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Preparing for the Bursting of the Psychedelic Hype Bubble

Article  in  JAMA Psychiatry · August 2022

DOI: 10.1001/jamapsychiatry.2022.2546

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 Opinion

Preparing for the Bursting of the Psychedelic Hype Bubble

VIEWPOINT

David B. Yaden, PhD Psychedelic research currently appears to be trapped In such cases, the first step is a rapid increase in ex-
Department of in a hype bubble driven largely by media and industry treme visibility and expectations. This peak of inflated
Psychiatry and interests. We believe that it would benefit the field of psy- expectations can be considered a bubble, and we be-
Behavioral Sciences,
chedelic research if this bubble were to be systemati- lieve that psychedelics are currently cresting this peak.
Johns Hopkins
University School of cally deflated by researchers and clinicians using good After the peak comes an equally steep decline in which
Medicine, Baltimore, science communication practices. highly inflated expectations are dashed. Formerly overly
Maryland; and Center The term bubble is often applied to something of positive press reports may become overly negative. Af-
for Psychedelic and
Consciousness
value that has become overvalued in popular percep- ter the bottom of the trough, well-calibrated assess-
Research, Johns tion. As a society, we are familiar with the term as it has ments of the state of the evidence may begin to occur.
Hopkins University been applied to, for example, the internet (the dot- Finally, the process reaches the plateau of productivity,
School of Medicine,
com bubble of the 1990s) and the value of housing (the which is where we hope the field of psychedelics settles
Baltimore, Maryland.
housing bubble of the early 2000s). In terms of psyche- because it is the social context in which rigorous re-
James B. Potash, MD delics, headlines have turned from presenting alarmist, search and responsible clinical applications flourish most
Department of extremely negative views of the drugs (approximately effectively.
Psychiatry and 1960s to 2000s) to acknowledging their positive po- If perceptions of psychedelic science shift accord-
Behavioral Sciences,
tential (2006 to the present). However, in the past few ing to this process, then we are fast approaching a dan-
Johns Hopkins
University School of years, a disturbingly large number of articles have touted gerous moment for the research field. The potential for
Medicine, Baltimore, psychedelics as a cure or miracle drug as well as men- blowback is real; we saw this shift in the 1960s for psy-
Maryland. tioned the investment potential of psychedelics reach- chedelics. Many people forget that there were years of
ing billions of dollars. These extreme shifts in percep- glowing reviews in the 1950s and 1960s before the press
Roland R. Griffiths,
tion can create impediments to rigorous science and turned alarmist and a government clampdown pre-
PhD
Department of reasonable clinical applications. vented research progress for decades.8
Psychiatry and It is also worth remembering that psychedelic treat-
Behavioral Sciences,
State of the Evidence ments present real risks similar to virtually any effec-
Johns Hopkins
University School of The subject of treatments using psychedelics asks of our tive treatment. These risks increase in recreational set-
Medicine, Baltimore, society something that is difficult to do well: maintain a tings and include confusional states, abuse potential, and
Maryland; and Center degree of nuance, critical thinking, and grounding in the precipitation of enduring psychiatric conditions, par-
for Psychedelic and
scientific evidence. In our social media–influenced cul- ticularly in persons with preexisting vulnerabilities (eg,
Consciousness
Research, Johns ture, it seems easy to fall into extreme views. However, psychotic disorders). Unfortunately, it is a matter of
Hopkins University when it comes to psychedelics, the scientific data ap- when, not if, a patient or participant will be harmed, and
School of Medicine, pear to prove wrong superenthusiasts and super- we need to do everything possible to prevent such trag-
Baltimore, Maryland.
skeptics alike. edies. However, although some people are unfortu-
The superenthusiasts are incorrect in believing that nately harmed by any number of effective treatments,
psychedelics pose no risks because those risks are well the visibility of psychedelic use means that such cases
established.1 Furthermore, the treatment potential of will be widely reported, often without the context of how
psychedelics is real but is less impressive than ex- clinical trials contribute to scientific progress.
pected, as shown in a recent trial comparing psilocybin
with a gold-standard treatment of depression.2 On the Ethical Obligation for Science Communications
other hand, the skeptics are incorrect in thinking that the Regardless of how public perceptions of psychedelics
short-term subjective effects of psychedelics consist of change, researchers and clinicians have an obligation to
a psychoticlike state of delirium; well-replicated find- counter extreme statements when they spot them.
ings have shown these effects to be challenging yet posi- Headlines that fall into the category of superenthusiast
tive and highly meaningful, with persisting favorable ef- (eg, wonder drug) or superskeptic (eg, madness) should
fects for most people.3,4 Finally, the therapeutic potential be openly disputed.
Corresponding of psychedelics is not merely hypothetical but has been Overly hyped claims fall into 2 main categories:
Author: Roland R.
supported by the results of several clinical trials.2,5-7 clinical and social. Clinically, psychedelics are not a
Griffiths, PhD, Center
for Psychedelic and cure for mental disorders. We have not found evi-
Consciousness The Hype Cycle dence for this claim, and it increases the risk of
Research, Department Although the future is unknown, the Gartner Hype Cycle inflated patient expectations. Socially, psychedelics
of Psychiatry and
Behavioral Sciences, provides an illustration of what we might reasonably do not solve major issues such as racism and war. Such
Johns Hopkins forecast about public perceptions of psychedelics claims risk trivializing the complexities of the issues
University School of (Figure). The cycle begins with a novel and promising and resources needed to make real progress. That
Medicine, 5510 Nathan
technological trigger that attracts substantial attention— said, we need to be on guard for equally extreme
Shock Dr, Baltimore,
MD 21224 (rgriff@ examples from psychiatry include electroconvulsive negative claims that are likely just over the horizon.
jhmi.edu). therapy and risk gene identification. After all, we have evidence-based reasons to believe

