Bio-Psycho-Spiritual Perspectives on Psychedelics: Clinical and Ethical Implications

Psychedelics are again being studied for their traditional uses, medical applications, and social implications. As evidence for their clinical potential grows, researchers seek mechanisms explaining psychedelic effects and therapeutic efficacy. This paper reviews three frameworks—neurobiological, psychological, and spiritual—for understanding these effects and explores their implications for ethics and professional competencies in psychedelic medicine. The authors suggest interdisciplinary education to improve communication, develop multi-level models, and foster collaboration. They caution against overemphasizing neuro-mechanisms, risks from inducing vulnerable states, and challenges integrating spiritual frameworks. Developing new models that reflect emerging knowledge is a central goal for psychedelic science.

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Abstract

ABSTRACT:Psychedelics have again become a subject of widespread interest, owing to the reinvigoration of research into their traditional uses, possible medical applications, and social implications. As evidence for psychedelics' clinical potential mounts, the field has increasingly focused on searching for mechanisms to explain the effects of psychedelics and therapeutic efficacy of psychedelic-assisted therapy (PAT). This paper reviews three general frameworks that encompass several prominent models for understanding psychedelics' effects—specifically, neurobiological, psychological, and spiritual frameworks. Following our review, the implications of each framework for ethics and professional competencies in the implementation of psychedelics as medicines are explored. We suggest that interdisciplinary education may be necessary to improve communication between researchers, develop models that effectively incorporate multiple levels of analysis, and facilitate collaboration between professionals with diverse backgrounds in the implementation of psychedelic medicines. We also address pitfalls associated with overemphasis on neuro-mechanisms, risks associated with instigating vulnerable states of consciousness, and hurdles associated with the integration of spiritual frameworks in medicine. Ultimately, as psychedelics push the boundaries of explanatory frameworks focused on one level of analysis, developing new and more useful models to reflect knowledge being produced in this field should be a central aim of psychedelic science going forward.