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Review

Regulatory Challenges of Integrating Psychedelics into Mental Health Sector

by
Kerem Kemal Soylemez
*,
Emma Marie de Boo
and
Joanne Lusher
*
Department of Psychology, Regent’s University London, London NW1 4NS, UK
*
Authors to whom correspondence should be addressed.
Psychoactives 2025, 4(2), 11; https://doi.org/10.3390/psychoactives4020011
Submission received: 27 March 2025 / Revised: 18 April 2025 / Accepted: 22 April 2025 / Published: 22 April 2025
Versions Notes

Abstract

:
Psychedelic substances have recently emerged as a promising method for treating mental health conditions, despite a history of stigmatization and restriction in use. The present review synthesizes existing literature on the therapeutic potential of psychedelics such as LSD, psilocybin, and MDMA in addressing specific mental health conditions like depression, anxiety, and addiction. On reviewing the existing literature, it became apparent that when administered in controlled settings with psychological support, psychedelics can induce profound psychological insights, leading to long-lasting and positive changes in mood, cognition, and behaviour. This review discusses the ethical, social, and regulatory challenges linked to using psychedelics within the mental health sector across different countries, and how these might influence societal beliefs towards their efficacy and use. Further research would be beneficial for eliciting a deeper understanding of the use of psychedelics in the field of mental health, leading to the development of standardized administration protocols and a thorough appreciation of societal implications and long-term outcomes. This review discusses the potential for psychedelics to revolutionize mental health treatment while underlining the urgent need for rigorous scientific inquiry on this topic and the ethical considerations surrounding the use of psychedelics for therapeutic purposes.

1. Introduction

Psychedelic substances have a long and complex history, from their sacred use in indigenous rituals to their stigmatization and prohibition in the mid-20th century [1]. Once considered dangerous and illicit, substances such as LSD, psilocybin, and MDMA are now experiencing a resurgence as promising therapeutic tools for mental health conditions [2,3]. Research has highlighted their potential in treating mental disorders including depression, anxiety, and PTSD [3,4]. Moreover, the therapeutic potential of psychedelics is now being discussed extensively in the media [5,6,7], which further emphasizes the importance of reviewing this current topic. Even though substances such as MDMA are not considered as classic psychedelic substances, the present review includes them due to their common use in mental health treatment. This review therefore aims to synthesize the existing literature on the therapeutic applications of psychedelics, exploring their efficacy, safety, and the regulatory landscapes shaping their use in modern psychology and psychiatry.

2. A Brief History of Psychedelics and Mental Health

Psychedelics have been used by humans for centuries, particularly in indigenous traditions. In regions like Peru, ayahuasca, a plant-based psychedelic, has been used in shamanic healing ceremonies for generations [8]. The modern era of psychedelics began in 1938 when Swiss chemist Albert Hofmann accidentally synthesized LSD while working at Sandoz Laboratories. In 1943, he inadvertently ingested a small amount, leading to the discovery of its powerful psychoactive effects [9]. This accidental creation dramatically changed the use of psychedelics among the wider public [10]. During the 1950s, psychedelics were studied for their psychiatric benefits, with research suggesting their potential to treat depression, addiction, and other mental disorders. However, as their recreational use became widespread in the 1960s, a political and social backlash led to increasing restrictions. By the 1970s and 1980s, governments around the world classified psychedelics as illegal substances, effectively halting scientific exploration for decades. Since then, psychedelics have remained illegal in most places globally, with only limited exceptions for indigenous or religious use [1].

