Assessing Logistical and Ethical Barriers for Psychedelic-Assisted Therapy Implementation: A Cross-Sectional Pharmacist Survey

Despite the existence of current treatments for major depressive disorder (MDD), depression symptoms and burdens often persist, prompting the need for novel therapies, including psychedelic-assisted therapy (PAT), with promising potential for early and durable antidepressant responses. Objectives: This research aims to compare pharmacist opinions regarding logistical and ethical considerations surrounding current MDD treatments with those anticipated for PAT, as well as support for prescription use versus self-medication with psychedelics in specific scenarios and populations. Methods: Pharmacists were surveyed via cross-sectional convenience sampling to capture perceptions regarding current and future depression treatments. Survey responses were assessed with one- and two-way parametric and non-parametric analyses where appropriate. Results: Treatment costs and legal barriers were perceived as significantly greater logistical barriers for PAT compared to current treatments (P ≤ 0.01 and P ≤ 0.0001, respectively), whereas no significant differences were captured regarding ethical barriers. Prescription use of psychedelics in adult patients garnered significantly greater support than self-medication for depression in situations of post-suicide attempt, suicide prophylaxis, and after failing two or more antidepressants (P ≤ 0.0001, P ≤ 0.0001, and P ≤ 0.001, respectively). Prescription psychedelic use garnered significantly greater support than self-medication for use in elderly, incarcerated, active-duty military personnel, and veteran patients (P ≤ 0.01, P ≤ 0.01, P ≤ 0.0001, and P ≤ 0.05, respectively). Conclusion : Pharmacist perceptions of ethical barriers associated with PAT generally aligned with those perceived for current treatments, while logistical barriers regarding cots and legal barriers were perceived to be greater for PAT. Pharmacists generally expressed greater support for prescription psychedelic use compared to self-medication, with prescription use supported in many protected populations. PAT was perceived as an overall helpful addition to current depression treatments. • Psychedelics and current treatments pose similar ethical considerations • Logistical considerations differ for psychedelics and current treatments • Pharmacists support the prescription use of psychedelics • Pharmacists perceive psychedelics as helpful for depression