Your arguments are sorely needed, but also incomplete. There are psychedelic traditions that go back hundreds and in a few cases thousands of years… traditions that have been kept alive by an underground community, at great personal risk and sometimes great cost.
Yet now that the medical profession is finding value in psychedelics (and, let’s be honest, the prospect of great wealth), there’s a race to medicalize and pathologize that’s frankly abhorrent. It smacks of gate keeping, paternalism, and colonialism, and puts one in mind of childbirth, where (male) doctors took over a profession that had been the domain of grandmothers, mothers, aunts, and midwives throughout most of recorded history—a ghastly takeover that Western culture still hasn’t fully recovered from.
I won’t deny that a more medical approach to psychedelics can help some people in some situations. But for the vast majority, doctors, insurers, and “medical centers” are likely to do more harm than good—to say nothing of private equity firms already attempting to lock down patents for things like “set and setting.”
For myself, I have my community, my practices, and my lineage. I’m good, thanks.
You are 100 % correct.The current mainstream medical interest is to try and create a patented chemical variation/analogue, etc, and then milk it for money.
There are multiple Big Pharma companies joining the commercial rush, disguised as altruistic ' helping' those who can afford clinical settings.
This is such an important reflection. I deeply agree: community isn't peripheral to psychedelic healing, it's foundational.
And I think we can hold both truths. If most psychedelic experiences are already happening outside clinical settings, the question isn't whether community spaces should exist. It's how prepared they are to hold what actually emerges there.
Because what emerges is often trauma.
Psychedelic states can open deeply vulnerable material, and that requires more than good intentions. It requires training, ethical grounding, and the ability to respond skillfully in real time. Historically, these medicines were held in community, but not unstructured community. Trained healers, lineage, clear containers.
This isn't clinical vs. community. It's an opportunity for integration: community spaces supported by trauma-informed facilitators, strong ethics, and clear referral pathways.
Community is powerful, but it becomes medicine when it's trained, supported, and accountable.
Yes, let's fund the local containers. And let's support the people holding them to do it safely.
I really love this. The distinction you’re making feels essential — it’s not clinical vs. community, but how the two can inform and strengthen each other. Grateful for you adding this perspective!
It all comes back to community. But expanded consciousness in bigger communities threatens the narrative created for society by those who wish to atomize us for exploitation.
36 hours with the Bwiti in Cameroon. The intensity wasn’t just the medicine,it was an entire tribe holding you through the night. Community isn’t support for the experience. In most traditional contexts, community is the experience. The medicine and the people holding it are inseparable.
Doing this in any real achievable way starts with immediate problems and questions and faces demanding answers.
When I was introduced to most psychedelics, they were absolutely everywhere. In a wide variety, almost always with correct information.
That culture was vibrant and amazing. But major tragedy turned it inside out.
Since that time, I’ve never seen that kind of access. That kind of access is what made more people jump in, and in positive Environments with others who could help.
Psilocybin never really goes out of style. There’s always a high end weed guy who gets shrooms in every now and again.
DMT has its devotees, and finding them can be the most troublesome part.
LSD rolls through generations, kind of like a pop culture fad.
MDMA,MDA, MDE, can always be found in the darkest nightclubs. No one even tries to hide the exchange. But it’s less trustworthy I hear. I couldn’t say.
The problem with keeping it outside of the clinic is the pharmacy. The pharmacy’s reliability changes from city to season.
Really appreciate you sharing this perspective. Access is crucial to a vibrant culture, and reliability and trust are essential to making the most of this opportunity.
Yeah, community for mushrooms but I go to the WOODS for using peyote! I don't like 'others' around when I commune with nature. The minute you 'invoke' community, you lose many! We need to LEGALIZE everything. Let nature take it's natural course!
Beautiful article! So clear. And Id add there’s a massive difference between being a patient and a community member. Set and setting and psychological context are integral to the healing effects.
Indigenous wisdom is needed to integrate these experiences into community, as some cultures have been holding these ceremonies for thousands of years, with many medicine workers training for decades to hold ceremonial space.
Some of the issues that arise from the medical model are, the denial of God or Spirit. Western science deems this as not real, and these experiences are Spiritual in their essence. I have spent time with wisdom keepers from many different traditions, and they all hold ceremonies as a form of communion with a spiritual force.
Secondly, Western culture is predominantly adolescent in nature, and trapped in polarised thinking. When liberated people show up, it can be a shock. There are a lot of non-sensical rules in the West, that would be obliterated by the common sense that can come online after a well facilitated ceremony.
The clinical model taking hold in places like the United States is part of why I closed my practice and moved to Peru.
Community is not optional in the world of Ayahuasca. It is not a nice-to-have. For me, it is the medicine itself.
Sitting alone in a room while multiple providers observe you from a distance... that is not ceremony. That is something else entirely. And I think the path forward, the one that honors both the future and the lineage it comes from, asks us to move away from that model toward something more human, more relational, more alive.
The big question is HOW. What you are saying makes sense. But we have failed time and again to build benevolent communities to address homelessness, depression, addiction. The 12 step communities are a success but their model would shun psychedelics. Are there communities today who embrace your proposition? Where are they?
