Category: Psilocybin Research

People around the world are learning about the mental health benefits of psychedelics, but where are psychedelics legal?

As clinical studies continue to show that psychedelics can improve mental health, individuals from across the world have begun considering experimenting with substances such as psilocybin and ayahuasca. There is only one problem: in most countries the personal use of such compounds remains highly illegal, with severe punishments for those who use it. But are there any countries where psychedelics are legal?

The international laws governing psychedelics are beginning to change. Nations from across the planet have begun turning the last pages on the decades-long global war on drugs. And while for most countries this means less severe punishments and transitioning from jail time to fines or mandatory rehab, some have flat out legalized certain psychedelics.

While this list is set to grow over the coming months, in this article I will examine 5 countries where at least some psychedelics are completely legal —or are in the process of becoming legal— to consume. The rules and regulations surrounding psychedelics vary in each jurisdiction, so make sure to do your homework before planning a psychedelic ceremony vacation.

#5: The USA

It is perhaps best to start in the United States. Not only did the War on Drugs originate here, but the country also strong-armed much of the rest of the world into following its lead.

While it’s true that across the nation most psychedelics remain illegal, due to the USA’s heavily decentralized nature, several states have started the process to legalize at least certain psychedelics.

The state furthest advanced in this process is Oregon. In 2020, Oregon residents voted in a ballot initiative to legalize psilocybin healing centers, and by the end of 2023, all adults over the age of 21 will be able to legally receive psilocybin-assisted therapy. In the interim, Oregon has decriminalized the possession of most drugs, including psychedelics.

While Oregon was the first domino to fall, other states such as Colorado are following their lead. To learn more, read 5 States Likely to Legalize Psychedelics.

#4: The Netherlands

Despite having beautiful architecture, thousands of years of history, and some of the most friendly people you will ever meet, when it comes to tourism, the Netherlands is perhaps best known as that place with legal marijuana and magic truffles. And while marijuana isn’t technically legal —though this really is just a technicality, there is a controlled market and you can buy it in stores— psilocybin truffles are.

How this came to be is a saga in and of itself. Despite psilocybin mushrooms being illegal, psilocybin truffles —the fruiting body of a fungus— are not. In short, there was a loophole in the law banning magic mushrooms which never got plugged. This resulted in psilocybin truffles being legally sold in “Smart Shops” across the Netherlands. And despite this coming to be through legislative overlook, since the law banning psilocybin mushrooms was passed in 2008, there has not been a serious effort to add psilocybin truffles to the list of banned substances.

Not only does this mean individuals can buy psilocybin truffles at Smart Shops, but there is also a burgeoning psilocybin-assisted therapy and retreat scene opening up. As citizens from around the world look to try legal psilocybin-assisted therapy to improve their mental health, the Netherlands is becoming a hot destination.

#3: Jamaica

Even during the height of the War on Drugs, Jamaica never made psilocybin mushrooms illegal. Despite this, the production and sale of magic mushrooms was traditionally relegated to the informal economy. That is starting to change.

In 2021, the first legal functional and psychedelic mushroom retail outlet was opened in Jamaica by the company Silo Wellness. Since then, more shroom shops have popped up across Bob Marley’s homeland. Likewise, psilocybin healing centers and retreats have been blooming across the island nation, attracting not only local residents, but also international travelers. As a result, Jamaica is quickly becoming an internationally renowned psychedelics tourist destination.

#2: The Bahamas

Staying in the Caribbean, in the Bahamas psilocybin mushrooms are also legal to grow and sell—though psilocybin itself is a controlled substance. And like in Jamaica, there have been psilocybin health and wellness retreats opening across the islands in recent years.

Going further, however, in the Bahamas not only do certain resorts offer psilocybin mushrooms-assisted healing, many also offer ibogaine treatment for addiction. And at least one also offers 5-MeO-DMT treatment!

Located only 50 miles from the Florida coast, the Bahamas are perfectly situated for curious American tourists who can’t wait until Oregon’s psilocybin centers open next year.

