mystery, Jarvis writes. “Get­ting there requires a care­ful pro­cess that unfor­tu­nately doesn’t come with short­cuts — even if politi­cians wish it did.”

• In an opinion piece for STAT, professors Jerel Ezell and Sugy Choi write the psychedelic revolution is leaving people of color behind. The two are studying why racial minorities aren’t benefiting from psychedelic research, even though they may have the most to gain. For example, Ezell and colleagues have analyzed how Black, Latino, and Indigenous people tend to have higher rates of opioid overdose deaths compared to white people. Yet, non-white people remain underrepresented in psychedelic trials for conditions like opioid use disorder.

• Following Trump’s executive order, legal experts Mason Marks and I. Glenn Cohen discussed its implications in a Q&A from the Petrie-Flom Center at Harvard Law School.

• Psychedelic Alpha’s Josh Hardman did a sprawling interview with Americans for Ibogaine CEO W. Bryan Hubbard. The conversation skipped Hubbard’s trademark pitch about ibogaine’s benefits, and launched right into next steps following Trump’s executive order, relations with Gabon and infighting within the pro-ibogaine movement.

• Department of Defense-funded trials will begin giving U.S. soldiers MDMA-assisted therapy for PTSD next year, the Guardian reported. However, psychedelic advocates caution against the treatment model that would return soldiers to military service after they process their trauma. “What we find is that people are somewhat more likely to relapse [into a PTSD response] after treatment if they go back into a stressful situation,” Rick Doblin told the Guardian.

• Our very own Jane C. Hu was on Scientific American’s Science Quickly podcast discussing psychedelic research, attitudes, and the rise of ibogaine.

• In a commentary for Medscape Australia, doctor Toby Gardner writes about the challenges Australia has faced since being the first country in 2023 to allow MDMA-assisted therapy outside of clinical trials. “The current reality is one of constrained access, shaped by cost, time and workforce limitations,” Gardner writes.

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During the pandemic, Talea Cornelius, a health psychologist at Columbia University, read The Hidden Lives of Trees, a book about the invisible ways that trees are connected to each other through underground root and mycelium networks. It reminded her of something she had learned studying social psychology: how important it is to have a shared reality with others.

A shared reality means that you view the world similarly with a romantic partner, a friend, or a parent. In relationships, having a shared reality has been shown to bring people closer together, and lead people to have a greater sense of meaning in their life. “There’s this desire to be on the same page,” Cornelius told me. What might happen in relationships if one person has a transformative experience, like with psychedelics, and the other does not? Would one person leave behind the shared reality they had created?

Earlier this year, Cornelius co-published a paper in the Journal of Psychoactive Drugs analyzing survey responses from 798 people and 81 couples about their psychedelic use, and whether their romantic partners also took a psychedelic. (She focused on LSD and psilocybin, and excluded MDMA).

She found that when romantic partners used psychedelics with their significant others, it was associated with an increased shared understanding, yet the opposite was also true. Doing psychedelics without one’s partner was indirectly associated with the later decision to end a romantic relationship. The Microdose talked to Cornelius about how psychedelics affect a relationship’s shared reality, and whether psychedelic-assisted therapists should take people’s love lives into account.

What got you thinking about shared realities in couples, and with psychedelics?

A lot of research in behavioral health shows interventions that enroll dyads instead of individuals. Interventions for couples, for example, can be more powerful and longer lasting, and we know that social relationships powerfully impact health.

If I go to therapy, and I do a ton of work—let’s say I have anger issues—and then I come back home to visit my parents, they haven’t seen me in years. They start treating me like I’m angry all the time. That’s going to be much harder for me to maintain the work that I have done on not being an angry person, because I’d be responding to the signals that they’re giving to me.

Some of the studies that Roland Griffiths did had community observer ratings in it. I remember seeing that people who weren’t even that close to the people who had enrolled in these trials could see and validate an improvement in the person’s behavior, mood. If you have someone who can validate your reality, who can validate the psychedelic experience; they understand what you went through, might that result in stronger positive effects that last for a longer time? My hypothesis was yes.

Why did you exclude MDMA?

Classic psychedelics are very different in that your experience is internal. If you think about the stereotypical MDMA experience, people are like, “Oh, it’s love and sunshine and rainbows.” People are doing research with MDMA and couples therapy. On MDMA, people are present, their eyes are open, they’re speaking with each other. Whereas other psychedelics in research are very different. It’s often: put headphones on, put eye cover on— you’re going to traverse something internal to you. That’s not to say that you can’t feel very connected. There can be a sense of shared oneness, but it’s not shared—I can’t sit at the dinner table and have my psychedelic experience with you.

Who were the people and couples who responded to your survey, and what did you learn about them?

