On the Importance of Supporting Indigenous-Led Access and Conservation Efforts, and Self-Regulating Community Use, Even as We Celebrate Accelerating Medicalized Access to Psychedelic Therapies via FDA Approval

A Movement Milestone: The Executive Order and What It Means

The psychedelic healing movement, in which my family-run company and I play a small but influential part, is celebrating a major win and milestone. Last month, the President signed an executive order that will fast-track FDA approval for psilocybin-, methylone-, and MDMA-assisted therapies for depression, addiction disorders, and PTSD. It also lights a real fire under government agencies to expedite and support studies with ibogaine, a medicine that has already shown remarkable real-world healing results for treating PTSD and traumatic brain injury (TBI) in veterans,¹ as well as interrupting withdrawal for people caught in the throes of opiate addiction.

This extraordinary medicine is widely understood to reset the brain’s dopamine system and promote neuronal regrowth and neural plasticity, enabling people suffering from debilitating brain and psychological trauma, or struggling with substance use disorders related to that trauma, to reset and reorder their lives in a more constructive and intentional way. Like other psychedelic medicines and assisted therapies, ibogaine is not a magic bullet. Especially for those struggling with opiate addiction, it should be understood as a powerful detox modality that frees a person from physical cravings and opens a genuine window of opportunity to do the hard inner work of healing what led to the addiction in the first place. If a person is not ready or able to do that work, ideally through something like a six-week inpatient followed by a six-month outpatient group therapy program, and instead returns directly to traumatic environments and familiar neighborhoods and dealers, the chances of relapse are much higher than otherwise. Similarly, if someone does not truly want to quit, and is undertaking ibogaine therapy only because family and friends have pressured them, their chances of relapse are likewise high. But if they are genuinely tired of being sick and tired and really want to get the monkey off their back, ibogaine therapy can indeed be a miraculous intervention.

Psilocybin and LSD have also shown great promise in interrupting substance use disorders, especially with alcohol and nicotine. Bill Wilson, the founder of Alcoholics Anonymous, was a strong believer in LSD’s ability to induce an ego-shattering encounter with a “higher power,” and he, along with many patients and researchers in the psychedelic space, attested to the importance of the “mystical experience” in the healing process. In clinical studies conducted by Roland Griffiths and other researchers, that mystical experience is directly correlated with sustained sobriety. But only ibogaine, in addition to initiating a profound life review and ego-shattering encounter with the divine (to varying degrees for different individuals; 5-MeO-DMT used in the days after to help with integration is often helpful in this regard), actually and literally interrupts opiate addiction and withdrawal symptoms. But people will get out of psychedelic therapy what they put in, and preparing properly, then integrating and implementing lifestyle changes, including healthy diet, exercise, meditation, and therapy, are as crucial as, if not more crucial than, the medicine experience itself.

Medicine as Path and Practice: The Indigenous Model

This brings me to the central point of this article. While a single profound psychedelic experience can be incredibly healing and helpful, especially for acute PTSD and resolving underlying trauma, more often than not, psychedelic medicine and therapy should be understood as a path and a practice, like meditation and prayer. For myself and many others, learning from the indigenous medicine cultures that have held and worked with these medicines for thousands of years, one enters into a lifelong relationship with them, partaking with great respect and intentional rhythm.

The vicissitudes and challenges of life are not resolved once and for all in a single psychedelic session, no matter how profound and transformative. Ongoing difficulties and traumatic events are part and parcel of living, our personality quirks and habits are persistent, and these medicines have been used for millennia to help us cleanse, reset, and reconnect with nature and spirit for guidance and healing. A good medicine practice is like maintaining your car, going in for a spiritual tune-up on a regular cadence. In my own life, I’ve found that going deep in an intentional way roughly once a quarter is a good rhythm. Things tend to get more unruly internally and off-track when I go too long without it. I am also healthier overall, in my relationships, diet, exercise, and time in nature and surfing, than at any other point in my life, and the medicines consistently reinforce the importance of tending to these other practices and disciplines.