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 Opinion Viewpoint

Figure. The Hype Cycle

Visibility

Peak of inflated expectations

Plateau of productivity

Slope of enlightenment
Therapeutic applications of
psychedelics appear to follow the
general trajectory of other highly
Trough of disillusionment visible technologies. Concept from
Technology trigger Time Gartner, Inc. Image is licensed under
Creative Commons. Courtesy of
Jeremy Kemp.

that psychedelics show promise for treating mental disorders,
enhancing well-being, and advancing the study of psychological
and neurobiological processes.2-7,9,10
Conclusions
Across the field of psychedelic research to date, promising data sug-
gest that further studies are needed. Researchers should pursue
mechanistic studies that may shed light on biological underpin-
nings and psychotherapeutic processes responsible for the thera-
peutic effects of psychedelics. Such studies can help to refine treat-
ment approaches and achieve better target engagement. As
scientists and clinicians, we have an ethical mandate to dispute claims
not supported by available evidence. We encourage our colleagues
to help deflate the psychedelic hype bubble in a measured way so
that we can get on with the hard work of more precisely determin-
ing the risks and benefits of psychedelics.

ARTICLE INFORMATION
Published Online: August 31, 2022.
doi:10.1001/jamapsychiatry.2022.2546
Conflict of Interest Disclosures: Drs Yaden and
Griffiths reported receiving support through the
Johns Hopkins Center for Psychedelic and
Consciousness Research (CPCR) provided by Tim
Ferriss, Matt Mullenweg, Blake Mycoskie, Craig
Nerenberg, and The Steven and Alexandra Cohen
Foundation. Dr Griffiths also reported receiving
grants for research support from the Riverstyx
Foundation, the National Institute on Drug Abuse,
and a crowd-sourced funding campaign organized
by Tim Ferriss; personal fees from and serving on
the board of directors of the Heffter Research
Institute outside the submitted work; and serving
as site principal investigator for a multisite trial of
psilocybin-facilitated treatment of major depressive
disorder sponsored by the Usona Institute.
No other disclosures were reported.
Additional Contributions: We thank Mary Yaden,
MD, chief resident in Psychiatry at the Perelman
School of Medicine, University of Pennsylvania, for
her feedback.
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