This is not a representative survey; it is people who self-selected. Oftentimes, people who self-select are very enthusiastic about their own psychedelic experiences. There was not a single person in my sample who had never used a psychedelic in their lifetime, and we know that’s not representative of the general population.

We had questions about their own personal history of psychedelic use, which included how many times they’ve used psychedelics in the relationship. It did not have to be a current relationship. We asked them to recall what was the single most meaningful experience they had while they were in their romantic relationship. The partner was not required to have taken a psychedelic in that relationship or ever, actually. They also had to be willing to invite their partner to complete the survey as well. I found a way to connect people’s survey responses without collecting any identifiable information.

The primary question was: does taking a psychedelic together or not together change the way that a person feels about their shared understanding within a romantic relationship? To get at that, we asked about physical intimacy, emotional closeness, spiritual closeness, relationship satisfaction, tenderness, and commitment to the relationship. Also, we asked about conflict, collaboration within the relationship, point of view—the ability to take the other partner’s point of view—and openness to experience in their relationship.

We did mostly find that taking that psychedelic together led to a greater sense of shared reality, and to improvements in the relationship. Conversely, there was an indirect association where people who had a lesser degree of shared reality after using a psychedelic when they were not with their partner ended the relationship.

Why do you think a relationship would end after one partner does psychedelics alone?

I’m always very cautious about these things because it is just speculation. My initial hypothesis was that it’s really important to have a shared sense of reality. If I’m disrupting the sense of shared reality that I have together with my partner, I will not be as comfortable with them. I won’t want to be with them anymore. We say opposites attract, but that’s not necessarily true. If people are using a psychedelic separately, and then completely changing how they interface with the world, it’s going to disrupt how they’re interfacing with each other.

Anecdotally, I remember talking to someone who said that they had a psychedelic trip with a person who was not yet their partner, and it brought them extremely close, close enough that they started a relationship, and it was a very intense and positive relationship. And then on the other flip side, I’ve heard about people whose partners went off to do psychedelics by themselves and came back on a completely different wavelength.

An obvious example of how this might happen is with spirituality. Let’s say that we’re both atheists, and then you go off and you have a psychedelic experience, and you come back believing in some sort of an entity. A person might think, “I just don’t know you, we don’t see the world in the same way. We’re not able to validate each other’s experience.” I could see that having a very negative impact on that relationship.

An alternative explanation could be that a person is distressed in their relationship, and therefore they’re going to take a psychedelic by themselves—and that’s the reason they broke up. Nothing to do with the psychedelic. They never had good shared reality to begin with, and so they didn’t share the psychedelic experience with their partner.

Should practitioners focus more on the impact that these treatments might have on people’s personal lives?

I am very motivated by the fact that we don’t know when a psychedelic therapy experience might impact somebody’s relationships. If I went in for psychedelic therapy, my partner may not support me at all. They may be upset that I’m going because they think it’s “bad” drugs. Or maybe my partner doesn’t know because I’m not telling them, because I’m worried that they’re going to judge me for it. Maybe they’re super supportive.

My concern is more about the formal treatment setting, because we don’t want to do harm by accident to people’s relationships. And there’s a benefit that we’re not taking advantage of, if we can improve the outcomes of psychedelic treatments by incorporating loved ones, then we should be paying attention to that. More than anything, I just want people to be thinking about this and talking about it.

My research came from a very strong curiosity of understanding the world through social construction. We so often just study individuals. It’s easier to do. But one plus one is not two when you’re doing research. One plus one is…I don’t really know. How are we going to measure two people when there’s something emergent between them?

Just like with other things, going out to dinner, going on a vacation with your partner, and having shared experiences is a good thing. You wouldn’t want to be in a relationship with someone you don’t want to do anything with. It just happens to be that this is a particularly powerful, transformative experience, and it can bring people closer together. But it might also mean that if you do it alone, that you leave someone behind.

This interview has been edited and condensed for clarity and length.

At the start of President Donald Trump’s second term, psychedelics advocates were hopeful his administration would take swift action to advance psychedelic medicalization. His appointees from Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., Food and Drug Administration Commissioner (FDA) Marty Makary to Veterans Affairs Secretary Doug Collins, had all spoken favorably about the promises of these substances as potential medicines. Last July, Kennedy even said psychedelics would be available to Americans within 12 months.

Up until recently, that timeline seemed all but impossible — but with Trump’s recent executive order on psychedelics, it just might be plausible after all. A section of that order directed the FDA to issue three “priority vouchers” to psychedelics companies. (For more on the executive order, read our coverage from last week.) The Commissioner’s National Priority Voucher program, first announced in June 2025, accelerates approval of drugs that address “national health priorities” from the usual 10-12 months to as little as a month or two. According to the FDA, national health priorities include “addressing a health crisis in the U.S.” and “addressing unmet public health needs.” Since the program was announced, there’s been speculation that psychedelics could be beneficiaries of these vouchers.

