Your Questions About Psychedelics

Psychedelic drugs have won over some surprising converts. Scientists say they can treat a range of psychological ailments. Tech titans swear by them. Hollywood stars praise microdosing. Rick Perry — a onetime Texas governor and Trump official — is now an unlikely champion.

In a recent newsletter, we asked for your questions about psychedelic drugs. You wondered about ailments they can treat, the dangers of using them and where you can get some. Today, The Times’s expert beat reporters answer. (Got a question for us? Submit it here.)

Science and health

Andrew Jacobs, who covers psychedelic medicine for the Science desk, answers these questions.

I’ve read about so many compounds — psilocybin, LSD, ayahuasca, ketamine, MDMA, ibogaine. Which ones are used in psychedelic therapy, and why? Laura Wilcox, Arlington, Mass.

Many mind-altering drugs have shown promise for conditions like depression, anorexia and post-traumatic stress disorder. Some, like the anesthetic ketamine, are not considered classic psychedelics but are often lumped together with other drugs that shape perceptions of reality. Here’s a quick primer:

• Psilocybin, LSD and ayahuasca are classic psychedelics, or serotonergic hallucinogens, because they act via serotonin receptors to produce vivid perceptual changes and mystical-type experiences.

• MDMA, commonly known as Ecstasy or Molly, is an empathogen — a drug that fosters feelings of empathy, openness and connection to others. It increases the release of neurotransmitters like serotonin, dopamine and norepinephrine.

• Ibogaine, which induces a dreamlike state, is harder to classify and is best used under strict supervision. It has been associated with fatal heart arrhythmias.

Are psychedelics a possible cure for dementia or cognitive decline? Ginger Gillison Schlather, Washington, D.C.

The research is in its infancy. Investigators are especially interested in the drugs’ effects on neuroplasticity, mood and neuroinflammation — a key driver of Alzheimer’s disease. One study is looking at whether psilocybin can reduce depression and improve the quality of life for people with early-stage Alzheimer’s.

What can these drugs treat? Do they have a different effect on people with mental health disorders? Vee Crichton-Hill, St. Paul, Minn.

There are scores of psychedelic studies underway on end-of-life anxiety, depression, traumatic brain injury, obsessive compulsive disorder and others. Only ketamine can be legally used “off label” for treatment-resistant depression. MDMA may win approval to treat PTSD, and a psilocybin-like compound may win approval for severe depression. People with personality disorders have generally been excluded from trials because researchers worry they could react badly.

What are the risks? Jay Cantwell, Providence, Utah

Most psychedelics have a low risk profile when taken at standard doses in supervised settings. But there are short-term psychological risks, including anxiety, paranoia and confusion, that can be brought on by an especially intense experience. (Read below for more on “bad trips.”) There is less data on the long-term risks, but there have been rare cases of long-lasting paranoia, mood disturbances and hallucinations — symptoms that mirror schizophrenia.

To what extent are large pharmaceutical companies investing in this treatment? Emily Miller, Traverse City, Mich.

Today, most compounds are made by start-ups and small, independent players. As the government signs off on more uses, though, the big drugmakers will likely muscle in; a $3 billion marketplace now is expected to be worth $8 billion by 2032. But there are limitations: Many drugs can’t be patented because, like psilocybin mushrooms, they occur naturally. Others, like LSD, are old and have exceeded patent protection. Pharmaceutical companies may try to qualify for new patents by tweaking an existing drug’s molecular makeup or delivery method.

Law and culture

Ernesto Londoño covers drug use and policy for The Times and wrote “Trippy: The Peril and Promise of Medicinal Psychedelics,” which came out last year. He answers these questions.

Do we know how many Americans use psychedelics and what age groups they belong to? Helen Young, Massachusetts

It’s rising, especially among young adults. Last year, nearly t10 percent of people between the ages of 19 and 30 reported having used psychedelics in the past year, an all-time high. (Pun kind of intended.) More than 5 percent of older people said the same, a fivefold increase from 2019.

I recall hearing stories in my youth about people who became “stuck” on trips, sometimes taking a single dose and winding up committed to an institution. Does this actually happen, and how often? Jeff Feiler, Florence, N.J.

“Bad trips” take many forms. On rare occasions, people can experience distorted perception and struggle to perform certain tasks for days or even months. This phenomenon is called hallucinogen persisting perception disorder, and scientists don’t understand what causes it. (One example: An off-duty Alaska Airlines pilot had a breakdown during a flight in 2023 after taking mushrooms and tried to crash a plane.) More common bad trips involve revisiting traumatic memories, feeling deep grief or experiencing fear similar to a nightmare.

Is there a way to avoid a bad trip? Laura Knispel, Des Moines

There are steps people can take to make these experiences safer and less likely to induce panic. For starters, having someone sit with you — an experienced, ethical guide — can make a huge difference. Unfortunately, hucksters abound. Also, be mindful about dosing: Start small, particularly if you’re prone to anxiety. You can buy testing kits online to ensure you haven’t been sold a counterfeit. But there’s no guarantee of avoiding a bad trip, I’m afraid.

Where are psychedelics legal for mental health treatment, and how are the different states regulating them? Jane Tippet, Manhattan, Kan.

Ketamine psychotherapy is the most accessible. Clinicians in the United States offer it aboveboard, but there are risks for addiction and bladder damage. Oregon and Colorado allow the use of psilocybin mushrooms in a controlled setting, under the care of a licensed sitter. New Mexico is launching a similar program soon, and lawmakers elsewhere are watching. But under federal law, producing, selling or using compounds like psychoactive mushrooms, ayahuasca, LSD and peyote remains a serious crime.

