Closing the Doors of Perception: Optimism in Psychedelic Science 

By Luke Strong 

In 2018, Michael Pollan released the book How to Change Your Mind. Its subtitle, What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, despite being a mouthful, elucidates the optimism upon which it is built. 

From beginning to end, it is representative of the growing optimism within the psychedelic space, which has been rapidly increasing in the post-prohibition era [1]. From discussing psychedelic usage openly and talking directly with enthusiastic scientists, Pollan popularised the support of psychedelic science for treating mental health problems. 

Such optimism was echoed by the similarly-named Netflix series in 2022, which focused on the clinical trials surrounding LSD, psilocybin, MDMA, and mescaline. In each episode, patients described their experiences of being given a psychedelic drug under the supervision of trained therapists, who guided them through a strong trip to help them put their own lives in perspective, reducing the burdens of illnesses like OCD, addiction, and anxiety [2].  

Upon the show’s release, excitement pulsated beyond the psychedelic community, as people saw the true potential of these compounds. Across the US, such ideological progress was complimented by Decriminalize Nature ballot propositions, leading a shift towards more liberal drug policies that recognized the therapeutic potential and lack of harm intrinsic in natural psychedelic substances. 

This past August, much of this optimism came to a halt. After thirty years of clinical trials, the Multidisciplinary Association for Psychedelic Studies (MAPS) failed to receive approval from the US Food and Drug Administration (FDA) for the use of MDMA-assisted therapy. The trials in question consisted of three doses of MDMA supervised by a therapist, used in the treatment of PTSD. Ahead of the rejection, the advisory committee of the FDA reached an almost unanimous vote that the benefit-risk ratio did not justify its approval [3]. 

Though MDMA has already been prescribed in Australia and the psychedelic-adjacent esketamine has been approved the FDA process, it was a major moment for the psychedelic community, which likely would have permanently cemented a place for once-rejected drugs in medical contexts [4][5].  

It is easy to look at this decision and understand psychedelic science as just another innovation representative of the hype cycle. This cycle represents expectations regarding technology, wherein expectations reach an unrealistic peak before levelling out, where true technological progress takes place [6]. 

But to suggest the presence of this “hype cycle” ignores the litany of impressive research that has been taking place in Western medical contexts as early as the 50s [7]. Most of the hype regarding psychedelics represented extremely optimistic yet extremely well-founded mindsets built upon the ever-growing knowledgebase of psychedelic applications [8]. 

While the sentiments of Timothy Leary and the counterculture movement of the 60s overhyped the potential of psychedelics, upholding them as a panacea, the current pervasive psychedelic attitude is far from this. 

When looking at this decision, the implications have global ramifications. 

The United States is not the only country supporting and fostering clinical trials of psychedelics, but it has an undeniably strong influence on international medicine. By rejecting MDMA-assisted therapy, the US government has effectively told MAPS to reinvest millions of dollars, along with many years to reach the same approval stage.  

The lack of understanding of MDMA-assisted therapy’s potential and its need to be treated with unique drug-therapy combinations like esketamine, is well-noted by Drug Science.  They emphasise the failures of the FDA to adequately work with MAPS to find a way forward, seemingly abandoning a better, more thorough and nuanced understanding of psychedelic potential [9]. 

Though the legality of psychedelics across the world is promising in many regions, the FDA decision will undoubtedly be cited during upcoming psychedelic efforts. This means that the people who could benefit from psychedelics the most will likely not be able to access them.  

Psychedelic clinical trials are tightly regulated and limited to certain institutions. While trials are ongoing in the UK, primarily in London, when will the Psychedelic Renaissance come to a place like Northern Ireland? Given NI’s history of extraordinary, costly mental health problems, psychedelics could help reduce the burden of pervasive PTSD, anxiety, and depression.  

However, MAPS’s failed approval will now serve as an international example, swaying organizations and universities away from involving themselves in a lengthy process of approval. It also alerts governments to be wary of psychedelic science.  

We have no reason to withhold optimism regarding the potential of psychedelics, as decades of research show, but it will undoubtedly be some time until the potential of psychedelics begins to be fully unlocked. 

[1] Michael Pollan, How to Change Your Mind: The New Science of Psychedelics. (London: Penguin Books, 2018). 

[2] Lucy Walker and Alison Ellwood, “How to Change Your Mind” (Netflix, July 12, 2022), https://www.netflix.com/title/80229847. 

[3] Kai Kupferschmidt, “FDA Rejected MDMA-Assisted PTSD Therapy. Other Psychedelics Firms Intend to Avoid That Fate,” Science.org, 2024, https://www.science.org/content/article/fda-rejected-mdma-assisted-ptsd-therapy-other-psychedelics-firms-intend-avoid-fate. 

[4] Therapeutic Goods Administration, “Update on MDMA and Psilocybin Access and Safeguards from 1 July 2023,” Therapeutic Goods Administration (TGA) (Australian Government, July 3, 2023), https://www.tga.gov.au/news/news/update-mdma-and-psilocybin-access-and-safeguards-1-july-2023. 

[5] “FDA Approves New Nasal Spray Medication for Treatment-Resistant Depression; Available Only at a Certified Doctor’s Office or Clinic,” U.S. Food and Drug Administration (United States Government, March 5, 2019), https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified. 

[6] “Gartner Hype Cycle Research Methodology,” Gartner, 2024, https://gartner.com/en/research/methodologies/gartner-hype-cycle. 

[7] “Psychedelic Research Timeline,” The Beckley Foundation, December 15, 2016, https://www.beckleyfoundation.org/psychedelic-research-timeline-2/. 

[8]  Danilo De Gregorio et al., “Hallucinogens in Mental Health: Preclinical and Clinical Studies on LSD, Psilocybin, MDMA, and Ketamine,” Journal of Neuroscience 41, no. 5 (February 3, 2021): 891–900, https://doi.org/10.1523/JNEUROSCI.1659-20.2020. 

[9] David Nutt et al., “Allaying the Fears: MDMA with Therapy Is a Medicine,” Drug Science, August 6, 2024, https://www.drugscience.org.uk/allaying-the-fears-mdma.