Ask a Mizzou expert: What is psychedelic-assisted therapy?

COLUMBIA, Mo. -- The use of psychedelics by people struggling with mental health issues has gotten increased media attention in recent years. Prince Harry told “60 Minutes” he used psilocybin — also known as magic mushrooms — to deal with the grief of losing his mom at age 12. Celebrities including Kristen Bell, Mike Tyson and Seth Rogen have all reported turning to psychedelics for well-being. In 2023, “Last Week Tonight with John Oliver” covered the emerging topic of psychedelic-assisted therapy, detailing how it has helped veterans struggling with post-traumatic stress disorder.

Dani Adams, an assistant professor at the University of Missouri College of Health Sciences, studies how psychedelic-assisted therapy can potentially help treat anxiety, depression, grief, substance use disorders, post-traumatic stress disorder and other mental health conditions.

Read on for a Q&A with Adams about the growing momentum surrounding these therapies and the work that still needs to be done to improve access to mental health services.

How do psychedelics work?

Psychedelics are drugs that produce altered states of consciousness, affecting your perception, mood, feelings and thinking. Popular examples include psilocybin, MDMA and LSD.

Researchers hypothesize that psilocybin, for example, impacts neuroplasticity — changes in the brain that help people get ‘unstuck’ in thinking patterns to have more psychological flexibility.

MDMA — commonly known as ecstasy or molly — works by reducing activity in the amygdala, the part of the brain that detects threats, allowing users to confront trauma that may be too difficult to face otherwise.

LSD — lysergic acid diethylamide — can help people understand their feelings better and see their problems from a new perspective, potentially making it easier to heal.

What are some of the benefits of psychedelic-assisted therapy?

After experiencing psychedelic-assisted therapy, patients often report a sense of deep connection to something bigger than themselves, like nature or a higher power. Research shows the stronger a spiritual or mystical experience a patient has during psychedelic-assisted therapy, the better mental health outcomes they report.

Psychedelic-assisted therapies involving psilocybin and MDMA have shown promise in treating treatment-resistant depression, substance use disorders and PTSD. For example, a 2022 clinical trial of MDMA-assisted therapy found that 71% of participants no longer qualified for a PTSD diagnosis after just two months of treatment. Given how many people struggle with PTSD, particularly veterans, this therapy has the potential to help a lot of people.

What does a typical psychedelic-assisted therapy session look like?

Initial preparation sessions help inform a patient on what to expect based on their goals. For example, a veteran with PTSD may have a goal of reflecting on previous trauma to try to better understand and recover from it.

During the actual dosing session, one or two therapists or licensed clinical social workers are typically in a comfortable room with the patient for up to eight hours. After taking the psychedelic drug, the patient is able to explore their own mind in a safe and calm environment under careful supervision.

After the experience is over, a final integration phase allows the patient to make meaning of the experience. The therapist helps participants make sense of their dosing experience and helps them understand how to integrate new behaviors, attitudes and beliefs into their lives that can lead to long-term changes in their mental health.

Is psychedelic-assisted therapy currently legal in all 50 states?

No, but in 2020, Oregon became the first state to legalize psilocybin-assisted therapy. Colorado followed suit in 2022 and New Mexico in 2025. 

While early psychedelic-assisted therapy trials involving MDMA have shown promise, the FDA rejected it as an official mental health treatment last summer, citing the need for more research. It is anticipated that the FDA will decide on the status of psilocybin-assisted therapy in 2026.

Bills introduced in the Missouri legislature this year sought to make psilocybin-assisted therapy legally accessible to Missouri veterans enrolled in studies for treatment of depression, trauma and substance use.

While the gap between research and real-world practice for psychedelic-assisted therapy is expected to take more than a decade, what are some strategies for shortening this time frame to help those in need sooner?

Implementation science helps bridge the gap between research and practice by identifying barriers and developing strategies to overcome them. For example, dosing sessions require a private room for up to eight hours, which can be hard to come across at safety-net clinics like federally qualified health centers.

While psychedelic-assisted therapy shows promise, it remains in the early stages. It should be viewed as another tool in our toolbox of mental health treatments. Securing insurance coverage is vital so that everyone who needs this treatment can access it, not just those with financial resources.

What is Mizzou doing to advance psychedelic-assisted therapy?

At Mizzou, our School of Social Work has been accepted into the University Psychedelic Education Program, a nationwide learning collaborative that helps faculty proactively train students in this topic to reduce future bottlenecks.

Also, in partnership with a veteran and Mizzou social work student, I created a group at Mizzou called the Collaborative for Missouri Psychedelic-Assisted Therapy, which is trying to advance psychedelic-assisted therapy in Missouri in a safe, accessible and ethical way.

How has the conversation around psychedelic-assisted therapy research changed in recent years?

Michael Pollan’s 2018 book “How to Change Your Mind” led to a popular resurgence in the field, helping many see psychedelics in a new, more positive light. The book details how psychedelics have been used for hundreds of years by indigenous communities in spiritual ceremonies before getting caught up in the counterculture movement of the 1960s in the United States.

Timothy Leary worked at Harvard University in the 1960s, giving psychedelics to students in an unethical manner before he was fired. President Richard Nixon even called him the most dangerous man in America at the time. When Nixon signed the Controlled Substances Act in 1970, psychedelic-assisted therapy research ground to a halt for 30 years before it was resurrected in the early 2000s at Johns Hopkins University.

In 2023, the Psychedelic Sciences Conference had about 10,000 attendees. I will be attending the conference this summer in Denver with colleagues, and more than double the number of attendees are expected this year, so this field has grown significantly in recent years.