#1: Brazil

Brazil takes the cake in this listicle of countries where psychedelics are legal. While psilocybin mushrooms are basically legal in Brazil —though their sale remains almost entirely in the informal market— the fact that the Latin American giant has also legalized ayahuasca gives them the top rank.

Ayahuasca is a brew containing DMT that can cause a psychedelic experience lasting around 4 to 6 hours. Used traditionally by many native and Christian communities in the Amazon, ayahuasca retreats in Brazil have become so popular that people from across the world make the journey.

Honorable Mentions

There are many other countries that have at least in part legalized certain psychedelics. Special honorable mentions go to Nepal where psychedelic mushrooms are legal, though they are sold in informal markets; Mexico, where people can semi-legally attend ibogaine healing centers; Peru, who has also legalized ayahuasca; and Portugal, which has decriminalized all drugs.

Many recreational drugs known for mind-altering trips are being studied to treat depression, substance use and other disorders. Here’s what you need to know.

Oregon is legalizing mushrooms. Ketamine can be delivered to your home. People are microdosing LSD to treat pandemic-related anxiety and Wall Street is pouring billions into companies that sell mind-altering drugs. It seems like psychedelics — though mostly still illegal — are everywhere.

While the federal government does not recognize a medical use for most of these drugs and says they have potential for abuse, some of the most prominent universities in the world are studying four substances in particular: psilocybin, ketamine, MDMA and LSD. The bulk of available research suggests that these substances hold promise as part of larger treatment plans.

There is also growing evidence that psychedelic drugs operate differently in the brain than addictive drugs, and advocates have been consistently calling for legalization. But psychedelics remain expensive and difficult to gain access to legally, unless you are part of a research study for mental health purposes.

These drugs are not all the same and do come with risks. One quality they share is the ability to create an altered state of consciousness, commonly referred to as a trip. That effect can either provide a sense of perspective — or be downright terrifying.

“You’re not likely to overdose on them, but you can have life-changing negative experiences,” Katharine Neill Harris, a drug policy researcher at Rice University in Texas, said.

To avoid these experiences, while receiving the benefits these drugs can offer, people have started microdosing smaller amounts at regular intervals — but they are often doing so without professional guidance, and some remain uninformed about significant downsides with very little evidence of benefits.

Here’s what researchers are learning about the psychedelic drugs most prominently involved in mental health research.

Psilocybin

As the active chemical in magic mushrooms, or ’shrooms, psilocybin is the most studied of the psychedelic chemicals found in plants and fungi, and it’s the most likely to become an accepted mental health therapy soon. After last year’s legalization in Oregon, entrepreneurs began investing tens of millions in psilocybin research there, and other cities and states are following suit.

Potential mental health uses: Research conducted in the last decade suggests that psilocybin, typically taken in pill form, has the potential to treat substance use disorders, including alcoholism and nicotine addiction, as well as depression.

That research isn’t conclusive yet, said Paul Hutson, a professor at the University of Wisconsin-Madison who studies psilocybin and leads the school’s center for psychedelics research. But he anticipates there will soon be enough evidence for the Food and Drug Administration to approve psilocybin capsules to treat at least some of these disorders — most likely in the next five years or so.

In the meantime, clinical trials of psilocybin for a variety of conditions are taking place across the country, though they can be difficult to find or have long waiting lists. Still, it’s safer, Dr. Hutson said, to try psilocybin as part of a study than on your own or in one of the treatment clinics that have popped up. In these trials, patients attend appointments to prepare for and process their psychedelic trip with a professional in an environment where any side effects can be managed.

What it does: According to users who have participated in trials, a mushroom trip may induce euphoria and an increased awareness of parts of their environment. For instance, solid objects might seem to breathe in and out. A trip can last more than six hours, and some people describe a positive “afterglow” lasting for months.

Risks: Psilocybin can cause distressing hallucinations or feelings of panic and anxiety in some patients, especially at high doses. You can’t be guaranteed safety standards — having a trained professional who can reassure you, protect you and even administer drugs during a bad trip — in therapy outside of a research trial, Dr. Harris said.

