Since the 1960s, aboveground and underground psychedelic communities have stressed the importance of consent as a cornerstone of cognitive liberty, the belief that individuals should be free to alter their consciousness if and when they choose to do so. But some influential people within the psychedelic industry still seem to misunderstand the nature of this basic principle.

The history of psychedelic drug use evidences numerous instances where psychedelics have been administered without individual consent, and in which boundaries have been violated during psychedelic experiences. Within just the last two years, multiple accounts of boundary crossings and consent violations have surfaced, implicating figures involved in mainstream psychedelic therapy as well as the underground scene. 

Whistleblower Will Hall recounted his allegations of abuse at the hands of underground practitioner, Aharon Grossbard, who Hall claims crossed a number of boundaries without his consent during psychedelic sessions. Others have alleged that they received similar treatment from Grossbard. On the “Cover Story: Power Trip” podcast (co-produced by New York Magazine and Psymposia), many individuals also discussed experiences of alleged abuse and consent violations by Grossbard’s wife and fellow underground practitioner, Francoise Bourzat, as well as by underground practitioners who Grossbard and Bourzat trained. 

The aboveground psychedelic therapy industry has also been grappling with questions around consent in psychedelic sessions. 

On “Power Trip,” former Multidisciplinary Association for Psychedelic Studies (MAPS) clinical trial participant, Meaghan Buisson, spoke about her experiences of inappropriate touch during MDMA sessions by her former clinical trial therapists, Richard Yensen and Donna Dryer, and subsequent sexual abuse by Yensen. Following the release of video footage showing some of Yensen and Dryer’s conduct during the clinical trial, debates have been raging throughout psychedelic communities over what kinds of touch are appropriate during psychedelic therapy, what levels of consent should be required around touch and if it is ever acceptable for a therapist to engage in sexual contact with a client. That this last point is even in question is somewhat bewildering, considering sexual contact between therapist and client in any other scenario is deemed unethical by the American Psychological Association — and it is even illegal for therapists to engage in this behavior in places like California.

A Health Canada clinical trial inspection report card summary of a MAPS-funded Phase 2 MDMA trial site from June — prompted by a complaint filed by Buisson and others — rated the site “non-compliant.” The inspection summary listed 12 concerns about the trial site, including issues with patient consent.

“The sponsor did not get written informed consent for every person before they participated in the clinical trial or the amended clinical trial,” the summary stated. This, plus the other concerns listed in the summary, led Health Canada to put the trial at this site on hold “due to concerns for participant safety,” according to the Canadian Broadcasting Corporation (CBC). 

Following the release of video footage showing some of Yensen and Dryer’s conduct during the clinical trial, debates have been raging throughout psychedelic communities over what kinds of touch are appropriate during psychedelic therapy, what levels of consent should be required around touch and if it is ever acceptable for a therapist to engage in sexual contact with a client.

The same informed consent forms have come under scrutiny by participants who did sign them, but found that their experiences were not covered by the forms they signed. One participant explained on “Power Trip” how the trial felt like unfinished “open-heart surgery” where she was sent away from her therapists, metaphorically feeling like her chest was still wide open. This resulted in worsening of her mental health, to the point of suicidal ideation. Similarly, despite MAPS Executive Director Rick Doblin acknowledging the increased vulnerability of people under the influence of MDMA in his 2001 dissertation, the MAPS informed consent documents failed to disclose this risk to participants such as Buisson. The omission of proper informed consent and the subsequent harms caused by MAPS therapists underscores the importance of informed consent in the context of clinical trials.  

Looking further through the history of psychedelic drug use and consent violations reveals instances of Nazis experimenting on non-consenting prisoners with psychedelics; the CIA’s Project MK-Ultra, where operatives dosed each other and their targets without consent; the kidnapping and repeated non-consensual psychedelic dosing of Brandon Green by Gordon Todd Skinner; the exploitation of non-consenting prisoners and mental health patients during the first wave of psychedelic research in the 1950s through the 1980s; and more. Even Ken Kesey’s Acid Tests — which many view with rose-colored glasses — occasionally involved non-consensual dosing of participants. 

In their poster presentation at the 2022 Psychedemia conference, Natalie Villeneuve and David Prescott even poignantly noted that the introduction of psychedelic mushrooms to the Western world was founded on a violation of consent — referencing writer R. Gordon Wasson’s admitted deception of Mazatec curandera Maria Sabina in 1955.

“Sabina performed the [mushroom] ceremony [for Wasson] under the guise that her location and identity would be kept confidential. Against her consent, Wasson revealed this information, resulting in an influx of travelers to Sabina’s community seeking ‘enlightenment,’ all while disrespecting sacred customs,” Villeneuve and Prescott wrote. “While Wasson rose to fame for what he described as the ‘discovery’ of magic mushrooms, Sabina suffered the consequences of revealing sacred practices to an outsider. The community blamed Sabina for degrading the community with tourism, and she was ostracized, jailed, had her house burned down, her son was murdered and she died destitute.”

