One of the things that makes psychedelics different is that, instead of reducing suffering reliably, they can actually increase suffering ... They can be escapist, they can be highly euphoric, but they can also cause a difficult confrontation with painful dimensions of your existence. And I think that is precisely what makes them useful.

I do think that the kind of primary axis that a lot of drug use operates on is one of mitigating suffering. And how we conceptualize our own suffering is, ultimately, the fundamental question in how we use drugs ... Drugs are very, very useful for mitigating all sorts of suffering; that's why people love them—whether it's boredom, physical pain, emotional pain, depression, insomnia, whatever. They do that very effectively.

You take the two most commonly used psychedelic drugs, psilocybin-containing mushrooms and LSD, these are both psychedelics where essentially no one knows what dose they're taking. People will say one blotter contains 100 micrograms of LSD. They don't know that. If anything, all signs point to one blotter never containing 100 micrograms of LSD.

To completely dismiss the thing that makes psychedelics so valuable, which is that they can force you into uncomfortable confrontations with aspects of your personality and your life that could ultimately be very constructive, I think that that's something that should be appreciated about psychedelics, not something that people should treat as an undesirable outcome that should be avoided.

I think that's another kind of paradoxical aspect of this is people think of psychedelics as hallucinogens that detach you from reality, but they can have almost the opposite effect of forcing you to confront a reality that you are avoiding entirely.

They have done epidemiological analysis of the incidence of mental illness among psychedelic drug users, and the incidence of schizophrenia is not higher than the general population. So, if these were substances that reliably induced schizophrenia, we would know that by now...

I wish I could say, you know, everyone carry Narcan, use fentanyl test strips, carry little reagent test bottles with you, and you'll be okay. It's not that simple. I think people should do that, but in doing it, they should also recognize that the protection they provide is incomplete and, ultimately, the things that will protect people most are not trusting any street drugs at all.

We will always live in a world where people are trying to sell us things that make us feel good that might be bad for us—whether it's drugs or junk food or social media or who knows what else? I mean, this is just the reality of our existence, and the only way that we will be able to survive in this world is through cultivating a sophisticated understanding of those dynamics and learning to deal with our own suffering in the healthiest possible way.

I don't believe in the term 'bad trip.' I think it's not a constructive idea ... I say this as someone who's seen people have extremely difficult experiences ... I had a friend who had a psychotic break while using psychedelics, but I wouldn't call that a bad trip. I just don't think it's a useful phrase.

So much of what we think we know about drugs is really what we know about drugs in an environment where they are illegal.

When somebody is struggling with a problem using drugs, they often hide it. And when they do, it becomes almost impossible to help them. It's the worst thing a person can do.

I think that a lot of damage has been done, historically, in the way that we talk about drugs, whether it's during the Reagan Administration or the Nixon Administration, the War on Drugs, 'just say no,' the way that journalists historically have been complicit in the War on Drugs, the way that people don't learn from the mistakes of the past. And it has been very dark when you look at the way things were.

More people died of drug overdoses in 2020 than any other year in history.