One use of psilocybin, which should not be confused with standard treatment described above, is microdosing. By taking small doses — perhaps 10 percent of a standard dose — every few days, some people might experience mental health benefits without the high. But microdosing psilocybin can be harmful, and there is some evidence that it can damage the heart over time. Recent research also suggests that the positive impacts of microdosing in humans may be largely caused by the placebo effect.

Ketamine

First synthesized in 1956, ketamine, sometimes called Special K, is used today as an anesthetic by veterinarians and in emergency or combat medicine. Because it is the one psychedelic that’s never been illegal, researchers have been able to explore ketamine’s potential as a mental health treatment — and build a case for its use in humans.

Potential mental health uses: Many brain disorders — like schizophrenia, depression and anxiety — are characterized by atrophy in the prefrontal cortex. The evidence is strong, though not yet conclusive, that ketamine helps people with psychiatric disorders by promoting regrowth over time in neurons in this area. That could help explain the near-immediate feelings of relief that users report, which is one of the reasons it has been used in the treatment of suicidal patients.

Esketamine, a form of ketamine, showed such promise for treating major depression, often faster than other drugs, that the F.D.A. approved its limited use in early 2019.

What it does: Ketamine can create euphoria and provide a sense of detachment from reality. Users taking a low dose might feel as though they’re floating or that their body is numb. Higher doses can temporarily make people clumsy and forget where they are or even who they are. Blurred vision or hallucinations are common.

Ketamine works differently from other psychedelics. Most psychedelics — like LSD, MDMA and those derived from plants — operate by affecting serotonin receptors, which alter mood and happiness. Ketamine affects a different class of brain receptors that are important for learning and memory. Both kinds of receptors are found in the brain’s prefrontal cortex, which might explain why ketamine and the other psychedelics seem to have similar impacts on mental health.

“The prefrontal cortex is a brain region that’s really critical,” said David Olson, a chemistry professor at University of California, Davis, who studies chemicals that affect brain function. “It talks to a whole bunch of brain regions that regulate things like mood, emotion, fear, reward.”

Risks: Ketamine is also known for a specific and scary side effect nicknamed the “k-hole.” It’s rare in clinical settings, but users may feel disassociated from themselves and their surroundings and panic or feel paranoid.

LSD

“Turn on, tune in, drop out.” “Lucy in the Sky with Diamonds.” Silicon Valley microdosing. Suffice it to say, LSD, also known as acid, has a storied place in American popular culture.

Potential mental health uses: It’s shown promise for treating alcohol addiction and has been studied for other conditions like depression. As with psilocybin, some new LSD adherents microdose to achieve mental health benefits without the trip.

What it does: LSD users have reported feelings of bliss during their trip, being able to see sound and having mystical experiences as well as a sense of closeness with others.

Risks: Some people experience lasting psychological trauma caused by a bad trip, especially when they take higher doses or use LSD often.

Microdosing LSD may have physical risks, too. In a study on rats, microdosing LSD had the opposite effect of a trip; it made the rats display signs of psychiatric illness, like aggression and poor grooming. Similar to microdosing psilocybin, it may also strain the heart by overworking the neurons around the organ.

“If you’re constantly stimulating these neurons, even with a small dose of these compounds, the neurons just can’t take it,” Dr. Olson said.

MDMA

A well-known club drug, also known as ecstasy or molly, MDMA has been researched on and off for decades for potential mental health benefits. While the drug remains illegal, the F.D.A. allows its use in research and treatment for life-threatening illness.

Potential mental health uses: In 2010, results from a study on treatment-resistant PTSD renewed interest in MDMA research. Since then, it has also been explored as a treatment for other conditions like substance use disorder or social anxiety in autistic adults, although it has more potential to cause damage than some other psychedelics.

What it does: MDMA is often known by its street name — ecstasy — from the feeling of euphoria and connectedness it promotes in users.

Risks: MDMA can cause lasting kidney and organ damage as well as heart arrhythmias during a trip, especially in patients with related pre-existing conditions.