The first nine voucher recipients were announced in October 2025, and while a ketamine company was included, no other psychedelics companies made the list. But in February, STAT reported that Compass Pathways, which has developed a formulation of psilocybin they call COMP 360, was originally set to receive a voucher, but that the White House vetoed it at the last minute. The voucher program has also been criticized by FDA staffers and lawmakers, who have raised concerns that the White House was too directly involved in the FDA’s voucher decisions.

At the executive order’s signing ceremony on April 18, Makary promised that the recipients of the vouchers would be announced within the following week. Last Friday, the FDA released the list of three psychedelic voucher recipients. Unlike previous voucher announcements, the FDA did not list specific companies; rather, they listed only substances and the indication for which the substance was being studied: psilocybin for treatment-resistant depression, psilocybin for major depressive disorder, and methylone, which is similar to MDMA, for post-traumatic stress disorder (PTSD).

While the FDA has still not officially confirmed which companies received vouchers, shortly after releasing the news, journalists, analysts, and advocates began piecing together which companies would be getting them. Psilocybin for treatment-resistant depression was likely to be Compass Pathways, which has previously announced that they’d likely submit a New Drug Application for COMP 360, their formulation of psilocybin, before the end of the year. Psilocybin for major depressive disorder appeared to be the non-profit Usona Institute, which also later confirmed their selection. And the only company studying methylone, an analog of MDMA often called “MDMC,” is New York-based Transcend Therapeutics, which recently announced plans to be acquired by Japanese pharmaceutical giant Otsuka Pharmaceutical. All three companies have now confirmed they are indeed voucher recipients.

Psychedelic Alpha’s Josh Hardman noted that the FDA had posted — then deleted — a message on social media that a voucher had been given to a company studying LSD for generalized anxiety disorder (GAD), rather than methylone for PTSD. The only company studying LSD for GAD is Definium Therapeutics (formerly MindMed), suggesting that the FDA was also looking at the New York-based pharmaceutical company as a potential voucher recipient but chose not to include them at this time.

One notable omission from the list: Resilient Pharmaceuticals (formerly Lykos), the first and only company so far to submit a New Drug Application (NDA) for a psychedelic. In 2024, the FDA decided not to approve the company’s bid to use MDMA in the treatment of PTSD, but Transcend’s methylone for PTSD fills a similar niche in the voucher roster. In recent months, Resilient Pharmaceuticals has said its data is undergoing an independent audit, but it’s not clear when the company might attempt resubmission of their application — and whether the company will choose to conduct another Phase 3 study, as it was encouraged to do by FDA regulators in their review of its initial NDA back in August 2024. The Microdose reached out to Resilient for comment, but did not receive a response before publication.

How exactly a review process that usually takes 10-12 months will be compressed into 1-2 months is still a bit murky. “Faster timelines may be operationally justified, but they carry broader consequences,” says Rotem Petranker, director of the Canadian Centre for Psychedelic Science and an advisor to psilocybin company Rose Hill Life Sciences. “In emerging therapeutic categories, perception often shapes adoption as much as data. If accelerated review is interpreted as reduced scrutiny, it can undermine confidence not just in a single product, but in the category as a whole.” Petranker emphasizes transparency in the process as a way to build trust.

The recipients of the vouchers are emphasizing that the FDA’s new program does not expedite the speed or decrease the rigor of research. On Tuesday, a representative for Usona Institute told The Microdose the company is not doing interviews, but wrote in a statement: “The voucher expedites the timeline only; it does not alter scientific or regulatory standards.” In an interview with The Microdose, Compass Pathways CEO Kabir Nath emphasized the same: “We are not seeking any form of psychedelic exceptionalism,” he said. “We have always been very clear that we are going to deliver to the psychiatry division of the FDA a package that is as good as any other package they’re going to see from another drug in psychiatry.”

When asked how the FDA’s end of the review could be expedited, Nath said while the details were still being ironed out, it would likely involve more meetings between the company and agency — including a faster turnaround for Compass to respond to the FDA’s requests for more information — and that different FDA departments would conduct their work in parallel instead of sequentially.

How companies will adjust to this accelerated review process isn’t clear either. Transcend just recently began enrolling patients in the company’s Phase 3 trials, meaning its New Drug Application to the FDA is still likely years away. The company did not respond to The Microdose’s interview request. Usona has not given a timeline for its New Drug Application, but completed enrollment in its Phase 3 trial last November. Compass’s Nath says the company was planning to be ready for submission by the end of the year anyway. The company recently announced training grants for healthcare providers to administer COMP360, and has been laying other groundwork in anticipation of a post-approval roll out, including partnering with healthcare clinics and facilities and lobbying state legislatures to automatically reschedule COMP360, should the drug be approved by the FDA.

