Consciousness, Religion, and Gurus: Pitfalls of Psychedelic Medicine

Introduction

Scientific research on psychedelic compounds, particularly human studies, has expanded markedly over the past two decades. Johnson notes promising therapeutic results for classic serotonergic psychedelics (notably psilocybin) across conditions such as cancer-related depression and anxiety, tobacco and alcohol use disorders, and major depressive disorder, and for the nonclassic psychedelic MDMA in post-traumatic stress disorder. These trials have been notable for large treatment effects and an unusual treatment model in psychiatry: relatively few drug administrations delivered with preparatory and integrative psychological support have produced benefits that can persist for months, prompting characterisation of psychedelic therapy as a potential paradigm shift. Against this background of therapeutic and scientific enthusiasm, Johnson sets out to identify and explore epistemological and ethical pitfalls that could undermine psychedelic research and the future practice of psychedelic medicine. Rather than presenting new empirical data, the paper is a viewpoint that highlights three broad concerns—vagueness in use of the term "consciousness", introduction of investigators' or clinicians' religious/spiritual beliefs into clinical practice, and clinical/ethical boundary issues—and offers recommendations intended to guide future research and clinical implementation.