In mainstream culture and research settings, awareness about the transformative and therapeutic effects of psychedelics is skyrocketing. As the evidence base for their therapeutic benefits grows, we are witnessing the rapid medicalization of psychedelic substances, which are “moving from the fringes of medicine to the mainstream.”
Understandably so, for psychedelics are extraordinary. By acting on the brain’s default mode network—the baseline resting state of thoughts and emotions that gives a person their sense of “self” or ego—these medicines release ego’s grip and facilitate an experience of connection. What emerges is the centrality of humans as spiritual beings, and our journey as a species that seeks connection with nature and the divine. For millennia, humans have understood that psychospiritual exploration is beneficial for the betterment of human well-being; we should not need a psychiatric diagnosis and prescription to explore psyche or the divine.
This connection is so profound as to shift consciousness. From ancient Indigenous practices to the “underground” psychedelic and plant sacrament communities of today, individuals have sought psychedelics, or entheogens, for wisdom, healing, inspiration, and spiritual connection—to connect with the divine within. By supporting wholeness—a state of well-being and balance of mind, body, and spirit—psychedelics have the potential to catalyze a shift from a broken healthcare system towards a new, holistic system, and move the world toward a life-sustaining society.
Recently, I stepped into the psychedelic sphere as the executive director of the Psychedelic Research and Training Institute (PRATI), where our mission is to “reconnect to the sacred; self, community, nature, and spirit.” I came to this work somewhat circuitously. Over the past three decades I have worked at the nexus of healthcare, community, environment, and health.
Early on, I believed that with enough money and the right science, we could solve the injustices of the world and co-create a more equitable, life sustaining society. I believed we humans could do better. It soon became clear that it was never about resources and science; there is an abundance of both. Rather, it was apparent that our story in the US—by which I mean the dominant cultural narrative and how Western culture makes meaning—is incongruent with what it means to be part of the community of life, and thus life itself.
Yet, I still have hope and find joy in my work. These days, when I attend our group’s trainings of physicians, nurses, and therapists, I see example upon example of individual and collective transformation and healing. It is amazing to behold and embody. I believe new psychedelic business models and the consciousness-shifting capacity of these teacher medicines can truly help co-catalyze planetary health and well-being.
I am, however, no longer naïve. The threat on the horizon is clear enough. Sadly, in today’s world, much of healthcare is bought and sold. As a result, a gold rush in psychedelic medicine is under way, as financial capital seeks to commodify medicines that have been held in the commons as sacred teachers for millenia. Akin to the growth of the medical industrial complex, business models for psychedelics are ascending, in which the human condition is reduced to individual medical problems with a diagnostic and treatment solution.
Understanding Our Inter-Connected Living Systems
To appreciate the potential of psychedelics, some background is essential. Humans, comprised of more non-human cells than human cells by virtue of their microbial inhabitants, have been on this planet for a blink of an eye in a four-billion-year planetary time scale. Earth’s annual orbit around the sun elicits patterns of birth, life, death, decay, and transformation, in an enduring state of dynamic equilibrium. We hurtle through the cosmos upon a planet in interrelationship with the community of life, upon which we depend as a species for our very survival. The beauty of the universe’s harmonious workings is both mysterious and breathtaking.
Complexity science explains how all living systems—from microbes to human communities—express core properties, including the principle of inexplicability—that many forces of life cannot be explained and are unpredictable. These principles are found in lessons that nature has gifted us from time immemorial: the holistic interdependence of all life; the diversity that helps us flourish and thrive; small changes that can have large impacts; life’s movement through natural cycles of birth and death; healthy systems seeking right relationships; and life in dynamic equilibrium, constantly changing, imbued with an innate healing potential. Together, these ecological principles generate a model of wholeness. This knowledge is embedded in both modern science and ancient wisdom—and can be held as a sacred mystery.
This intelligence is deeply woven in the collective human psyche. Humans are wired for connection; deeply woven into the collective human psyche is the awareness of the holistic interdependence of all life.
Yet modernity has downplayed such connection and reinforced a mechanistic cultural narrative of separateness, which has in turn fostered individualism, hierarchies of human value, and “othering.”
Dominant cultural narratives and their associated economic paradigm are so incongruent with the principles of living systems—indeed with life itself—that it is no longer possible to ignore the pervasive symptoms of disconnection all around us. Some of the manifestations of this disconnection include species loss, environmental pollution, loneliness, inequality, health disparities, homelessness, and more. Climate change is recognized as a crisis of relationship, in that the disconnection from self, others and nature is seen as a root cause of the climate crisis. In short, humanity faces an existential crisis of disconnection.