I think anytime we try to control a gift God gave us, we run the potential of screwing it up. If we complicate that attempt to control it by further attempting to chase money to overly control it, then it becomes five alarm fire type danger of screwing things up.
The arguments made in your essay are thought provoking and eloquently put. The clinical model for care largely demystifies and attempts to rationalize an experience that is ineffable. With that being said, the clinical model is also the most available path towards societal integration for psychedelic healing. It has already addressed and knocked down many barriers that a community model would face, the two largest being access to legal supply and accreditation.
Since the second wave of clinical research has been federally funded since the early 1990s with Rick Strassman's DMT studies, the supply pipeline has had decades to develop. Giving safe legal access to this classification of medicines for research purposes. In the case of your model, what would you suggest the solution of safe and legal supply would be? Additionally what are the necessary steps taken today to ensure this future? It is apparent that mass legalization of growing methods would be a public safety risk and it would be very difficult for it to happen.
The issue of legality in supply also leads into the question of legality in administering the medicine along with the operation and opening of psychedelic communities. In your essay you mention "rigorous screening, clear escalation protocols, trained staff and volunteers" within the context of legal communities, this opens up the question of the requirements for training, screening and protocols. If your model were to be adopted nationwide, it would necessitate a framework in which some sort of standardization of techniques would be applied in order to ensure safety. By nature psychedelics induce the user into a volatile, malleable state so it must follow that the community overseeing the experience holds a tremendous amount of responsibility. What would some of the potential guard rails put in place to ensure that this responsibility does not end up in the wrong hands? Furthermore, what would the process of legally opening an accredited facility look like? Would there be training or certification required in order to do so? If not, I believe that it would fundamentally weaken the legitimacy of a community based movement in the eyes of the law and public perception.
The barriers to entry, "create regulatory bodies, train therapists, and secure investment to open up clinics, all of which cost hundreds of millions of dollars." implicitly ensure safety throughout the process of a psychedelic experience from preparation to integration. While I am not saying it is impossible, the creation of structures that could rival this level of safety across many different communities is incredibly difficult to achieve and is the largest barrier stopping this model today.
Your arguments are sorely needed, but also incomplete. There are psychedelic traditions that go back hundreds and in a few cases thousands of years… traditions that have been kept alive by an underground community, at great personal risk and sometimes great cost.
Yet now that the medical profession is finding value in psychedelics (and, let’s be honest, the prospect of great wealth), there’s a race to medicalize and pathologize that’s frankly abhorrent. It smacks of gate keeping, paternalism, and colonialism, and puts one in mind of childbirth, where (male) doctors took over a profession that had been the domain of grandmothers, mothers, aunts, and midwives throughout most of recorded history—a ghastly takeover that Western culture still hasn’t fully recovered from.
I won’t deny that a more medical approach to psychedelics can help some people in some situations. But for the vast majority, doctors, insurers, and “medical centers” are likely to do more harm than good—to say nothing of private equity firms already attempting to lock down patents for things like “set and setting.”
For myself, I have my community, my practices, and my lineage. I’m good, thanks.
Hi Thomas. I mention that humans have been doing psychedelics in community for thousands of years! And I also linked to an article on that
You are 100 % correct.The current mainstream medical interest is to try and create a patented chemical variation/analogue, etc, and then milk it for money.
There are multiple Big Pharma companies joining the commercial rush, disguised as altruistic ' helping' those who can afford clinical settings.
This is such an important reflection. I deeply agree: community isn't peripheral to psychedelic healing, it's foundational.
And I think we can hold both truths. If most psychedelic experiences are already happening outside clinical settings, the question isn't whether community spaces should exist. It's how prepared they are to hold what actually emerges there.
Because what emerges is often trauma.
Psychedelic states can open deeply vulnerable material, and that requires more than good intentions. It requires training, ethical grounding, and the ability to respond skillfully in real time. Historically, these medicines were held in community, but not unstructured community. Trained healers, lineage, clear containers.
This isn't clinical vs. community. It's an opportunity for integration: community spaces supported by trauma-informed facilitators, strong ethics, and clear referral pathways.
Community is powerful, but it becomes medicine when it's trained, supported, and accountable.
Yes, let's fund the local containers. And let's support the people holding them to do it safely.
I really love this. The distinction you’re making feels essential — it’s not clinical vs. community, but how the two can inform and strengthen each other. Grateful for you adding this perspective!
It all comes back to community. But expanded consciousness in bigger communities threatens the narrative created for society by those who wish to atomize us for exploitation.
Facts! United we stand, divided we fall
36 hours with the Bwiti in Cameroon. The intensity wasn’t just the medicine,it was an entire tribe holding you through the night. Community isn’t support for the experience. In most traditional contexts, community is the experience. The medicine and the people holding it are inseparable.
Wow that sounds incredible! Community is truly the medicine
This is a incredible piece. I honestly believe the proper place for these medicines we call them is in the community and in ceremony.
Thank you, really appreciate this! The importance of community and ceremony runs deep
Doing this in any real achievable way starts with immediate problems and questions and faces demanding answers.
