Making psychedelics into medicines: The politics and paradoxes of medicalization
Journal of Psychedelic Studies – July 30, 2019
Source: OpenAlex
Summary
The "medicalization" of psychedelics, while promising, faces critical challenges. Ethnographic research since 2014 reveals how political and economic contexts can undermine therapeutic safety and efficacy. The high cost of gaining approval for these drug studies incentivizes diluted treatments, potentially hindering broader decriminalization and legalization efforts. This shift also risks re-framing traditional use as "abuse," a concern for sociology and criminology. Understanding these dynamics is vital for future public policy and psychological well-being, influencing societal behavior.
Abstract
This commentary considers efforts to turn psychedelics into medications that can be administered through healthcare systems as examples of “medicalization.” I draw on ethnographic research both inside and outside of university-based clinical trials from 2014 to date, together with analogous examples from psychiatry and drug research and development. Rather than taking a normative stance on medicalization, I situate it in a wider political, economic, and cultural context to better understand its logics and effects. I begin by suggesting the resurgence of psychedelic science has been concerned with medicalization from the outset, recently prompting a crisis in the “psychedelics community” over its self-identity and values. Next, against the confident public messaging surrounding psychedelics, I consider how attempts to scale up and market psychedelic-assisted therapy could end up undermining the safety and efficacy of the therapy itself. I then outline the movements to decriminalize, legalize, and minimize the harms and risks of using psychedelics in their currently illicit therapeutic and recreational modalities. Finally, I explore how working toward psychedelic medicalization over the coming years may influence the movements toward decriminalizing and legalizing psychedelics use, focusing on the underarticulated ways in which medicalization may disregard or even hinder, rather than help, decriminalization and legalization efforts. I call attention to how the cost of gaining approval for therapies incentivizes the development of diluted-yet-profitable forms of psychedelic-assisted treatments, and how frameworks developed for “proper use” demarcate what counts as “abuse” and enable those with newly sanctioned access to psychedelics to condemn afresh their illicit use.