Journal of Psychedelic Studies
September 19, 2019
Logan Neitzke-Spruill
58 citations
The concept of set and setting—non-pharmacological factors like mindset and environment that shape psychedelic experiences—has seen little theoretical development since its mid-20th-century popularization. Bridging set and setting theory with social psychology and sociology of medicine, this review argues that race contributes to both set and setting. Psychosocial factors that drive racial differences in mental health also create meaningful differences in set, while the character of race relations in the United States provides a distinct cultural setting for racialized users, whether in therapy or naturalistic contexts. Racial identification may thus influence how psychedelic experiences are framed and interpreted, with implications for clinical protocols, practitioner education, and diverse patient needs.
Journal of Psychoactive Drugs
August 8, 2018
Logan Neitzke-Spruill, Carol Glasser
27 citations
People who use psychedelic drugs for religious reasons or who identify with a religion tend to report more intense mystical experiences than those who do not. A survey of 119 participants recruited from psychedelic-related websites found that a majority were White males with some post-secondary education. The study measured participants' history of psychedelic use, the context of their use, and their scores on a Mysticism Scale. The results suggest that both religious identification and using psychedelics specifically for religious purposes are associated with higher mysticism scores.
Nature Medicine
June 3, 2025
Chloé Pronovost-Morgan, Kyle T. Greenway, Leor Roseman et al.
26 citations
A Delphi consensus study with 89 experts from 17 countries identified 30 extra-pharmacological variables that are important or very important for reporting the setting in psychedelic clinical trials. These variables, forming the ReSPCT guidelines, cover physical environment, dosing session procedure, therapeutic framework and protocol, and subjective experiences. The findings reveal significant ambiguities in current conceptualizations of set and setting. The guidelines provide a new standard for designing and documenting contextual factors in psychedelic research.
Neuroethics
June 20, 2024
Logan Neitzke-Spruill, Caroline Beit, Jill O. Robinson et al.
26 citations
Psychedelic experiences can be transformative, changing how people think and behave. In interviews with 26 participants in psychedelic retreats, 20 reported insights or experiences they believed were inaccessible without the drugs' psychoactive effects. All but one participant reported changes in identity, values, beliefs, desires, or behavior, with behavioral changes being most common. Participants felt capable of deciding to use psychedelics partly because they sought information beforehand. Several reported an enhanced ability to make changes in their lives. The findings highlight the importance of subjective embodiment and personal agency in shaping outcomes, raising neuroethical issues about consent and moral psychopharmacology.
The American journal of bioethics : AJOB
January 1, 2025
Logan Neitzke-Spruill, Caroline Beit, Lynnette A. Averill et al.
19 citations
The FDA rejected Lykos Therapeutics' application for MDMA-assisted therapy for PTSD in August 2024, partly due to a highly publicized case of alleged sexual misconduct by an unlicensed therapist during a Phase 2 trial. Several other cases of misconduct by facilitators at psychedelic retreats have raised questions about whether physical contact is ever appropriate during psychedelic-assisted therapy. Drawing on research about supportive touch in other clinical settings and considering features of psychedelics that increase the potential for harm, the authors advocate for a precautionary approach to harm-reduction while arguing that supportive touch should not be entirely discarded.
PLoS One
May 2, 2025
Nikita Singh, Srijith Kambala, Logan Neitzke-Spruill et al.
10 citations
Public interest in psychedelics and adult use has grown alongside research into their clinical potential. A landscape analysis of online, publicly available information identified 298 organizations offering psychedelic retreats to English-speaking consumers between July and December 2023. Most organizations focused on general wellness rather than religious identity. Ayahuasca was the most commonly offered substance, followed by psilocybin and San Pedro. Retreats were held at 440 distinct physical locations worldwide, with 130 inside the United States and 310 outside. Prices varied widely. Further research into retreat practices is recommended to reduce harm and support consumer education.
Perspectives in biology and medicine
January 1, 2024
Logan Neitzke-Spruill, Neşe Devenot, Dominic Sisti et al.
7 citations
Psychedelics are again being studied for their traditional uses, medical applications, and social implications. As evidence for their clinical potential grows, researchers seek mechanisms explaining psychedelic effects and therapeutic efficacy. This paper reviews three frameworks—neurobiological, psychological, and spiritual—for understanding these effects and explores their implications for ethics and professional competencies in psychedelic medicine. The authors suggest interdisciplinary education to improve communication, develop multi-level models, and foster collaboration. They caution against overemphasizing neuro-mechanisms, risks from inducing vulnerable states, and challenges integrating spiritual frameworks. Developing new models that reflect emerging knowledge is a central goal for psychedelic science.
JAMA Netw Open
January 2, 2026
Amy L. Mcguire, Logan Neitzke-Spruill, Jill O. Robinson et al.
