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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 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]
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Cites
Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & Klinedinst, M. A. (2016) · Journal of Psychopharmacology · doi:10.1177/0269881116675513 · Cited by 2,201 · cited 1×
“While previous decades of psychedelic research have focused on a wide array of psychological problems using many different psychedelic substances, modern research has demonstrated the strongest evidence for psychedelic-assisted therapy in the treatment of post-traumatic stress disorder (PTSD) [18], depression [19], en…”
BackgroundNichols, D. E. (2016) · Pharmacological Reviews · doi:10.1124/pr.115.011478 · Cited by 1,762
Drug harms in the UK: a multicriteria decision analysis
Nutt, D. J., King, L. A., & Phillips, L. D. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61462-6 · Cited by 1,681
Human hallucinogen research: guidelines for safety
Johnson, M., Richards, W., & Griffiths, R. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108093587 · Cited by 1,203
Psilocybin with psychological support for treatment-resistant depression: six-month follow-up
Carhart-Harris, R. L., Bolstridge, M., Day, C. M. J., Rucker, J., Watts, R., Erritzoe, D. E., Kaelen, M., Giribaldi, B., Bloomfield, M., Pilling, S., et al. (2018) · Psychopharmacology · doi:10.1007/s00213-017-4771-x · Cited by 970
Long-term follow-up of psilocybin-facilitated smoking cessation
Johnson, M. W., Garcia-Romeu, A., & Griffiths, R. R. (2017) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2016.1170135 · Cited by 696
Sota, J., Insalaco, A., Cimaz, R., Alessio, M., Cattalini, M., Gallizzi, R., Maggio, M. C., Lopalco, G., Torre, F. L., Fabiani, C., et al. (2019) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.01526 · Cited by 616
Connock, M., Juarez-Garcia, A., Jowett, S., Frew, E., Liu, Z., Taylor, R., Fry-Smith, A., Day, E., Lintzeris, N., Roberts, T. E., et al. (2007) · Health Technology Assessment · doi:10.3310/hta11090 · Cited by 610
Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials
Krebs, T. S., & Johansen, P.-Ø. (2012) · Journal of Psychopharmacology · doi:10.1177/0269881112439253 · Cited by 583
Johnson, M. W., Hendricks, P. S., Barrett, F. S., & Griffiths, R. R. (2019) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2018.11.010 · Cited by 506 · cited 1×
“Traditional or "classic" psychedelics are serotonergic agonists that include lysergic acid diethylamide (LSD), mescaline, dimethyltryptamine (DMT), and psilocybin [3].”
BackgroundPredicting responses to psychedelics: a prospective study
Haijen, E. C. H. M., Kaelen, M., Roseman, L., Timmermann, C., Kettner, H., Russ, S., Nutt, D., Daws, R. E., Hampshire, A. D. G., Lorenz, R., et al. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.00897 · Cited by 417
Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen
Bamford, J., Fortnum, H. M., Bristow, K., Smith, J., Vamvakas, G., Davies, L. M., Taylor, R. S., Watkin, P. M., Fonseca, S., Davis, A. C., et al. (2007) · Health Technology Assessment · doi:10.3310/hta11320 · Cited by 389
Effects of Schedule I drug laws on neuroscience research and treatment innovation
Nutt, D., King, L. A., & Nichols, D. E. (2013) · Nature reviews. Neuroscience · doi:10.1038/nrn3530 · Cited by 355
Danforth, A. L., Grob, C. S., Struble, C., Feduccia, A. A., Walker, N., Jerome, L., Yazar-Klosinski, B., & Emerson, A. (2018) · Psychopharmacology · doi:10.1007/s00213-018-5010-9 · Cited by 280 · cited 1×
“While previous decades of psychedelic research have focused on a wide array of psychological problems using many different psychedelic substances, modern research has demonstrated the strongest evidence for psychedelic-assisted therapy in the treatment of post-traumatic stress disorder (PTSD) [18], depression [19], en…”
BackgroundPsychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development
Schenberg, E. E. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.00733 · Cited by 270
The use of the psychological flexibility model to support psychedelic assisted therapy
Watts, R., & Luoma, J. B. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.12.004 · Cited by 269
Self-citationPsychoactive drugs and harm reduction: from faith to science.