Our overburdened healthcare system is experiencing a similar crisis. Modern healthcare was shaped by the biomedical model, a paradigm that focuses on the treatment of disease symptoms through a reductive model that often loses sight of the complex whole. While this model is conducive to individualized, acute care, its mechanistic approach limits its ability to support overall well-being and wholeness.
In contrast, holistic medicine (also known as integrative or functional medicine) acknowledges the interconnection of mind, body, and spirit, and it views the body as self-healing, imbued with an innate intelligence. In this context of differing models of health—one dominant and another reemergent—psychedelics, holistic by their very nature, are proliferating.
Clinical trials, as reported by Nature and the National Institutes of Health, demonstrate substantial benefits of psychedelic-assisted treatments. This research shows that the therapeutic benefit of psychedelics is closely correlated to the mystical experience; psychedelics confer a lasting, augmented connection to nature. The inner and outer worlds become holistically interconnected. We’re called to reconsider and disrupt the story of disconnection and embody the truth that we are interdependent beings. From this awareness, we can appreciate psychedelics as sacred molecules and plant teachers, rather than a medicine or drug.
Venture Capital Swoops In
Nevertheless, our cultural operating system of disconnection and its associated economic paradigm maintain a tenacious hold on our health system. In particular, financial capital is flowing into the emerging psychedelic sector; over the past three years, venture capital firms have invested roughly $140 million in psychedelics, from psychedelic training to drug development. The psychedelic drugs market is projected to reach $6.85 billion by 2027.
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COMPASS Pathways, a leader in emerging psychedelic therapies, holds nine patents on “synthetic psilocybin.” (These patents have recently been challenged on the basis that they were granted for a naturally occurring form of psilocybin). Irwin Naturals has acquired a network of ketamine treatment clinics as part its plan “to become the world’s largest chain of psychedelic mental health clinics.” Applying the industrial food system’s vertical integration playbook, Field Trip, the world’s first mental wellness company focused exclusively on psychedelic-enhanced psychotherapy, is opening psychedelic assisted psychotherapy (PAP) clinics across North America, providing their drug division a drug-to-patient pipeline.
Without a change in this trajectory, it is easy to imagine that, like the medical-industrial complex and industrial agriculture, the psychedelic industry will build a powerful, self-reinforcing model of commodification, wealth extraction, and medicalization of these medicines’ sacred properties—an example of hubris and willful ignorance at a time when the health and wellbeing of the human species is at a tipping point.
It is clear that amid our global mental health crisis, both financial investments in mental health services and a transformation of linear models and associated hierarchical systems are needed—and that psychedelics can play a critical role. How those investments are structured and controlled are important considerations if we aspire to move the needle on health and wellbeing overall. There is a growing spiritual void as our current economic model erodes the vital sense of connection and relationship with one another and the community of life; these relationships make us healthy and whole.
Unwittingly, we have allowed our economic model to put the sacred in service to the economy, instead of the other way around. This model of centralized ownership and organization of capital can be seen as a root cause of our growing economic inequities, environmental degradation, and health disparities. Wealth inequality may in fact represent one of the largest detrimental influences on the health of individuals, communities, and the natural world. Because wealth inequality’s influence on people’s health, it is not enough to simply think holistically. We must steward and embed a holistic values system within the organizational rules of ownership and governance to unlock the true health potential within and between us all.
Stewardship: A Pathway to Health Justice and Wholeness
Fortunately, integrative models are now emerging along with a nascent community of learning and practice. Stewardship models offer a set of legal rules that upend how money and power operate in organizations. Though they take various forms, they have in common an emphasis on the importance of multi-stakeholder ownership and governance, long-term financing to protect the sale of assets, and a fiduciary duty to the purpose of the organization and its stakeholders; in other words, they prioritize purpose over profits. Practically, these rules seek to limit the ability of capital owners to extract social and ecological assets—assets that anchor and regenerate health—for individual financial gain.
Building these models is challenging and complex. For example, one of the biggest challenges faced by The Food Commons, an early pioneer stewardship model for regional food, was how to access working capital. As described in the paper, “Early Lessons from the Food Commons,” the organization’s values and principles were “held captive by capital markets seeking control or above-market returns.” Despite these and similar challenges, notable examples of stewardship models are taking form.
The Multidisciplinary Association for Psychedelic Studies (MAPS) and MAPS Public Benefit Corporation (MAPS PBC) may be two of the most well-recognized organizations in the psychedelic arena. Perhaps less appreciated is their pioneering stewardship model. MAPS PBC is a wholly owned subsidiary of MAPS, a 501c3 nonprofit. It catalyzes healing and well-being through psychedelic drug development, therapist training programs, and eventually the sale of prescription psychedelics, prioritizing public benefit above profit. In this model, donations to MAPS fund MAPS PBC research, clinical trials, and programs. In turn, MAPS PBC’s proceeds support MAPS’ mission.