3. The Impact of Set and Setting in Psychedelic Experiences

The effects of psychedelics are highly variable and are significantly influenced by the concepts of set and setting [11]. This variability is therefore essential to understand in therapeutic application. Set refers to the internal mindset of the individual, while setting refers to the external environment in which the psychedelic experience takes place [12]. Psychological factors such as expectations, prior experiences, emotional state, and personality traits play a crucial role in shaping the nature of the experience [13]. In a paper on predicting reactions to psychedelic drugs, Aday [14] writes that individuals with high levels of openness and suggestibility may be more likely to report profound mystical or transformative experiences, which have been correlated with positive therapeutic outcomes. He also highlights the contrary finding that those with high levels of anxiety or unresolved trauma may be more prone to challenging experiences, commonly referred to as bad trips [15]. These experiences can be distressing but may also provide opportunities for emotional breakthroughs when properly integrated into therapy [16].
As Golden and colleagues [17] write, the external environment, including the physical surroundings, social context, and the presence of trained facilitators or therapists, also have a profound impact on the psychedelic experience. Clinical trials emphasize the importance of a calm, comfortable, and aesthetically soothing setting, often incorporating music [18], soft lighting, and supportive guidance to help patients navigate their experience [19]. Barber and colleagues [20] suggest that a well-structured setting can help reduce anxiety, enhance introspection, and promote positive outcomes, whereas an unpredictable or hostile environment may increase the risk of paranoia and negative emotional responses.
The therapeutic framework within which psychedelics are administered, whether it be structured psychotherapy, an indigenous ceremonial setting, or casual recreational use, can significantly shape the meaning of the experience [21]. These factors highlight the importance of careful preparation and post-session integration in maximizing the benefits of psychedelic-assisted therapy [22]. Individuals should be able to process and apply insights gained during their altered states of consciousness in meaningful and constructive ways.

4. Re-Emergence of Psychedelics in Mental Health Treatment Across Countries

While some countries remain strict in prohibiting psychedelics, others are at the forefront of integrating them into mental health treatment [23]. Switzerland has been conducting clinical trials using LSD and psilocybin [24]. Some of these trials have sought to treat patients with life-threatening diseases, demonstrating their potential for easing psychological distress in palliative care [25,26]. Table 1 presents a list of the countries and their status on legalization towards the use of psychedelics.
The United States has begun approving clinical trials, with the FDA granting breakthrough therapy designation to psilocybin and MDMA for depression and PTSD, respectively [27]. Similarly, Australia has recently authorized the use of psilocybin and MDMA for specific psychiatric conditions under regulated settings [28]. As Nutt explains, Australia’s approval of psilocybin and MDMA for clinical use reflects a pragmatic approach, driven by the need for innovative mental health treatments. Clinical trials conducted over the past 60 years show that both drugs are highly effective with minimal risks in medical settings, while the reality of widespread self-medication highlight the importance of regulated access [29]. Australia’s decision sets a precedent for global psychedelic drug development, and Nutt goes on to highlight that real-world data from Australian patients could support further expansion, especially if the FDA rejects similar applications.
Meanwhile, Portugal and the Netherlands maintain more lenient policies, allowing controlled use of certain psychedelics [30]. In contrast, many countries still enforce strict bans, limiting research and safe access. In the UK, psychedelic substances are still very much controlled, says the founder of Hystelica, a UK-based team of researchers investigating psychedelics and their effects on female biology. While there have been attempts to allow access to psilocybin for therapeutic relief in end-of-life cancer patients and military veterans [31], the UK government has so far denied any reviews or changes. The global landscape of psychedelic therapy continues to evolve, reflecting both cultural attitudes and scientific advancements in understanding these substances’ potential [32].
Whilst the re-emergence of psychedelics in mental health treatment is slow and fragmented, it is gradually moving towards legalization in some regions. Nutt [33] discusses this stagnation, arguing that unlike other medical fields that have advanced with disorder-specific treatments, psychiatric medicine has seen little innovation since the 1970s, relying on outdated drugs despite significant progress and investment in neuroscience. This lack of progress has fuelled a demand for alternative treatments like psychedelics, which are showing promise in treating depression, PTSD, and anxiety. However, regulatory frameworks and political resistance continue to impede broader access and research, leaving many patients without potentially life-changing therapies.

