European Citizens Initiative: PsychedeliCare

European Citizens Initiative: PsychedeliCare Bárbara Inês Pires Messias Master's Thesis Sociology of Law International Institute of Sociology of Law Oñati, 2024/2025 Supervisor: Aitor Jimenéz Submitted on July 24th, 2025 Acknowledgments My deepest gratitude to my parents and sister for all the unconditional support in every moment. To my partner, for being the space where I could slow down. To my master’s professors for opening many horizons, both personally and professionally, and to my supervisor Aitor, for his enthusiastic support and guidance. To the IISL staff and the village of Oñati, for their hospitality and for taking care of us. And to my twelve friends in Oñati, in whom I found a home – and to whom I dedicate this thesis. 2 Table of contents Abstract 4 1. Introduction 4 1.1. Personal Background and Remarks 4 1.2. Thematic Background 5 1.3. Methodology 6 2. The European Citizens Initiative 8 2.1. Background 8 2.3. EU Legislative Process and Participatory Democracy 10 2.4. Past ECIs and Stop Vivisection Case 11 2.5. What Makes a Successful Signature-Collection Campaign? 14 2.6. Evolution and Critical Reflections 16 3. Psychedelics & PsychedeliCare 17 3.1. Background 17 3.2. Origins – History of Use and Prohibition 20 3.3. Current situation 26 3.4. PsychedeliCare 27 4. Psychedelics Go Grassroots 28 Conclusion 31 References 33 3 Abstract This thesis examines the European Citizens’ Initiative (ECI) PsychedeliCare, first as a participatory democracy tool to reform psychedelic policy in the European Union, and beyond its procedural role, as a grassroots movement uniquely positioned to shape both the development and reception of psychedelic policies. By combining document analysis, critical discourse analysis, and autoethnographic insights, it investigates the dynamics of democratic participation and the evolving field of psychedelics, touching upon its historical trajectory and the development of psychedelic-assisted therapy (PAT) – the focus of PsychedeliCare. Framing the ECI as a form of legal mobilization, this work draws on the perspective of Michael McCann (1994), who emphasizes that the adjacent social movement is as significant as the legislative outcome itself. This work argues that although ECIs rarely result in binding legislative change, the movement behind them – often grassroots in nature, as in the case of PsychedeliCare – is crucial as a citizen-led sociocultural intervention. In this context, grassroots actors in the psychedelic field are crucial in engaging both legislatively and non-legislatively. The former offers a bottom-up alternative to top-down governmental or corporate lobbying, helping to shape policy directions and include civil society in a field that remains vulnerable to centralized, stateor market-driven integration. The latter enables efforts such as awareness-raising, public education, and harm reduction, of most importance for destigmatization and the dismantling of the existing moral panic. Ultimately, the presence of a grassroots movement behind an ECI on psychedelic reform is not incidental but central to its effectiveness, both in campaigning and in ensuring the integration of PAT in a safe, accessible, and non-extractivist manner. 1. Introduction 1.1. Personal Background and Remarks As a member of an European Citizens’ Initiative (ECI), during the course of the masters’ degree in Sociology of Law, I became increasingly aware, more than when I first joined the project back in may 2024, of the relevance and importance of this democratic tool in the context of participatory democracy in the European Union (EU). Additionally, during my studies, as it’s the very focus of this ECI, I was able to explore the relevant socio-legal dimensions of the psychedelic field in the therapeutic and medical context that PsychedeliCare ECI operates on, but also the spheres of personal use, in matters of public health. These two rich topics motivated me then, to write this thesis about the ECI tool and PsychedeliCare as a case study. Given such, it is then important to acknowledge, at the very beginning of this thesis, my own standpoint. Being part of the object I proposed myself to study demands that I take on two different roles. One of the researcher, scholar and social scientist that requires me, at the very least, not to be attached to the outcome of advocacy, so rather than engage, observe and document. The other, as part of a citizens' movement, of the activist, pushing a dissident political agenda. But is that really the case? Scholars and intellectuals are in a “privileged” position when it comes to knowledge, so as Noam Chomsky (2017) puts it, “it is the responsibility of intellectuals to speak the truth and to expose lies” (p.16). Otherwise at risk of conforming to the power structures in place and perpetuating injustices. So, the role of the researcher is not one rather than engaging – but perhaps before engaging. One can argue, both roles, with each other, get stronger, and society may benefit more from them. 4 1.2. Thematic