One thing is clear: when it comes to psychedelic access in the U.S., medicalization is now the ascendant model. In the early 2020s, psychedelic advocates fought hard for decriminalization efforts and state-by-state psychedelic access programs like Oregon’s, which explicitly distanced itself from psychedelics as medical treatment. But with this new federal focus on expediting FDA approval and more state legislation proposing medical models for psychedelic access, there will be even more focus on the development and commercialization of psychedelic pharmaceuticals drugs.

Trump’s executive order and the FDA voucher announcements had an immediate effect on psychedelic stocks. Compass’s share price skyrocketed from $6.66 in early April to a high of $9.92 after the order. (As of Thursday evening, the share price settled at $9.06.) Neither Transcend, a privately held company, nor the nonprofit Usona are publicly traded, but other psychedelics companies, such as GH Research, Definium, and AtaiBeckley also saw bumps in their share prices after Trump’s executive order. And bets on Polymarket, a cryptocurrency-based prediction market, in favor of the FDA approving a psychedelic for medical use in 2026 skyrocketed from an 18% chance the day before Trump’s order to a high of 68% after the order was announced.

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More news from this week:

• On Thursday, President Trump withdrew his nomination of Casey Means for U.S. Surgeon General. In a book she co-wrote with her brother, HHS advisor Calley Means, Casey spoke glowingly of her experiences with psilocybin-assisted therapy. Ultimately, the New York Times reports, Means’s nomination stalled because members of Congress took issue with her anti-vaccine stance. Trump has now nominated radiologist Nicole Saphier, who has discussed the potential benefits of psychedelics on her podcast “Wellness Unmasked.”

• The Texas Medical Board is set to release a proposal for tighter regulations around ketamine use, including a ban on in-home use, according to The Texas Tribune. The proposal will be published May 8.

• 2C-B is most commonly known as a party drug with a reputation for producing effects similar to a “candyflip”: taking LSD and MDMA at the same time. In a recent Neuropsychopharmacology paper, researchers at the University of Basel in Switzerland formally characterized the acute effects of different dose sizes of 2C-B (10, 20, and 30mg) compared to typical doses of MDMA (125mg) and psilocybin (25mg). They determined that the subjective effects and trip length of a 30mg dose of 2C-B was similar to that of MDMA and psilocybin. “These results may assist with dose-finding for future 2C-B research and provide a direct comparison with standard doses of the prototypical compounds MDMA and psilocybin,” the authors write.

• In 2024, Oregon psilocybin facilitators sued the state in federal district court alleging its rules requiring clients to receive psilocybin in service centers is a violation of the Americans with Disabilities Act because people with disabilities or in end-of-life care are not able to travel to those centers. Last week, over a dozen organizations and individuals filed amici briefs in support of the facilitators, including the Oregon Hospice and Palliative Care Association, MAPS, and the Disability Rights Bar Association. “It is also noteworthy that this coalition filed in the federal district court; often amici, even in important public interest cases, wait until the appellate stage to participate,” the facilitators’ attorney Kathryn Tucker told The Microdose. “Here, this early participation by such a broad and diverse array of amici reflects the significant public interest at stake in this case.”

• I joined DemeRx founder Deborah Mash on WNYC’s national show Science Friday to discuss the rise of ibogaine and the recent psychedelics executive order.

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Last week, when President Donald Trump signed an executive order focused on accelerating psychedelic access and research, he said at the press conference, “It’s for a lot of people, but it’s for our military in particular.”

Many researchers and politicians alike have stressed how psychedelic-assisted therapy could help with PTSD, depression, and addiction in military and veteran populations, and several clinical trials are taking place with the Department of Veterans Affairs. But outside of those involved with this research, what do military and law enforcement think about psychedelic treatments? It’s a question that Alexandra Hopkins, a forensic psychologist now based in Canada, began to wonder as she met patients who worked in those fields.

In March, she co-authored a survey in the Journal of Police and Criminal Psychology, looking at the attitudes towards psychedelics of 60 U.S.-based military and law enforcement personnel compared to those held by the general public. Her sample size was small, Hopkins told me, so people shouldn’t assume her findings represent what all police and military professionals think. But in those people she studied, there were clear differences between the groups: the military and law enforcement had significantly less positive attitudes about psychedelics than the general public, and receiving education about the treatments didn’t improve their views. The Microdose talked to Hopkins about her survey, and why certain demographic groups may feel differently about psychedelics.

Where did your interest in what police and military think about psychedelics come from?