5. Perceptions of the Use of Psychedelics

Despite growing scientific interest, public perceptions of psychedelics remain polarized [34]. While some individuals view them as groundbreaking treatments, others still associate them with their illicit past. A 2025 qualitative study by Soylemez and colleagues explored the attitudes of individuals with no prior experience with psychedelics, revealing key themes that shape public perception. These included concerns over loss of control, the necessity of professional oversight, and the influence of generational and cultural differences. While younger individuals and those from more liberal cultural backgrounds demonstrated greater openness to psychedelics, many participants emphasized the importance of integrating these substances into structured, medical settings to ensure safety [35].
The stigma surrounding psychedelics continues to affect regulatory decisions and the willingness of individuals to engage with psychedelic-assisted therapy [36,37]. There remains a significant gap in the literature regarding the impact of psychedelics on mental health. The lack of comprehensive, large-scale studies leaves policymakers hesitant to approve these substances for medical use. Therefore, there is an urgent need for more research to validate these anecdotal experiences and provide robust data on the safety and efficacy of psychedelics in mental health treatments. While there are studies which show the potential of psychedelics in treating mental health conditions [38,39], much of the existing evidence is anecdotal, often shared with friends or on online forums. These platforms reveal personal experiences of therapeutic benefits and emotional breakthroughs, which, while compelling, lack the scientific rigor needed to influence policy and clinical practice [40]. Bridging the gap between anecdotal evidence and scientific research is crucial for shifting societal perceptions and reducing stigma [41]. By expanding empirical studies and leveraging personal narratives from online platforms, the field can move toward greater acceptance and accessibility of psychedelics as viable mental health treatments.
Research into psychedelics is on the rise following decades of prohibition [42], with wider acceptance growing and promising results emerging [43], with the goal being the integration of psychedelics into therapeutic settings for mental health treatment [44]. The vast majority of psychedelic users are outside the scope of clinical trials, leaving much valuable experiential data unrecorded. Platforms like ‘Erowid’ and ‘Bluelight.org’ have helped collect anecdotal reports, but these are often dismissed by researchers due to the lack of scientific rigor [45].
Fadiman, known for pioneering microdosing research, initially focused on high-dose, transformative experiences but shifted attention to the subtle yet profound effects of microdosing [46]. Despite facing regulatory barriers and lacking institutional support, Fadiman began collecting self-reported data from individuals worldwide [47]. In his book he shares results ranging from alleviating anxiety and depression to enhancing creativity and productivity [48]. However, the lack of formal scientific studies makes it difficult to validate these findings and they remain largely anecdotal.
Online forums and blogs provide platforms for individuals to share their experiences with psychedelics [49], often offering perspectives that challenge mainstream narratives [50]. This sharing of knowledge is invaluable but also highlights the need for more scientific research to bridge the gap between subjective experience and empirical evidence.
Within the realm of psychedelics, the heavy reliance on anecdotal evidence poses a significant challenge to scientific understanding and public perception [51]. The subjective nature of psychedelic experiences [52], shaped as they are by personal perceptions and cultural narratives, further complicates objective evaluation [53]. Legislation, for instance, plays a crucial role in shaping societal attitudes [54,55]; the classification of psychedelics as a Schedule 1 substance in many countries reinforces negative stereotypes and hinders open communication [56]. As Perloff [57] discusses, the media plays a powerful role in influencing the publics opinion. Hooking headlines, such as “Moms on Mushrooms” [58], create misleading narratives [59] that are detached from the actual content of the article, leading to false assumptions [60]. Bias often emerges from the mismatch between personal experiences and socially constructed beliefs [61].
Building on the impact of media narratives and legal frameworks, the resurgence of interest in psychedelics [62] reveals a growing tension between scientific progress and outdated policies [63]. In the UK, where psychedelics remain tightly regulated under the Psychoactive Substances Act 2016, promising research on psilocybin for treating depression is gaining momentum [64], yet legislative reform lags behind. As Neill [65] addresses, “it is high time the UK changes psychedelics laws”. This disconnect between scientific evidence and policy not only limits access to potential mental health treatments [66] but also perpetuates stigma through media coverage [67]. As Ruhrmann [68] explains, biased headlines and fear-driven narratives further distort public perception by reinforcing outdated stereotypes. As a result, meaningful progress in psychedelic science is delayed.