All of this history makes it hard to comprehend many of the seemingly positive reactions to a news story earlier this year about a man whose wife secretly dosed him with psilocybin for a period of weeks. 

Canadian Senator Larry Campbell told a crowd at the Catalyst Psychedelics Summit in Kingston, Ontario that his wife had laced his coffee with small doses of psilocybin for weeks during the coronavirus pandemic without telling him. He claimed his mood improved during this time and his wife eventually admitted what she had been doing. 

In any scenario but this, an individual non-consensually dosing a senator with drugs could be construed as an act of assault, and it is absolutely a crime to do this in Canada. However, beyond criminality, Dr. Charles Grob — a professor of Psychiatry & Biobehavioral Sciences and Pediatrics at Harbor–UCLA Medical Center — noted that surreptitiously dosing someone could lead to a number of issues if the dosed individual has adverse reactions and does not know what is in their system.

In this case, seemingly because Campbell’s claims of mood improvement fit the ideal narrative of the psychedelics industry, this story has been embraced positively by many influential industry figures. 

For example, Ronan Levy — the co-founder of psychedelic pharmaceutical start-up Field Trip Health and host of the company’s podcast “Field Tripping” — tweeted the story about Campbell and his wife saying: “From unwitting to witting. That’s the nature of wisdom. An ex-police officer turned senator unwittingly took ‘magic’ mushrooms without realizing — now he microdoses the drug most days to ease his depression.” 

This commentary seems to imply that Levy accepts Campbell’s wife’s secret dosing of her husband and that he believes that Campbell gained wisdom from the experience. This sentiment — that a patient may gain wisdom from non-consensual dosing — would raise serious concerns, if not objections, coming from any pharmaceutical executive outside the psychedelic industry. Considering the lack of scientific evidence for the efficacy of microdosing (which is what Campbell’s wife was giving him), Levy’s statement becomes even more dubious. When asked for comment, Levy did not respond.

This commentary seems to imply that Levy accepts Campbell’s wife’s secret dosing of her husband and that he believes that Campbell gained wisdom from the experience. This sentiment — that a patient may gain wisdom from non-consensual dosing — would raise serious concerns, if not objections, coming from any pharmaceutical executive outside the psychedelic industry.

Grob remarked on the lack of clinical evidence of the efficacy of microdosing, and called attention to the fact that there are even potential understudied harms of microdosing. He pointed to observations made by psychedelic researcher, Dr. David Nichols, that psychedelics like LSD stimulate the 5-HT2A receptor, which is primarily responsible for psychoactive effects, but that there is also stimulation of the 5-HT2B receptor, which is partially involved in maintaining the structural integrity of cardiac valves. 

“So what happens if, every day or every few days, you’re pulsing that receptor with a 5-HT2B agonist?” Grob asked. “Could you run into cardiac issues down the line? No one has begun to study this in either a clinical or even a preclinical setting. That’s just the point.” In Grob’s opinion, an individual should be allowed to consent to the potential risks and benefits of a treatment, or consent to a treatment with the understanding that the potential risks and benefits are not fully understood.

Other psychedelic executives were even more explicit than Levy about their approval of Campbell’s wife’s actions.

Patrick Moher — the co-founder and president of psychedelic media company Microdose Psychedelic Insights and a board director of veteran-focused psychedelic charity Heroic Hearts Project Canada — tweeted the story about Campbell with the commentary: “Shoutout to Larry’s wife for spiking his coffee with 🍄s 😂.”

Moher’s statement on Twitter was challenged with references to some of the most influential figures in underground psychedelic history condemning this sort of non-consensual behavior. 

For example, in “Moving Into the Sacred World of DMT” underground LSD chemist Nick Sand explicitly states his objections to non-consensual dosing. 

“One of the two ‘commandments’ we had in the religious institution that we established in the ’60s called the League for Spiritual Discovery was, ‘Thou shall not change the consciousness of another person without their consent,’” Sand wrote. “On the surface, this means don’t dose anyone without their knowledge. Dosing someone without them knowing it is a mean-spirited form of violence. Our consciousness, limited as it may be, is ours. It is intensely personal. It is also our entry and connection with Divine consciousness. So to dose someone without their knowledge is to mess around with their connection with God. To do this for fun or revenge is nothing short of an abomination. It is disgusting and the height of unconsciousness. This is sin.”

LSD researcher Timothy Leary’s “The Politics of Ecstasy” also states, as its first commandment, “Thou shalt not alter the consciousness of thy fellow man.” Leary specifies later that, “You can help him alter his consciousness. Or you can get his conscious, alerted permission to alter his consciousness for him in the direction he wants.”

In response to these statements being brought to his attention, Moher wrote that he believes consent is important, but then pointed to a passage in the reporting about Campbell which stated, “Campbell…said he’d never considered psilocybin before. He said his wife had told him of her plan, but he hadn’t paid attention.” 

Moher’s response indicates that he believes the actions of Campbell’s wife were acceptable because she mentioned her plan, even though Campbell stated that he did not pay attention. At no point did Campbell actually say that he gave his wife permission to dose his coffee with other drugs.