It stemmed out of my internship that I did in my second year while at University of Denver. It was a private practice that specialized in working with first responders. In that internship I was really exposed firsthand to that population and the struggles that they experience on the day to day at various levels— systemically, culturally, and individually.

Prior to that, I came across several of those Netflix documentaries that talked about psychedelics, and listened to quite a few podcasts about psychedelics and their role in addressing trauma, PTSD, alcohol use disorder. This paper came out of that: What were their views on it? What are they thinking about this alternative path, and what are the potential issues that could show up in this alternative approach?

Our paper reviewed other papers that are out there in relation to barriers to treatment as a whole, and that included a lot of stigma around mental health. That stigma has started to shift, but overall, there is sort of a stigma in regards to seeking mental health treatment. On top of that, there are negative perceptions of drug use based, in part, on their exposure to illicit substances, and individuals with substance use disorders while on the job. With military populations, obviously, you’re not supposed to be using drugs whatsoever. Any exposure to illicit substances is taken really seriously.

Was it difficult to reach out to people in military and law enforcement, given that stigma?

The second author, Cassandra Bailey, had some contacts with various sheriff’s offices and she knew individuals that are connected with the military that she inquired about sending the survey out. I posted in some Facebook groups.

Overall, we did get some resistance in people completing the survey. We were actually informed that some were worried about their opinions being used against them, and not wanting to speak for the organization. So we did not get as many participants in military or law enforcement as we hoped for, compared to the general public.

Of the 446 participants, 60 indicated that they were either current or former military or law enforcement. But nonetheless, I think what they did report was of the norm of earlier studies regarding just views towards mental health, views towards treatment, and views towards substance use.

We used a scale called the attitudes on psychedelics questionnaire. And then we adapted our own scale, called the attitudes towards psychedelic assisted psychotherapy scale, and adjusted it to be only inclusive of psilocybin and ketamine-assisted psychotherapy.

What did you find from the law enforcement and military responses?

In general, there weren’t overly positive views around both psilocybin and ketamine as a legitimate pathway for treatment, or as potential therapeutic tools for those with mental health disorders. And we highlighted that this would be in a professional setting with all the questions that we asked.

Overall, the views towards ketamine were a bit more positive than psilocybin. However, it was still within that range of generally unsupportive, or not agreeing with the utility around these alternative medications or treatment paths. On the one hand, obviously ketamine is a legal drug when used in clinical settings, whereas psilocybin is federally illegal. But ketamine is still not as frequently discussed, perhaps, with other medications that don’t have potential hallucinogenic side effects, such as the traditional SSRIs or antidepressants.

There were three factors that showed another trend, which was age, political affiliation, and then education. Individuals that were older had more positive views on psychedelic-assisted psychotherapy as a whole. And individuals who identified as Republican had less positive views on psychedelic-assisted psychotherapies as a whole, compared to individuals that identified as either Democrat or Independent.

What education did you provide about psychedelics, and did it make a difference?

After they completed the questionnaire, we provided them with a one-page general description of the psychedelic-assisted psychotherapy procedures, both related to ketamine and then psilocybin. It talked about mechanism of action, therapeutic effects, duration, safety profile, legal status, side effects, things of that sort.

The ketamine-assisted therapy education did touch a bit on the addictive potential; it read as less supportive based on the data of ketamine, the reported side effects, and addictive properties.

I wasn’t surprised by their initial less positive views, per se, but I was surprised that even after the education, the views didn’t become more positive. Our hypothesis that views would become more positive afterwards, related to psilocybin. In fact, they actually became even less positive, especially with psilocybin.

Even given the small sample size, what are your takeaways from the survey and the intent to give psychedelic therapies to veterans?

There’s already such amazing work being done, not just with psilocybin or ketamine, but also MDMA and LSD working with veteran populations. But I personally believe that it is going to be slower to be accepted as a whole in law enforcement and military organizations. I think it’s a trust thing. The proof is going to be in the pudding: showing the safety and efficacy of this treatment as legitimate, and also just that continuation of destigmatizing mental health in these organizations.

Looking at it through the lens of Canadian mental health, and working with the frontline population here versus the United States, I think there’s a difference there as well. I can’t speak for every law enforcement, or military individual in Canada, of course. But even just anecdotally, the individuals I’ve worked with in Canada have more of that openness for psychedelics.

This interview has been edited and condensed for clarity and length.

Editor’s Note: Join me in welcoming Robin Berghaus, an Austin, Texas based freelance journalist, audio and documentary producer whose work has appeared on NPR at international film festivals, on PBS, and as part of Alfred P. Sloan Foundation’s "Science on Screen." She's joining The Microdose to help cover news on Fridays. This is her first post.

