Overcoming Perception Barriers and Promoting Safe Access to Psychedelics

In part 1 of this exclusive Q&A, Cape Cod Symposium faculty members Raghu Appasani, MD, PC, Gaetano Vaccaro, PhD, CSAT, and Kaci Hohmann, JD, discuss the barriers and opportunities of psychedelic therapy in conventional psychiatric medicine and addiction recovery. They offer insight into the potential benefits, ethical considerations, and the evolving perceptions and impact of psychedelic therapy.

Part 2 of this Q&A dives even deeper into some of the key topics from their session, including the most promising therapeutic benefits of psychedelics, how psychedelics function as adjunctive therapies, and the key legal challenges and considerations.

Dr Appasani, Dr Vaccaro, and Hohmann presented their session, "Psychedelics—Ethical Concerns and Efficacy for Modern Psychiatry," Thursday evening at the Symposium in Cape Cod, Massachusetts, with moderator Cherlyne Short-Majors, PhD.

For more coverage on the 2024 Cape Cod Symposium on Addictive Disorders, visit the newsroom. 

Editor’s note: This interview has been edited for length and clarity.

Meagan Thistle, Senior Managing Editor of PBHLN: Given the controversial nature of psychedelic therapy, what do you believe are the most significant barriers to its acceptance within mainstream medicine and society? How can these barriers be addressed?

Raghu Appasani, MD, PC: While psychedelics hold considerable promise for a range of therapeutic applications, they are not a universal remedy. Their use should be carefully considered and guided by professional medical advice, particularly for individuals with preexisting mental health conditions or those on specific medications. The current research is promising, but ongoing studies and clinical trials will continue to refine our understanding of who can benefit most and under what conditions.

Typically, I do not recommend the use of psychedelics in those with a personal or family history of psychosis or severe mood disorders, uncontrolled medical conditions, pregnant or breastfeeding individuals, those with personality disorders, and those on certain medications that may interact negatively.

Gaetano Vaccaro, PhD, CSAT: The repurposing of psychedelic substances for therapeutic use is not a new concept, but it is a rapidly emerging field within conventional medicine and addiction recovery.  Therefore, it is vital that therapists and medical providers educate themselves and their patients on the appropriate, effective, and safe use of these substances, based on the best and most current research. Mental health and medical providers often do not engage in conversations with patients about psychedelic treatments, and patients are not usually forthcoming about what they are doing for fear of being judged or rejected by providers.

This creates a dangerous environment of secrecy and duplicity that can result in medical complications, injuries, and fatalities. For this reason, I feel it is vital for therapists and psychiatrists to have open and honest conversations with patients about the types of adjunctive treatment they are accessing and for providers to share information and guidance with each other about the ethical and most beneficial use of all adjunctive therapies.

Kaci Hohmann, JD: I always come back to one thing when asked this question: education. Psychedelic drugs have long been stigmatized in Western culture. Reframing the conversations around these substances to center evidence-based science and research is an important component of developing a better general understanding of the relative safety and efficacy of psychedelic treatment.

Public perception of psychedelics has already undergone a significant shift in the past decade, and when public perception shifts, that is often the impetus for significant change. I would just caution that taking things one step at a time and ensuring people are well-educated on this topic will likely result in more safe access and effective outcomes.

CONTINUE TO PART 2>>

Raghu Appasani, MD, PC, is an Integrative & Addiction psychiatrist, psychotherapist, impact media producer, entrepreneur, and author who combines psychotherapy, pharmacology, nutrition, and holistic methods to provide personalized care. Dr. Appasani is also a neuroscientist, exploring the clinical applications of non-ordinary states of consciousness and delving into the human experience, and is a clinical professor at UCSF and Mount Sinai New York. He founded The MINDS Foundation, a mental health NGO in India, and serves as the CEO at PYM Health. He is currently launching a new venture, Rooted, focused on helping families build healthier relationships with technology. He is also the Program Director of Nutrition/Youth/Metabolic Mental Health & Psychedelics at the California Institute for Stress & Resilience.

Gaetano Vaccaro, PhD, is a Licensed Clinical Psychologist and Certified Sex Addiction Therapist (CSAT), as well as an expert in Organizational Psychology and Optimal Performance. Dr Vaccaro is the creator of RISC-Relationships, Intimacy and Sexual Compulsivity - a multi-modal treatment program for substance abuse, sexual compulsivity, and process addictions, workshop facilitator for SOAR- Survivors of Abuse in Recovery – for survivors of sexual trauma.
Dr Vaccaro is currently the National Clinical Advisor with Constellation Behavioral Health for Alta Mira Recovery Program and Bridges to Recovery in Beverly Hills, CA. Dr Vaccaro previously served as Clinical Director for the Sexual Addiction Program at Blue Tiger Recovery; Clinical Director at The Meadows - Gay Men’s Institute in Palm Springs; Interim Executive Director at Alta Mira Recovery Programs in Sausalito; Program Director and Clinical Director at Moonview Sanctuary in Santa Monica. Dr Vaccaro began his Clinical career at the LAGLC Jeffrey Goodman Clinic in Los Angeles and is currently in private practice in Palm Springs.

Kaci Hohmann, JD, is a business attorney at Emerge Law Group, headquartered in Portland, Oregon. She is licensed to practice law in Oregon, Colorado, and New Jersey. Kaci has extensive experience advising clients on a variety of business-related matters in cannabis, psychedelics, and traditional markets. She was a member of the drafting team for Oregon Measure 109, which legalized psilocybin services in Oregon. Kaci is co-chair of Emerge Law Group’s psychedelics practice group and chair of the Oregon State Bar’s Cannabis and Psychedelics Law Section.