When I was introduced to most psychedelics, they were absolutely everywhere. In a wide variety, almost always with correct information.
That culture was vibrant and amazing. But major tragedy turned it inside out.
Since that time, I’ve never seen that kind of access. That kind of access is what made more people jump in, and in positive Environments with others who could help.
Psilocybin never really goes out of style. There’s always a high end weed guy who gets shrooms in every now and again.
DMT has its devotees, and finding them can be the most troublesome part.
LSD rolls through generations, kind of like a pop culture fad.
MDMA,MDA, MDE, can always be found in the darkest nightclubs. No one even tries to hide the exchange. But it’s less trustworthy I hear. I couldn’t say.
The problem with keeping it outside of the clinic is the pharmacy. The pharmacy’s reliability changes from city to season.
Really appreciate you sharing this perspective. Access is crucial to a vibrant culture, and reliability and trust are essential to making the most of this opportunity.
https://youtu.be/MA2nUMmmPYI?si=Re5Ih7pmJ4vfJJbo
Rock on!
Yeah, community for mushrooms but I go to the WOODS for using peyote! I don't like 'others' around when I commune with nature. The minute you 'invoke' community, you lose many! We need to LEGALIZE everything. Let nature take it's natural course!
Truth, sometimes nature is the best community. I've had plenty of trees keep me company in trying times
The thought of ‘tripping’ with doctors around me, TERRIFYING!
Beautiful article! So clear. And Id add there’s a massive difference between being a patient and a community member. Set and setting and psychological context are integral to the healing effects.
Great point. The framing itself (patient vs. community member) can meaningfully shape both the experience and the outcomes
Indigenous wisdom is needed to integrate these experiences into community, as some cultures have been holding these ceremonies for thousands of years, with many medicine workers training for decades to hold ceremonial space.
Some of the issues that arise from the medical model are, the denial of God or Spirit. Western science deems this as not real, and these experiences are Spiritual in their essence. I have spent time with wisdom keepers from many different traditions, and they all hold ceremonies as a form of communion with a spiritual force.
Secondly, Western culture is predominantly adolescent in nature, and trapped in polarised thinking. When liberated people show up, it can be a shock. There are a lot of non-sensical rules in the West, that would be obliterated by the common sense that can come online after a well facilitated ceremony.
The clinical model taking hold in places like the United States is part of why I closed my practice and moved to Peru.
Community is not optional in the world of Ayahuasca. It is not a nice-to-have. For me, it is the medicine itself.
Sitting alone in a room while multiple providers observe you from a distance... that is not ceremony. That is something else entirely. And I think the path forward, the one that honors both the future and the lineage it comes from, asks us to move away from that model toward something more human, more relational, more alive.
The big question is HOW. What you are saying makes sense. But we have failed time and again to build benevolent communities to address homelessness, depression, addiction. The 12 step communities are a success but their model would shun psychedelics. Are there communities today who embrace your proposition? Where are they?
I think anytime we try to control a gift God gave us, we run the potential of screwing it up. If we complicate that attempt to control it by further attempting to chase money to overly control it, then it becomes five alarm fire type danger of screwing things up.
The arguments made in your essay are thought provoking and eloquently put. The clinical model for care largely demystifies and attempts to rationalize an experience that is ineffable. With that being said, the clinical model is also the most available path towards societal integration for psychedelic healing. It has already addressed and knocked down many barriers that a community model would face, the two largest being access to legal supply and accreditation.
Since the second wave of clinical research has been federally funded since the early 1990s with Rick Strassman's DMT studies, the supply pipeline has had decades to develop. Giving safe legal access to this classification of medicines for research purposes. In the case of your model, what would you suggest the solution of safe and legal supply would be? Additionally what are the necessary steps taken today to ensure this future? It is apparent that mass legalization of growing methods would be a public safety risk and it would be very difficult for it to happen.
The issue of legality in supply also leads into the question of legality in administering the medicine along with the operation and opening of psychedelic communities. In your essay you mention "rigorous screening, clear escalation protocols, trained staff and volunteers" within the context of legal communities, this opens up the question of the requirements for training, screening and protocols. If your model were to be adopted nationwide, it would necessitate a framework in which some sort of standardization of techniques would be applied in order to ensure safety. By nature psychedelics induce the user into a volatile, malleable state so it must follow that the community overseeing the experience holds a tremendous amount of responsibility. What would some of the potential guard rails put in place to ensure that this responsibility does not end up in the wrong hands? Furthermore, what would the process of legally opening an accredited facility look like? Would there be training or certification required in order to do so? If not, I believe that it would fundamentally weaken the legitimacy of a community based movement in the eyes of the law and public perception.
The barriers to entry, "create regulatory bodies, train therapists, and secure investment to open up clinics, all of which cost hundreds of millions of dollars." implicitly ensure safety throughout the process of a psychedelic experience from preparation to integration. While I am not saying it is impossible, the creation of structures that could rival this level of safety across many different communities is incredibly difficult to achieve and is the largest barrier stopping this model today.