Emerging Psychedelic-Assisted Therapies: Implications for Nursing Practice

Main Article Content

Dominique Denis-Lalonde
Andrew EStefan


Psychedelic-assisted therapy research is demonstrating unprecedented rates of success in treating mental
illness, addictions, and end-of-life distress. This psychedelic renaissance is a turning point in how com-plex human conditions can be treated and has implications for nursing knowledge, advocacy, and practice internationally.

This article aims to explore the current state of knowledge in the field of psychedelic-assisted therapy and the practice implications for nurses.

A scoping review of the literature was undertaken with a focus on mental health, addictions, and palliative care indications. Commentaries, syntheses, and reviews from the last 20 years were included, as well as all relevant primary study results. We then explored what is known about the nurse’s past and present role in this field.

The nurse’s role in psychedelic-assisted therapy and research has been hitherto mostly invisible and thus remains under-explored and undefined. The profession is ideally positioned, however, to contribute to the future of this promising field.

As advocates for safe, ethical, and interdisciplinary practice, nurses can lead the development of psychedelic-assisted therapy practice, ethics, research, advocacy, policy, and education. This article provides guidance and support for prescient nursing leadership in these areas.


Download data is not yet available.

Article Details



1. Tupper KW, Wood E, Yensen R, Johnson MW. Psyche-delic medicine: a re-emerging therapeutic paradigm. Can Med Assoc J 2015;187(14):1054–9. doi:10.1503/ cmaj.141124
2. Doblin RE, Christiansen M, Jerome L, Burge B. The past and future of psychedelic science: an introduction to this issue. J Psychoactive Drugs 2019;51(2):93–7. https://doi.org/10.1080/02791072.2019.1606472
3. Grob CS, Greer GR, Mangini M. Editors’ introduction: hallucinogens at the turn of the century. J Psychoac-tive Drugs 1998;30(4):315–9. doi:10.1080/0279107 2.1998.10399707
4. Dyck E. Psychedelic psychiatry: LSD from clinic to campus. Baltimore, MD, US: Johns Hopkins Univer-sity Press; 2008.
5. Nichols DE. Serotonin, and the past and future of LSD. MAPS Bulletin Special Edition 2013;23(1):20–23. Retrieved from http://www.maps.org/news-letters/ v23n1/v23n1_p20-23.pdf.
6. Mangini M. Treatment of alcoholism using psyche-delic drugs: a review of the program of research. J Psychoactive Drugs 1998;30(4):381–418. doi:10.10 80/02791072.1998.10399714
7. Tanne JH. Obituaries: Humphrey Osmond. BMJ. 2004;328(7441):713–4. Retrieved from https://www .ncbi.nlm.nih.gov/pmc/articles/PMC381240/
8. Carhart-Harris RL, Goodwin GM. The therapeutic potential of psychedelic drugs: past, present, and fu-ture. Neuropsychopharmacology 2017;42:1–9. http:// dx.doi.org/10.1038/npp.2017.84
9. Haden M, Emerson B, Tupper KW. A public-health-based vision for the management and regulation of psychedelics. J Psychoactive Drugs 2016;48(4):243–52. http://dx.doi.org/10.1080/02791072.2016.1202459
10. Meckel F. Guidelines in applying psychedelic thera-pies. In: Winkelman M, Sessa B, editors. Advances in psychedelic medicine: state-of-the-art therapeutic applications. Santa Barbara, CA, US: Praeger; 2019.
11. Phelps J. Developing guidelines and competencies for the training of psychedelic therapists. J Humanist Psychol 2017;5(5):450–87. doi:10.1177/0022167817711304
12. Greer G, Tolbert R. Subjective reports of the effects of MDMA in a clinical setting. J Psychoactive Drugs 1986;18(4):319–27. doi:10.1080/02791072.1986.1 0472364
13. Noorani T, Garcia-Romeu A, Swift TC, et al. Psy-chedelic therapy for smoking cessation: qualitative analysis of participant accounts. J Psychopharmacol 2018;32(7):756–69. doi:10.1177/0269881118780612
14. Johnson MW, Hendricks PS, Barrett FS, Griffiths RR. Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. Pharmacol Ther 2019;197:83–102. doi:10.1016/j.pharmthera.2018.11.010
15. Garcia-Romeu A, Richards WA. Current perspectives on psychedelic therapy: Use of serotonergic halluci-nogens in clinical interventions. Int Rev Psychiatry 2018;30(4):291–316. doi:10.1080/09540261.2018. 1486289
16. Johnson MW, Richards WA, Griffiths RR. Human halluci-nogen research: Guidelines for safety. J Psychopharmacol 2008;22(6):603–620. doi:10.1177/0269881108093587
17. Ot’alora GM, Grigsby J, Poulter B, et al. 3,4-Methyl-enedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial. J Psychopharmacol 2018;32(12):1295-1307. doi:10.1177/0269881118806297