Alan Watts is often quoted about hanging up the phone once you get “the message,” but how that’s often interpreted is wrong. There is no single message but rather a lifelong dialogue and relationship with nature, spirit, and community that these medicines help facilitate. Saying we no longer need ceremony, medicine, or sacred community once we’ve received “the message” misses the point. That said, when we do have a profound experience, we often come to recognize that our everyday reality is itself as miraculous and worthy of sacred attention as any formal ceremony. And I appreciate this saying in the sense that it’s time to stop chasing medicine experiences as a goal in itself, which is a form of addiction, and get to work on improving ourselves, serving others, and getting after our purpose in life, which the medicines can support.

The way indigenous medicine cultures hold and revere these medicines, engaging with them ceremonially in a regular rhythm within responsible, self-regulating communities, and integrating them responsibly and reverentially into cultural life, shows the way for the rest of us. The medicine is as much the community container itself, of mutual support, camaraderie, and accountability, as it is the actual medicine. The antidote to the epidemic of depression and loneliness in our society is connection and community.

The Medical System: Essential but Insufficient

The recent executive order, and the broader efforts of champions and organizations throughout the psychedelic reform ecosystem to integrate these medicines into our medical system at the federal level in a good way, are enormously important. The Psychedelic Education Partnership is working to train up current and future doctors, nurses and other mental health professionals to properly prepare, oversee and integrate psychedelic therapy sessions. Hopefully federal and state licensure rules for medical professionals will soon also allow at least one psychedelic therapy experience for such professionals in training, via state regulated access programs like Oregon and Colorado that are open to all adults. First-hand understanding of the internal terrain and dynamics of these powerful medicines and therapeutic modalities is obviously crucial for those who would administer them effectively. We are not going to get to broad public availability without these crucial steps, and the medical therapeutic container is enormously important and even ideal for deep individual work and healing; many will need this well-regulated more western style access point to feel comfortable accessing psychedelic healing.² And even as our healthcare system woefully underserves and underinsures many of those who most need help, insurance can and should cover the significant costs of psychedelic therapy and aftercare.

Speaking of, it is equally important to celebrate the outstanding work that the Healing Advocacy Fund and the Psychedelic Mental Health Healing Alliance are doing at the state level: driving toward Medicare and Medicaid coverage of not only the facilitated psychedelic sessions themselves, but of all preparation and aftercare as well, and working within community healing settings too. Oregon and Colorado’s state regulated access programs are also available to all adults without a formal DSM³ diagnosis so long as they do not have a contraindication such as schizophrenia, but for whom insurance will never cover treatment,.

But even under an ideal future scenario where everyone struggling with PTSD, alcoholism, depression, and related conditions gets to participate in a six-month individual and/or group therapy cohort with multiple preparation and integration sessions interspersed with three powerful medicine experiences fully covered by insurance, what happens to those people in the months and years afterward?⁴ After a veteran has had a life-saving experience with psychedelic medicine inside the medical system, where do they turn in the following years for this kind of ongoing healing? Insurance is unlikely to cover recurring sessions, though making it so should remain an important goal for the movement.

The Case for Decriminalization and Self-Regulating Medicine Communities

The answer is what indigenous communities’ show us: the importance of forming responsible, self-regulating medicine communities, organized as churches or otherwise. Decriminalization of these medicines matters not only because no one should be imprisoned for choosing to use them for personal growth, healing, insight, or enjoyment outside of regulated contexts. It also matters so that responsible, self-regulating medicine communities can emerge from the underground, form de novo, and flourish: communities that people can plug into, that provide sound education, ongoing support, and integration guidance around best practices for set and setting, safety screening, facilitator training, and accountability. Growing and providing medicine within these community containers, with good information and education, both is sufficiently safe as well as far more economically accessible than via regulated access programs.

Good decriminalization policy also includes training for first responders, police, firefighters, doctors, and nurses, on how to engage with someone in psychedelic distress, as well as broader public education so that people understand the importance of set and setting and how to engage responsibly and safely with these powerful medicines. Crucially, it should also clarify who should avoid them due to psychiatric contraindications such as schizophrenia. My wife Mia Bronner sits on the board of the Zendo Project, which is currently scaling its Emergency Psychological Response training throughout the country so that first responders interfacing with people in emotional crisis, whether psychedelics are involved or not, know how to engage, support, and de-escalate safely and responsibly.

