237. SAFETY AND ETHICAL CONSIDERATIONS FOR PSYCHEDELIC ASSISTED PSYCHOTHERAPY (PAP)

Psychedelic-assisted psychotherapy (PAP) shows promise for conditions like major depressive disorder and PTSD, but its safe and ethical clinical use requires rigorous standards. Ethical concerns include heightened expectations about transformative effects, unavoidable unblinding in trials, challenges with informed consent, conflicts of interest, grandiosity, problematic interpersonal dynamics, the underground psychedelics movement, and screening processes. Globally-endorsed standards do not yet exist, but initial work has identified key factors to consider. Further research and continued discussion are needed to refine best practices.

Study at a glance

Abstract

Abstract Background There has been a surge of interest in psychedelic research, especially with regards to the therapeutic properties of these compounds. This has led to the emergence of psychedelic assisted psychotherapy (PAP). PAP is showing promise for a range of mental health conditions, including major depressive disorder and PTSD, leading to (perhaps premature) international changes in scheduling and regulatory policies in relation to psychedelics. Aims & Objectives This presentation will present the specific safely and ethical factors that need to be considered when engaging in PAP research and its implementation into clinical practice. Method A review of relevant literature will be presented. This will be supplemented with case-examples and evidence from my own extensive experience conducting clinical trials with a range of psychedelic compounds. Results Researchers and clinicians have raised ethical concerns regarding PAP. Specific issues to be discussed include: i) the challenge of heightened expectations regarding the supposed transformative effects of psychedelics, ii) the unescapable unblinding in clinical trials, iii) the challenges of informed consent, iv) minimising conflicts of interest and grandiosity, v) risks of problematic interpersonal dynamics, vi) the complexities of the underground psychedelics movement, and vii) the processes that are involved in screening and eligibility for PAP. Discussion & Conclusions To assure the safe and ethical clinical administration of psychedelics, we must develop, obtain consensus for, and disseminate rigorous ethical and practice standards. There are not yet globally-endorsed standards, but initial work has highlighted important factors to consider. Further research, and continued conversation, are required to refine best practices.