A group of physicians who support drug policy reform says in a new position paper that it’s time for states to decriminalize personal use and possession of an array of psychedelic substances.
The report from Doctors for Drug Policy Reform (D4DPR) says decriminalizing use and possession of psychedelics by adults “provides a viable path to reducing mass incarceration, addressing systemic inequities, supporting public health, and lays the foundation for rational drug policy reform.”
“Criminalizing the personal use and possession of psychedelics is a costly misuse of resources,” it contends. “A cohesive state-level decriminalization framework would better align with evidence-based drug policies, ensuring a more just and effective response to substance use.”
The paper was written and developed by Kristel Carrington, a New York-based psychiatrist, psychotherapist and psychopharmacologist. It focuses on what it calls “well-researched psychedelics,” such as psilocybin, LSD, ibogaine, 5-MeO-DMT, MDMA, DMT (including ayahuasca) and mescaline, but adds that “this does not imply that other psychedelics should remain criminalized.”
Most psychedelics are currently considered Schedule I drugs under the Controlled Substances Act, a classification the report says “fails to reflect scientific evidence that psychedelics pose a very low risk of serious harm, minimal potential for problematic use, and have shown promising applications in mental health treatment through large-scale clinical trials.”
“The Schedule I status of psychedelics falsely inflates their risk and perpetuates a legal regime that imposes excessive punishment for nonviolent drug offenses,” Carrington wrote, adding that research from the 1990s through today “has provided substantial evidence” that psychedelics are less harmful than either controlled substances such as heroin and cocaine or non-controlled substances like tobacco and alcohol.
But federal drug policy has been slow to catch up. “Despite increasing scientific and medical support for their integration into healthcare,” the report says, “these substances remain classified as Schedule I under outdated drug policies that fail to reflect current evidence.”
Most people nevertheless support an end to psychedelic prohibition, the D4DPR paper contends, pointing to a 2023 study by UC Berkeley that “found that 61% of registered U.S. voters favor the legalization of psychedelic plants and fungi, highlighting shifting public attitudes on psychedelic policy.”
“This sentiment reflects increased public awareness of the gap between drug policies and scientific evidence,” the paper says. “The misalignment between the legal psychedelics’ classification and their actual risk underscores broader systemic failures in drug policy.”
A better approach, D4DPR asserts, would be to remove criminal penalties around the use and possession of psychedelics—a change the group says would advance public health, promote social equity and allow better allocation of scarce public health and safety resources.
“A harm reduction-based approach ensures a more just, evidence-driven, and equitable framework for drug policy, reducing incarceration rates, mitigating stigma, and fostering public health-centered solutions,” it says. “This policy framework does not include the cultivation, sale, or distribution of psychedelics, but prioritizes harm reduction by eliminating outdated and ineffective penalties for personal use.”
“Decriminalization is an immediate practical step toward addressing inconsistencies in current drug statutes while allowing the federal government to retain jurisdiction over their legal status and enforcement,” the new paper concludes. “This approach builds a more equitable and rational drug policy by prioritizing public health, reducing incarceration, and lessening financial burdens on the criminal justice system.”
In addition to defining clear quantity thresholds for personal possession and setting age limits on possession, D4DPR also advises collaboration with medical and community groups to create training programs for clinicians, law enforcement and young people as well as redirecting funds from law enforcement to public health.
It says reforms should include “automatic expungement of past convictions for simple possession of psychedelics, including cases where individuals were inappropriately charged for distribution.”
Metrics and data should be collected on criminal justice and health impacts, the group continues, while Indigenous perspectives should inform policymaking “to ensure ethical and inclusive reforms.”
The decriminalization document comes on the heels of another D4DPR position paper about treatment strategies for opioid use disorder. That paper, by Hunter Platzman, argues that rather than rely agonist treatments such as methadone and buprenorphine, policymakers should embrace additional safer supply interventions, such as prescribing pharmaceutical-grade heroin.
While agonist treatments are legal, well established treatments, that paper argues, they’re used by fewer than 35 percent of people with opioid use disorder. Others are either unable to access the therapies or refuse them altogether. Prescription heroin, Platzman argues in the report, “demonstrates superior efficacy compared to traditional medications like methadone” and is far less lethal than highly toxic synthetic opioids, such as fentanyl.
In April of last year, meanwhile, D4DPR argued in a separate position paper that hemp-derived cannabinoids should be regulated more like marijuana.
“Our understanding of these compounds is limited,” the paper said of compounds like delta-8 THC. “Many have never been observed in nature and their toxicology is unknown.”
“Our stance at D4DPR,” it continued, “is that all intoxicating cannabinoids should be subject to a regulatory framework to ensure public safety.”
The cannabinoids paper was an attempt to bridge what the group described as a policy gap between between hemp—legalized federally through the 2018 Farm Bill—and marijuana, which remains federally illegal.
“The reason we got into this problem is by making this artificial distinction between two plants, hemp and cannabis, that are identical plants. One has low amounts of THC and one doesn’t,” the group’s president, Adinoff, said. “That’s what got us into this mess.”
D4DPR was long known as Doctors for Cannabis Regulation (DFCR) but rebranded in 2023 to reflect a growing focus on “a wider range of drug policy issues beyond cannabis,” including psychedelics and broader harm reduction matters, leaders said at the time.
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