6. The Role of Psychedelic Guides and Therapists

The presence of skilled psychedelic guides and therapists is a crucial element in ensuring the safety, efficacy, and overall success of psychedelic-assisted therapy. As Meikle and colleagues [69] discuss, patients undergoing psychedelic-assisted therapy often experience heightened vulnerability due to the consciousness-altering effects of these substances. This state can amplify suggestibility and emotional sensitivity. This necessitates the presence of skilled facilitators to provide a safe environment and prevent potential abuses of power [70]. Unlike traditional pharmacological treatments, where medication is prescribed with minimal interaction [71], the therapeutic potential of psychedelics is deeply intertwined with the guidance and support provided before, during, and after the experience [72]. Psychedelic facilitators, whether they are trained therapists, medical professionals, or indigenous healers, must possess a unique set of qualifications, undergo specialized training, and adhere to strict ethical guidelines to optimize patient outcomes while minimizing risks [73].

7. Qualifications and Training

Phelps [74] discusses that psychedelic-assisted therapy requires facilitators to have a strong foundation in psychology, psychotherapy, or psychiatry along with specialized training in psychedelic modalities. Many psychedelic therapists hold advanced degrees in clinical psychology, counselling, or social work, though some may come from alternative backgrounds such as spiritual counselling or indigenous shamanic traditions. The field is increasingly professionalizing, with organizations like the Multidisciplinary Association for Psychedelic Studies (MAPS) [75], the California Institute of Integral Studies (CIIS) [76], and other institutions offering formal certification programs in psychedelic-assisted therapy. These training programs typically involve coursework on the history and science of psychedelics, pharmacology, risk assessment, harm reduction strategies, and practical facilitation techniques. A key component of psychedelic therapy training is experiential learning. Villiger [77] questions that many training programs include supervised practice sessions where facilitators undergo their own psychedelic experiences in controlled settings. This exposure is believed to help guides develop deeper empathy, first-hand insight into the psychedelic state, and a greater ability to support patients through challenging moments [78].

8. The Role of the Guide in Preparation, Session Facilitation, and Integration

Phelps [79] structures psychedelic therapy into three distinct phases: preparation, the psychedelic session, and integration. Each of these phases requires specific skills and techniques from the facilitator. As Modlin and colleagues [80] write, the preparation phase takes place before a patient undergoes a psychedelic session. The therapist or guide plays a crucial role in setting expectations, building trust, and preparing the individual for the experience. This phase may involve in-depth psychological assessments, discussions about personal history, goal setting, and addressing potential fears or anxieties. Skilled facilitators help patients cultivate a positive and open mindset, which can significantly impact the quality of their experience. During the session, Kishon and colleagues [81] explain the guide provides a supportive and non-directive presence, ensuring the safety and well-being of the individual. Unlike traditional talk therapy, psychedelic therapy does not involve active intervention but rather a facilitative approach, encouraging patients to explore their inner world. The guide may offer reassurance, help the patient navigate intense emotions, and create a structured environment that fosters introspection. Some therapists utilize music [82], guided meditations, or specific somatic techniques to assist in emotional processing. In cases where distressing or challenging experiences arise, the therapist helps the patient work through these feelings rather than suppress them, allowing for deeper therapeutic breakthroughs [83]. One of the most critical roles of the facilitator occurs after the psychedelic experience, during the integration phase [84]. This involves helping the patient to make sense of their journey, process emotions, and translate insights into actionable changes in their daily life. Effective integration support may involve journaling, therapy sessions, meditation, or engagement with supportive communities [85]. Without proper integration, even profound psychedelic experiences can fade into confusion, leaving individuals without clear direction on how to apply their newfound perspectives [86].

9. Ethical Considerations in Psychedelic Therapy

Given the heightened emotional vulnerability that psychedelics can induce, facilitators must adhere to strict ethical guidelines to protect patients from potential harm [87]. One of the foremost ethical concerns is the issue of power dynamics between the facilitator and the patient [69]. This applies to all altered-state therapies [88]. Because individuals undergoing psychedelic therapy often experience states of deep emotional openness, there is a risk of exploitation or coercion. Ethical psychedelic practitioners must uphold clear professional boundaries, ensuring that patients are never subjected to inappropriate physical, emotional, or psychological influences [89]. As Dunlop and colleagues [53] mention, another major ethical concern is informed consent and autonomy. Patients must be fully educated about the potential risks, benefits, and unknowns associated with psychedelic therapy before engaging in treatment. Transparency regarding potential adverse effects, contraindications with other medications, and the possibility of reactivations (flashbacks) is essential to fostering an environment of trust and accountability. Azevedo et al. [90] find that cultural sensitivity and inclusivity are crucial in psychedelic facilitation. Many psychedelic substances, such as ayahuasca, have deep cultural and spiritual significance in indigenous traditions. Facilitators must respect and acknowledge the historical and cultural roots of these substances while avoiding appropriation or commercialization of sacred practices. Some modern therapy models seek to integrate indigenous wisdom with Western clinical approaches, fostering a holistic and respectful therapeutic framework [91].