How do you gain access to these spiritual/medical interventions without leaving the country or running afoul of the law? Alex Carswell, Pasadena, Calif.

The Drug Enforcement Administration grants a handful of groups permission to import and administer psychedelics under religious freedom laws. The Native American Church got special dispensation in the 1980s for its religious use of peyote. Eventually, the Drug Enforcement Administration granted exemptions to churches in Oregon, Arizona and Washington state that consider ayahuasca — a potent Amazonian brew that contains DMT — a sacrament. In recent years, many psychedelic enthusiasts who had operated underground have begun offering retreats and ceremonies after registering as churches. The legality of these groups is murky.

THE LATEST NEWS

Middle East

• Israeli troops have already reached the outskirts of Gaza City. Palestinians there are considering whether to uproot themselves once again.

• Israel’s newly approved settlement project is in one of the most sensitive areas of the occupied West Bank, just east of Jerusalem. It’s been discussed and delayed for decades.

• With these new settlements, Israel’s hard-line finance minister said that the idea of a Palestinian state was “being erased from the table.”

Trump Administration

• President Trump demanded that a Federal Reserve governor resign immediately, citing unconfirmed allegations of mortgage fraud.

• Trump’s recent words and actions have revealed what he sees as an ideal picture of America, in which diversity is taboo and people of color must set their grievances aside, Zolan Kanno-Youngs writes.

• Uganda has reached a deal with the administration to accept migrants deported from the U.S.

• Almost as soon as Michael Boulos proposed to Trump’s daughter Tiffany in 2021, he and his family started benefiting financially, a Times investigation found.

More on Politics

• New York City’s mayor, Eric Adams, suspended a close adviser from his re-election campaign after she gave a journalist cash tucked inside a potato chip bag.

• A federal judge blocked a Texas law that would require the Ten Commandments to be displayed in every public school classroom.

War in Ukraine

• Under a deal with Russia, the bodies of thousands of fallen Ukrainian soldiers are arriving at a railway station in southern Ukraine. Forensic teams are working to identify them.

• Trump assigned Marco Rubio, the secretary of state, the especially tricky job of negotiating Ukrainian security guarantees with Europe. Rubio will meet with European officials today.

• Russia’s top diplomat said it would insist on being part of any guarantees. Europeans and Ukrainians say that’s absurd.

• Your pick: In the most clicked link in The Morning yesterday, Maggie Haberman explains how Trump has been engaging with Russia and Ukraine. Watch the video here.

More International News

In late May, Stephen Miller, Trump’s immigration policy adviser, ordered ICE leaders to increase arrests. They did so largely by broadening their focus beyond immigrants with a criminal record, a Times analysis found. See more charts that show how the summer surge in arrests led to a new high in deportations.

OPINIONS

People deserve the right to force tech companies to take down deepfakes of themselves, Senator Amy Klobuchar writes.

Origami: Beautiful new folding patterns could help build structures in space.

Stranded: An American hiker survived a week in the Norwegian wildernesswith no food, no water and a broken leg. He told The Times how.

Tech visionary: Warren Brodey, who has died at 101, helped lay the groundwork for A.I. with his ideas about the liberating possibilities of technology. His life’s many unexpected turns included work on C.I.A.-funded studies on extrasensory perception.

SPORTS

M.L.B.: The Yankees drafted a college shortstop, Core Jackson, who admitted that he had drawn a swastika on a Jewish student’s door while drunk. Jackson called his action a “really stupid mistake.”

W.N.B.A.: Paige Bueckers tied the rookie single-game scoring record with 44 points during the Dallas Wings’ narrow loss to the Los Angeles Sparks.

A WHITE-ONLY ENCLAVE

When Debra Kamin, a Times real estate reporter, first reached out to Eric Orwoll, a founder of an Arkansas housing development that admits only white, heterosexual people, he asked a question we hear from a lot of sources: Why should I talk to you? “I responded with the truth,” Debra told me. Orwoll is part of a growing movement in America, she said to him. Her goal was to help readers understand a phenomenon that may be unfamiliar to them.

“I treated him like a human,” she said. “He invited me in.”

Readers look to The Times to take them into worlds they don’t know or may not even want to think about. That kind of reporting requires talking to people — all kinds of people — and getting them to open up. The easy thing for Debra would have been to focus on the shock value of a racist all-white community. But the more urgent issue for readers, she concluded, was what this community could mean for the fair-housing laws that have defined real estate for more than half a century.

“There was no need to sensationalize or dilute anything,” she told me. “The community members I met all spoke openly about their views on white people and their plans for their segregated community.”

Her story is one of our most-read articles this week, and more than 1,000 readers posted comments on it — including Orwoll, who jumped in to share more of his thinking. Many readers sharply disagreed with his views, but, as Debra hoped, they also engaged in a compelling conversation about the law, race and American society. — Patrick Healy, a Times assistant managing editor for trust

More on culture

• Faced with a maze of apps, payments and passwords, people are increasingly signing up for their streaming services through a single provider.

• Can you match popular novels to the vacation spots where they’re set? Take a quiz.

THE MORNING RECOMMENDS …

Cook Pierre Franey’s turkey chili, which has over 20,000 ratings.

Snack on a kiwi. (They’re loaded with nutrients.)