Psychedelics are a class of drugs that are known for their ability to alter perception, mood, and consciousness. They have been used for thousands of years by indigenous cultures in spiritual and medicinal practices. In recent years, there has been renewed interest in the therapeutic potential of psychedelics for mental health conditions such as depression, anxiety, and PTSD.

However, the legal status of psychedelics in the United States is a complex and evolving issue. While some psychedelics are legal for medical use, others are classified as Schedule I drugs, meaning they are illegal for any use [1]. However, the growing interest in the potential therapeutic benefits of psychedelics has led to increased attention on the legal status of these substances.

Ketamine

Ketamine is a dissociative anesthetic that is used medically for pain relief and as an anesthetic. It is legal for medical use in the United States and is commonly used in hospitals and clinics. In addition to its medical use, ketamine has also gained attention for its potential as a rapid-acting antidepressant. In 2019, the FDA approved a nasal spray version of ketamine called Esketamine for treatment-resistant depression [2]. Other common formulations are intravenous (IV), intramuscular (IM), sublingual (SL), and intranasal racemic ketamine. These are all legal as well but are offered “off-label” as they have not been officially labeled for a specific medical use by the FDA.

Psilocybin

Psilocybin is a naturally occurring psychedelic compound found in certain types of mushrooms. It is classified as a Schedule I drug under federal law, meaning it is illegal for any use. However, several cities and states have taken steps to decriminalize psilocybin, meaning that enforcement of laws against possession and use of psilocybin is made a low priority for law enforcement [3]. In 2019, Denver, Colorado became the first city in the United States to decriminalize psilocybin mushrooms. Since then, several other cities and states have followed suit, including Oakland, California, and Ann Arbor, Michigan. There is also recent legislation in Oregon and Colorado that will soon make psilocybin treatments legal when used in specific clinical ways.

LSD

LSD (lysergic acid diethylamide) is a powerful synthetic psychedelic that can produce intense changes in perception, thought, and mood. It is classified as a Schedule I drug under federal law, meaning it is illegal for any use. Possession, distribution, and manufacturing of LSD are all federal offenses [3].

MDMA

MDMA (3,4-methylenedioxymethamphetamine), also known as ecstasy, is a synthetic drug that produces a euphoric and empathogenic effect. It is classified as a Schedule I drug under federal law, meaning it is illegal for any use. However, in 2021, the FDA approved the use of MDMA-assisted psychotherapy for the treatment of PTSD. This approval is limited to use in clinical trials and is not yet available for general use [4].

Most other psychedelics are unfortunately not yet legal in the U.S. Despite the legal obstacles, research into the therapeutic potential of psychedelics has continued to advance. Studies have shown promising results for the use of psilocybin and MDMA in the treatment of mental health conditions such as depression, anxiety, and PTSD. The FDA has also approved the testing of ketamine, psilocybin, MDMA, and some other psychedelics in clinical trials for the treatment of mental health and adjacent conditions such as depression and PTSD [4, 5, 6].

A note about decriminalization

It is important to note that decriminalization does not mean legalization. Decriminalization means that the enforcement of laws against possession and use of a substance is made a low priority for law enforcement. It does not mean that possession and use of the substance are legal. The possession, distribution, and manufacturing of psilocybin, LSD, and MDMA are all federal offenses and carry severe penalties especially in certain regions [3].

In conclusion

The legal status of psychedelics in the United States is complex and varies depending on the specific substance and its intended use. While some psychedelics are legal for medical use, others are classified as Schedule I drugs, meaning they are illegal for any use. However, the decriminalization of certain psychedelics in some cities and states is an indication of changing attitudes towards these substances and their potential therapeutic benefits.

It's important to note that the laws regarding psychedelics are constantly changing and it's important to stay up to date with local and federal regulations. If you are interested in exploring the potential therapeutic benefits of psychedelics, it is important to do so under the guidance of a qualified healthcare professional.

References:

1. Drug Scheduling. DEA. Published 2018. Accessed March 10, 2023. https://www.dea.gov/drug-information/drug-scheduling
2. FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic. U.S. Food and Drug Administration. Published 2019. Accessed March 10, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified
3. Psychedelics Legalization & Decriminalization Tracker - Psychedelic Alpha. Psychedelic Alpha. Published 2023. Accessed March 10, 2023. https://psychedelicalpha.com/data/psychedelic-laws
4. MDMA - Multidisciplinary Association for Psychedelic Studies - MAPS. Multidisciplinary Association for Psychedelic Studies - MAPS. Published July 13, 2022. Accessed March 10, 2023. https://maps.org/mdma
5. Carhart-Harris RL, Goodwin GM. The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future. Neuropsychopharmacology. 2017;42(11):2105-2113. doi:https://doi.org/10.1038/npp.2017.84
6. Carhart-Harris RL, Bolstridge M, Rucker J, et al. Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry. 2016;3(7):619-627. doi:https://doi.org/10.1016/s2215-0366(16)30065-7

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