This post is my ponderings from years of working in healthcare, investing, and psychedelics, I hold no views or opinions with a tight grip. ‘I am the wisest one alive, for I know one thing, and that is that I know nothing.’ I’m happy to be proved wrong, these discussions are what’s needed to bring about the change we all want to see.
Most industries grow at the rate of demand from society and its consumers. If this was the case with the psychedelic industry, we’d have legality and commercialization by now. I see two kinks preventing this flow, one that’s obvious and one perhaps less so. I’ll share these and then my thoughts for what’s to come.
The obvious kink of course is the law—psychedelics are a schedule 1 narcotic thanks to Nixon and the 60s, and as a result, bringing them to market requires the long and convoluted FDA approval and drug development process, or the grassroots state legislative appeals. Both of which are hitting strides, with 25+ states on the decrim/legalization train and 50+ clinical trials underway with 3 fast-tracked after receiving breakthrough therapy designations from the FDA. Though, still not as fast as it could be, and given the state of our world today, as is needed.
The other less obvious kink I see slowing the psychedelic industry’s growth is a problem most industries have today, but perhaps is more poignant in the psychedelic space for reasons I’ll get to. That is, the go-to-market approaches are based on existing systems. In the case of psychedelic medicine, these are the healthcare and pharmaceutical systems we have today. I think few people that read this will argue that these systems don’t even serve their original purpose well, let alone an entirely new industry that’s trying to form and mold onto it.
The healthcare system. This is based on diagnosing and treating diseases. Often with very little holistic care involved, i.e. reactive and transactional vs. proactive and personalized. I spent 3 years in the preventative health tech and longevity spaces in San Francisco before joining Field Trip so this one I could spend a whole post digging into, I’ll spare you with a brief overview instead.
It’s rare to get a check-up that lasts more than 10 minutes with your primary care doctor today. Healthcare providers often spend more of their time charting than they do with their patients. I witnessed this unfortunate reality and the regretful but despondent providers behind it during my 2 years working as a scribe in the ER in college, and I have two sisters who work as a nurse and doctor who’ll report the same. Further, healthcare delivery and access are deeply flawed. With much of our country uninsured due to high cost and low accessibility, many families are going without regular healthcare altogether. And when we zero in on the mental healthcare side, many of the same issues apply that you can read about in this book by the previous director of NIMH.
The pharmaceutical system. This system is fueled by patenting drugs. And with our country’s comparatively flex patenting requirements, manufacturers can and do tweak their drugs every 20 years in order to extend the patent, and continue making money sans competition. This leads to little to no incentive or free-market competition to drive innovation, better drugs, fewer side effects, and market-driven pricing. More on this perspective from Harvard and Carey Turnbull, a top psychedelic investor and philanthropist.
While psychedelics can be seen as a drug for improving our health, I believe that they are much more than that and should be looked at with fresh eyes. We are in the early stages of a great renaissance taking place in mental health with the help of these plants and molecules, alongside decades of a growing global mental health crisis, do we want to bring them into the same systems that brought us here? That’s what’s happening today, and it’s not working well.
If you’ve read any of my posts on my journeying, or have experienced on your own, or watch tv, you know psychedelics are a whole different game than traditional healthcare. These are not an antidepressant or talk therapy. They’re not a heart surgery or bandaid or special diet. Psychedelics, in their highest potential, are a window into your soul. A transformation of consciousness. Or, as I’d prefer to put it, an awakening to your true consciousness, the one that exists under the Default Mode Network (DMN)-shade of ego thinking that our minds have evolved to be driven by.
The problem with shoe-boxing this novel experience into old systems is that it limits, or even reduces, this effect. There’s a reason why psychedelics are being shown to positively impact a wider array of mental health illnesses than any treatment or medication available today, including cannabis. It’s because of the unique power in their experience. When one is thrust into a new level of consciousness and sees their divine truth with a blindingly beautiful force, how can depression live there? Self-destructive behaviors like addiction, suicide, eating disorders? PTSD and traumas from the past? These are deeply ingrained and conditioned suffering that have little to no effective treatments today, yet in 1-3 sessions, psilocybin and MDMA (and others) are proving to cure or significantly reduce these symptoms for 70-88% of participants.
So what’s the alternative? How should these be developed and distributed to the world? I have suggestions where we can look.
The first would be to observe the leaders who practice time-tested methods gleaned from thousands of years of working with entheogenic plants. Indigenous tribes of the Amazon, Central America, and Native Americans have used psilocybin-producing mushrooms, ayahuasca, peyote, 5-MeO-DMT, ibogaine, and other combinations of psychoactives to bring a vast array of physical and mental healing to those who partake. Some examples of their practices include a ceremonial group setting, chanting and live music, deep connection with nature, meditation, spiritual rituals, minimalist organic setting with little to no technology. Another is the personalized touch shamans bring to their students, prescribing specific concoctions, doses, and practices based on the individuals’ needs and goals, and supporting them before during and after based on this awareness and connection.
This suggestion often gets an eye-roll from conventional investors and entrepreneurs looking for the next big thing, but riding the wave of public hype only works as long as the results follow. Patient outcomes must be the top priority, for both this reason and pure integrity, and these communities know better than we do on that front.
The second place to look would be within yourself. Otto Scharmer, professor at MIT, calls this precensing—when contemplating a problem, instead of downloading solutions from existing paradigms, can we open our minds and hearts, “slow down, connect with Source, and enter the field of the emerging future that wants to be created through us”? Or from Einstein, “The world we have created is a product of our thinking; it cannot be changed without changing our thinking. No problem can be solved from the same consciousness that created it. We must learn to see the world anew.” And one way to do that is through the topic of contemplation itself — have a psychedelic journey for your own healing and awakening.
Many of the leaders of psychedelic companies and funds today haven’t taken them in therapeutic contexts themselves. Would you invest in the early days of Peloton or SoulCycle if the founders didn’t exercise? Or Blue Bottle if James Freeman didn’t drink coffee? Or Calm app if Michael or Alex never meditated? I wouldn’t.
I think we owe it to ourselves to look inward and presence solutions for every new venture we take on, but perhaps especially when deciding how to commercialize these powerful medicines.
It’s easy to create through existing models—ski down the pre-grooved trails. But that’s not how innovation happens. That’s not how the new earth will be created. That’s how we land at the same problems that brought us to the climate, financial, and mental health crisis’, war, inequality, I need not go on. It’s time for deep systemic changes, and we’re in a period of widespread global disruption from which these can emerge if we respond with intention. Respond with heart as much as head, and with humble curiosity over blind ignorance.
And with that, I’ll end with a contrarian view of one version of reality that could arise from this renaissance that I’ll put out there for your pondering—psychedelics not being commercialized at all.
Picture it: the grassroots movement born from Oregon measure 109 grows in number and power, along with anecdotal and researched evidence of the benefits these medicines bring to both citizens and our policymakers, leading to a decision to make psychedelics available on a controlled basis in controlled settings for free, paid for by state tax system. They’re seen and treated as a rite of passage and/or pinnacle method for mental health that, through offering it freely to all, will increase both the productivity and wellbeing of the country. Sure this could bring its own period of chaos, but maybe we need that in order to wake up and create the new order that saves us and our planet.
Depression and anxiety cost the global economy $1 trillion per year in lost productivity. If we need to attach a dollar sign to why people’s mental health is worth investing in, there’s one for you. What if these, along with all other treatable mental illnesses, were eradicated or significantly reduced? What would our GDPs become then? What would get done? But, more importantly, how would we all feel? This idea is one itself that arose from my own moment of precensing. Any reality is possible, and we create it.