Strong Bipartisan Support for Controlled Psilocybin Use as Treatment or Enhancement in a Representative Sample of US Americans: Need for Caution in Public Policy Persists

Introduction

Psilocybin is a naturally occurring psychedelic that has re-emerged in scientific and policy conversations because recent clinical research suggests potential therapeutic benefits, particularly when administered in controlled settings alongside psychological support. Earlier work indicates efficacy signals for conditions such as major depressive disorder and reports of positive psychosocial and pro‑social effects in healthy participants, while recognised acute and longer‑term harms appear to be highly context‑dependent and more likely during unsupervised or unregulated use. At the same time, regulatory change has begun: the FDA has granted psilocybin breakthrough therapy status for some depressive indications, and Oregon has decriminalised and legalised supervised psilocybin use in licensed facilities, including for non‑medical well‑being enhancement. Public attitudes toward these legal, supervised models remain understudied, and existing research on enhancement has focused mainly on cognitive ‘‘smart pills’’ rather than psychedelics or well‑being enhancement. Sandbrink and colleagues set out to fill this gap by measuring moral judgments about legally sanctioned, professionally supervised psilocybin use for either psychiatric treatment or for improving well‑being in healthy individuals (‘‘enhancement’’). The study presented nationally representative US adults with brief, scientifically accurate background information and randomly assigned them, in a between‑subjects vignette design, to evaluate the moral status of an individual’s supervised psilocybin use for one of those two purposes. The authors pre‑registered their analysis and aimed to test how moral evaluations vary by purpose and by individual difference factors such as political orientation, age, and moral foundations.