The 'Civilising' of Psychedelics: Pharmaceuticalisation from Below as a Part-Process of American and European Informalisation

Abstract

In April 2026, US President Donald Trump signed an executive order fast-tracking access to psilocybin and ibogaine for the treatment of serious mental illness. This follows decades in which psychedelics had been vilified as a group of drugs entirely lacking in therapeutic potential, associated with counter-cultural groups such as hippies, and whose use was both criminalised and widely stigmatised. Our central questions are: How have the substances, practices, understandings and relationships that comprise psychedelic use developed, and shifted, over time? And how might we best understand the overall structure and dynamics of such changes? We argue that the recent psychedelic renaissance cannot be understood as the simple ‘discovery’ of a therapeutic potential that previously lay dormant in the substances themselves. It is better grasped as a part-process of longer-term informalisation processes, bound up with shifting balances of power between established and outsider groups and with the changing behavioural and emotional standards – the social canons – through which psychedelic use has become refigured. Drawing on the figurational sociology of Norbert Elias and relational work on substance use and health, we trace the shift in psychedelics from counter-cultural sacrament to therapy and technology of the self. Through dialogue with a multimodal, multi-source evidential base, we develop the concept of ‘pharmaceuticalisation from below’ to characterise both the contemporary uptake of psychedelics and the broader figurational dynamics this expresses.