MAPS is currently studying MDMA-assisted psychotherapy as a method of treating PTSD. The clinical trials are in Phase 3 — the last stage before approval from the U.S. Food and Drug Administration — and MAPS, which has been working toward this moment since its inception as a research and advocacy organization in 1986, has been preparing for a post-approval world. Before the Cultural Trauma workshop in Kentucky, MAPS had trained 285 therapists, with the idea that — while they can’t legally practice yet — they will be ready to open their doors once approval is final. But fewer than 10 percent of those trained were people of color. If MAPS wanted therapists to treat clients of color, they would need to train therapists of color.
Last year, there were at least 20 conferences in the United States covering the latest developments in psychedelic science and medicine. It’s a conference-happy community, which makes sense: Most of the substances discussed at these events are labeled as Schedule 1 or 2 by the U.S. Drug Enforcement Administration, so, outside of clinical research, their use is illegal. (Schedule 1 drugs are considered to have the highest potential for abuse, with “no currently accepted medical use.” MDMA is a Schedule 1 drug, as is cannabis, and is ranked as more dangerous than oxycodone and cocaine, which are both Schedule 2.) Conferences are one of the few places where researchers, clinicians, advocates and the curious public can learn about developments in the field and meet other psychedelic proponents. Compared to a huge event like New York City’s Horizons: Perspectives on Psychedelics conference, which has convened every fall in New York for 13 years and last year brought in over 2,800 attendees, the two-day public workshop in Kentucky was tiny, with fewer than 100 participants and very little attention from a media that energetically covers psychedelic developments.
But the gathering — which featured talks on drug legalization and systemic racism, presentations on Indigenous healing methods, experiential group exercises, and even a dance performance — was groundbreaking. It was historic not only because it was the first such training for therapists of color, but because it marked a turning point in the mainstreaming of psychedelics. Many of the organizers and presenters are part of a larger effort to diversify the world of psychedelic healing. They are pushing back against the popular narrative that psychedelics originated in White, mid-century countercultural movements and, perhaps most significant, fighting to ensure that the new field of psychedelic medicine — often touted as a miracle for long-standing and deep-rooted struggles like treatment-resistant depression, addiction, anxiety and PTSD — will be accessible to all. This includes Black and non-White communities that have been historically over-policed and heavily incarcerated for possession or sales of some of these substances. (White people and Black people are equally likely to use illegal drugs, a 2009 Human Rights Watch report found, but Black people are arrested for drug offenses at much higher rates than White people.)
George, who is Black, spoke directly to these inequities at the climax of her talk. While White people might see psychedelic use as edgy or controversial, there is little legal risk in White use of these substances. “Western researchers have taken some of these Indigenous religious traditions, using them outside of their spiritual context … and then take it for ourselves and go to a rave and jump around and flash the lights,” George said. “We go in the mountains and have a self-discovery kind of experience.” Her voice rose as audience members clapped in agreement. “All of that is amazing. Let’s do that. But let’s bring others with us. Let’s find ways for those who have been oppressed for generations to experience the same freedom that some of us in this room have on a Saturday morning because they feel like it. Not on a Tuesday night when they’ve had to take off work and find a babysitter to take care of the kids so they can come to the clinic and participate in this research and pray that it frees them, so they can keep their families and keep their jobs.”
She continued: “Lives depend on us. You see what I’m saying? When you really think about it, when you break it down like that, lives depend on us.”
It would be hard to avoid coverage of what’s been called “the psychedelic renaissance”: It’s everywhere. In a recent episode of “60 Minutes,” Anderson Cooper reported on successful clinical trials at Johns Hopkins and New York University that found psilocybin can help with, respectively, smoking cessation and binge drinking. Gwyneth Paltrow’s Netflix show “The Goop Lab” dedicated an episode to following Goop employees at a healing psilocybin retreat in Jamaica, where mushrooms are legal. And, of course, there’s science journalist Michael Pollan’s No. 1 New York Times bestseller “How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.” The politics around psychedelics are changing as well: With great effort from advocates, various measures to decriminalize possession of certain entheogens have passed in Oakland and Santa Cruz, Calif., as well as Denver, and similar campaigns are underway in Chicago and other cities. In November, this movement will come to D.C., when residents will vote on whether to decriminalize magic mushrooms.
