Beyond Medicalization: Psychedelic Therapy and the Promise of Community-Based Healing

Author’s note: For transparency, I am the co-founder of Elemental Psychedelics, a state-approved training center for psilocybin mushroom practitioners in Colorado. While my experience informs my perspective, this article is not intended to promote our organization but rather to critically examine the psychedelic movement through the lens of someone deeply involved in both research and practice.

I get it. Many readers might have a bad taste in their mouth for “throwing more drugs” at people. I myself have written at length about people’s lived experiences with the realities of antidepressant and antipsychotic drugs, the need for truth-telling about psychiatric medications, bias in clinical trial reporting of the harms of psychiatric medications, and the possibilities of peer-to-peer alternatives as pockets of hope and resistance to the mainstream psychiatric machinery.

Over the past 15 years, I have also closely observed the re-emergence of psychedelics in psychiatric, communal, and spiritual spaces, which I’ve found is often characterized by hype around psychedelics as a fast track to changing your mind. Taking all of this into consideration, the question for me has become: Do psychedelics represent something meaningfully different here? And the answer I have arrived at is yes, I sincerely hope that something meaningfully different is afoot. And at the same time no, nothing will be different if we don’t allow ourselves to also be changed by the possibilities psychedelics present.

Psychedelics can radically disrupt psychiatric practice as usual and rethink healing, connection, and relationality in the world. I believe the outcomes of psychedelic healing are what many MIA readers also want, but anti-drug sentiment and a very real history of psychiatric harms are big roadblocks to move through.

In November 2022, Colorado voters passed Proposition 122, the Natural Medicine Health Act, creating a first-of-its-kind framework for accessing certain psychedelic fungi and plants for healing purposes. Unlike other state models that narrowly medicalize access, Colorado established a broader community-based approach that honors multiple types of facilitation over strict clinical protocols and embraces ecological wisdom alongside scientific knowledge.

As implementation unfolds, we stand at a crossroads: Will this emerging field truly disrupt the problematic paradigms of conventional psychiatry, or will we replicate the same systems that have pathologized human suffering and reduced healing to a standardized consumer product?

Colorado’s Unique Approach to Psychedelic Policy

Colorado’s Natural Medicine Health Act creates a framework that fundamentally differs from the clinical trial models being pursued at the federal level with patentable, synthetic psilocybin molecules. While Oregon pioneered state-level psilocybin services for non-therapeutic uses and New Mexico’s legislature recently approved medicalized uses, Colorado’s approach goes further than any of these models. Colorado’s approach importantly emphasizes natural medicines in their fungal and plant forms rather than synthetic compounds and allows for multiple pathways for legal use. These distinctions matter deeply for reasons I’ll explore.

The framework centers on several key elements:

1. It emphasizes facilitation over medicalization. Rather than creating a strictly clinical model where only doctors or therapists can provide services, the Colorado model creates pathways for diverse facilitators trained in various traditions and backgrounds. This allows for ceremonial, spiritual, and community-based contexts rather than solely clinical ones.
2. It prioritizes decentralized access. Instead of consolidating services in medical institutions, the model allows for healing centers with different approaches and philosophies, creating a more pluralistic ecosystem where various cultural, spiritual, and therapeutic lineages can coexist.
3. It respects both scientific and traditional wisdom. While honoring evidence-based approaches, the framework acknowledges that indigenous and traditional knowledge about these medicines predates modern science and is equally valid.

Early implementation of the Natural Medicine Advisory Board has shown promising signs of embracing these principles, with stakeholder engagement from diverse communities and a commitment to equitable access. But powerful commercial interests are already pushing to reshape this model.

Commercial Interests and the Push for Synthetic Alternatives

As Colorado’s natural medicine framework takes shape, legislative efforts have emerged advancing synthetic alternatives to natural psilocybin mushrooms. House Bill 25-1063, approved in April 2025, represents one such effort, revealing the intersection of commercial interests, intellectual property concerns, and the pharmaceutical model’s influence on psychedelic policy.

I have concerns about the bill’s focus on isolated crystalline polymorph psilocybin, which follows a troubling pattern we’ve seen with cannabis, tobacco, and coca plants where extraction has led to unintended harms. While I understand the need for FDA approval processes and recognize that extracted forms of psilocybin may benefit those with specific physical health conditions, research indicates that isolated compounds may lack the full therapeutic potential found in whole mushrooms, which contain numerous beneficial compounds beyond psilocybin alone.

The bill’s narrow specification of crystalline polymorph psilocybin rather than psilocybin generally suggests specific commercial interests are at play and is reminiscent of how we once over-simplified THC’s role in cannabis. Using these medicines in an isolated, extractive way divorced from cultural and communal context risks creating unnecessary harms where therapeutic benefits could otherwise flourish.

This is how the same problematic paradigms get recreated. In order to sell psychiatric drugs, companies have to create markets and demand for drugs. So it’s not just over-prescription; it’s also the focus on individual pathology that makes drugs sellable. The difference with psychedelics—if we get it right—is greater attention to ecological and cultural context.

The push for synthetic compounds isn’t just about standardization or safety—it’s about ownership. Natural mushrooms cannot be patented, but synthetic compounds and delivery methods can be. This concentration of ownership contradicts the ethos of community access and shared knowledge that has characterized historical psychedelic use.

The Problems with Industrial-Scale Psychedelic Therapy

The current mainstream healthcare system operates on an industrial scale, treating human suffering as a technical problem to be fixed efficiently. When applied to psychedelic therapy, this approach threatens to strip these experiences of their transformative potential.

