Ethical and legal issues in psychedelic harm reduction and integration therapy
Open accessAbstract
Psychedelic-assisted therapy may represent an upcoming paradigm shift in the treatment of mental health problems as recent clinical trials have demonstrated strong evidence of their therapeutic benefits. While psychedelics are currently prohibited substances in most countries, the growing popularity of their therapeutic potential is leading many people to use psychedelics on their own rather than waiting for legal medical access. Therapists therefore have an ethical duty to meet this need by providing support for clients using psychedelics. However, incorporating psychedelics into traditional psychotherapy poses some risk given their prohibited status and many therapists are unsure of how they might practice in this area. This paper explicates such risks and describes ways in which therapists can mitigate them and strive to practice within legal and ethical boundaries. A harm reduction approach will be emphasized as a useful framework for conducting therapy around clients' use of psychedelics. It is argued that therapists can meet with clients before and after their own personal psychedelic experiences in order to help clients minimize risk and maximize benefit. Common clinical scenarios in this growing clinical area will also be discussed.
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The pressing need for novel therapeutic options for treatment-resistant psychiatric disorders is leading many patients to self-administer psilocybin rather than waiting for further evidence of efficacy, legal medical, and protected access.
“The pressing need for novel therapeutic options for treatmentresistant psychiatric disorders is leading many patients to selfadminister this drug, rather than waiting for further evidence of efficacy, legal medical, and protected access. 98”
From The revival of psilocybin between scientific excitement, evidence of efficacy, and real-world challenges (2024) · cites this paper as [98]
The Background information on psychedelic therapy, harm reduction, and integration section (page unavailable) says people seek psychedelics for healing when existing treatments have failed and that limited legal access leads some to use them on their own. It does not establish that these people are specifically self-administering psilocybin, or that they are doing so rather than waiting for further evidence of efficacy or protected access. (LLM, conf=0.86)
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Psychedelic-related deaths in England, Wales and Northern Ireland (1997–2022)
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Focusing on the negative: cases of long-term negative psychological responses to psychedelicsPreprint
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Review of Psilocybin Use for Depression among Cancer Patients after Approval in Oregon
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The Pharmacology and Clinical Applications of Psychedelic Medicines Within Midwifery Practice
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Ensuring psychedelic treatments and research do not leave anyone behind
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Multimodal Neuroimaging of the Effect of Serotonergic Psychedelics on the Brain
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Harm reduction practises for users of psychedelic drugs: a scoping review
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Chaplains in Psychedelic Assisted Therapy: Rationale and Competencies
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Examining Volunteer Bias in Psychedelic Research
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THE SEROTONIN 5-HT2ARECEPTOR AS AN EVOLVING NEUROTHERAPEUTIC TARGET
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Protecting Patient Autonomy in Psychedelic-Assisted Psychotherapy: A Nursing Ethics Perspective
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- Authors
- Pilecki, B., Luoma, J. B., Bathje, G. J., Rhea, J., & Narloch, V. F.
- Affiliations
- Adler University (US)
- Corresponding author
- Pilecki, Brian
- Venue
- Harm Reduction Journal
- Published
- 2021-04-07
- Volume
- 18
- Issue
- 1
- Pages
- 40-40
- ISSN
- 1477-7517 (ISSN-L)
- PMC
- PMC8028769
- OpenAlex
- W3149986569
- Cited by
- 141
- References
- 69
- Citations by year
- 2026: 25 · 2025: 34 · 2024: 34 · 2023: 24 · 2022: 21 · 2021: 3
- FWCI
- 13.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Harm Reduction Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- None
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- psychedelic therapy, harm reduction, psychedelic use, therapist ethics, legal issues, prohibited substances, clinical scenarios
- MeSH terms
- Behavior Therapy, Hallucinogens, Humans, Morals, Psychotherapy, Harm Reduction
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