Clinical investigators anticipate that psychedelic medicine, including MDMA and psilocybin, could eventually fit into routine clinical care and may even improve it, despite distinct challenges. These treatments differ from existing ones in drug effects, treatment models, and broader goals. Key translational challenges include uncertainty about the role of psychotherapy, high treatment costs and scalability issues, and the effects of hype and stigma on clinical uptake. The findings are based on interviews with 21 investigators at major academic psychedelic research centers across the United States.
Telehealth platforms expanded access to mental health care during the COVID-19 pandemic, including online prescribing of ketamine for off-label psychiatric use. A wrongful death lawsuit against a telehealth ketamine provider illustrates how combining off-label prescribing with on-demand delivery can weaken clinical safeguards. With limited oversight of many telehealth platforms and the drugs they prescribe, responsibility for patient safety falls heavily on clinicians. To sustain responsible care, structures must support robust clinical relationships, monitoring, and accountability.