Conflicts of interest: 5 Questions for researcher Elena Koning

Koning discusses how conflicts of interest play out in the psychedelic research world.

For decades, the U.S. government has avoided funding scientific research on psychedelic drugs, particularly those listed by the U.S. Drug Enforcement Agency under the most restrictive Schedule I category for “drugs with no currently accepted medical use and a high potential for abuse.” Schedule I drugs include psilocybin, LSD, MDMA, peyote and heroin. But research on some of these substances has continued with funding from non-profits, philanthropists, and companies. Now, many psychedelics clinical trials are paid for by businesses collaborating with university researchers, and it’s not uncommon to see academic journal articles with a paragraphs-long “conflicts of interest” section, declaring researchers’ affiliations with and monetary stakes in psychedelic companies. 

Elena Koning, a neuroscience PhD student at Queens University in Canada, has been studying the potential for psychedelic therapy to treat eating disorders. She and two collaborators recently published a piece titled “How corporate involvement in psychedelic research could threaten public safety,” in The Conversation. The Microdose spoke with her about how conflicts of interest play out in the psychedelic research world.  

What other industries have experienced research-related conflicts of interest like this?

Largely, it's more or less the same across fields: corporations obviously have a motivation to pursue profit for their shareholders, which can differ from researchers’ typical motivation, which is to uncover what is accurate and what is truthful, not what can be commercialized or profited from. This was also an issue in the tobacco industry; there was compelling scientific evidence for the harms of tobacco that started coming up in the mid 20th century, but companies knew that if that evidence came out, it would harm the industry. So some groups created controversy about those researchers’ potential conflicts of interest; they made an effort to dismantle the scientific evidence by reducing trust in the research, and that ended up delaying regulation of tobacco, which allowed the industry to flourish for longer and make more money. It’s been estimated that hundreds of thousands of deaths could have been prevented if stricter regulations on tobacco had been enacted when it was initially proposed by scientists. 

Conflicts of interest have also happened more recently in the opioid industry. There have been close relationships between prescribers and corporations, and companies that are profiting from opioids have been funding medical education and training, and providing doctors with promotional materials. That can have a psychological impact, where prescribers feel an expectation to prescribe the medications the company offers, as well as financial incentives. In some cases it can lead to the dissemination of biased information, and contributes to misconceptions about risks and benefits about these drugs. 

Why is so much psychedelic research funded by companies?

Corporate involvement in psychedelic research has increased a lot over the decades for a few reasons. There’s a long history of regulatory hurdles, which have restricted psychedelic research from being conducted, primarily in the mid 20th century. Those restrictions persist today, which makes it difficult to study these substances; they're illegal, so funding opportunities haven't always been widely available because of the political and cultural opposition to psychedelic research. That opened up the door to alternative funding sources like for private industry. Now, the industry is booming; demand for alternative therapeutic approaches is at an all time high and there are a lot of startups coming up right now, with a lot of corporations eager to be involved in research so they can capitalize on this really fast growing industry. 

That can also be favorable to researchers because psychedelic trials can be quite costly. Working with companies can allow researchers to have the resources they need to conduct psychedelic trials and bring these new therapies to market. So there's motivation on both sides, especially because while some government funding now exists, it is very competitive. 

What kind of conflicts might come up as psychedelic researchers are working on these corporate sponsored studies? 

Researchers partnering with corporations might experience a social or professional pressure to conform with the expectations of corporations, which is to create positive results that show that psychedelics are a useful medicine and can be commercialized. These corporate-sponsored studies also may favor study designs which may not identify adverse events: why would you fund a study if you think that a lot of people are going to be harmed and it's not going to end up with a positive result? There might also be fewer sessions of follow-ups to minimize cost, which can lead to worse tracking and reporting of adverse events.

But even outside corporate involvement, we’re all human, and we all have biases. Lately, people have been talking about the potential effects of “excessive enthusiasm”: people get attached to the idea of psychedelic healing. Many people who have personal experience with them say it’s one of the most meaningful experiences of their lives. The use of psychedelics by researchers that are studying them is high. So, researchers might have an unconscious bias to expect positive results in their own work, which could lead to more positive results being identified, or negative results being minimized. 

Has this work changed the way you think about corporate involvement in research? 

When I went into this paper, I was pretty anti-corporation. And while there are obviously issues, corporate involvement isn’t going away any time soon, and I think we’d be a lot farther behind in medicine and technology if we didn't have that funding. Moving forward, I think we need to be more cautious in understanding the ways that corporations can influence research and how to mitigate those, but I wouldn’t want to see corporate involvement just disappear altogether.

How do we mitigate the potential negative effects of conflicts of interest?

At the governmental level, we could increase funding opportunities for psychedelic trials, so that the research can occur regardless of corporate involvement. And we need to make sure that any funding supporting research publications or presentations is always disclosed, so people consuming that information can be informed about that. 

Another thing we can do is register clinical trial protocols before corporate funding is acquired, so this can reduce the influence of conflicts of interest that affect study methodology and design. That can ensure that safety data remains a primary outcome of the research, rather than just trying to maximize positive effects. 

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