Alaska: A Model for the Next Generation of State Policy

This brings me to Alaska, where the indigenous-led Natural Medicine Alaska (NMA) team is championing a ballot measure that builds on the excellent policy enacted in Colorado. On the regulated access side, the NMA effort adds “plant-based” MDMA therapy, where MDMA can be produced in-state from high-safrole-containing grasses grown in greenhouses, avoiding federal commerce clause issues. MDMA therapy is remarkable for couples counseling and personal insight and growth, in addition to treating trauma and PTSD, but since neither of the former are diagnoses under the Diagnostic and Statistical Manual (DSM), they are highly unlikely to be covered through the FDA-approved medicalized route. What Alaska is pursuing is opening up MDMA therapy and healing to all adults, crucially building this in to complement what other states have done with psilocybin.

The NMA policy also allows licensed facilitators working on the regulated access side to provide medicine and services inside a client’s home, which is a significant cost savings compared to Oregon and Colorado, which require sessions to be conducted only inside licensed service centers. The NMA policy also lays groundwork for the integration of ibogaine therapy on the regulated access side. Given ibogaine’s cardiac risk profile, it is not decriminalized outside of medically supervised contexts. However, NMA does decriminalize other natural psychedelic medicines, including ayahuasca (and DMT-containing plants generally), Huachuma/San Pedro and other mescaline-containing cacti (excluding peyote), and psilocybin mushrooms. The NMA policy directs the state to offer a voluntary online course that any Alaskan can complete to learn about best practices and safety, and mandates first responder training statewide. The policy also establishes a “Traditional Use Council” composed of indigenous representatives from the different major plant medicine traditions, that will certify traditional healers who have worked ten years or more within an authentic indigenous lineage. This will help distinguish legitimate skilled practitioners from “neo-shamans” often with dubious experience and expertise. Perhaps something like Chacruna’s ethics and reciprocity training program for ceremonial leaders might at some point be included.

Why Alaska Will Succeed Where Massachusetts Did Not

After a fairly similar measure was defeated by voters in Massachusetts in the last election cycle, it’s fair to ask what’s different here. The primary problem with the Massachusetts effort was the poor drafting of the ballot title and summary by the state Attorney General’s office, which made the measure sound like a marijuana dispensary initiative. Our polling identified the problems with the language, but since the same polling showed the actual substantive policy had majority support, and we had overcome a big initial polling deficit in Oregon in 2020 with paid media, we misguidedly believed a robust paid media effort could overcome the bad drafting. Once voters were in the booth, however, the confusing language proved fatal.

In Alaska, by contrast, the campaign had sufficient time to successfully lobby for improved language from the AG’s office. Last month a poll with both online and phone cohorts in which the full and exact title and summary language was read or heard — and in both cohorts, support sits at 59%. Even more impressively, that support does not drop after negative messages are presented without any accompanying supportive messages. This is the first state in which we have seen that dynamic. Alaska is famously libertarian, and voters are considerably less concerned about the home-grow provisions so crucial to a functional decrim model. Alaska’s population is also roughly one-tenth that of Massachusetts, meaning a comprehensive educational campaign can be run for around $2 million, compared to the more than $9 million each raised for Colorado and Massachusetts.

While I was not initially enthusiastic about this effort running in the 2026 cycle, preferring to give Oregon’s and Colorado’s programs more time to establish themselves culturally, and to allow the federal government to complete its FDA-approval work, now that it will run in the 2028 cycle, I believe the entire movement should rally behind and support it. Right now, the near-term need is for the campaign to raise $400,000 to support the signature drive, which must submit signatures by this September. By early 2028, it will begin voter education efforts in earnest. In the meantime, the executive order and the integration of psychedelic therapies into our national medical system will provide meaningful additional reassurance to Alaskan voters come November 2028. Once enacted, Alaska would reset the standard for responsible state level policy: combining a regulated access program with thoughtful decriminalization that enables the flourishing of safe, self-regulating medicine communities that people can join after completing a supervised healing experience on the regulated access side.

