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Larissa Hope credits psilocybin, the active compound in magic mushrooms, with aiding her recovery from a severe mental health condition.
At 17, Hope landed a role in the television drama “Skins,” but the sudden fame triggered a buried trauma. Finding antidepressants ineffective, she experienced a turning point with a small, clinically supervised dose of psilocybin.
“When I experienced it, I burst out crying,” she recounts. “It was the first time in my life I had ever felt a sense of belonging and safety in my body. I kept saying, ‘I’m home, I’m home’.”
Nearly two decades later, Hope maintains that this experience, combined with therapy, helped her confront suicidal thoughts.
However, experiences with psychedelics vary widely. Jules Evans, a university researcher, had a starkly different introduction to altered states when he used LSD recreationally at age 18.
The experience plunged him into what he describes as a “deluded” state.
“I believed that everyone was talking about me, criticizing me, judging me. I thought, I’ve permanently damaged myself; I’ve permanently lost my mind.”
“It was the most terrifying experience of my life.”
Evans, now director of the Challenging Psychedelic Experiences Project, assists individuals navigating difficulties after psychedelic use. He reports experiencing social anxiety and panic attacks for years following his experience, eventually receiving a diagnosis of post-traumatic stress disorder (PTSD).
These contrasting experiences highlight the central dilemma facing medical professionals, regulators, and policymakers:
Should physicians be permitted to prescribe treatments incorporating magic mushrooms and other potentially therapeutic psychedelic drugs?
This question arises amid a surge of new research suggesting psychedelic drugs may be beneficial in treating depression, obsessive-compulsive disorder, PTSD, trauma, and addictions.
Currently, psychedelic medicine is illegal except within authorized research or clinical trials. Since 2022, over 20 trials have explored various psychedelic medicines for conditions like depression, PTSD, and addiction.
While many of these studies suggest potential benefits, others report mixed or unclear results.
To date, only a few studies have definitively found no benefit regarding their primary outcomes.
Results from a major clinical trial of psilocybin, conducted by UK biotech firm Compass Pathways, are expected later this year.
The UK’s medicines regulator awaits this data as it deliberates whether to ease current restrictions and permit the use of psychedelic medicine outside of research and trials.
Prof. Oliver Howes, chair of the Royal College of Psychiatrists’ Psychopharmacology Committee, expresses optimism, viewing psychedelics as a promising potential treatment for psychiatric disorders, including for NHS patients.
“One of the key messages is that this is something we desperately need – more treatments and better treatments for mental health disorders…”
“These treatments are really interesting because they’ve shown promise in these small-scale studies… and have the potential to work quicker.”
He also urges caution, emphasizing the importance of trial results: “It’s really important that we get evidence and not overhype the potential benefits.”
Others have echoed this caution. A report by the Royal College of Psychiatrists, published in September 2025, highlighted potential risks associated with psychedelics, and physicians emphasize that using these drugs is not only illegal but can also be harmful.
Drug use has a long history, with substances like magic mushrooms, opium, and cannabis used for recreation and rituals for centuries.
In the 1960s and 1970s, LSD gained popularity within the counterculture movement, with figures like Harvard psychologist Timothy Leary encouraging youth to “turn on, tune in, drop out,” urging them to awaken their inner potential, engage with society, and reject social norms.
However, these drugs soon became associated with social unrest and moral decline.
Their prohibition in the late 1960s and early 1970s led to increased restrictions on scientific research.
However, groundbreaking scientific advancements in the 2010s by Prof. David Nutt and his team at Imperial College London initiated a process that may ultimately alter this landscape.
Subsequent clinical trials involving depressed patients indicated that psilocybin was at least as effective as conventional antidepressants, with fewer side effects. Prof. Nutt also emphasized its rapid action.
“We thought rather than wait for eight weeks for antidepressants to switch off the part of the brain associated with depression, maybe psilocybin could switch it off in the space of a few minutes.”
While scientifically promising, this view is not universally accepted.
Prof. Nutt is a respected scientist, but his assertions have generated controversy.
He was dismissed as chair of the government’s drugs advisory body in 2009 following public comments deemed incompatible with his role as a government advisor.
In recent years, Prof. Nutt’s studies have spurred numerous investigations worldwide into the potential therapeutic benefits of other psychedelic drugs.
At University College London, neuroscientist Dr. Ravi Das is investigating why some habits solidify into addictions while others fade away, believing psychedelics may hold the key.
His study is recruiting heavy drinkers to test whether dimethyltryptamine (DMT), a short-acting psychedelic also used recreationally, can be used to target the brain’s memory and learning systems.
This research builds on evidence suggesting that psilocybin can disrupt habitual behaviors associated with addiction.
