Drug-centered or drug-assisted? Epistemic perspectives and methodological tensions in psychedelic psychotherapy
European Journal for Philosophy of Science October 25, 2025 Karen Yan, Chao Ni, Yun-Ying Kuo et al.
The paper distinguishes two views of psychedelics: the drug-centered view (DCP) and the drug-assisted view (DAP). Both rely on evidence-based medicine and randomized controlled trials to validate therapeutic efficacy. Using MDMA-assisted psychotherapy as a case study, the authors reconstruct the causal reasoning behind its proposed effects, identify two key causal assumptions, and critically examine them. They argue that DAP's reliance on evidence-based medicine is not just methodological but also reflects questionable epistemological assumptions inherited from the empirically supported therapy tradition. The paper proposes value-based practice as a complementary methodology better suited to the relational and value-laden aspects of DAP.