Abstract
This commentary explores public priorities in psychedelic research, drawing insights from extensive conversations between the author and the general public during lectures and seminars across the UK. Two primary themes emerged from this exchange: areas where further research is desired and concerns about the current direction of psychedelic research. Key topics of interest include psychedelics' effects on neurodivergent individuals, ageing, pain management, cognitive enhancement, psychosis, and interactions with the female menstrual cycle. Areas of concern pertain to the involvement of pharmaceutical companies in psychedelics research, the potential medicalisation of psychedelics, and the growing interest in psychedelic tourism. The commentary emphasises the need for a constant dialogue between scientists and the public, critical engagement with research and the integration of diverse perspectives in order to foster a broader understanding of psychedelics and their potential applications in this rapidly evolving field.
Psychedelics have seen a resurgence in public interest over the past decade. These compounds have attracted attention for their potential medical, personal, and cultural applications. Yet, as with any nascent field, questions arise about the direction of future research and its prioritised areas. In this commentary, I aim to explore public priorities in psychedelic research, drawing from insights I had from members of the general public whilst delivering lectures across the UK. At the time of writing, no body of empirical work sought to identify and quantify the range of public priorities in psychedelics research as defined by members of the general public.
With psychedelics being a focal point of various groups - recreational users, patients, scientists, clinicians, commercial entities, or regulatory authorities – it is not unreasonable to consider that the priorities for where research efforts seeking to advance this field converge might not always overlap with those of the public at large. Aligning scientific research with the interests of the public has been linked to higher rates of engagement and support (Fischhoff, 2013). In the UK, major funders of research now consistently require patient and public involvement in the design of scientific studies (UKRI Framework, 2018). When the public sees scientific research as addressing their concerns and benefiting society, it builds trust in the scientific community and its work. However, in fields with a lot of hype, there is a risk that public trust in the science may decline if expectations are not fulfilled (Master & Resnik, 2013). Research guided by public priorities also helps address disparities in healthcare, education, and technology, promoting equity and inclusivity (Jasanoff, 2003). This in turn bolsters the research’ potential to influence policy, especially when affected communities are actively involved (Reed et al., 2018). Although the importance of involving the public, their needs, and priorities in the design of psychedelics research has been highlighted, the evidence suggests this has been lacking in the majority of contemporary studies (Close et al., 2021).
My role as a researcher and science communicator meant that I had the opportunity of being in an unique position to listen to members of the general public in informal settings and hear their thoughts, questions and personal priorities regarding the direction of research in the psychedelics field. During 2021–2024 I delivered over 50 public lectures across the UK. The audience members were adults over 18 years of age, members of the general British public, with an interest in attending a lecture on ‘The Science of Psychedelics’. The lectures I delivered covered anthropological findings and use of psychedelics in indigenous communities, the history of psychedelics in the West, emergence of the first wave of research after the discovery of LSD and the key findings of that time, the subsequent war on drugs and the Controlled Substances Act 1970, the re-emergence of the field and a systematic review of the recent studies looking both at phenomenological and biological effects of psychedelics, therapeutic applications, and short- and long-term effects of naturalistic use (see Supplementary Materials – lecture slides). The lectures were aimed solely for educational purposes. After each lecture, I encouraged participants to ask questions, discuss topics I might have not covered, or share personal experiences that might differ from the research findings.
It is important to acknowledge this was not intended to be a systematic inquiry aimed at empirically quantifying interest in any particular sub-topic within the psychedelics research field, nor have I carried out a survey. Rather, after each Q&A I made notes of the questions that were asked for personal use – to help me understand my audience better. In doing so, I realised that the insights gained from this practice could be valuable not only to other researchers but also to the wider public. Therefore, I decided to write this commentary to formalise and share these anecdotal observations more systematically.
Some factors need to be considered. First, members of the public who attended these lectures had a direct interest in learning more about psychedelics. Second, although the acceptance of psychedelics worldwide is increasing, this is likely to vary between specific regions due to different political, social and cultural contexts which inadvertently affect those engaging with these substances (Balaet, 2024; Balaet et al., 2023). Third, those who chose to come forward in a public setting to ask questions might not be representative of the wider population with an interest in psychedelics. These factors would have influenced the questions I was asked, and should be considered as well when crafting future directions based on the topics that emerged. Furthermore, there are many reasons and combinations of reasons that might underlie what prompted such questions – personal intuitions or sober appraisals about what deserves further attention, enduring fascinations, linking timely topics together, personal fears or concerns and likely many others that remain unknown. Uncovering why public interest converged around these themes, some which do not have historic precedent, could be the subject of future research.
I categorise the themes that surfaced into two groups: areas of interest where further research is desired, driven by personal curiosity or an urgent need for treatment options; and areas of concern regarding the current trajectory and outcomes of existing research.