Several concerning trends have emerged:

• Clinical protocols increasingly standardize dosing, setting, and therapeutic frameworks, often ignoring the deeply personal and culturally-embedded nature of psychedelic experiences. This one-size-fits-all approach reflects the reductionist tendencies of conventional psychiatry.
• Like conventional psychiatric models, industrial-scale psychedelic therapy often locates problems within individuals rather than recognizing the social, cultural, and ecological contexts that contribute to suffering. This reinforces the narrative that “something is wrong with you” rather than acknowledging that many struggles are natural responses to unhealthy systems. Within the former narrative, drugs are designed to fix or force conformity. Under the latter, drugs can be used as tools to catalyze both individual and collective change.
• As investor capital pours into psychedelic companies, pressure mounts to scale services for maximum profitability. This creates incentives to efficiently administer preparation and integration sessions—the aspects most practitioners consider essential—while guaranteeing potential clients a fixed number of dosing sessions, which generate more revenue. This approach ignores the often slow pace of embodied healing that mushroom work can catalyze, treating psilocybin mushrooms as another targeted treatment technology that will repair your brain networks for you after just a few sessions. Within this, there is a failure to practice honest informed consent about what exactly therapeutic mushroom work entails for true and sustained change.
• Institutional and patriarchal models of power represent traditional psychiatry. We wrote a blog about women’s leadership in the psychedelic space as an essential part of doing power differently. Psychedelics move us to sharing power with our communities, holding humility for what remains unknown, and honoring the wisdom that is distributed across people and groups.

When psychedelic medicines enter these systems unchanged, they risk becoming tools that reinforce existing power structures rather than catalysts for genuine transformation. The true potential of psychedelic healing lies not just in new compounds but in new paradigms of healing.

Beyond the Psychiatric Paradigm

The conventional psychiatric paradigm has serious limitations that psychedelic approaches might help us transcend—but only if we’re willing to fundamentally reimagine mental health support.

Traditional psychiatry often:

• Reduces complex human experiences to diagnostic categories
• Treats symptoms while overlooking root causes
• Minimizes the importance of relationship and community
• Privileges narrowly defined expert knowledge over lived experience
• Separates the Western mind from body, spirit, and environment

These limitations have caused real harm. The overreliance on medication, lack of true informed consent in psychiatric practice, pathologization of trauma responses, gaslighting of people’s lived/living experiences, and enforcement of normative behavior have left many feeling dehumanized rather than healed. The stories shared on platforms like Mad in America attest to these harms.

Psychedelic experiences, when properly supported, offer different possibilities:

• Rather than diagnosing deficits, psychedelic experiences often foster reconnection—to self, others, nature, and a sense of meaning. This shift from pathology to connection is fundamental.
• Psychedelics can help us honor both scientific understanding and other ways of knowing—intuitive, somatic, spiritual, and ancestral. This integration challenges the supremacy of rational materialist approaches that dominate psychiatry.
• Many psychedelic experiences foster a deep sense of connection to the natural world, helping us recognize that human health cannot be separated from ecological health. Integrating such psychedelic experiences can move people toward truly altering their relationship to the natural world. This challenges the individualistic focus of conventional approaches.
• Rather than isolating treatment to the individual patient, community-based psychedelic frameworks recognize that healing happens in relationship. The container of community support becomes as important as the medicine itself. Psychedelics are not meant to be used indefinitely. With proper support and good integration, at some point we become the medicine through our actions and relationships in the world.

For these alternative approaches to flourish, we need frameworks that honor personal sovereignty, community wisdom, and traditional knowledge alongside scientific evidence. Colorado’s natural medicine model, despite its imperfections, creates space for these possibilities—if we can preserve its integrity as implementation proceeds.

Emerging Signs of Hope

Despite the significant challenges facing the psychedelic movement, I see promising developments that give me hope for truly transformative approaches to mental health and well-being.

Across Colorado, communities are organizing to create healing circles, peer support networks, and educational initiatives centered around psychedelic medicines. These grassroots efforts often emphasize reciprocity, accessibility, and genuine community engagement.

I’ve witnessed practitioners who prioritize deep preparation and integration work, creating containers for healing that respect the profound nature of these experiences. Many emphasize relationship-building, careful attention to set and setting, and ongoing community support that extends far beyond the acute psychedelic experience.

Indigenous leaders continue to advocate for recognition of their ancestral relationships with these medicines and for approaches that honor their knowledge and sovereignty. Their persistence reminds us that these substances have been used within cultural frameworks for millennia, not as isolated interventions but as elements of complex knowledge and healing traditions.

And within more conventional treatment settings, pioneering practitioners are finding ways to bring the insights of psychedelic work into their practice—emphasizing connection, somatic awareness, and trauma integration even when working within existing healthcare systems.

For Colorado’s natural medicine framework to fulfill its promise, we must maintain vigilance against co-optation by commercial interests while nurturing these emerging community-based approaches. This requires ongoing engagement from diverse stakeholders committed to preserving the spiritual and communal essence of psychedelic healing.

A Final Reflection

This journey requires holding a lot of paradox and sitting with both hope and despair as we witness the complex meeting of psychedelics and entheogens with the fullness of our humanity—the light and the dark of ourselves and the social and economic systems we have built. I try to hold it all, and when it gets to be too much, I choose hope, connection, and creation as my guiding lights forward.

The question remains open: Will psychedelics represent something meaningfully different from conventional psychiatric drugs, or will we recreate the same problematic paradigms and harm? The answer depends on our collective capacity to be changed by these medicines—to allow them to transform not just individual minds but our systems, relationships, and our ways of being in the world.