Recent research into psychedelic compounds for psychiatric conditions has revived interest in their effects outside clinical trials. Data on psychedelic use and interpersonal violence remain limited. While 1960s work by Timothy Leary did not show reduced criminal recidivism with psychedelic-assisted psychotherapy, newer studies suggest psychedelics may lower individuals' risk of interpersonal violence. Forensic psychiatrists should understand this research and how psychedelics might factor into forensic assessments. The article covers basic information on psychedelic substances, their effects and mechanisms, historical and recent research on psychedelics and criminal behavior, and offers a practical method for evaluators to assess psychedelic use in forensic contexts.
Psilocybin shows promise as a treatment for psychiatric illnesses, but its federal illegality in the U.S. complicates access and regulation despite state-level decriminalization efforts. This article reviews current legal regulation, standard of care, right to effective treatment, and the respectable minority doctrine. It discusses ethical issues including provider bias, patient-provider dynamics, informed consent, and equity and access that psychiatrists must consider as psilocybin access expands for research.