Areas of interest
The most frequently discussed topic was the effect of psychedelics on individuals with autism spectrum disorders. Surprisingly, this area has received scant attention in research relative to the apparent public interest. Literature dating back to the first wave of psychedelic research in 1959 reports the controversial use of LSD for ‘treating’ children with autism, followed by contemporary proposals to re-explore these substances for therapeutic purposes (Sigafoos, Green, Edrisinha, & Lancioni, 2007; Markopoulos, Inserra, De Gregorio, & Gobbi, 2022). Distinctively, the audience's focus was not on therapeutic application but on comprehending how the effects of psychedelics phenomenologically vary in this population. Questions arose about any additional risks and how neurodivergent individuals can safely navigate their experiences with psychedelics.
There was considerable interest in the potential role of psychedelics in ageing, particularly concerning dementia and cognitive decline. Many attendees enquired whether these substances could enhance cognition in older individuals or prevent further cognitive deterioration. Recent research points to the potential of psychedelics in this area (Winkleman et al., 2023), but clinical trials specifically targeting the elderly are still awaited. This gap in research may be due to challenges with obtaining consent from individuals with cognitive impairments for psychoactive drug studies.
Given the prolific anecdotal reports regarding microdosing there was notable curiosity about psychedelics for cognitive enhancement and learning. But recent studies suggest that microdosing may not significantly impact cognitive performance in naturalistic settings (Balaet, 2022; Dinkelacker & Pop, 2023). This discrepancy between anecdotal experiences and empirical findings calls for future research to address reasons underlying it (Balaet et al., in prep).
The use of psychedelics for pain management emerged as a central area of interest. Attendees expressed a strong desire to understand how psychedelics could help manage chronic pain, whether in microdoses or macrodoses. Early findings are promising, indicating that individuals who self-medicated with psychedelics experienced substantial improvements in pain (Bornemann, Close, Spriggs, Carhart-Harris, & Roseman, 2021), pointing towards a significant avenue for future research.
A recurring question concerned the long-term psychosis risks associated with psychedelic use. Scepticism surrounds old narratives that a single LSD trip could cause ‘insanity’. This concern probes into whether a psychotic state results directly from the drug or is influenced by factors like the set and setting, broader sociocultural context, and internalised narratives of the user. While psychedelics have historically been employed to simulate psychosis in experiments, this methodology has drawn criticism over its validity. Friesen reviews the narrative entanglement between psychedelics and psychosis in depth (Friesen, 2022).
Another area of significant interest was the use of psychedelics by individuals with pre-existing schizophrenia or psychosis. For those diagnosed with these conditions and interested in experiencing psychedelics, there is a notable lack of data regarding safety and specific risks. Whilst research is starting to outline the risks for healthy individuals, patient populations have been less studied, largely due to ethical considerations. In cases where research has been conducted, recruitment criteria have been cautiously designed to minimise risks. Wolf et al. (2023) discuss whether psychedelics might exacerbate schizophrenia or have therapeutic potential in this population. However, similar to the autism spectrum discussions, the primary concern of the audience was not the therapeutic use of psychedelics but rather the need for safety guidelines tailored to individuals with schizophrenia who wish to use psychedelics for purposes other than treatment. This underscores a growing demand for nuanced and condition-specific psychedelic harm reduction guidelines.
Traumatic Brain Injury (TBI) has a profound impact on individuals and their families. Adjusting to cognitive changes and mourning the loss of their former selves is a significant challenge for those affected. There is growing interest in the potential of psychedelics to foster neurogenesis and restore neural connections, which could be beneficial for TBI (Khan, Carter, Aggarwal, & Holland, 2021). To date, the lack of experimental evidence in human trials and the ethical complexities involved in consenting patients with varying degrees of cognitive impairment remain substantial hurdles. This gap highlights the need for cautious and ethical exploration in this area.
A frequently echoed question involved the interaction of psychedelics with the female menstrual cycle and menopause. This area of inquiry is particularly intriguing, as it explores how psychoactive compounds may have varying effects on women based on their hormonal fluctuations. Research, such as the studies conducted by Gukasyan and Narayan in 2022, suggesting that psychedelics can trigger the resumption of menses following amenorrhea, highlights the potential for a significant interaction with the menstrual cycle. This goes hand in hand with a broader societal awakening to understanding the unique biological responses of the female body – historically underrepresented in drug research.
The public had an enthusiastic response to the study comparing escitalopram with psilocybin (Carhart-Harris et al., 2021) and further highlighted a need for comparative studies looking at psychedelics for mental health treatments. With SSRIs being a mainstay treatment in the UK (McCrea, Sammon, Nazareth, & Petersen, 2016), juxtaposing effects of a well-known antidepressant with a psychedelic provides a familiar benchmark. Studies like these are pivotal in providing context for the effects of psychedelics, rendering them more accessible and relatable. This approach not only demystifies these substances but also enhances public comprehension, potentially facilitating the greater acceptance and integration of psychedelic therapies alongside conventional medications.