Others have commented positively on this news story, claiming that Campbell’s admission signals progress for the drug reform movement, that it is a positive anecdote for the efficacy of microdosing, or just sharing the story with a crying laughing (“😂”) or clapping (“👏”) emoji. 

Although some individuals have expressed concern about Campbell’s non-consensual dosing, the embracing of this story as a positive data point by individuals with outsized influence in the psychedelic pharma space is concerning and speaks to a need for industry leaders to take issues of consent more seriously than they currently are. 

Although some individuals have expressed concern about Campbell’s non-consensual dosing, the embracing of this story as a positive data point by individuals with outsized influence in the psychedelic pharma space is concerning and speaks to a need for industry leaders to take issues of consent more seriously than they currently are. 

While Grob does not doubt that the intentions of Campbell’s wife were probably good, he believes that Campbell was exposed to undue potential risk — physically and emotionally — because of this surreptitious dosing. Grob, who is director of the Division of Child and Adolescent Psychiatry at Harbor–UCLA Medical Center, said that this issue of non-consensual dosing occasionally arises with parents of depressed teenagers.

“[It is a] thought that parents of teenagers might have if the kid is in terrible shape, and they think the recommendation of a medication could help, but the kid refuses,” Grob said. “You can’t force the kid. And if you’re surreptitiously dosing them and they find out, it completely blows trust with their parents and the trust of mental health professionals who may want to work with them.” 

Bioethicist Emma Tumilty Ph.D. agreed with Grob, stating that even the best of intentions should not override the need to secure an individual’s consent prior to dosing. 

Tumilty noted that deceiving an individual, or circumventing their consent, is typically done as an act of self interest on the part of the deceiver. It is a tactic employed to get their own way without having to communicate with the other person.

“Autonomy, our right to determine our own lives (and what is done with our bodies or information, etc.) in our own way is our most fundamental right and should be respected through the process of consent, whether in social, medical or research settings,” Tumilty said. “Dosing an individual without their consent is a form of forcing one’s will that crucially disregards the will of others. It’s extremely disappointing as a bioethicist and just as a member of society to see people talking about this as if it is acceptable and in some cases even seeming to champion it.”

Issues of consent seem especially nuanced to some people with an affinity for psychedelics, oftentimes because the drugs produce experiences strong enough that individuals may emerge from even non-consensual experiences with positive insights (though this is assuredly not always the case). 

One popular psychedelic-focused TikTok user with over 90,000 followers has published a number of videos detailing her beneficial mental health outcomes from psychedelics, some of which demonstrate consent violations being framed positively. In one video (which currently has over 36,500 likes) discussing a 5-MeO-DMT retreat, for example, she states that she took her first hit of 5-MeO-DMT and her guide repeatedly said: “more, more.” 

She said that the effects of her first dose were “awful and terrifying” and that she had no idea what was happening. 

“Then I started coming back a little bit and I turned around to lie down, and my guide was sitting next to me to tell me: ‘You’re going to have to smoke a little bit more,’” she states in her video. “And I was like, ‘No. Absolutely not. That was terrible.’ And [the guide] whispered, ‘You’re on the verge of a great breakthrough. Trust the process.’” So she followed the guide’s orders, took another hit, and luckily reported being overcome by beauty. 

This positive reaction, however, was no more guaranteed than her initial negative reaction, and her guide ignored very clear verbal resistance to taking more of the drug. The guide would likely frame her encouragement to take more of the drug as being in the best interest of her client, but the fact remains that she committed a clear violation of consent. 

Grob said that throughout his time as a psychedelic researcher, he too has been aware of individuals who have had positive insights from non-consensual dosing. However, he has “known other people who’ve found it to be very disturbing, very disconcerting and it was a very, very frightening experience for them.”

“Years ago, I knew of someone…who was quite elderly and approaching the end of his life and someone he knew — and I wouldn’t doubt their intentions were good — decided to dose him with LSD as he was on his deathbed, as he was starting to expire, thinking it might help him let go,” Grob said. “But it did just the opposite. It caused a very intense state of vegetation from what I was told, that was very, very disturbing.”

Surreptitiously dosing an individual with drugs or acting against their consent can be socially, emotionally and physically harmful. It is concerning that some executives championing psychedelic treatments seem to have an ethical blind spot around issues of consent if the non-consenting party is lucky enough to have a positive experience. For any progress to be made regarding consent and safety during psychedelic treatment, a healthy culture of consent must be established early on. This includes consideration regarding consent to dose, consent to touch and — as companies begin announcing things like VR exposure therapy while on psychedelics — consent to what a patient may be exposed to in an extremely vulnerable state of mind. 

FURTHER READING:

Learning Good Consent

American Medical Association “Informed Consent” page

Philosophical Foundations of Respect for Autonomy

A Precautionary Approach to Touch in Psychedelic-Assisted Therapy

Psychedelic Sisters in Arms

Let’s Talk About Psychedelic Therapy Abuse (Thread)

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