EFG Magazine

For Western psychiatry, the psychedelic revolution is coming at the perfect moment. There hasn’t been a blockbuster pharmaceutical since the SSRIs debuted more than 30 years ago, and while many credit Prozac and its ilk with alleviating distressing symptoms, there has been widespread disagreement over the effectiveness of SSRIs since their debut.

Psychedelics are supposed to be the antidote to all that. Contrary to conservative fears, doctors broadly agree that psychedelics aren’t physically addictive. In some studies, participants taking psychedelics experienced a greater reduction in depressive symptoms than those taking SSRIs. Best of all, they’re supposed to be effective after just a few doses, although how long their effects last remains up for debate.

When touting the potential benefits of these drugs, clinicians who work in this sphere tend to favor medical terminology. They talk about “targeted,” “evidence-based” treatment regimens that act on specific neurotransmitters. And they like to cite “neuroplasticity,” the idea that the brain can change its structure in response to input or experience. Doctors maintain that psychedelics must go through clinical trials and gain FDA approval because ingesting them carries some (rare) risks and the substances don’t interact well with certain medications. At the same time, companies looking to market them stress that these drugs are low-risk to calm anyone who has preconceived notions about psychedelics.

Problem is, it’s deeply naive to expect that individuals who run for-profit businesses—and the projected profits are huge—will be satisfied keeping their customer base limited to those with specific, diagnosable mental health conditions. Given that they’ve doubled down on the “medical usage only” party line, the main path forward for these companies is to convince more and more people that they, too, suffer from these conditions, essentially mirroring past tactics of traditional pharmaceutical companies.

To wit, few of these investors have neglected, during their media blitzes, to cite the “increased need” for mental health treatment post-pandemic, despite disagreement among researchers about whether mental illness has actually risen globally since the onset of the coronavirus. And it’s similarly irrational to believe these companies when they market their treatments as being for one-time use only, which makes no sense from a financial standpoint. Their raison d’être is making products that you have to return to again and again, like social media platforms.

One way of creating repeat customers is to broaden the list of conditions psychedelics might help, thus increasing the potential number of consumers. A recent press release for Nushama, a New York City-based ketamine clinic founded by two men with backgrounds in finance and law, listed a dizzying array of conditions ketamine could potentially treat, including depression, anxiety, chronic pain, addiction, “trauma-induced mood disorders,” “trauma-related OCD,” eating disorders, and IBS.

Nushama medical director Elena Ocher, whose background is in medical pain management, said the list of conditions the drug treats is based on data from clinical trials, "combined with studied applications, our clinical practice, and empirical medical experience.” The clinic provided a list of studies conducted on ketamine’s application in the treatment of PTSD, anorexia, OCD, and substance use disorders, though it stipulated that all were “small in scale.” Will Siu, a Harvard- and Oxford-trained psychiatrist who uses ketamine in his private practice and independently reviewed Nushama’s press release, says, “It’s complete baloney. The only thing that there is evidence for with ketamine—strong—is treatment-resistant depression.” 

Another way to make more money is to keep moving the goalposts for what “better” means. Fine? Content? Euphoric? What the companies have to do, essentially, is make any bad feeling, no matter how appropriate or logical in context, into a symptom of a mental illness that needs to be cured. Look at the websites of many of these clinics, and you’ll see this insidious kind of paternalism at work. Cute infographics suggest you might be a potential patient if you have an opioid dependency or are depressed, but also if you “feel blocked,” are “lacking purpose,” or struggle with “stress,” as if they’re all stars in the same constellation of disease, when in reality, many are natural, unavoidable parts of life, that cannot, and likely should not, be medicated away.