Working with Indigenous allies is the ethical way to develop psychedelic-based pharmaceuticals

Psychedelic medicine is having a moment of tremendous growth and innovation as researchers rediscover its potential mental health benefits. Although numerous biopharmaceutical companies are aiming to capitalize on these age-old therapies, many of them are leaving behind the Indigenous communities that pioneered the use of these medicines, have successfully used them for generations, and continue to have significant expertise in the area.

Research increasingly suggests that psychedelics may be able to help treat addiction, post-traumatic stress disorder, depression, and anxiety — to name just a few conditions — and that they may facilitate personal growth. In the United States alone, at the start of 2022, more than 50 publicly traded companies were focused on the development or administration of psychedelics. The U.S. market for psychedelics is already $2 billion and is projected to grow to $10.75 billion by 2027.

The timing isn’t coincidental. Society is emerging from a crippling pandemic, witnessing yet another international war, and grappling with major socioeconomic shifts. Despite the promise of psychedelic medicine to address the mental health challenges of this moment, the lessons of the past — most notoriously those learned from the development of opioid drugs, which promised to drastically ease pain without much thought to their potential repercussions for individuals and society — must not be forgotten. Biopharmaceutical companies working with psychedelics have a responsibility to do things differently.

One thing that must be “done differently” is including in the process — and financially rewarding — Indigenous peoples whose communities have been safely using for centuries many of the naturally occurring compounds on which new psychedelic medicines are based. This is an ethical imperative, because the collective awareness of the potential of these substances comes directly from these communities.

To be sure, modern scientific research is important for developing psychedelics as medicines. But so is information from ancient cultures that have mastered these medicines at scale.

Psychedelics are largely unfamiliar to western cultures, but they aren’t new to medicine. Eurasian shamans in ancient Siberia, the ancient Greeks and Egyptians, and the Mayans all used some form of naturally occurring psychedelics. The earliest archeological evidence of humans using mescaline dates to 5700 BC and, over the centuries, the Aztecs, Plains Indians, and others have used mescaline in healing ceremonies and rituals.

Indigenous communities already understand psychedelic technologies and have varying viewpoints on current trends in the biopharmaceutical industry. The best approach is to consult those that have done so successfully for thousands of years on how to best use these medicines today.

Researchers and companies working on psychedelic medicines do not need to reinvent the wheel. Instead, they can and should engage with Indigenous communities. I believe that the most rigorous, data-informed, and thus safest way to develop psychedelic therapeutics is to embody an inclusive — rather than an extractive — model of development. Doing so requires adopting ethical governance structures in which companies share the earned benefits with Indigenous communities while those communities share their knowledge on how to safely administer these substances.

I founded Journey Colab in 2020 with this goal in mind. My colleagues and I are developing a portfolio of synthetic psychedelic therapies to treat addiction, beginning with a synthetic form of mescaline to treat alcohol use disorder. Alcohol-related deaths have increased since the onset of the pandemic. Moreover, while at least 14.5 million Americans live with alcohol use disorder, only about 7% receive lasting benefits from currently available treatments. This shockingly low success rate must change.

Mescaline, a naturally occurring psychedelic, targets serotonergic receptors in the brain. These receptors influence anxiety, memory, mood, sleep, and other biological and neurological processes. Influencing these receptors can have a therapeutic impact on people living with alcohol use disorder. Research suggests that synthetic mescaline may be able to safely and reliably create a period of targeted neuroplasticity — a “window of change” — in the human brain, enabling an individual to open their mind to the concept of behavioral change.

Mescaline is more tolerable and longer acting than other substances that have been explored to treat alcohol addiction. That’s a powerful benefit, since animal models show that longer-acting compounds may offer longer-lasting benefits. These benefits, in addition to mescaline’s historic use in Indigenous communities, make synthetic mescaline a unique tool in the psychedelic therapy toolbox and an important psychedelic to bring to the market.

Before establishing Journey Colab, my colleagues and I approached several U.S.-based Indigenous communities with an inclusive governance model in mind. We were determined to include Indigenous leaders and scientists in various elements of our work to learn how they successfully integrate mescaline into their communities. In return, those communities will share in the value generated by Journey Colab through the Journey Reciprocity Trust. Under this arrangement, 10% of Journey’s founding equity — stock issued to founding members of a company — is permanently dedicated to the trust, to be used for the benefit of Indigenous communities that have traditionally used psychedelic medicines, as well as for groups working on the conservation of naturally occurring psychedelics and those working to increase equitable access to mental health care. The trust places these communities on the same plane as founders, early employees, and investors.

This collaboration with Indigenous communities is integral to Journey’s business model and future success in helping people overcome addiction.

One concept that Indigenous leaders have shared with us is a healing economy, one in which community members and other stakeholders support one another with effective tools rather than simply siphoning profits away from communities.

Medications alone do not work to treat addiction. That is why I and others believe that combining psychedelics, therapy, and community is needed to have long-lasting effects. The synthetic psychedelics under development today will eventually be administered by licensed providers in community facilities operated by locals who understand the needs of the people they are serving.

Concerns about patenting psychedelic treatments are valid, especially when these efforts are backed by large pharmaceutical corporations like those that led us into the opioid crisis. But there is a safe and ethical way to bring these important treatments to the market: informing innovation with traditional wisdom.

Companies with strong corporate governance models that are rooted in diversity and inclusion can avoid deceptive marketing tactics and the exclusionary, profit-at-all costs mentality that all too often leads to the overprescription of drugs. Psychedelics can avoid the dark path that opioids took by hewing to a more ethical and innovative future.

To date, only Indigenous communities have been able to responsibly scale up psychedelic technologies. Working alongside them and including them in governance structures is the right way forward for companies in this sphere, enabling them to not only make more ethical decisions, but safer ones.

Jeeshan Chowdhury, a physician-scientist who is trained in psychedelic-assisted therapy, is the founder and CEO of Journey Colab.