4 citations
Psychedelic retreat organizations vary widely in their safety precautions. All 49 organizations interviewed collected participant medical histories, and 73.5% excluded individuals with certain health conditions. Most required or recommended medication washout periods ranging from one day to over six weeks. While 69.4% worked with a licensed health care professional or someone with emergency response training, only 65.3% had such personnel in attendance at retreats at least some of the time. All organizations offered integration support. The variability in practices, particularly around medication washout and polysubstance use, may increase risks to participants. Best practice guidelines are needed and should be codeveloped with Indigenous and nonclinical communities.
Library, Museums and Press - UDSpace (University of Delaware)
February 4, 2025
Logan Neitzke-Spruill
2 citations
People who use psychedelic drugs rely on socially defined frameworks of understanding to make sense of their experiences and integrate them into everyday reality. Drawing on social-phenomenology, cognitive sociology, and set-and-setting theory, this analysis examines over 200 narrative reports from 100 individuals collected between 1960 and 1964 as part of the Harvard Psilocybin Project. The accounts describe experiences with psilocybin, mescaline, and LSD. The work proceeds in three phases: describing the quality of the psychedelic experience, identifying how individuals integrate it into daily life, and outlining what these experiences reveal about the social construction of everyday reality in the United States. The aim is to demystify psychedelic experiences and generate more useful ways of thinking about psychoactive substances.
Translational Behavioral Medicine
January 1, 2026
Joshua Mitchell, Logan Neitzke-Spruill, David S. Mathai et al.
1 citation
Clinical investigators anticipate that psychedelic medicine, including MDMA and psilocybin, could eventually fit into routine clinical care and may even improve it, despite distinct challenges. These treatments differ from existing ones in drug effects, treatment models, and broader goals. Key translational challenges include uncertainty about the role of psychotherapy, high treatment costs and scalability issues, and the effects of hype and stigma on clinical uptake. The findings are based on interviews with 21 investigators at major academic psychedelic research centers across the United States.
Brazilian Journal of Psychiatry
January 1, 2025
David S. Mathai, Jill O. Robinson, Kevin Wagner et al.
1 citation
Among 2,639 Hispanic and Latin American adults with obsessive-compulsive disorder (OCD) living across the Americas, 9% reported using psychedelics or related substances for treatment. Most (72%) had received traditional treatments like psychiatric medication or psychotherapy. Psilocybin, LSD, and MDMA were the most used psychedelics. Users were more likely to be male, have received non-ERP therapy, and have a comorbid psychiatric diagnosis. Outcomes for OCD symptoms varied widely by drug and were difficult to predict, but were most favorable for classic serotonergic psychedelics. Real-world evidence suggests Hispanic and Latin American adults are exploring psychedelics as a treatment for OCD, though further research is needed to establish safe and effective use.
FOCUS The Journal of Lifelong Learning in Psychiatry
July 1, 2026
Lynnette A. Averill, Logan Neitzke-Spruill
Psychedelic-assisted therapies show promise for stress- and trauma-related conditions that have not responded well to existing treatments. Current explanations focusing on brain changes and neurotransmitter effects are insufficient to explain how healing occurs through preparation, altered states, relationships, meaning-making, and integration. The authors propose a multilevel framework that distinguishes mechanisms of action from mechanisms of change, describing how neuroplasticity, memory updating, relational processes, context, and meaning-making may interact to create time-limited windows for experiential relearning. Ethical considerations and the possibility of increased vulnerability when safeguards are inadequate are discussed, along with guidance for clinicians.
Psychedelics
May 1, 2026
Madeleine Cluck, Alison B. Purcell, Zuzana Kazan et al.
Psychedelic-assisted therapy (PAT) differs from standard psychiatric treatments by requiring fewer doses and promoting profound cognitive shifts. Autism Spectrum Disorder (ASD) has been treated with medication and behavioral therapies, but adverse effects and negative perceptions of therapy within the autistic community have spurred interest in PAT. Overlap in neuropsychological effects of psychedelics with autism, such as serotonergic signaling and prosocial behavior, suggests potential benefits for autistic adults. However, PAT's sensation-heavy experiences may induce stress in some participants, and most research on reducing distress focuses on neurotypical populations. The modalities, goals, and integration of PAT may need adaptation for autistic adults, and ethical considerations are warranted before large-scale clinical trials.
Psychedelic Medicine
April 23, 2026
Jill Oliver Robinson, Ruiying (aria) Xiong, Logan Neitzke-Spruill et al.
A survey of 212 US institutional review board (IRB) chairs found that many lack knowledge about psychedelic risks and benefits, with 35–51% reporting gaps. Most chairs expressed neutral attitudes toward psychedelics (35–47%) and similar confidence reviewing psychedelic and nonpsychedelic protocols (61–78%). However, 33–53% reported heightened concern about psychedelic administration research, including legal, employment, and social risks, participant safety, consent challenges, and vulnerable populations. About half (47.2%) saw heightened institutional risk. Most (82.9%) agreed with requiring extensive monitoring of psychedelic sessions, but views on other protections varied widely. The findings suggest IRBs are not broadly conservative but uncertain, with concerns mirroring unsettled issues in the field.