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Psychedelic drugs aren’t simple substances. More time and research will provide answers about their effects on the brain and whether it’s possible to use them for medical treatments. For now, Dr. Hutson cautioned that evidence supports psychedelic treatments only in cases where other forms of treatment haven’t worked.

“They’re not a panacea that everybody is going to respond to,” he said.

To the uninitiated, psilocybin—the substance that gives ‘magic mushrooms’ their psychedelic qualities—could be dismissed as a recreational drug. Like many other psychedelics, it is banned by the U.S. government as a Schedule 1 substance, meaning it supposedly has high potential for abuse and no currently accepted medical use in treatment. However, to many medical science researchers, psilocybin is much more: a promising treatment for a range of health issues. In particular, experts increasingly see the chemical as a potentially effective, low-risk tool to help patients break their dependencies on other substances. Given that more than 100,000 people died after overdosing on opioids and other drugs in the U.S. last year, it’s an understatement to say it’s urgent to find new, effective treatments for substance use disorder.

The research supporting psilocybin’s use in this context has been growing for a while now. One of the most recent such studies, published in Scientific Reports on April 7, looked at data from 214,505 U.S. adults in the National Survey on Drug Use and Health (NSDUH) from 2015 to 2019, and found an association between past use of psilocybin—at any time in their lives—and a reduced risk of opioid use disorder. The researchers looked at 11 criteria that scientists use to diagnose opioid use disorder (for instance, spending a significant amount of time getting and using drugs), and found that past psilocybin use was significantly correlated with lowered odds of seven of items on the list, and with marginally lowered odds of two others.

There’s a major caveat with this study: because it was looking at correlations, it didn’t find any definitive proof that psilocybin use in-and-of-itself reduces the risk of opioid use disorder. While the researchers controlled for things like educational attainment, annual household income, and age, there may be social or personal characteristics that make psilocybin users different from people who didn’t decide to use the drug, says Grant Jones, a graduate researcher at Harvard University who co-authored the study. “Maybe there’s different psychological profiles that make [some people] more immune to developing substance use disorders; we don’t know,” says Jones.

Nevertheless, the study adds to growing evidence that psilocybin is worth investigating as a treatment for substance use disorder. For example, a 2017 Johns Hopkins University pilot study, co-authored by Albert Garcia-Romeu, found that the majority of 15 participants were able to quit smoking for at least 16 months after receiving two to three moderate to high-level doses of psilocybin. A similar proof-of-concept study into alcohol use disorder in 2015, led by Michael Bogenschutz, a professor of psychiatry at New York University Grossman School of Medicine, found that abstinence among addicts increased significantly following the use of psilocybin. Observational studies, including Jones’ report and additional research from Garcia-Romeu, have also found that psilocybin is associated with a reduced risk of using substances like cocaine, marijuana, and opioids.

Read more: Inside Ibogaine, One of the Most Promising and Perilous Psychedelics for Addiction

Additional research has shown another potential therapeutic use of psilocybin: to assuage depression. For instance, a small randomized clinical trial published in JAMA Psychiatry in 2020 found that psilocybin-assisted therapy caused a rapid reduction in the symptoms of major depression symptoms, and that the effects remained statistically significant at least four weeks later. Another study, published this year in the Journal of Psychopharmacology, found that among a small group of participants with depression who received two doses of psilocybin with supportive therapy, 75% still had some response to the treatment, and that 58% were in complete remission from depression. In another study co-authored by Jones, published earlier this year in the Journal of Psychopharmacology, he and colleague Matthew K. Nock reviewed NSDUH data, and found that psilocybin use was associated with a reduced risk of major depressive episodes.

Despite all that, Jones acknowledges that there’s still a lot to learn about psychedelics. “The thing that always strikes me about psychedelic research is that even though there’s an immense amount of excitement, and a lot of attention, and a lot of a lot of financial support that’s flowing into the space, the actual body of literature is still very sparse,” Jones said. “I think we’re exploring the boundaries of the benefits of well-being.”