Heather, N., WODAK, A. D., Nadelmann, E. A., & O'Hare, P. A. (1993) · Cited by 265
Inclusion of people of color in psychedelic-assisted psychotherapy: a review of the literature.
Michaels, T. I., Purdon, J., Collins, A., & Williams, M. T. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1824-6 · Cited by 265
Psychedelic Drugs Reconsidered
Seelye, E. E. (1980) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1980.34.4.593 · Cited by 257
Marcela Ot’alora, G., Grigsby, J., Poulter, B., Derveer, J. W. V., Giron, S. G., Jerome, L., Feduccia, A. A., Hamilton, S., Yazar‐Klosinski, B., Emerson, A., et al. (2018) · Journal of Psychopharmacology · doi:10.1177/0269881118806297 · Cited by 252
The role of passion in sustainable psychological well-being
Vallerand, R. J. (2012) · Psychology of Well-Being Theory Research and Practice · doi:10.1186/2211-1522-2-1 · Cited by 245 · cited 1×
“Using the dualistic model of passion, it is possible to view such use of psychedelics as a type of harmonious passion, or ongoing engagement with an activity that enhances life, rather than obsessive passion, which is a type of engagement with an activity that can interfere with other life domains [53].”
BackgroundPsychedelic Drugs Reconsidered
Grinspoon, L., & Bakalar, J. B. (1979) · Medical Entomology and Zoology · Cited by 239
George, J. R., Michaels, T. I., Sevelius, J. M., & Williams, M. T. (2019) · Journal of Psychedelic Studies · doi:10.1556/2054.2019.015 · Cited by 230
Schultes, R. E. (1969) · Science · doi:10.1126/science.163.3864.245 · Cited by 228
Rhead, J. (2018) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2018.1535149 · Cited by 224
Harm Reduction Therapy: A Practice-Friendly Review of Research
Logan, D. E., & Marlatt, G. (2010) · Journal of Clinical Psychology · doi:10.1002/jclp.20669 · Cited by 213
A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy
Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2020.1769878 · Cited by 212
Self-citationSystematic Review: The Effects of Growth Hormone on Athletic Performance
Liu, H., Bravata, D. M., Olkin, I., Friedlander, A. L., Liu, V. X., Roberts, B. K., Bendavid, E., Saynina, O., Salpeter, S. R., Garber, A. M., et al. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-148-10-200805200-00215 · Cited by 182
Doe-Simkins, M., Quinn, E. K., Xuan, Z., Sorensen-Alawad, A., Hackman, H., Ozonoff, A., & Walley, A. Y. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-297 · Cited by 175
The cost-effectiveness of harm reduction
Wilson, D. P., Donald, B., Shattock, A. J., Wilson, D. P., & Fraser‐Hurt, N. (2014) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2014.11.007 · Cited by 172
Measham, F. C. (2018) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2018.11.001 · Cited by 170
CHARACTERIZATION OF THREE NEW PSYCHOTOMIMETICS
Alexander, T., & Nichols, D. E. (1978) · Elsevier eBooks · doi:10.1016/b978-0-08-021938-7.50010-2 · Cited by 163
Psychoactive Substances in Prehistoric Times: Examining the Archaeological Evidence
Doce, E. G. (2015) · Time and Mind · doi:10.1080/1751696x.2014.993244 · Cited by 150
Kohn, B., & Hofmann, A. (1981) · The Antioch Review · doi:10.2307/4638477 · Cited by 146
Haines, L. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2018.0644 · Cited by 141
Callaway, J. C., & Grob, C. S. (1998) · Journal of Psychoactive Drugs · doi:10.1080/02791072.1998.10399712 · Cited by 137
Ecstasy pill testing: harm minimization gone too far?