10. Challenges and Considerations

The integration of psychedelics into mental health care faces numerous ethical, social, and regulatory challenges [92]. Ethical concerns include ensuring informed consent, preventing misuse, and managing potential adverse effects [87]. The multifaceted and highly personal nature of experiences within the realm of psychedelic use makes it difficult to establish standardized treatment protocols that accommodate diverse patient needs and expectations [93]. The subjective nature of psychedelic experiences adds complexity to clinical applications, as individual responses vary based on psychological, cultural, and environmental factors [94]. Without clear guidelines, comprehensive education, and regulatory alignment, the widespread adoption of psychedelics in mental health care will remain a contentious and challenging endeavour.
A further consideration is the method of administration, particularly the debate between microdosing and macrodosing. Though microdosing, the taking of sub-perceptual doses, has gained popularity for cognitive and mood enhancement [95], its long-term efficacy and safety remain empirically under-researched. Conversely, macrodosing under controlled settings can induce profound therapeutic experiences, but requires professional supervision to mitigate risks [96]. These challenges must be addressed to ensure psychedelics are used safely and effectively in psychiatric care.
In 2015, the UK Government published ‘the Psychoactive Substances Act 2016’ [64], making it an offence with a maximum sentence offence to produce, offer, supply or import/export any psychoactive substances. Exemption is provided for healthcare activities and approved scientific research in cases of a legitimate need to use psychoactive substances in a professional capacity. In 2018 this Act was reviewed in light of challenges related to the legal classification of medicinal products, the determination of psychoactive effects, and the reliability of testing methods, specifically those for synthetic cannabinoids [97].
Despite these legal frameworks [98], there remains ambiguity in distinguishing between recreational and therapeutic use, which complicates the establishment of clinical guidelines [99]. Moreover, stigmatization and cultural perceptions surrounding psychedelics continue to hinder their acceptance within mainstream mental health care [100]. Addressing these challenges will be crucial in unlocking the therapeutic potential of psychedelics while safeguarding public health and safety.

11. Key Findings from Research

Research on psychedelics has demonstrated their potential to significantly impact mental health treatment, particularly for conditions like depression, PTSD, and anxiety. Studies indicate that psychedelics, when administered in controlled settings with psychological support, can induce profound emotional and cognitive shifts, leading to long-lasting positive changes in mood and behaviour [17]. Clinical trials have highlighted their effectiveness in cases where conventional treatments have failed, with psilocybin and MDMA showing particular promise for treatment-resistant depression [101] and PTSD [102]. Additionally, psychedelics appear to enhance neuroplasticity [103], potentially contributing to cognitive flexibility and emotional resilience [104]. The therapeutic effects are often amplified when psychedelics are integrated into structured psychotherapeutic frameworks, emphasizing the importance of professional guidance. However, challenges remain in establishing standardized treatment protocols, understanding individual variations in response, and addressing long-term safety concerns. While these findings support the growing interest in psychedelic-assisted therapy, further research is necessary to refine clinical applications and regulatory approaches.

12. Future Directions

Although current research does highlight the therapeutic potential of psychedelics, several key areas require further exploration to ensure their safe and effective integration into mental health care. It is essential to establish standardized treatment protocols, including guidelines for dosage, frequency, and patient selection, to optimize therapeutic outcomes while minimizing risks [105]. Additionally, more longitudinal studies are needed to assess the long-term effects of psychedelic-assisted therapy, particularly regarding potential risks such as persistent perceptual changes or psychological distress. Expanding clinical trials to include more diverse populations will also be critical in understanding how factors such as cultural background, pre-existing mental health conditions, and individual neurobiology influence treatment outcomes. Furthermore, the broader societal implications of psychedelic use, including regulatory changes, public perception, and potential medicalization versus commercialization, must be considered. As research advances, collaboration between scientists, policymakers, and healthcare professionals will be necessary to create a balanced approach that maximizes benefits while addressing ethical, legal, and safety concerns.

