“If patients with mental illnesses are to be treated fairly in comparison with other categories of patients, they must be given access to promising experimental therapies, including psychedelics. The right of early access to promising therapies was advanced as an ethical principle by activist Larry Kramer during the AIDS pandemic, and has now largely been adopted by the medical establishment. Patients are regularly granted access to experimental drugs for many illness categories, such as cancer and infectious diseases. The need for expanded access is especially relevant during evolving crises like the AIDS and the coronavirus pandemics. In contrast to non-psychiatric branches of medicine, psychiatry has failed to expedite access to promising drugs in the face of public health emergencies, psychological crises, the wishes of many patients, and the needs of the community. Psychiatry must catch up to the rest of medicine and allow the preferences of patients for access to guide policy and law regarding unapproved medications like psychedelics….
Open questions include how to amplify the voices of patients regarding experimental therapies like psychedelics, how to implement early access, how to educate the public about this option once it exists, and how to ensure equitable access for multiple marginalized groups. A model of political engagement like ACT UP may not work for patients whose symptoms include lack of motivation and will, and who are at risk for re-traumatization. The authors are exploring an entirely patient-led counterpart to traditional academic peer review, which allows diverse patient communities to provide meaningful input into therapies that result from trials….”