WINSTOCK, A. R., Wolff, K., & Ramsey, J. M. (2001) · Addiction · doi:10.1046/j.1360-0443.2001.96811397.x · Cited by 132
Over 30 million psychedelic users in the United States
Krebs, T. S., & Johansen, P.-Ø. (2013) · F1000Research · doi:10.12688/f1000research.2-98.v1 · Cited by 124
The Psychopharmacology of Hallucinogens
(1978) · Elsevier eBooks · doi:10.1016/c2013-0-02910-6 · Cited by 123
Bruhn, J. G., Smet, P. A. G. M. D., El-Seedi, H. R., & Beck, O. (2002) · The Lancet · doi:10.1016/s0140-6736(02)08701-9 · Cited by 104
The role of Indigenous knowledges in psychedelic science
Fotiou, E. (2019) · Journal of Psychedelic Studies · doi:10.1556/2054.2019.031 · Cited by 104
Development of a Psychotherapeutic Model for Psilocybin-Assisted Treatment of Alcoholism
Bogenschutz, M. P., & Forcehimes, A. A. (2016) · Journal of Humanistic Psychology · doi:10.1177/0022167816673493 · Cited by 102
Weitzman, E. R., & Nelson, T. F. (2004) · Journal of Drug Education · doi:10.2190/w6l6-g171-m4ft-twap · Cited by 98
Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions
Denning, P. (2000) · Cited by 95
Harm Reduction: History, Definition, and Practice
Riley, D., & O'Hare, P. A. (2000) · Sage eBooks · doi:10.4135/9781452220680.n1 · Cited by 91
Williams, M. T., Reed, S., & Aggarwal, R. (2019) · Journal of Psychedelic Studies · doi:10.1556/2054.2019.016 · Cited by 89
Psychedelic Psychotherapy: Insights From 25 Years of Research
Richards, W. A. (2016) · Journal of Humanistic Psychology · doi:10.1177/0022167816670996 · Cited by 83
Harm reduction: Reducing the risks of addictive behaviors.
Marlatt, G. A., & Tapert, S. F. (1993) · Cited by 82
Diversity, equity, and access in psychedelic medicine
Williams, M. T., & Labate, B. C. (2019) · Journal of Psychedelic Studies · doi:10.1556/2054.2019.032 · Cited by 79
Clostridium difficile infection in returning travellers
Stevens, A. M., Esposito, D. H., Stoney, R. J., Hamer, D. H., Flores‐Figueroa, J., Bottieau, E., Connor, B. A., Gkrania‐Klotsas, E., Goorhuis, A., Hynes, N. A., et al. (2016) · Journal of Travel Medicine · doi:10.1093/jtm/taw099 · Cited by 64
Harm Reduction: A Social Work Practice Model and Social
Agenda, J., Brocato, J., & Wagner, E. F. (2003) · Health & Social Work · doi:10.1093/hsw/28.2.117 · Cited by 59
Brindley, P. G. (2021) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000005349 · Cited by 49
The effectiveness of harm reduction in preventing HIV among injecting drug users
WODAK, A. D., & Maher, L. (2010) · New South Wales Public Health Bulletin · doi:10.1071/nb10007 · Cited by 48
Practicing Harm Reduction Psychotherapy. An Alternative Approach to Addictions
Hearn, A. (2012) · Alcohol and Alcoholism · doi:10.1093/alcalc/ags015 · Cited by 43
Early peyote research an interdisciplinary study
Bruhn, J. G., & Holmstedt, B. R. (1973) · Economic Botany · doi:10.1007/bf02862854 · Cited by 37
New Records of Mushroom Stones from Guatemala
Lowy, B. (1971) · Mycologia · doi:10.1080/00275514.1971.12019194 · Cited by 32
Inside bad trips: Exploring extra-pharmacological factors
Oña, G. (2018) · Journal of Psychedelic Studies · doi:10.1556/2054.2018.001 · Cited by 26
Reflections on crafting an ayahuasca community guide for the awareness of sexual abuse
Peluso, D. M., Sinclair, E., Labate, B. C., & Cavnar, C. (2020) · Journal of Psychedelic Studies · doi:10.1556/2054.2020.00124 · Cited by 23
