The current resurgence of psychedelic research relies on data and know-how originally generated by drug user communities, who documented toxicity, dosage, and other practical information during decades when public research was prohibited. As legalization approaches, this community-generated knowledge is being transferred to pharmaceutical companies, patented, and turned into billion-dollar assets. This transfer depends on reframing psychedelics as therapeutic rather than recreational. The phenomenon offers a critical lens for examining the concept of 'user innovation' more broadly.
Ibogaine, a controlled substance, is reported to interrupt addiction. Because it is illegal, a network of addicts and harm reduction activists has explored its use for treating substance dependency in underground and off-shore clinics. Practitioners have developed strategies to mitigate harm from the drug's potential cardiotoxicity. This case study examines how a medical subculture can create global governance without public funding or state regulations. The authors argue that the global market in alternative addiction care foreshadows a future market-based healthcare system.