Ethical Considerations

As a Registered Nurse in the UK, we are duty bound to consider Ethics.

The first thing to state is the obvious in the UK at the moment – They’re not legal, most being a Class A drug. But as anyone who lives in the real world knows, this obviously doesn’t stop people from taking them.

Access to legal psychedelic medicine will likely increase personal or “underground” use as more people become aware of psychedelics.

Although changes in their legal status are moving, these substances should always be approached with caution, respect, and under the guidance of professionals.

Therapists have an obligation to become better educated and prepared to incorporate psychedelic experiences into their practice so that individuals who choose to use psychedelics can be better supported when seeking therapy.

Harm reduction sessions before psychedelic treatment help clients make informed choices about psychedelic use and focus more heavily on safety and education.

Clients who seek professional guidance in relation to psychedelics often have little experience or knowledge with these substances and are unsure whether psychedelic use is a good idea for them.

Preparation sessions must include the establishment of a therapeutic relationship, an exploration of participants’ mental health issues, and discussion of participants’ intentions for dosing sessions. Information must be provided about the substance and its effects, potential risks and benefits, and strategies are identified for responding to difficult experiences that may show up during the dosing sessions.

In a harm reduction approach, the therapist does not advocate for or against the use of psychedelics, but instead focuses on the client’s goals and welfare and attempts to help the client determine for themselves what behaviours will lead them toward the life they desire. Consistent with this aim, the therapist often begins with helping the client clarify reasons for seeking an illicit psychedelic experience and may suggest alternative pathways for achieving desired goals, such as suggesting that a client seeking relief from depression first consider more established approaches such as psychotherapy and antidepressants.

Psychedelics are receiving increasing attention from the public, clinicians, and policymakers as evidence mounts to support psychedelic-assisted psychotherapy (PAP) and therefore partnering with a qualified psychotherapist is also a huge consideration.

There may be potential interactions between psychedelics and medications clients are currently taking. Unless the therapist is a prescriber, therapists should obtain clarity, from a medical prescriber, willing to provide relevant information. 

Clients may think psychedelics are a “quick fix” unaware of the potential for challenging experiences or the emergence of avoided problems, memories, or emotions.

Therapists can also reduce risk through carefully considering the language used on advertising, forms, and in documentation.  For example, it is important to be consistent in all written materials that the clinician does not facilitate access to controlled or prohibited drugs.

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