Drug-centered or drug-assisted? Epistemic perspectives and methodological tensions in psychedelic psychotherapy
Karen Yan, Chao Ni, Yun-ying Kuo, Mu‐hong Chen
European Journal for Philosophy of Science October 25, 2025 Peer reviewed DOI: 10.1007/s13194-025-00679-9 via OpenAlex
Summary
The paper differentiates between the drug-centered view and the drug-assisted view of psychedelics, highlighting their reliance on evidence-based medicine and randomized controlled trials for validating therapeutic efficacy. Using MDMA-assisted psychotherapy as an example, it critiques two key causal assumptions within the drug-assisted perspective. The authors argue that the reliance on evidence-based methods reflects questionable epistemological assumptions and suggest that value-based practice may better address the relational aspects of drug-assisted therapy.
Study at a glance
| Design | theoretical analysis |
|---|---|
| Key finding | The reliance on evidence-based medicine in the drug-assisted view of psychedelics reflects questionable epistemological assumptions from traditional empirically supported therapies. |
Abstract
Abstract This paper distinguishes the drug-centered view of psychedelics (DCP) and the drug-assisted view of psychedelics (DAP). While these approaches differ conceptually, both rely on the methodology of evidence-based medicine, using randomized controlled trials to validate therapeutic efficacy. Using MDMA-assisted psychotherapy as a case study of DAP, we reconstruct the causal reasoning underlying its proposed therapeutic effects, identify two key causal assumptions, and critically examine them. Our analysis shows that the DAP community’s reliance on evidence-based medicine is not merely methodological, but also reflects questionable epistemological assumptions inherited from the empirically supported therapy tradition. We conclude by proposing value-based practice as a complementary methodology better suited to the relational and value-laden dimensions of DAP.