“Every time someone drinks, a bit like Pavlov’s dog, you’re learning to associate things in the environment with the rewarding effect of alcohol,” he explains. “We’ve been focusing on whether certain drugs, such as psychedelics, can break down those associations.”
This is an early-stage study, but successful outcomes in this and future trials could lead to its integration into NHS treatment (subject to regulatory approval).
“If psychedelic therapies prove to be both safe and more effective than current treatments, I would hope to see them made accessible via the NHS — rather than to just the privileged few who can afford them privately,” he states.
Ketamine, previously studied by Dr. Das, occupies a different legal category and can be used in medical treatment in the UK.
Other psychedelics, including DMT, LSD, psilocybin, and MDMA, are currently considered to have no legitimate medical use and are restricted to research purposes under stringent medical licenses.
Dr. Das believes that positive trial results could shift perspectives as scientific evidence accumulates. “I hope if there’s sufficient evidence, the government will be open to revising the scheduling of these drugs,” he says.
However, an analysis published in the British Medical Journal in November 2024 questioned the ease with which the precise effects of psychedelic drugs can be determined.
“Because hallucinogens are often combined with a psychotherapy component, it is difficult to separate the effects of the drug from the therapeutic context, complicating comprehensive evaluations and product labeling.”
The analysis also suggested that short-term trials may not detect “the potential for harm and serious adverse events from long-term use of hallucinogens… The potential for abuse or misuse must also be considered.”
While research suggests therapeutic benefits from psychedelic medicines, physicians remain cautious. Prof. Howes believes that, with the exception of ketamine, psychedelic treatments should not be routine medical practice outside research settings until larger, more rigorous trials provide more robust evidence for their safety and effectiveness.
“In a clinical trial setting, it’s very carefully evaluated. If people take these on their own or in a backstreet clinic, then there is no guarantee of that and the safety issues start becoming a major issue.”
His warnings are supported by data gathered by Challenging Psychedelic Experiences, indicating that 52% of regular psychedelic users have had an intensely challenging psychedelic experience, with 39% considering it “one of the five most difficult experiences of their life.”
Additionally, 6.7% reported considering self-harm or harming others following a challenging experience, and 8.9% reported being “impaired” for more than a day afterward.
According to Mr. Evans, some individuals required medical or psychiatric assistance and continued to feel worse for weeks, months, or even years after their experience.
“Ideally, I would love doctors and regulators to know more about these adverse effects, and how people can recover from them, before they say any of these therapies are safe,” he argues.
However, Prof. Nutt, Prof. Howes, and Dr. Das believe that progress toward clinical application is hindered by the difficulty in obtaining permission for medically supervised clinical trials.
“There are so many people suffering unnecessarily,” Prof. Nutt told BBC News. “And some of them are dying, because of the unreasonable barriers to research and treatment that we face in this country. It is, in my view, a moral failing.”
“When these medicines are proven to be safe and effective, I think it is vital they are made available through the NHS to all who need them, not limited to the private sector, as happened with medical cannabis.”
Prof. Howes shares this view, albeit with caution.
“There are big barriers to doing this research, so we do ask for the government to review the regulations of these substances for research because it does lead to long delays, and we desperately do need new treatments.”
Mr. Lemarchand’s analysis calls for greater scrutiny of trials. “To guarantee that hallucinogens are rigorously vetted before endorsing them as safe and effective treatments, medical journals must appraise the evidence more critically, fully account for limitations, avoid spin and unsubstantiated claims, and correct the record when needed.”
The Advisory Council on the Misuse of Drugs asserts that Schedule 1 “contains those of no medicinal value,” and therefore should be subject to the strictest controls. Ministers also directly link the Home Office licensing regime to public protection.
The government has supported plans to ease licensing requirements for some clinical trials approved by the Medicines and Healthcare products Regulatory Agency and Health Research Authority, with efforts underway to implement exemptions for certain universities and NHS sites. A cross-government working group is coordinating the cautious rollout, pending the results of pilot projects.
However, some physicians, including Prof. Howes, feel that changes are progressing too slowly. “There’s still a lot of red tape holding things up,” he says.
Supporters of psychedelic medicines hope that the Phase 3 trials by Compass Pathways will lead to further relaxations, at least regarding research.
Larissa Hope believes these trials are important.
She says that her experience with psilocybin, the active ingredient in magic mushrooms, helped her gain insight into her experiences of suicidal ideation and trauma.
“I had a solid plan to end my life. Then suddenly, death wasn’t the only way,” she says. “Under psilocybin, my nervous system began, for the first time, to recognize what peace felt like.”
Top Image Credit: Getty Images
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