There’s a huge difference between recreational use and what people mean when they talk about psychedelics assisted psychotherapy.

It is a thing and it is legal in the US, UK and other countries using ketamine, and (where legalized) psilocybin and cannabis. Clinical trials are ongoing in many parts of the world especially using MDMA and LSD. The substances in use in the mainstream by reputable providers are not technically psychedelics (primarily ketamine), but used for their ability to induce almost/similar to psychedelic experiences .

It’s not just a matter of adding a drug to an existing therapy session - therapists need to be specially trained and there are many training providers springing up. The parameters of sessions can be quite different in terms of time and format.

People do use psychedelics (illegally) for self-therapy, and again, it’s a very different experience and process than using them for fun. The effect people are looking for, whether with a therapist or solo, is not the ‘high’ but the lowering of defences, access to dissociated material and the ability to think and feel about things that are unbearable when sober. Also, their empathogenic qualities, which help with building self compassion. Integration after solo sessions is something a lot of therapists are already comfortable doing.

There is tons of evidence already around the effectiveness of ketamine as a treatment for depression, and MDMA is very close to getting over the line. At a one year follow up of the MAPs MDMA trial, 67% of participants with PTSD were symptom free. That research is now in the last stage before FDA approval and will likely be fully approved sometime in 2022. FDA has fast tracked the last stage due to COVID and already granted extended compassionate access, recognizing the great need for new treatments for intractable mental health problems.

For a really rational perspective on this, Prof David Nutt’s Drug Science Podcast is brilliant.

Anyway....just wanted to add some context...