Setting, context and the regulatory atmospheres of psychedelic medicine.
Alex K Gearin, I Glenn Cohen, Albert Garcia-Romeu
The International journal on drug policy July 1, 2026 Peer reviewed DOI: 10.1016/j.drugpo.2026.105327 via PubMed
Summary
Psychedelic drug policy significantly influences the contexts and atmospheres in which these substances are consumed. The article discusses how regulations in the U.S. and Australia define various aspects of psychedelic use, such as personnel and settings, while introducing the concept of regulatory atmospheres to explain how policy shapes these experiences. It highlights the tension between legal pathways and the ongoing impact of prohibition on traditional practices, suggesting that certain perceptions of risk and efficacy are favored over others.
Study at a glance
| Key finding | Regulatory frameworks for psychedelics actively shape consumption atmospheres, affecting how these substances are experienced and understood. |
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Abstract
The revival of psychedelic medicalization is often narrated as a story of scientific legitimacy and neurotherapeutic promise, yet the unusual sensitivity of psychedelics to environmental conditions has encouraged research on music, therapy, setting, and other contextual factors. Treating setting and context as the building blocks of felt atmospheres, this article examines how regulation actively shapes atmospheres of consumption for substances that alter affective and sensory perception. Debates over drug-centric versus therapy-centered models are situated within the broader issue of how law shapes contexts and settings of psychedelic consumption. Policy developments in the United States and Australia show how emerging legal pathways have variably defined personnel, setting, access, substance, and the permitted forms of "holding space" or providing support or therapy. We introduce the concept of regulatory atmospheres to describe the diffuse and sometimes invisible ways in which policy shapes the contextual conditions of psychedelic use. Although policy rarely addresses atmospheres directly, we argue that it powerfully conditions them, which the case of psychedelic drug policy makes particularly clear. Alongside emerging legal pathways, the persistent shadow cast by prohibition over underground and traditional contexts reveals how some ontologies of risk and efficacy are privileged over others.