Many people are now touting the benefits of microdosing, states across the country are taking steps towards decriminalizing or legalizing these substances, and psychedelic therapy is gaining a foothold as an intriguing treatment innovation. To better understand just how much ground this trend has gained in the national consciousness, we surveyed over 1,800 American adults about their current knowledge of psychedelics and awareness of their potential use in treating mental health conditions like depression and PTSD.
How Americans Feel About Psychedelics
We found that the psychedelics trend—buzzy thought it may be in mental health circles—has not yet reached a tipping point amongst Americans at-large:
Only 15% have a positive opinion of psychedelics.34% have a negative opinion.The remaining half of Americans are either neutral on the subject or have never heard of psychedelics at all.
Our survey suggests a few factors that might shift the general awareness and perception of psychedelics—knowledge, professional endorsement within the medical community, and continued lowering of legal barriers. With limited exceptions, psychedelics are not legal throughout the US, and Americans do not have a strong sense of what these drugs actually do. In many ways, we may be at an inflection point similar to where things stood with cannabis over the last decade—widespread legality for medical purposes, a growing body of research into alternative potential uses, and the ingredients for what became a major industry based around cannabis-derived products. Now, CBD supplements are a multi-billion dollar business representing a major corner of the wellness space, and federal marijuana legalization appears to be on the horizon. Only time will tell if psychedelics may follow a similar path.
Where Psychedelics Fit Into the Mental Health Conversation
Psychedelics are controlled substances, meaning that their manufacture, possession, and use is regulated by the government. While recent years have seen a wave of decriminalization in some cities and counties across the US, these drugs are technically illegal under federal law. Ketamine is the only psychedelic that has achieved a manner of broad legality—but only for medical use. In 2019, a ketamine-derived nasal spray became the first FDA-approved psychedelic medicine, to be used specifically for treatment-resistant depression. It has shown to be a very effective—if expensive—option for individuals whose condition has not responded to traditional anti-depressant medications. Other psychedelics are a different story:
To date, Oregon is the only state that has passed a bill that will make psilocybin (the active compound found in magic mushrooms) legal for medicinal use, despite promising research into its effects on individuals with depression. MDMA (ecstasy) is generally only legal for use as part of FDA-approved clinical trials and expanded access situations in select hospitals (again, there is promising research on its uses for post-traumatic stress disorder). LSD (acid) is illegal to possess in any form, though it has become one of the most popular substances for microdosing over the past several years.
Given these facts, it’s little surprise that Americans are not in favor of psychedelic use unless certain conditions are met.
Safety, Supervision, and Medical Justification
While Americans seem to have a firm stance against psychedelics in general, the tenor of responses shifts when the context of mental health is given stronger consideration:
About a third (34%) of Americans are already aware psychedelics are being used for mental health reasons, but only 6% know someone who has done so.29% have heard of psychedelics being used for a specific condition (primarily depression and PTSD).50% of Americans who have seen a therapist recently have heard of such usage for psychedelics.
While only 15% have positive feelings about psychedelics in general, 24% are in favor of using them as part of treatment for a mental health condition. That number rises to 36% amongst those who have seen a therapist recently. Almost half of Americans would support legalization of at least some psychedelics for the purposes of mental health treatment, as long as it was appropriately supervised. Support is greatest (61%) among Americans who have seen a therapist in the last 30 days. As the abstractions and unknowns around psychedelic and their therapeutic potential are stripped away, it seems people are much more likely to adjust their views. A shift in the official status of these possible treatments is a critical component of public sentiment, according to the survey. Only 17% say they would definitely consider psychedelics as part of treatment for a mental health condition, but the right circumstances lead to more openness:
35% of Americans would be more likely to consider psychedelics for mental health care if recommended by a doctor or therapist.30% would be more likely if a specific drug were FDA-approved, and if they were taken in the office of a mental health or medical professional.46% and 45% of those recently in therapy would be more inclined to try psychedelics upon a doctor’s recommendation or FDA approval, respectively.
Accessibility
Should some or all of the above hurdles be cleared, it still won’t be as simple as walking to your local pharmacy and filling a prescription or accessing psychedelic care through your regular therapist and having the treatment covered by insurance. There is extremely limited infrastructure to support these types of therapies at the moment, and existing options are expensive and figure to remain so:
Because it is FDA-approved, Spravato—the medication that is derived from ketamine and approved for use in treatment-resistant depression—may be covered by insurance (Note that Spravato itself does not fit the classic definition of a psychedelic.). But off-label ketamine infusion therapies can cost thousands for a single treatment and are not FDA-approved. Psychedelic retreats, where legal, cost thousands to attend. If legality continues to progress on a state-by-state basis, simply traveling to where you could legally try psilocybin therapy, for example, would be too cumbersome for most people in need of these treatments. The modern conception of psychedelic therapy is largely a white and male-dominated space, meaning that these modalities may not be fully prepared to cater to diverse clientele. Clinical trials in general have long struggled to be inclusive of racial, sexual, and gender minorities, and training will be necessary to ensure cultural competence in the use of these therapies.
Many of the disparities that currently limit access to adequate mental healthcare in BIPOC and other disadvantaged communities would likely extend to psychedelic treatments, whether or not they are fully legalized.
A Word From Verywell
When it comes to psychedelics, Americans are cautious, but curious. Better scientific and psychological understanding of these drugs, their effects, risks, and potential benefits will be the first steps toward wider acceptance, continued decriminalization and, ultimately, normalization as a mental health treatment option when appropriate.
Methodology
Verywell Mind surveyed over 1,800 Americans age 18+ across a wide range of demographics including age, race, income, geographic location, and sexual orientation.