18. Sessa B, Sakal C, O’Brien S, Nutt D. First study of safety and tolerability of 3,4-methylenedioxymetham-phetamine (MDMA)-assisted psychotherapy in patients with alcohol use disorder: Preliminary data on the first four participants. BMJ Case Rep 2019;12(7):e230109. doi:10.1136/bcr-2019-230109
19. Trope A, Anderson BT, Hooker AR, et al. Psychedelic-assisted group therapy: A systematic review. J Psy-choactive Drugs 2019;51(2):174–188. doi:10.1080/0 2791072.2019.1593559
20. Byock I. Taking psychedelics seriously. J Palliat Med 2018;21(4):417–421. doi:10.1089/jpm.2017.0684
21. Mithoefer MC, Grob CS, Brewerton TD. Novel psychopharmacological therapies for psychiatric disorders: Psilocybin and MDMA. Lancet Psychiatr 2016;3(5):481–88. doi:10.1016/S2215-0366(15)00576-3
22. Strassman R. The Spirit Molecule: A Doctor’s Revo-lutionary Research into the Biology of Near-Death and Mystical Experiences. Rochester, VT: Park Street Press; 2001.
23. Berg L. Notes from a psychedelic research nurse. Newsletter of the Multidisciplinary Association for Psychedelic Studies 1994;5(1). Retrieved from https:// maps.org/news-letters/v05n1/05134nrs.html
24. Rosa WE, Hope S, Matzo M. Palliative nursing and sacred medicine: A holistic stance on entheogens, healing, and spiritual care. J Holist Nurs 2019;37(1):100–106. doi:10.1177/0898010118770302
25. Mithoefer MC, Wagner MT, Mithoefer AT, et al. The safety and efficacy of 3,4-methylenedioxymethamphetamine -assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: The first randomized controlled pilot study. J Psychopharmacol 2010;25(4):439–52. doi:10.1177/0269881110378371
26. Dore J, Turnipseed B, Dwyer S, et al. Ketamine as-sisted psychotherapy (KAP): Patient demographics, clinical data and outcomes in three large practices administering ketamine with psychotherapy. J Psy-choactive Drugs 2019;51(2):189–98. doi:10.1080/0 2791072.2019.1587556
27. California Institute of Integral Studies. About the certificate in psychedelic-assisted therapies and research [Internet]. San Francisco, CA, US:Author; 2019. https://www.ciis.edu/research-centers/center-for-psychedelic-therapies-and-research/about-the -certificate-in-psychedelic-assisted-therapies-and-research
28. Penn AD, Ot’alora M, Raison CL. MDMA-assisted therapy for posttraumatic stress disorder. In: Sum-mers RF, Jeste DV, editors. Positive psychiatry: A casebook. Washington, DC: American Psychological Association; 2019.
29. Wagner AC, Mithoefer MC, Mithoefer AT, Monson CM. Combining cognitive-behavioral conjoint therapy for PTSD with 3,4-methylenedioxymethamphetamine (MDMA): A case example. J Psychoactive Drugs 2019;51(2):166–73. doi:10.1080/02791072.2019.1 589028
30. Multidisciplinary Association for Psychedelic Studies. Press release: FDA grants breakthrough therapy designa-tion for MDMA-assisted psychotherapy for PTSD, agrees on special protocol assessment for phase 3 trials. Santa Cruz, CA, US: Author; 2017. https://maps.org/news/ media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials
31. Dos Santos RG, Osório FL, Crippa JA, et al. Anti-depressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): A systematic review of clinical trials published in the last 25 years. Ther Adv Psychopharmacol 2016;6(3):193–213. doi:10.1177/2045125316638008
32. COMPASS Pathways. COMPASS Pathways receives FDA breakthrough therapy designation for psilocybin therapy for treatment-resistant depression: 2018. https:// compasspathways.com/compass-pathways-receives-fda-breakthrough-therapy-designation-for-psilocybin-therapy-for-treatment-resistant-depression/
33. Usona Institute. FDA Grants Breakthrough Therapy Designation to Usona Institute’s Psilocybin Program for Major Depressive Disorder: 2019. https://www .businesswire.com/news/home/20191122005452/ en/FDA-grants-Breakthrough-Therapy-Designation-Usona-Institutes
34. Carhart-Harris RL, Bolstridge M, Day CM, et al. Psilo-cybin with psychological support for treatment-resistant depression: Six-month follow-up. Psychopharmacol 2018;235:399–408. doi:10.1007/s00213-017-4771-x
35. Watts R, Day C, Krzanowski J, et al. Patients ’ accounts of increased “connectedness” and “acceptance” after psilocybin for treatment-resistant depression. J Humanist Psycho 2017;57(5):520–64. doi:10.1177/0022167817709585
36. Dean JG, Liu T, Hu S, et al. Biosynthesis and extracel-lular concentrations of n,n-dimethyltryptamine (DMT) in mammalian brain. Sci Rep 2019;9(9333):1–11. doi:10.1038/s41598-019-45812-w