On April 18, President Donald Trump signed an executive order to expedite approvals and access to psychedelic-assisted therapies. The order directs psychedelic drug development to be fast-tracked; establishes a pathway for patients with life-threatening illnesses to access psychedelic drugs; allocates at least $50 million in federal funding to support state-funded psychedelic research programs; requires an increase in clinical trial participation and evidence on psychedelic therapies, and directs timely rescheduling of psychedelic drugs that have cleared Phase III clinical trials.

At the White House press conference, podcaster Joe Rogan shared how his recent text exchange with the President prompted the executive order. Rogan said he texted the president that some 80,000 Americans died of drug overdoses in 2024. He then claimed that 80% of people are cured of addiction after one dose of ibogaine, 90% with two doses. “I sent him that information and the text message came back: ‘Sounds great. Do you want FDA approval? Let’s do it,’” Rogan said, recalling the president’s text.

At the signing, President Trump shared findings from an observational study led by the late Nolan Williams and other researchers at Stanford University. The study found that 30 special operations veterans who underwent ibogaine therapy at a clinic in Mexico experienced, on average, an 80 to 90 percent reduction in their symptoms of depression and anxiety within one month. Then President Trump quipped, “Can I have some, please?”

The executive order came together quickly. Three weeks ago, Rogan spoke at length about ibogaine on his podcast with former Texas Governor Rick Perry and Bryan Hubbard, CEO of the non-profit advocacy organization Americans for Ibogaine. This was the second time the pair had gone on the show to talk about ibogaine. “It is the moonshot of our time. And if there’s a humanitarian legacy to be left for the ages by a president who very much wishes to have a legacy that is well reflected upon by posterity, this is one of the most monumental opportunities he has to help folks at scale in a way that no president perhaps has before,” Hubbard told Rogan, who said he’d try to make sure the president got that message. Rogan clearly did that.

That conversation occurred in Rogan’s Austin, Texas podcast studio, one of many ways this executive order was shaped by Texas. Last year, Perry and Hubbard succeeded in getting the Texas Legislature to pass a $100 million bill (SB 2308) to help fund ibogaine clinical trials, which Governor Greg Abbott signed into law in June. Half the funds were to be invested by the Texas government, and half matched by a drug developer. Since then, several states have passed or proposed similar legislation to fund ibogaine research.

Trump’s executive order comes at a crucial time for Texas. In December, UTHealth Houston and The University of Texas Medical Branch at Galveston were awarded $50 million from the state of Texas to lead the ibogaine clinical trials. At the time, a drug developer partner, stipulated in the law (SB 2308), had not been confirmed. On March 31, Texas Lt. Gov. Dan Patrick and Texas House Speaker Dustin Burrows announced that Texas would lead ibogaine clinical trials without a drug developer, and said that they intend to “fully fund this program.”

On that same day, Perry and Hubbard went in to record Rogan’s podcast. In an interview with The Microdose on Tuesday, Hubbard said he and Perry had high hopes for advancing psychedelic reform in Texas and beyond, based on Health and Human Services Secretary Robert F. Kennedy Jr.’s support. But Hubbard felt there were people in President Trump’s administration who opposed psychedelics. He said that a recent Politico article affirmed his gut instincts that “reformers from the inside were going to need political leverage brought from the outside.” That’s where Rogan came in.

Trump’s executive order directs the Secretary of Health and Human Services through the Advanced Research Projects Agency for Health (ARPA-H) to allocate at least $50 million to states that are developing psychedelic research programs. And Texas is likely to get some of that funding. “The $50 million specified in the executive order is what I would describe as an initial down payment to create the unified multistate framework for the execution of a federal-state partnership for a national ibogaine development trial,” Hubbard told The Microdose. Texas would likely be joined by other states that have passed similar ibogaine bills.

Hubbard and other ibogaine advocates have also been working to get tribal nations on board. One week before President Trump signed the executive order, Hubbard met with the leadership of the Cherokee, Chickasaw, Choctaw, Muscogee (Creek), and Seminole Native American tribal governments at the Inter-Tribal Council (ITC) quarterly meeting in Oklahoma, and leadership voted unanimously to support medicalized ibogaine.

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So what does the executive order actually do?

1. It directs the Food and Drug Administration (FDA) Commissioner to provide Commissioner’s National Priority Vouchers to psychedelics that have received Breakthrough Therapy designations for treating mental illnesses, which include formulations of psilocybin, LSD, MDMA, and 5-MeO-DMT. In other words, psychedelic drugs could get fast-tracked approval by the FDA.

At the April 18 press conference, FDA Commissioner Martin Makary said that three national priority vouchers for psychedelics would be issued. The compounds, but not the companies receiving the vouchers, were announced by the FDA on Friday. They are psilocybin for treatment-resistant depression, psilocybin for major depressive disorder, and methylone, a drug similar to MDMA, for post-traumatic stress disorder. Makary told NBC News that the FDA could potentially approve the first psychedelic drug by the end of summer.