The highs and lows of drug tourism: a travel medicine perspective
Flaherty, G. T., Maxemous, K. K., Nossier, R. E., & Bui, Y. (2017) · Journal of Travel Medicine · doi:10.1093/jtm/tax068 · Cited by 19
Steers, M. N., Neighbors, C., Hove, M. C., Olson, N. D., & Lee, C. M. (2015) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2015.76.749 · Cited by 17
Haeny, A. M. (2013) · Ethics & Behavior · doi:10.1080/10508422.2013.860030 · Cited by 17
Application of the Passionate Attachment Model to Recreational Use of MDMA/Ecstasy
Davis, A. K., & Rosenberg, H. (2015) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2014.973125 · Cited by 15
Weingardt, K. R., & Marlatt, G. A. (1998) · Springer eBooks · doi:10.1007/978-1-4899-1934-2_24 · Cited by 14
Sijbrandij, M., Farooq, S., Bryant, R. A., Dawson, K. S., Hamdani, S. U., Chiumento, A., Minhas, F., Saeed, K., Rahman, A., & van Ommeren, M. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1922-5 · Cited by 14
L.Fisher, G., & Roget, N. A. (2009) · doi:10.4135/9781412964500.n153 · Cited by 14
Practicing Harm Reduction Psychotherapy: An Alternative Approach to Addictions
Maisto, S. A. (2003) · Clinical Psychology Review · doi:10.1016/s0272-7358(02)00160-5 · Cited by 10
The Dualistic Model of Passion applied to recreational marijuana consumption
Davis, A. K. (2016) · Addiction Research & Theory · doi:10.1080/16066359.2016.1242722 · Cited by 9
Psychedelic therapy in the Czech Republic: A theoretical concept or a realistic goal?
Postránecká, Z., Vejmola, Č., & Tylš, F. (2019) · Journal of Psychedelic Studies · doi:10.1556/2054.2019.003 · Cited by 7
The Concept of “Conduct Unbecoming” as Applied to a Physician's Extra-Medical Behavior
Gutheil, T. G., Book, H. E., & Brodsky, A. (2011) · The Journal of Psychiatry & Law · doi:10.1177/009318531103900204 · Cited by 3
Research works printed but not linked: 4
- Tanne JH. Humphry Osmond. BMJ. 2014;328(7441):713.
- United Nations Office on Drugs and Crime. Amphetamine-type stimulants: a global review. 1996.
- Ekman Schenberg E. Psychedelic-assisted psychotherapy: a paradigm shift in psychiatric research and development. Front Pharmacol. 2018;9:733. · DOI
- Carlin SC, Scheld S. MDMA-assisted psychotherapy code of ethics. MAPS Bull Spring. 2019;29(1):10.
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Bremler, R., Katati, N., Shergill, P., Erritzøe, D., & Carhart-Harris, R. L. (2023) · Scientific Reports · doi:10.1038/s41598-023-41145-x · Cited by 128
The neuroplastic brain: current breakthroughs and emerging frontiers
Gazerani, P. (2025) · Brain Research · doi:10.1016/j.brainres.2025.149643 · Cited by 153
Ethical and Practical Considerations for the Use of Psychedelics in Psychiatry
Barber, G., & Dike, C. C. (2023) · Psychiatric Services · doi:10.1176/appi.ps.20220525 · Cited by 73
Rosenblat, J. D., Husain, M. I., Lee, Y. L., McIntyre, R. S., Mansur, R. B., Castle, D. J., Offman, H., Parikh, S. V., Frey, B. N., Schaffer, A., et al. (2022) · The Canadian Journal of Psychiatry · doi:10.1177/07067437221111371 · Cited by 68
Lutkajtis, A., & Evans, J. (2023) · Journal of Psychedelic Studies · doi:10.1556/2054.2022.00232 · Cited by 67
Metadata
- 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 › Clinical 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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