The Austin Health Commons (AHC) borrows its model from the Food Commons and Commons Health Network. AHC is a 501c3 nonprofit working to build new ways for the Austin community to achieve health through community ownership of health care, to foster root-cause community healing, and to provide access to holistic health care for all. Karisha Community Center for Wellness PBC will serve as AHC’s management service organization, providing clinical services and stewarding Conscious Health Care, a holistic paradigm for health and healing. Similar to the MAPS stewardship model, AHC will own Karisha. Currently, Karisha is in the process of a direct public offering to support clinic construction and is about to launch virtual visits, while the AHC offers racial healing circles and community education.
The Nautilus family of enterprises—Nautilus Psychiatric Services (a PLLC), Nautilus Sanctuary, and the Nautilus Psychedelic Medicine Institute (a PBC)—is another emerging stewardship model. Nautilus Sanctuary is a nonprofit center for research and training in psychedelic-assisted therapy in New York City that contracts with Nautilus PLLC for medical and psychotherapeutic services. The Sanctuary’s mission is to develop and model best practices, financial sustainability, increased access, prosocial applications, world-class training, and ethical scalability of psychedelic therapies, with a top priority to make psychedelic treatment safe, accessible, and affordable. Recently, to raise capital, the decision was made to incorporate Nautilus Psychedelic Medicine Institute as a PBC, which will act as a management service organization for NPS PLLC. The plan is to convert Nautilus PBC into a true stewardship organization to fully protect and steward Nautilus assets.
In a recent conversation with Nautilus co-founder Dr. Casey Paleos, his passion and conviction for this work was palpable. “We are trying to solve the riddle of how to fulfill our mission of making these treatments accessible and affordable to patients without sacrificing quality or burning out our providers,” Paleos explained. “We don’t have all the answers right now, but we know that in part it comes down to establishing the right culture, one that prioritizes the purpose of the work above all else. At the end of the day, this has to be about more than just the provider’s paycheck, or the investor’s return on investment.”
Synthesis, a Dutch organization expanding to the US, offers safe, legal, medically supervised psychedelic retreats and a psychedelic practitioner training program. Recently, Synthesis became the first startup in the psychedelic space to adopt and raise funds as a stewardship-ownership organization. In this variation of the model, stewards hold shares with no economic benefit but maintain majority voting control. Moreover, the company cannot be sold, except to another stewardship company. Profits are shared with stakeholders and/or donated to mission-aligned companies.
While not exhaustive, these examples have been provided to advance knowledge about business models aligned with the consciousness of an imagined next health system. As an overview, important details of the nuanced differences between these models are lacking. There is also limited discussion about the relationship between management service organizations (entities that provide the non-clinical, business functions of a medical practice pursuant to state laws) and licensed health providers. There is an urgent need for a regenerative capital pool to help nurture these business models.
Left unspoken is the evolving relationship between the wisdom and holistic approaches of the vibrant, informal underground psychedelic economy, composed of community-led psychedelic medicine and integration groups, traditional healers, indigenous traditions, spiritual practitioners, and others. However, these examples serve to demonstrate the emergence of a powerful holistic mindset and business models of health and healthcare that embody and anchor the inextricable relationship between health, community, economics, environment, and the sacred.
Just Transition (see Climate Justice Alliance’s just transition design graphic, pictured below) is a community-designed set of “strategies to transition whole communities to build thriving economies that provide dignified, productive and ecologically sustainable livelihoods; democratic governance and ecological resilience”—a regenerative economy. The strategies can be appreciated as holistic blueprint for The Great Turning, a term used to describe the unfolding global shift from an industrial society to a life-sustaining civilization and associated shift in global consciousness from disconnection to interconnectedness.
The timescale and ease of this transition is not pre-ordained. For example, within the psychedelic sphere there is a fraught debate and important learning around the appropriation of Indigenous cultural practices and plant medicines. This learning and unlearning takes time, while climate science informs us we have little time to act. However, the coherence with emergent healthcare models illuminates the importance of the sacred over the economy—and the value of a holistic vison and its potential to catalyze planetary health and well-being.
While our cultural mindset is deeply entrenched, with the engagement of the psychedelic community, a living system model of health becomes possible, anchored in nature, community gathering and healing centers, and local, living economies expanding and growing, like a mycelial network emerging from the detritus of an old consciousness.