Background In recent years, the EU has made efforts to integrate participatory democratic mechanisms, among which the ECI stands out as a rare example of legally institutionalized civic engagement. Parallel to this, a “Psychedelic Renaissance” has gained momentum across medical, academic, artistic and activist circles – reigniting debates about the legal status of psychedelic substances in both therapeutic and personal-use contexts. In these circumstances, initiatives like PsychedeliCare emerge at the intersection of participatory democracy and psychedelics. By leveraging the ECI, citizens are not only demanding legislative reconsideration of psychedelic prohibition but also challenging the deeper normative tensions between law, science, and social values that have historically shaped the governance of these substances. Thus, the main research question is – Can the ECI tool be used to reform psychedelic policies in the EU? To answer it, the present work will be divided in three parts, exploring different subquestions. Part I. The European Citizens Initiative Focusing on the subquestion – To what extent can ECIs lead to substantive legal or policy reform at the European level? Touching upon definition and process, historical development, broader processes the ECI represents, comparison with both other EU democratic mechanisms, and outcomes of past initiatives. Part II. Psychedelics & PsychedeliCare Elaborating on – Why are citizens coming together to demand psychedelic policy reform? Exploring definitions and history of psychedelic uses and prohibition, current state of policy and field, then moving on to the case study of PsychedeliCare. Part III. Psychedelics Go Grassroots Interrogating – What is the role of such a citizen-led organization shaping the psychedelic field? An intersection of the previous chapters, exploring the need for grassroots involvement in this context. The ECI has been extensively discussed (Greenwood, Weisskircher, Bouza García & Villar), but mostly from a European Law perspective, and none of the works are simultaneously focusing on the theme of advocacy, limiting the exploration of the ECI’s potentiality. Tosun & Schaub (2021) for instance, focus rather specifically on narrative strategies (storytelling, cost-benefit framing, evidence as persuasion) employed by ECIs, but fail to address the connection between the narrative strategies and thematic content. This deficit is aggravated especially when it comes to the socio-legal issues raised by ECIs. In general, the literature has not yet engaged much with ECIs through a socio-legal analytical lens, a gap this thesis aims to address. As a result, Savigny's theoretical perspectives and the debate of legal mobilization and grassroots organization will be integrated, relevant to further understand the broader dynamics and what the ECI it actually is – a bottom-up social movement looking to influence the law. On the psychedelics side, the importance of bottom‑up organisations in shaping this rapidly emerging policy space remains strikingly under‑analysed. Much of the existing scholarship in this “Psychedelic Renaissance” still gravitates toward biomedical efficacy trials, market forecasts, or high‑level regulatory pathways, leaving grassroots actors to the margins. Yet citizen‑led initiatives such as PsychedeliCare illustrate that normative change in this domain is being driven as much from the ground up as from expert committees or corporate boards. This thesis points to the importance this type of grassroots mobilisation, 5 as it operates both as a legal trigger and as a cultural project: it contests patents, fostering Indigenous knowledge and equity concerns, and provides education that formal regulation alone cannot deliver. By analysing PsychedeliCare through the combined lenses of legal mobilisation theory, Savignian socio‑legal evolution, and Moore’s semi‑autonomous social fields, this thesis therefore makes three specific contributions. First, it conceptualises ECIs as legal-cultural movements potentially capable of mediating the science‑law gap around psychedelics. Second, it offers an insider account for campaign strategy, revealing some tactics such as narrative framing, coalition‑building, digital organising tools, and country specific strategy. Third, it demonstrates that grassroots participation is not merely an accessory to policy reform but a substantive safeguard against the risks of top‑down medicalisation and commercial capture, ensuring that future regulatory frameworks remain attuned to the historical injustices and community needs. 