Last month in Denver, an estimated 10,000 scientists, clinicians, CEOs and entrepreneurs convened for the Psychedelic Science 2023 conference — the most visible symbol yet of the “psychedelic renaissance.”
Scientific research is demonstrating the potential of psychedelic-assisted therapy (PAT) to treat a range of mental health conditions, including addiction, major depressive disorder, anxiety and post-traumatic stress disorder. Ketamine therapy is increasingly widespread, and the Food and Drug Administration seems poised to approve the therapeutic use of both methylenedioxymethamphetamine (MDMA) and psilocybin in the next couple of years.
Public policy is catching up with psychedelic science. An analysis by Washington University researchers shows state-level psychedelic reform bills surged from five in 2019 to 36 in 2022. The public is paying more attention, too. Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) indicate that 2.6% of the U.S. population over age 12 used psychedelics in 2021, a significant increase since 2015.
These scientific, political and social developments will soon outstrip the capacity of the infrastructure needed to deliver on the promise of psychedelics and, perhaps more importantly, to mitigate the risks of use outside of clinical and community support settings. Leading psychedelic therapy organizations — such as the Multidisciplinary Association for Psychedelic Studies, which has led clinical trials on MDMA and organizes the Psychedelic Science conference; and Fluence, which provides professional trainings in psychedelic therapy — are predicting a critical shortage of mental health providers trained in psychedelic-assisted therapy.
Already, mental health clinicians are encountering increasing numbers of clients who are curious about psychedelics, using them for recreation or self-medication or who need help managing challenges resulting from their use. These mental health workers will require training in Psychedelic Harm Reduction and Integration (PHRI), which doesn’t involve administering psychedelics but uses harm reduction practices for clients considering or using psychedelics. Legal nationwide, PHRI enables professionals to support clients immediately and provides a foundation for potential future psychedelic-assisted therapy training.
Social workers will likely play an outsized role in realizing the potential and minimizing the risks of the psychedelic renaissance. According to SAMHSA, the National Association of Social Workers and the Association of Social Work Boards, the more than 250,000 clinical social workers within America’s health and human service systems are the largest group of mental health providers in the nation — more than psychiatrists, psychologists, and psychiatric nurses combined.
Aside from their sheer number, social workers are particularly well-equipped to address two critical issues facing psychedelic services: ensuring equitable access and providing culturally relevant care. Clinical social workers provide more affordable services than other mental health professionals. They tend to work with more vulnerable and lower income populations, and they are a diverse workforce whose education emphasizes the importance of cultural humility, client self-determination and personal empowerment. In addition, many social workers follow harm reduction models of care for drug use and are already trained to work with individuals who use various substances.
PAT is relatively expensive and requires two practitioners, so it will likely remain inaccessible to many for some time. Training social workers in PHRI is the low-hanging fruit, but little has been done so far. While a handful of social work schools have begun to educate their current students about the impact of psychedelics, there is almost no training tailored to their hundreds of thousands of licensed graduates. Every state requires these licensed social workers to complete continuing education courses, which creates a huge opportunity for the social work profession and the nation. The immediate challenge is that much of the capacity and expertise in psychedelic therapies lies outside of schools of social work.
Schools should promptly seize this opportunity by collaborating with training institutes and community partners, such as the partnership now being explored between the University of Maryland School of Social Work and Fluence. With backing from philanthropic and business sectors, and by developing affordable, accessible continuing education programs, we can fully realize the potential of the psychedelic renaissance.
Megan Meyer (MMEYER@ssw.umaryland.edu) is an associate professor in the School of Social Work within the University of Maryland, Baltimore. Victor Cabral is director of Policy and Regulatory Affairs at Fluence.