The Sacred Plant Alliance: Protecting and Upleveling the Church Container

This brings me to another crucial effort deserving of support: the Sacred Plant Alliance (SPA), a professional membership association for responsible, self-regulating medicine churches, is planning efforts that engage with the DEA to reform its religious exemption process that is meant to review and approve safe and sincere entheogenic churches.. Since formation in 2019, SPA has focused reform efforts on a fair legal process for exemption; but the association has now begun its most significant steps to ensure DEA finally issues the regulations, including proposing its own developed legal framework for DEA to review and filing a lawsuit to prevent prejudice and harm in the current or future version of the process. SPA represents its members through legal advocacy and promoting ethical and safety-oriented practices, like proper safety screening, facilitator education, addressing cult-like dynamics, and other measures to keep these churches healthy and mutually accountable.⁵ SPA is also committed to maintaining a respectful and responsible relationship with indigenous medicine traditions and to sourcing medicine in ways that are not harmful or exploitative to those cultures, which is grounded in SPA’s ethical framing of sacred practices and particularly in recognition of U.S. obligations to its indigenous peoples and medicine. The initial phase of their legal efforts to properly establish the exemption framework, as well as finalizing the strategy for litigation of the existing process, carries a price tag of $180 K, with $120 K still to raise for base operations this year as well.

The Conservation Crisis: Protecting the Medicines at Their Source

An unfortunate side effect of the “psychedelic renaissance” and the exploding global demand for medicines like peyote, iboga, ayahuasca, 5-MEO and huachuma is the rapid depletion of wild sources. I recently returned from an extraordinary trip to Peru with the Indigenous Medicine Conservation (IMC) Fund, to visit Collectivo Huachuma and learn about their remarkable conservation work. The IMC Fund raises and disburses funds to support indigenous-led conservation efforts across the various medicine bio-cultures.

Huachuma, or San Pedro, is often, and I now understand inaccurately, touted as a sustainable source of mescaline for non-native practitioners, in contrast to the peyote gardens of southwest Texas, which are being rapidly depleted. While San Pedro grows far more quickly than peyote and across a much wider geographic range (including in my San Diego neighborhood and throughout Southern California), the practice of purchasing San Pedro powder online from Peruvian sources has resulted in the eradication of approximately 95% of the wild medicine from its native range in the Andes, in just the past two decades.

Visiting the maestros and medicine communities there, I was deeply impressed by their mystical wisdom and generosity of spirit.⁶ They fully support Huachuma flourishing and healing people around the world, but they ask that people grow and harvest their own medicine rather than sourcing powder from the internet. They would like those working with this medicine to cultivate some form of respectful, informed relationship with the healing traditions that have flowed forth from the Andes. It’s worth noting that many styles of serving medicine and ceremony exist, and the maestros honor and respect one another’s approaches. Perhaps eventually there will be “fair trade” medicine available for broader consumption, but right now newly planted gardens are being prioritized for local use. Those of us in the U.S. and globally should begin planting San Pedro as soon as possible for use in the churches and ceremonies springing up across the country. I sometimes describe Huachuma as “MDMA without the hangover” — it is not as strongly altering as other plant and fungal medicines, and is more about opening the heart, dropping into our emotional truth, and bringing us into presence with each other, the miraculous natural world, and the divine spirit flowing through it all.

Iboga, the Nagoya Protocol and the “1% for the Planet” Model

Similar challenges face iboga that is being stripped at a rapid rate from the jungles of Gabon to feed surging global demand. The group Americans for Ibogaine recently visited Gabon, the spiritual homeland of the healing iboga tradition, and hopes to build financial support from the commercialization of ibogaine that honors the intent of the Nagoya Protocol, which holds that indigenous medicine cultures should share in the benefits of any pharmaceutical drug derived from their traditional medicines.⁷ In light of our deplorable history of slavery and now this incredible healing flowing from west Africa to heal trauma for modern day Americans, this is that much more important. Since the FDA approval pathway will almost certainly involve a synthetic ibogaine molecule rather than a naturally sourced one, benefit sharing will need to be built in through a mechanism other than fair-trade sourcing. I have been advocating that the psychedelic pharmaceutical sector adopt a 1% for the Planet model, directing 1% of net revenues to the IMC Fund for redistribution to projects in the relevant bio-culture; a program that could also apply to state-licensed medicine providers. A strong endorsement here for the IMC Fund’s work and for the partner organizations it supports, including Blessings of the Forest, Indigenous Peyote Conservation Initiative, UMIYAC, Colectivo Huachuma and others.

