Researchers Argue for Equality in Psychedelic Terminology Used in Medical Care

Research Terminology

Researchers at the Department of Medical Ethics and Health Policy (Perelman School of Medicine, University of Pennsylvania), argued for the development and adoption of a standardized, objective, and medically-founded vocabulary for psychedelics for use by researchers, clinicians, and patient-centric organizations including commercial enterprises.  Different language choices were offered to compel thinking from those within the clinical sphere.  By changing the vocabulary typically used in discussion of treatment, researchers hoped to propel advancement of psychedelic therapies into the world of mainstream medicine.  

The Research, Summarized:

  • Researchers argued for the adoption of a standardized vocabulary for psychedelics used in medical and scientific research settings
  • The use of objective language rather than stigmatizing vocabulary or slang was favored to advance public acceptance of the potential benefits of psychedelic medicines
  • Changing the language surrounding medical discussion of psychedelics may allow patients to better communicate with researchers and clinical therapists about their experiences and outcomes
  • The standardization of psychedelic language may combat stigma curbing the validity of further exploration and use of psychedelics in mainstream medicine

Authors of the study highlighted the push by practitioners within the realm of addiction medicine to change terminology from words that were assumptive or subjectively pejorative to those that were medically-focused and unbiased, e.g, favor of the term “withdrawal management” over “detoxification” or “detox” and the move away from terms such as “abuser” and “addict” within the clinical sphere to words which do not serve to invoke moral judgment.  

They recommend similar changes to occur in the world of psychedelic medicine.  Such changes are rooted in the shift away from terms that may harken to recreational drug use like “molly
and “shrooms” in favor of terms that are based purely upon the chemical structure or mechanism of action of any particular psychedelic substance used in therapy.  In this respect, authors further suggested that names should not be based upon drug side effects, e.g., “hallucinogens.”  The term “psychedelic,” itself, may instead be replaced with “5HT2A receptor agonist.”

Words used within the medical sphere often pave the roadway to clinical drug approval granted by the United States Food and Drug Administration (US FDA).

The Multidisciplinary Association for Psychedelic Studies (MAPS) and other organizations focusing on evidence-based innovations in the realm of clinical research including Compass Pathways have highlighted FDA approval as the gateway toward broader accessibility and acceptance of psychedelic treatments from both patient and clinician perspectives.  As the pathway to FDA approval is rigorous, highly vetted, and standardized, researchers campaigning for a new psychedelic linguistic framework argued that the FDA approval process must be met with a standardized scientific lexicon, i.e. “medical model,” for distinguishing psychedelics used for medical purposes from those used to facilitate recreational, spiritual, and religious experiences.  Doing so may not only enable a wider range of potentially beneficial treatments for patients, but also strengthen the relationship patients have with their therapists.

Dual communication between patients and their healthcare providers requires a mutual sense of understanding which may be cultivated upon a platform of shared language.  Such language must be precise so that patients understand the therapy offered and how it may be experienced while being empowered to share the complexities of their own unique and individual experience.  

Authors of the study drew attention to the historical framework surrounding usage of the word “trip” as a general reference to the psychedelic experience and how its lingering use in the context of modern medicine may undermine clinical encounters.  The negative connotation that trip or “tripping” carries with underground or counterculture movements is one which researchers argued has contributed to the misconception of mental healthcare as different from healthcare in the aggregate.  Further contributing to this misconception are the blurred lines between morality and spirituality vs. medical disorders treated in medical settings which must abide by medical protocols.  “Tripping” also may carry the connotation of a negative psychedelic experience.  Within the context of medical communication between patients and providers, the potential multiple meanings arising with use of the word trip, i.e., simply having an experience using psychedelics vs. having an adverse psychedelic experience, further blurs lines that may be detrimental to the progress of clinical care.  Rather than using the word trip to document a difficult psychedelic experience reported by a patient, researchers suggested that healthcare providers use the term “acute adverse psychological reaction” instead.  

Although there are no terms that are purely neutral, with all language interpreted subjectively based upon an individual’s unique circumstances and experiences, it is important for both patients and providers to have the ability to communicate in a way that is effective, unbiased, and without judgment.  The entire world has been shaped through the use of words, with the world of healthcare being no different.  Words are the ground zero upon which all institutional platforms are constructed.  They are the building blocks for the frameworks that mold mindsets and approaches.  If we aim to shape a better institution for the benefit of patients, we must first start with the building blocks.