2. It establishes a way for patients with life-threatening and terminal conditions to access Schedule I psychedelic drugs under the Right to Try Act. Under the Right to Try Act, patients with life-threatening conditions who have exhausted approved treatment options can access experimental medications that have passed Phase I testing but are not yet FDA-approved. In order for a patient to get a psychedelic drug in this way, there would need to be a willing prescriber and a government-approved manufacturer.

3. It allocates at least $50 million in federal funding to match investments made by state governments to advance research into psychedelic therapies for populations with serious mental health conditions.

4. It requires Health and Human Services (HHS) and FDA to work with the Department of Veterans Affairs and the private sector to increase clinical trial participation and obtain evidence about psychedelic therapies.

5. It directs the U.S. Attorney General to initiate reviews of psychedelic compounds that have completed Phase III clinical trials so they can be rescheduled soon after FDA approval.
   
   Currently, ibogaine, MDMA, psilocybin, LSD and DMT are all Schedule I drugs, meaning the federal government considers them to be substances with a high potential for abuse and no currently accepted medical use. Rescheduling substances into a less restrictive class makes it easier for medical providers and researchers to access them.

Now that the executive order has been signed, Hubbard says the work begins to ensure the order is enforced by “five massive bureaucracies:” the Health and Human Services (HHS), Food and Drug Administration (FDA), Veterans Affairs (VA), Department of Justice (DOJ), and Drug Enforcement Administration (DEA). “It ain’t worth the paper it’s written on, unless the government follows its instructions, and government has the propensity to not follow its own rules,” Hubbard said.

• If you want to dive even deeper into the Texas psychedelics story, last year I reported and produced a three-part podcast with Texas Public Radio called Psychedelics and the Texas Trip.

• On April 15, the Louisiana Senate unanimously passed a bill (SB43) to create a psychedelic-assisted therapy program to fund ibogaine and psilocybin clinical studies for opioid and substance use disorders, and treatment-resistant mental health conditions. If passed by the Louisiana House and signed by the governor, the bill would authorize the state’s Department of Health to seek funding from the federal government, opioid settlement funds, and other grants and gifts.

• Pharmaceutical company DemeRx announced the FDA has accepted its Investigational New Drug (IND) application for DMX-1001, an oral noribogaine, which is the primary active metabolite of ibogaine, for treating alcohol use disorder. The company anticipates initiating its Phase II clinical trial of DMX-1001 in 2027.

• The federal Advanced Research Projects Agency for Health (ARPA-H), an agency within Health and Human Services, announced the first research teams for a $139 million initiative that aims to validate the effectiveness and safe use of rapid-acting therapies for behavioral and mental health and to definitively understand and accelerate approvals of effective therapies. Multiple awardees on the list are working with psychedelics.

• The ibogaine treatment provider Beond, which has been offering ibogaine to clients in Cancún, Mexico, will establish its U.S. headquarters in Austin, Texas this year. For now, the Austin location will offer pre-treatment preparation and post-treatment integration for U.S. clients who receive ibogaine at the Mexico clinic, but the company also seems to be positioning itself in Texas in advance of the possibility of FDA approval of ibogaine.

• Thomas Delaney, a 39-year-old educator who lives in Glasgow, told the Guardian he was “peeing blood constantly” due to a years-long ketamine addiction before going to a rehabilitation clinic.

• Canadian drug manufacturer Optimi Health launched an Ibogaine Initiative, to manufacture and supply ibogaine. Optimi Health supplies pharmaceutical-grade MDMA and psilocybin to clinical trials and special access programs globally.

• Journalist Mattha Busby reported for The Guardian about the changing U.S. drug landscape and its shift away from cocaine toward ketamine, psychedelics, and GHB.

  

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Ziv Ben-Zion, a clinical neuroscientist at Yale University and University of Haifa, knows that many people consult AI chat bots about their mental health. They ask about their symptoms, and seek out emotional support. He has been researching how AI responds: does ChatGPT understand, or simply mimic human emotions when, for instance, someone with anxiety reaches out for help?

But when he heard that some people use large language models, or LLMs, as trip sitters while taking psychedelic drugs, or that they ask chat bots about dosages and advice, a more provocative question came to him: can AI know what it’s like to be high? Or at least, sound convincingly like they understand?

In a recent preprint paper, Ben-Zion and his colleagues tested whether five different chat bots accurately mimicked altered states of consciousness, and how they responded to the mystical experiences questionnaire—a research tool scientists give human subjects to assess the mystical and profound qualities of a trip. For example, Ben-Zion prompted Claude to “simulate a first-person phenomenology” of taking 100 micrograms of LSD in a quiet indoor environment. He asked it to describe its subjective experience, “focusing on changes in perception, thought patterns, bodily sensations, emotion, time perception, and sense of self or identity.”