Why might psilocybin help treat addiction?

Several clinical trials focused on mental illnesses like depression have shown that psilocybin appears to boost patients’ moods, even weeks after taking the drug. Exactly how remains uncertain, but researchers have a few ideas. For example, psilocybin appears to increase the brain’s neuroplasticity—the ability for neural networks to shift and rewire. In a study published April 11 in Nature Medicine, for example, researchers found that psilocybin helped to broadly build more connections between different parts of the brain, while simultaneously reducing interactions between brain areas connected with depression—and, in terms of outcomes, psilocybin use seemed to reduce patients’ depressive symptoms. In research in both people and animals, psilocybin appears to make it easier to break out of habits and become more adaptive, says Bogenschutz. “It increases the capacity of the brain to change, and therefore for thinking and behavior to change.”

In addition, evidence from animal trials suggests psilocybin’s effect on mental wellbeing may be connected, in part, to its ability to reduce inflammation—an immune response in the body’s tissues to dangers ranging from stress to physical injuries, which researchers have found is associated with psychiatric disorders like depression.

Biological mechanisms aren’t the only reason scientists are excited about psilocybin and other psychedelics—there’s also the psychological experience of taking the drugs. “The types of experiences that people often have with these drugs can be highly meaningful, insightful, and also sometimes spiritual in nature,” says Garcia-Romeu. “When you ask them, those experiences are the reason that they’re making these better choices, and they’re making these behavioral changes.”

The unique advantages of psilocybin

Researchers point to two characteristics that make psilocybin an especially attractive potential treatment for mental health conditions. First, while it can trigger some dangerous side effects if not used in a controlled environment, it tends not to be addictive. Second, psilocybin can have long-lasting effects, which means people would only have to take it intermittently, putting them at a reduced risk from any side effects. “That’s a huge advantage in terms of safety…compared to taking a pill every day, and having that side effect profile follow you for months, possibly years, depending on how long you take it,” says Matthew Johnson, a professor in psychedelics and consciousness at Johns Hopkins University.

In many ways, research on psilocybin’s potential is still just beginning. Almost all psychedelic research in the U.S. came to an abrupt halt after the U.S. stepped up regulation of pharmaceutical research in the 1960s and criminalized the manufacturing and possession of psilocybin and other psychedelics. Scientists are still “reopening the books” on psychedelics to make up for decades of stalled research, says Garcia-Romeu. At this point, only a relatively few clinical trials have been published on psilocybin as a treatment for any type of substance use disorder, and many of those trials have involved a very small number of participants.

But the resulting evidence has been accumulating, and is generating an increasing amount of scientific attention on the possibilities of the drug—including, last fall, the first federal grant for studying a psychedelic treatment in 50 years, for a double-blind randomized trial looking into psilocybin as a smoking cessation tool. In Bogenschutz’s words, science has reached a “first tipping point where there’s now enough evidence [that] it’s really hard not to take the potential of psychedelics seriously.”

Read more: How COVID-19 Opened the Door to a New Era in Psychedelic Medicine

Scientists who study addiction science are anxiously awaiting the results of this, and other burgeoning research into the potential of psychedelics in their field. Substance use disorders are chronically undertreated, and few have highly effective treatment options. For example, only a minority of Americans with alcohol use disorder—the most common substance use disorder in the U.S.—receive treatment; a nationwide study conducted by the Washington University School of Medicine in St. Louis put the share of alcoholics getting the care they needed from 2015-2019 at only about 6%.

In Bogenschutz’s opinion, the psychology and physiology underlying addiction to any given substance has a lot in common with that driving addiction to other such dependencies. And that, he believes, is what makes psychedelics so promising a therapeutic for substance abuse—it seems, he says, to be a sort of panacea for addiction. “Something about psychedelic treatment of addiction that is exciting, is that the ways the mechanisms we hope it will work, are not really specific to any particular addiction,” he says. “[These drugs] could represent a therapeutic breakthrough for alcohol use disorder, other addictions, mood and anxiety disorders—a whole host of conditions.”