A prevalent, more metaphysical question was whether the reality experienced under psychedelics is objectively more 'real' than our everyday reality. Attendees were intrigued by the possibility that psychedelics might provide access to actual alternate realities. Despite some speculation and the rise of prominent figures who entertain these ideas, there is a lack of empirical endeavours aimed at exploring concepts like the 'DMT world' as an alternate realm. This area of inquiry remains speculative, and the adequacy of current scientific methods to tackle such profound and existential questions remains uncertain. Yet, this curiosity reflects a broader interest in the potential of psychedelics to transcend the boundaries of our conventional understanding of reality, which should not be dismissed by researchers.
Areas of concern
A noteworthy concern was the limited platform given to indigenous practitioners in the mainstream discourse around psychedelics research. Attendees highlighted the need for a more inclusive approach that goes beyond the scientific perspectives prevalent in Western academia. They argued for integrating indigenous wisdom and practices to provide a more holistic understanding of psychedelics, encompassing cultural and spiritual dimensions. They also expressed curiosity about how psychedelic research findings from South America and Asia differ from those in Western Europe and the USA (see a discussion on this topic regarding mental health findings during the COVID-19 pandemic in Bălăeț et al., 2023). This interest stems from the concern that current popular studies are primarily based on Western samples and therefore might not fully represent global experiences. This calls for a more inclusive research approach that accounts for cultural and geographical diversity.
The influence of pharmaceutical companies in funding psychedelics research has raised eyebrows. Some attendees questioned the lack of funding for psychedelics compared to mainstream antidepressants, whilst others were wary of potential conflicts of interest. Concerns about researchers being influenced by personal financial interests – such as owning shares in companies marketing psychedelic treatments – were frequently mentioned. This scepticism mirrors worries within the scientific community about preserving the integrity of this re-emerging field. Concerns were also voiced about the future accessibility of psychedelics, particularly in light of potential medicalisation. There is anxiety that treatments might be prohibitively expensive, limiting access to financially able individuals. Additionally, there was apprehension about the repercussions of a negative psychedelic experience within such a setting, especially when combined with financial costs. The conversation also touched on the limitations that medicalisation might impose on recreational use, suggesting a possible continued restriction on access due to regulatory frameworks.
A common concern raised was how to handle a difficult psychedelic experience, specifically when alone. People expressed a need for evidence-based harm reduction practices and strategies to navigate challenging experiences. The focus was on scientific research-backed methods rather than relying solely on anecdotal advice found online. They also demonstrated a keen interest in using scientific evidence to explore traditional beliefs rooted in indigenous practices, including the significance of dietary considerations and the combination of psychedelics with other compounds.
Finally, the rising interest in psychedelic tourism brought questions about its safety and authenticity. This interest often came from individuals considering such options having exhausted conventional mental health treatments.
Closing reflections
Reflecting on the numerous questions received after my lectures, I have taken extensive notes and spent considerable time contemplating how best to share these insights. Learning was a two-way street: whilst I hope my audience learnt something new, the Q&A sessions invariably enriched my understanding, making them a personal highlight. With this manuscript, my goal is to foster a dialogue between scientists and the general public. I share these with the hope that they inspire my academic peers, inform journalistic articles, and resonate with those capitalising on psychedelics, to better understand the public sentiment regarding their actions. I extend my heartfelt thanks to my audience for their valuable contributions and for bringing up a wonderfully diverse range of topics. For topics not covered – those lost in the nuances of translation or limited by the confines of time – I apologise for their omission. They are equally important but perhaps did not emerge as consistently. Going forward, I particularly encourage members of the general public to engage critically with scientific research, for it not only helps refine our hypotheses but also shape our insights. As this article circulates, I invite readers to add their stories and perspectives to the public domain, enriching the discourse. My aspiration is for a future brimming with more diverse viewpoints in this evolving field of psychedelics research.
Funding sources
At the time of writing this article, MB was funded by the Medical Research Council Doctoral Training Programme at Imperial College London.
Author contribution
MB is the only author.
Conflict of interest
MB declares no conflict of interest.
Supplementary material
Supplementary data to this article can be found online at https://doi.org/10.1556/2054.2025.00362.
Acknowledgements
I would like to express my sincere gratitude to everyone who has attended my public lectures and shared their experiences, thoughts, and ideas about psychedelics so openly. Your contributions are invaluable in ensuring that I remain open-minded and engaged, preventing me from becoming too entrenched in my own perspectives. My aim is to contribute meaningfully toward addressing real-world issues, and your input plays a crucial role. Additionally, I would like to extend my appreciation to psychedelic student societies across the UK, art and music festivals, and organisations, particularly Seed Talks, for their significant role in bridging the gap between the general public and academics such as myself, thus fostering a mutually beneficial discourse on topics of widespread interest like psychedelics. Finally, I thank my mother who babysat my toddler whilst I wrote this article, as well as everyone else part of the 'village' who helped in a similar fashion and made it possible for me to deliver so many lectures away from home.
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