Other Essential Indigenous-led and focused Efforts and Orgs to Support

The World Ayahuasca Conference, being championed by indigenous leaders from South America, is one of the most significant indigenous-led gatherings in the movement’s history. ICEERS, a wonderful European-based organization serving as a bridge and helping with fundraising, is central to this effort. I am happy to make introductions for anyone interested. The remaining funding gap is approximately $300,000, and the conference is scheduled for September 9–11 in Spain.

Chacruna deserves recognition for holding space for indigenous, BIPOC, and LGBTQ+ communities in the U.S. Their recent conference was as powerful as ever, they recently launched an ethics and reciprocity training certificate program for ceremonial leaders and facilitators working outside regulated access programs, and they steward their own Indigenous Reciprocity Initiative. Chacruna also helped develop the Sacred Plant Alliance and remains a key organization to support.

How do we responsibly educate and initiate our young? Hopefully with far more care than my own introduction, which came from a college friend with little education or context. It turned out fine for me, but others have not been so fortunate. Instilling genuine education and respect for how to approach these medicines is essential. The Psychedelic Parenthood Project seeks to destigmatize and normalize multigenerational families within medicine communities, much as indigenous cultures do so beautifully. Leaders involved come from the Santo Daime, one of the few legally recognized ayahuasca churches in the U.S., that formed in Brazil roughly a century ago and is now global, weaving together Amazonian, West African, and Catholic influences in a remarkable synthesis. I am reminded of Aldous Huxley’s Island and his vision of “moksha medicine”: a thoughtful approach to responsibly initiating young people, similar to how youth in indigenous medicine cultures are welcomed into these traditions when they are of age and ready.⁸

Closing Reflection: Ancestral Intelligence and the Path Forward

I’m writing this en route to and from a sun dance ceremony outside of Mexico City to which I’ve been honored and privileged to participate by invitation, hosted by the remarkable healing center and organization Nierika, under the guidance of Lakota spiritual leaders, family and friends. This is my fourth year dancing, and I remain a humble beginner, barely scratching the surface of the power and depth of this ceremony and these indigenous lifeways. I strongly believe that the Indigenous connection to spirit and nature holds the key to our collective healing and to restoring our relationship with the Earth and the divine.

The psychedelic movement has a unique opportunity and responsibility to serve as a bridge: allowing these lifeways and teachings to permeate global culture in a good way, to the genuine benefit rather than the detriment of our indigenous elders. But this requires conscious, ongoing attention to that relationship, rather than defaulting to our consumption-driven Western tendency to prioritize our own needs and healing without care or concern for the indigenous stewards of this planet, or for nature at large.

Supporting the organizations and efforts named here is a meaningful starting point. Our friends at ICEERS have been using the beautiful term “Ancestral Intelligence” to describe the indigenous wisdom, lifeways, and mystical science we must reweave into the fabric of global culture. Not as nostalgia, and not in opposition to modernity, but as a living counterweight and guide, so that we may consciously steward our collective impact on our planetary home, and find our way to integrating powerful modern forces like Artificial Intelligence in a manner that genuinely serves all life.

I look forward to a growing global wave of appreciation, understanding, and healing of and from indigenous wisdom and ways, that honors their medicine traditions and cultures, and moves us toward the fulfillment of the Eagle and Condor prophecy. That ancient vision foretells a time when indigenous and Western ways of knowing and being come into genuine integration, giving rise to true collective healing and flourishing on this planet. The Lakota leaders Crazy Horse and Black Elk had visions in the late 1800s, that within seven generations this would come to pass, which I hope and pray means in the lives of our children or children’s children if not our own.

The red nation shall rise again and it shall be a blessing for a sick world; a world filled with broken promises, selfishness and separations; a world longing for light again. I see a time of seven generations when all the colors of mankind will gather under the sacred tree of life and the whole earth will become one circle again.