13. Conclusions

The resurgence of psychedelics in mental health treatment represents a significant shift in both scientific understanding of these substances and societal attitudes towards them. Once dismissed due to stigma and prohibition, psychedelics are now starting to be recognized for their potential to address treatment-resistant psychiatric conditions such as depression, PTSD, and anxiety. Research has demonstrated promising therapeutic outcomes, particularly when these substances are administered in controlled settings with professional guidance. However, challenges remain, including ethical considerations, regulatory barriers, and the need for standardized treatment protocols. As global policies evolve and research expands, it is crucial to balance innovation with safety, ensuring that psychedelics are integrated responsibly into modern mental health care. Continued interdisciplinary collaboration will be essential in shaping the future of psychedelic-assisted therapy, maximizing its benefits while addressing the complexities associated with its use.

Author Contributions

Conceptualization, K.K.S., E.M.d.B. and J.L.; investigation, K.K.S., E.M.d.B. and J.L.; resources, K.K.S., E.M.d.B. and J.L.; writing—original draft preparation, K.K.S., E.M.d.B. and J.L.; writing—review and editing, K.K.S., E.M.d.B. and J.L.; visualization, K.K.S., E.M.d.B. and J.L. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflicts of interest.

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Table 1. Countries and their status on legalization.
Table 1. Countries and their status on legalization.
CountryLegalization StatusFurther Details
ArgentinaDecriminalizedPersonal possession decriminalized. Trafficking remains penalized.
ArmeniaDecriminalizedPossession for personal use is not a crime, but “small amounts” are not legally defined.
AustraliaRestrictedMDMA and psilocybin available for specific medical use since 1 July 2023.
AustriaDecriminalizedPersonal use and possession are decriminalized; therapy may replace punishment.
BahamasLegalMagic mushrooms are legal, though sales are prohibited under international law.
BelgiumDecriminalizedUse is not a crime, but possession, production, and sale carry heavy penalties.
BoliviaLegalAyahuasca is legal and culturally recognized.
BrazilPartially LegalAyahuasca legal since 1986 for religious and therapeutic purposes only; mushrooms are legal, but psilocybin is not.
British Virgin IslandsLegalUse and possession of magic mushrooms is legal, but sale is prohibited.
CanadaRestrictedSome exemptions exist; BC has decriminalized drug possession; psychedelic storefronts exist but face legal challenges.
ChileDecriminalizedPossession for personal use is not a crime, but amounts are not specified.
ColombiaDecriminalizedPersonal possession has been decriminalized since 1994, but legal conflicts persist.
Costa RicaNot PenalizedPersonal drug use is prohibited but not penalized; production and trafficking are illegal.
CroatiaDecriminalizedSmall-quantity possession is decriminalized; mandatory rehab or fines apply.
CzechiaDecriminalizedPossession of small amounts is treated as a misdemeanour; ketamine is legally accessible.
DenmarkIllegal (Medical Use Recognized)Psilocybin is illegal but recognized for therapeutic use; ketamine is available medically.
EcuadorDecriminalizedPersonal drug possession is decriminalized with defined quantity limits; sale remains illegal.
EstoniaDecriminalizedSmall-quantity possession is punishable by fines or short administrative detention.
FinlandIllegal (Uncertain for Ayahuasca)Small-quantity possession can lead to fines or imprisonment; ayahuasca plants are in legal limbo.
FranceIllegal (Reduced Penalties)Drug possession remains illegal, but fines were reduced in 2020; spores are legal, but cultivation is not.
GermanyIllegal (Reduced Prosecution)Psychedelics remain illegal, but courts can exercise discretion and avoid prosecution for small amounts.
IcelandIllegal (Fresh Mushrooms Unregulated)Dried psilocybin mushrooms are illegal, but fresh ones may be picked legally.
IsraelIllegal (Medical Use Allowed)Psychedelics are illegal, but medical use is permitted; Israel was the first country to allow MDMA for PTSD treatment.