37. Osório F, Sanches R, Macedo L, et al. Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: A preliminary report. Braz J Psy-chiatr 2015;37:13–20. doi:10.1590/1516-4446-2014-1496
38. World Health Organization. Model list of essential medicines, 21st list (Licence: CC BY-NC-SA 3.0 IGO). Geneva, Switzerland: Author; 2019. https://www.who .int/medicines/publications/essentialmedicines/en/
39. Fadiman J, Korb S. Might microdosing psychedelics be safe and beneficial ? An initial exploration. J Psy-choact Drugs 2019;51(2):118–122. doi:10.1080/027 91072.2019.1593561
40. Dyck E. Psychedelics and dying care: A historical look at the relationship between psychedelics and palliative care. J Psychoact Drugs 2019;51(2):102–107. doi:10 .1080/02791072.2019.1581308
41. Griffiths RR, Johnson MW, Carducci MA, et al. Psilocybin produces substantial and sustained de-creases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol 2016;30(12):1181–19. doi:10.1177/0269881116675513
42. Ross S, Bossis A, Guss J, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial. J Psychopharmacol 2016;30(12):1165–80. doi:10.1177/0269881116675512
43. Gasser P, Holstein D, Michel Y, et al. Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. J Nerv Ment Dis 2014;202(7):513–520. doi:10.1097/ NMD.0000000000000113
44. Bogenschutz MP. It’s time to take psilocybin seriously as a possible treatment for substance use disorders. Am J Drug Alcohol Abuse 2017;43(1):4–6. doi:10.1 080/00952990.2016.1200060
45. Krebs TS, Johansen, P-Ø. Lysergic acid diethylamide (LSD) for alcoholism: Meta-analysis of randomized controlled trials. J Psychopharmacol 2012;26(7):994– 1002. doi:10.1177/0269881112439253
46. Bogenschutz MP, Forcehimes AA, Pommy JA, et al. Psilocybin-assisted treatment for alcohol depend-ence: A proof-of-concept study. J Psychopharmacol 2015;29(3):298–99. doi:10.1177/0269881114565144
47. Sessa B, Higbed L, Nutt D. A review of 3,4-meth-ylenedioxymethamphetamine (MDMA)-assisted psychotherapy. Front Psychiatr 2019;10(138):1–7. doi:10.3389/fpsyt.2019.00138
48. Johnson MW, Garcia-Romeu A, Cosimano MP, Griffiths RR. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. J Psychopharmacol 2014;28(11):983–92. doi:10.1177/0269881114548296
49. Johnson MW, Garcia-Romeu A, Griffiths RR. Long-term follow-up of psilocybin-facilitated smoking cessation. Am J Drug Alcohol Abuse 2017;43(1):55–60. doi:10 .3109/00952990.2016.1170135
50. Brown TK, Alper K. Treatment of opioid use disorder with ibogaine: Detoxification and drug use outcomes. Am J Drug Alcohol Abuse 2018;44(1):24–36. doi:10 .1080/00952990.2017.1320802
51. Brown TK, Noller GE, Denenberg JO. Ibogaine and subjective experience: Transformative states and psy-chopharmacotherapy in the treatment of opioid use disorder. J Psychoactive Drugs 2019;51(2):155–65. doi:10.1080/02791072.2019.1598603
52. Krupitsky E, Burakov A, Romanova T, et al. Keta-mine psychotherapy for heroin addiction: Immediate effects and two-year follow-up. J Subst Abuse Treat 2002;23:273–83.
53. Danforth AL. Embracing neurodiversity in psychedelic science: A mixed-methods inquiry into the MDMA experiences of autistic adults. J Psychoactive Drugs 2019;51(2):146–54. doi:10.1080/02791072.2019.1 587116
54. Michaels TI, Purdon J, Collins A, Williams MT. Inclu-sion of people of color in psychedelic-assisted psy-chotherapy: A review of the literature. BMC Psychiatr 2018;18(245):1–14. doi:10.1186/s12888-0181824-6
55. International Council of Nurses. The ICN code of ethics for nurses. Geneva, Switzerland: Author; 2012. https:// www.icn.ch/sites/default/files/inline-files/2012_ICN_Co-deofethicsfornurses_%20eng.pdf#targetText=The%20 ICN%20Code%20of%20Ethics,the%20standards%20 of%20ethical%20conduct.&targetText=The%20nurse%20 advocates%20for%20equity,other%20social%20 and%20economic%20services.
56. Noorani T. Making psychedelics into medicines: The politics and paradoxes of medicalization. J Psychedelic Stud 2019; Ahead of print. doi:10.1556/2054.2019.018
57. Lamkin M. Psychedelic medicine is coming. The law isn’t ready. Scientific American; 2019. https://blogs .scientificamerican.com/observations/psychedelic-medicine-is-coming-the-law-isnt-ready/
58. Reutter L, Kushner KE. Health equity through action on the social determinants of health: Taking up the challenge in nursing. Nurs Inq 2010;17(3):269–80. doi:10.1111/j.1440-1800.2010.00500.x
59. Argento E, Tupper KW, Socias ME. The tripping point: The potential role of psychedelic-assisted therapy in the response to the opioid crisis. Int J Drug Policy 2019;66:80–81. doi:10.1016/j.drugpo.2018.11.006