Entheogens like peyote and ayahuasca have been used within Indigenous cultures for thousands of years, but this latest wave of research has mostly focused on two substances: MDMA, a derivative of the sassafras tree, which was first synthesized in a lab in 1912 and used in therapeutic settings throughout the ’70s and early ’80s before being labeled a Schedule 1 drug in 1985; and psilocybin, added to Schedule 1 in 1971. Psilocybin is found naturally in some mushrooms and has been used in Indigenous cultures all over the globe; mushroom iconography has been found in prehistoric cave paintings.
In the late 1990s, a handful of researchers started to take up the work that had been dropped when these substances were criminalized. (Dropped, at least, in aboveground situations; therapists continued, and still continue, working underground.) Now the field has exploded: When George says that “lives depend” on therapists learning to use these modalities, she’s not being dramatic. The numbers would impress anyone. In the Johns Hopkins smoking-cessation study, conducted in 2006 with a small group of participants, 80 percent of long-term smokers stopped smoking for at least six months after their psilocybin treatment. After a year, 67 percent were still nonsmokers. Nine years later, Johns Hopkins published the results of another trial in which psilocybin was used successfully to treat depression and anxiety in cancer patients, with the changes lasting in 80 percent of participants after six months. The university has invested so much in the field that it launched a stand-alone Center for Psychedelic and Consciousness Research last year and is working on studies to use psilocybin to treat addiction, anorexia and many other issues.
Meanwhile, in 2017 the FDA granted “breakthrough therapy” status to MDMA-assisted psychotherapy to treat PTSD, after privately funded MAPS studies found that 56 percent of participants experienced significant relief — so much so that they no longer met the requirements for PTSD. (The FDA can’t discuss ongoing trials, a spokesperson told me over email.) Breakthrough status is given to therapies that have shown great promise, with the idea that they will be given priority within the FDA approval process, and MAPS predicts MDMA-assisted psychotherapy will be available sometime in the next few years. I’ve experienced the treatment myself: After editing a story about MDMA-assisted psychotherapy many years ago, I connected with a highly skilled underground therapist to address the lingering effects of my father’s death when I was 14, effects that talk therapy and meditation hadn’t relieved. While it was difficult and painful to face the trauma that I’d buried, I greatly benefited from the work.
But as study after study showed positive outcomes over the years, one thing was constant: There was little diversity among both the study leads and the participants. In 2015, Natalie Ginsberg, MAPS’s director of policy and advocacy, came across the name of Monnica Williams, a clinical psychologist then at the University of Louisville. Williams, who is Black, studied obsessive-compulsive disorder, anxiety and the effects of racism, and her work excited Ginsberg, who wrote Williams to ask if she might be interested in working with MAPS. “Social marginalization compounds trauma,” Ginsberg wrote me via email. Regardless of the origin of their trauma, which could stem from any number of causes, including sexual assault, childhood trauma and military service, “people who experience the highest rates of trauma are those most marginalized from society, which in the U.S. includes people of color.”
Williams had no previous experience with psychedelics. “I had a boyfriend in high school who used LSD once or twice, and I don’t remember any remarkable transformations happening as a result,” she told me. It took some convincing. “It kind of seemed like maybe the fad of the week, you know?” recalls Williams. “Where they say, you know, you drink a glass of water with vinegar and lemon juice and you lose 50 pounds. Like, yeah, right. But actually reading the research, seeing the videos of the participants getting better … when you do this work, you can look at people and you can tell: That person is really ill. And then you see that same person later and they’re smiling and their face is bright. And they’re making eye contact and they’re talking about the future. Seeing that whole progression on a videotape, that’s kind of what convinced me.”