Psychedelic medicine is an emerging field that uses substances like MDMA to produce non-ordinary states of consciousness. MDMA is in phase-3 FDA trials for treating PTSD and was designated a breakthrough therapy in 2017 due to its safety and efficacy when combined with manualized therapy. Historical and contemporary racial mistreatment triggers physiological stress responses in Black people, similar to those in anxiety disorders. The paper explores how entheogens in psychedelic-assisted therapy could address negative race-based experiences and promote healing among BIPOC. It also discusses the ethical need for culturally competent providers and for recruiting BIPOC into research and training.
The mental health field, including psychedelic-assisted psychotherapy, has not adequately centered the needs of people of color. Monnica Williams and colleagues show that Black women and other people of color experience harm when therapists are unaware of and ill-equipped to address race-related topics. Functional Analytic Psychotherapy training has benefits but is limited for therapists who have not deeply reflected on their own racism, privilege, and oppression. Leaders in psychedelic-assisted psychotherapy must adopt a standard of intersectional cultural humility for all practitioners. Increasing the number of trained therapists of color is essential to address racial disparities in access to these trauma treatments.
People of color have been significantly underincluded in psychedelic-assisted therapy (PAT) research, despite facing challenges commonly addressed in PAT and often more severe symptoms. A systematic review of the past 10 years of psilocybin, MDMA, and LSD clinical trials in the United States (N = 27) found that only 3 out of 27 studies (11.11%) incorporated community-engaged research (CEnR) practices. In the rare instances CEnR was integrated, researchers used community consultation, which involves relatively little engagement with community members. The authors recommend incorporating five CEnR principles to improve representation in PAT trials: mapping and engaging local stakeholders, leveraging existing university-hospital infrastructures, co-designing research and outreach initiatives, securing dedicated CEnR resources, and establishing mechanisms for ongoing evaluation.