ItalyDecriminalized (Administrative Penalties)Drug possession carries no criminal penalties but may result in administrative consequences like license suspension.
JamaicaLegalPsilocybin mushrooms are fully legal; Jamaica actively supports the psilocybin industry.
LatviaDecriminalizedDrug possession for personal use is an administrative offense punishable by a fine; larger amounts can lead to prison.
LithuaniaDecriminalized (Reduced Penalties)Possession of small amounts is punished with community service or house arrest; trafficking carries severe penalties.
MexicoDecriminalizedPossession of small amounts of psychedelics is not punishable; indigenous use of psilocybin mushrooms and peyote is protected.
NepalUnclear (Not Actively Policed)Mushrooms are uncontrolled, and their use is not policed; other drugs are illegal.
NetherlandsDecriminalized (Legal Loopholes)Psilocybin mushrooms are illegal, but truffles, spores, and grow kits remain legal; small personal use amounts are decriminalized.
New ZealandIllegal (Regulated Psychoactives)Psychoactive substances must be pre-approved by the government; mescaline cacti can be grown ornamentally but not for use.
North MacedoniaDecriminalizedPsychedelic possession is decriminalized with fines of EUR 100–250; distribution and gifting still carry prison sentences.
NorwayProposed DecriminalizationA 2021 proposal sought to decriminalize drug possession, but reform stalled in Parliament.
PeruLegal (Traditional Use)Ayahuasca is legal and protected as cultural heritage; possession of small drug amounts for personal use is not criminal.
PortugalDecriminalized (Since 2001)Portugal was the first country to decriminalize all drugs, treating use as a public health issue rather than a criminal offense.
SloveniaDecriminalizedPsychedelic possession is decriminalized with fines of EUR 42–209; manufacturing and sale remain illegal.
SpainDecriminalized (Personal Use)Small quantities for personal use are legal; selling and distributing remain illegal. Ayahuasca legality is evolving.
St. Vincent and the GrenadinesLegal (Research and Medical)Licenses granted for research and medical psychedelic use, including psilocybin, ibogaine, and ayahuasca.
SwedenIllegal (Cacti Exception)Psychedelic drugs are illegal, but growing mescaline-containing cacti is allowed; extracting mescaline is not.
SwitzerlandDecriminalized (Religious and Medical Use)Ayahuasca is legal for religious use; small amounts of LSD, MDMA, and psilocybin are decriminalized.
ThailandIllegal (Potential Reform)Drug penalties were reduced in 2017; research into psilocybin for medical use is ongoing, with possible future rescheduling.
UkraineDecriminalized (Private Use)Drug use in private is not a crime; public use can lead to up to 3 years in jail. Medical ketamine use is permitted.
United KingdomIllegal (Cacti Exception)Psychedelics are illegal, but psychoactive cacti can be grown for ornamentation. Psilocybin rescheduling has been debated.
United StatesMixed Legal StatusPsychedelics are federally illegal, but some states (Oregon, Colorado) have decriminalized or legalized psilocybin and other substances.
UruguayLegal (Personal Use)Possession of all drugs for personal use has been legal since 1974, but cultivation remains illegal except for cannabis.
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Soylemez, K.K.; de Boo, E.M.; Lusher, J. Regulatory Challenges of Integrating Psychedelics into Mental Health Sector. Psychoactives 2025, 4, 11. https://doi.org/10.3390/psychoactives4020011

AMA Style

Soylemez KK, de Boo EM, Lusher J. Regulatory Challenges of Integrating Psychedelics into Mental Health Sector. Psychoactives. 2025; 4(2):11. https://doi.org/10.3390/psychoactives4020011

Chicago/Turabian Style

Soylemez, Kerem Kemal, Emma Marie de Boo, and Joanne Lusher. 2025. "Regulatory Challenges of Integrating Psychedelics into Mental Health Sector" Psychoactives 4, no. 2: 11. https://doi.org/10.3390/psychoactives4020011

APA Style

Soylemez, K. K., de Boo, E. M., & Lusher, J. (2025). Regulatory Challenges of Integrating Psychedelics into Mental Health Sector. Psychoactives, 4(2), 11. https://doi.org/10.3390/psychoactives4020011

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