Daniel Rosenbaum and Daniel Z. Buchman draw attention to commercial involvement in psychedelic research and to the population health risks associated with this involvement.

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“The first wave of psychedelic research was disrupted by conflict between cultural and political forces. The current wave of psychedelic research could be susceptible to an emerging conflict between entrepreneurial enthusiasm and scientific deliberation.”

– Phelps, Shah and Liberman, 2022

Psychedelic therapies are enjoying a resurgence in mental health and substance use research. Until recently, however, public funding for psychedelic research and drug development was limited. Not only were psychedelics such as psilocybin and 3,4-methylenedioxymethamphetamine (MDMA) illegal in most jurisdictions, they were also perceived as a threat to social mores and institutions. Moreover, there was a general disinterest from the pharmaceutical industry in off-patent drugs. These challenges provided an opening for private actors to fund research involving psychedelics and to accelerate commercialization.

Photo credit: openclipart.org. Image Description: psychedelic image of pills.

Today there is enormous interest from investors, venture capitalists, and entrepreneurs in capitalizing on the potential of psychedelics to treat psychiatric illnesses such as depression, posttraumatic stress disorder (PTSD), alcohol use disorder, and others. Corporations that produce psychedelics or provide psychedelic therapy have emerged as a multi-billion dollar industry. This new industry appears to be following the Big Pharma model – that is, of bringing products to market that are prescribed and administered in healthcare settings – as opposed to the path of cannabis, another relatively new legalized industry in Canada and some US states, which has focused on broad retail availability. Anticipating therapeutic approvals by the FDA, EMA, and other regulatory agencies, psychedelic companies are engaging in rapacious patent-grabbing, attempting to secure patents ranging from synthetic formulations of psilocybin to the room and manner in which psilocybin is administered.

These trends are of ethical concern because similar practices in peer industries like the tobacco, food, alcohol, and pharmaceutical industries are known to contribute to health risks, threats to research integrity, and interference in policy-making. Such practices include lobbying to oppose regulatory controls that go against industry interests; sponsoring, conducting, and disseminating scientific research that generates evidence that is favourable to their products while suppressing or generating controversy about unfavourable research; and shifting research agendas in directions that may knowingly or unintentionally be harmful to public health. Indeed, scholars have identified how conflicts of interest are a public health issue. Together, these forces are referred to as the commercial determinants of health: “the conditions, actions and omissions by commercial actors that affect health.”

Matters relating to psychedelic industry-healthcare relationships have received some attention in alternative media, and some psychedelic non-profit organizations have produced guidelines focused on “ethical sponsorship and transparency” for psychedelic conferences. Within the psychedelics community, “a deep disappointment and anger” has been directed toward the activities of for-profit psychedelic companies and the lack of commitment to the principles of open science and open praxis called for and endorsed by many figures in the field. Other leading voices are less wary of industry involvement. Psychedelic medicine is already seeing for-profit interests engaging in practices related to financial sponsorship that are similar to their corporate peer industry counterparts. For example, there are reports that donor interests are shaping psychedelic research agendas at major academic centres. Non-profit philanthropic funding tends to influence research priorities based on numerous factors independent of disease burden – and often those of primary interest to the donor. Likewise, philanthrocapitalist donors apply market-based strategies to philanthropic goals to achieve a return on investment over the long term. This matters ethically as corporations and philanthrocapitalist donors developing or investing in products that can be commercialized can, through funding relationships, steer research agendas away from those that are in the primary interest of public health.

Because corporations have a legal duty to pursue profit for their shareholders, it is unsurprising that a recently or soon-to-be legalized industry like psychedelics – one that has generated considerable hype and a high, if volatile, market valuation – would engage in such activities. Some scholars advocate for healthcare professional-industry relationships as necessary to advance knowledge, maintain innovation and progress, and benefit society. But critics of these arguments point to the substantial empirical evidence on motivated reasoning (also called motivated bias) to underscore the pernicious influence of corporate sponsorship of research. These critics argue that a clinician or researcher who receives financial sponsorship from a corporate donor is likely to be emotionally motivated, consciously or unconsciously, to bias their advice in favour of the sponsor’s interest even when presented with evidence to the contrary.

As the field of psychedelics continues to develop in an environment of limited public funds for research, there is a major need for independent research to produce trustworthy evidence. Independent research would help develop a clear understanding of the safety and efficacy of psychedelic therapies. These issues pertaining to financial entanglements with industry suggest that there is still much work to do. There is substantial evidence of population health hazards due to industry influence. Our responses need to go beyond the individual (e.g., conflict of interest disclosures) and the institution, and instead need to address the issue through structural and systemic responses – that is, through policy and law. In the meantime, we join others in calls to increase public investment in psychedelic research in order to minimize financial dependence on corporate interests and the risks to individual and population health it can create.

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Daniel Rosenbaum is a Psychiatrist and Clinician Investigator at the University Health Network (UHN) in Toronto. He is a co-founder and faculty member at the UHN Psychedelic Psychotherapy Research Group, and a Lecturer at the University of Toronto.

Daniel Z Buchman is a Bioethicist and Scientist at the Centre for Addiction and Mental Health, and an Associate Professor at the University of Toronto. @DanielZBuchman