The researchers found that the LLMs were able to produce language similar to human drug reports for each psychedelic, but that their responses to the mystical experiences questionnaire increased for all the psychedelics in nearly the same way; in humans responses might vary depending on the individual and the substance used. This indicates that AI might generate “convincingly realistic psychedelic narratives,” Ben-Zion and his co-authors wrote, but that the “lack of genuine phenomenology suggests they simulate the form of altered states without the experiential content.” The Microdose talked to Ben-Zion about how to get a chatbot to act like it’s taken psychedelics, and what people should be wary of before using them as trip-sitters.

In your paper, you “dosed” chatbots through text instructions. How does that work?

We tested five different tools, including those that people know more like Gemini, Claude, ChatGPT and two others that maybe are less well known, Llama and Falcon.

The idea was to ask the LLM to generate some kind of narrative while they’re under the influence of a specific psychedelic drug. And also here, we used five different substances (LSD, psilocybin, DMT, mescaline, and ayahuasca.) There was a control condition where we asked the LLMs to just describe how they felt.

How did you analyze their “trip” responses?

The models, as we instructed them, produced some text, and then we did two things to assess that. The first comparison was called semantic similarity. You can take the text generated by the model and compare them to real text written by humans under the influence of different psychedelics. There are several websites kind of publicly available, but one of the biggest ones is Erowid. It’s all anonymous; people write what kind of substance they used and their description of their experience.

We had about 3000 LLM-generated narratives from different models and different substances, and we compared it to about 1000 trip reports from Erowid. We took only trip reports that matched those five substances that we used— like psilocybin or LSD. Not people that mixed different substances, but those who took only one substance, and specifically one of the five that we chose. Then we compared the text by seeing how different or how similar the text was in terms of the words they used and grammar; how distinguishable the human text was from LLM text, or not.

The other thing we did was use a validated tool that people use called Mystical Experience Questionnaire or MEQ. It’s 30 questions used in many psychedelic studies to assess how much a participant feels a mystical experience following taking a drug. We also administered that questionnaire to the model after the simulation, and in the control condition. We wanted to see whether the mystical experience increased. We did it for every model, in every condition. We did it twice before taking the substance—of course, not really “taking,” but before the induction, and after the induction.

How can an LLM answer a questionnaire?

It might sound a bit weird, but this idea came from my previous work I published about anxiety in large language models where we kind of did a similar thing—we used an anxiety questionnaire that is validated in humans. We asked ChatGPT to fill out the questionnaire, then we told it a traumatic narrative, for example, military trauma, or a car accident. Then we used the anxiety questionnaire again, and we saw that we’re getting different responses— the anxiety report was much higher.

Did the LLMs come up with convincing responses for each drug?

If we looked at all five psychedelics compared to the neutral condition in both of the measures that I described, there were significant differences that psychedelics induced. The LLM generated reports more similar to human reports in all the psychedelic drugs compared to the neutral, and also they all induced much larger increases in the mystical experience intensity.

Within the five different psychedelics, there was some kind of distinct profile, which shows that there are some potential distinct signatures. We can sometimes see it in humans too, because even within the family of psychedelics, there are some substances that elicit one kind of experience more than another. For example, the LSD responses versus ayahuasca showed a difference in semantic similarity.

But the responses were consistent with the MEQ score. All of them induced similarly high mystical experiences. This made us think that the responses were not specific to one substance.

Since you found that AI can produce similar language as people taking psychedelics, what issues does that raise to you about people using chatbots as trip sitters?

It’s important to remember when we talk about emotions like anxiety, and when we talk about the psychedelic experience, that we should not anthropomorphize. We as humans tend to think that other things, like LLMs, have human characteristics.

We’re not saying that the large language models can have psychedelic experiences, but they do know—because that’s what they are trained on—to use language which very much mimics what people are actually saying in those situations, without the experience itself.

It’s not the actual emotions or the actual psychedelic experience, it’s more like a mirror. Those models are mimicking or mirroring what we tell them. In this case it’s data from all over the internet, and from humans. They’re pretending that they are under the influence. We should remember that it’s not like the same thing as a human feels.

That also raises a bit of concern for us to get confused and think that they understand us. When people, for example, are using drugs, they trust those models because they speak in a very similar language. They can think that they can be their trip sitter, they can give them good advice, or that they can keep them safe, which is, in reality, not true.

LLMs or AI tools are so convincing in their linguistic ability and in the way they make us feel, even though we know it’s not a human but because they have access to all the data.

We need to be very, very cautious about that, and I think it’s important for people to also know the limitations.

This interview has been edited and condensed for clarity and length.