1.3. Methodology This thesis employs qualitative research and analysis, exploring the normative tensions surrounding psychedelic substances, as well as its relevant socio-legal dynamics, and PsychedeliCare ECI. It employs document analysis, for instance, Regulation (EU) 2019/788), institutional documents from the European Commission, previous ECI campaign documents, and reports. Also, a comparative analysis of all the existing participatory democracy tools and traditional law-making vs ECI; and a critical analysis of the outcomes of each ECI is also employed to further explore the potentiality of the tool. Critical discourse analysis (Fairclough, 2013) was employed specifically to reveal ideological elements and power relations that lay beneath legal texts, such as the San Francisco ordinance against Opium Dans. Additionally, narrative analysis (Riessman, 2008) was undertaken to explore media narratives in the 60’s and 70’s regarding psychedelics. The study integrates theoretical frameworks drawn from socio-legal theory, particularly legal mobilization theory (McCann, 1994; Lehoucq & Taylor, 2020), grassroots (Smith, 1997), classical socio-legal theory (Savigny, 1831), biopower (Foucault, 1965, 1973, 2003), and Semi-Autonomous Social Field (Moore, 1973). Legal mobilization theory touched upon strategic invoke of legal rights and mechanisms (like the ECI) to influence socio-political agendas and legislative frameworks, through a voluntary citizen-led manner. Savigny situates legal phenomena within the evolving consciousness of society, thus helping frame ECIs as potential responses to societal shifts in norms, values, and perceptions. Foucault, on the other hand, helps to understand the power dynamics in the psychedelics medical and media framing; Moore’s theory later concerns the normative conflict between the scientific and legal fields when it comes to the safety and medical use of psychedelics. An auto-ethnographic (Ellis, 2004) element is integrated, as I reflect critically on my positionality within the campaign, acknowledging how this perspective informs and limits the analysis and integrates insider insights, such as best practices for campaigning. Such data collection involved participatory observation in campaign events such as the PsychedeliCare February campaign launch in the European Parliament (EP) (Brussels), where observations were documented systematically in reflective research diaries, alongside informal discussions with other campaigners. Also, I add but also events on the field, such as Conferences – 2nd Multidisciplinary conference: Science of Psychedelics in Practice, I attended in 6 Zagreb in April, or the Psychedelics Law Bootcamp at Harvard Law School, in Boston, July 2025. This methodology seeks to intertwine EU law and psychedelics, highlighting the applicable socio-legal phenomena and explores how law, scientific knowledge, civil society, and historical narratives interact to shape contemporary psychedelic policy discourse in Europe. Autoethnography provides a vantage point, as it allows access to informal practices, strategic discussions, and further dimensions of activism typically inaccessible to external observers. Overall, this methodological approach aimed to intertwine EU law, psychedelic policy, and existing socio-legal dynamics. 7 2. The European Citizens Initiative 2.1. Background This section addresses the question – To what extent can ECIs lead to substantive legal or policy reform at the European level? It sets the foundation for understanding participatory democracy, on which PsychedeliCare is based. It will begin by explaining what an ECI is, its definition, legal basis, and purpose. It will then explore the history and evolution of the tool, how and why it was created, highlighting the challenges it aims to tackle. To contextualize its relevance, some statistics will be presented. Following this, the chapter outlines the procedural steps involved in launching and submitting an ECI. It then introduces the theoretical framework of legal mobilization to situate the ECI within the broader system of democratic tools and bottom-up legal strategies. This includes an analysis of the grassroots nature of ECIs and their function as a form of legal mobilization. It will then be compared to traditional EU law-making with the ECI mechanism, as well as with other participatory democracy tools available to EU citizens. It then continues by assessing the concrete outcomes of past ECIs to evaluate their potential, including a literature review on best practices for successful campaigning. Finally, the chapter concludes with a discussion on the evolution of the ECI and some critical reflections on its institutional strengths and limitations. Established under the Treaty of Lisbon in 2009, through the Article 11(4) of the Treaty on European Union (TEU) and the Article 24(1) of the Treaty on the Functioning of the European Union (TFEU), this tool is operational since 2012, one year after its adoption by the European Parliament (EP) in the Regulations (EU) No 211/2011 and (EU) 2019/788. The ECI allows EU citizens to propose new legislation to the EC. According to this institution, over 1000 people have launched ECIs since its inception (European Commission, European Citizens' Initiative, n.d.). Of the 142 projects submitted, only 119 were registered, either fully or partially. Rejected initiatives included proposals to stop trade with Israeli settlements or address Brexit (“British friends—stay with us in EU”, 2018; “Stop Brexit”, 2017). All 23 rejections were based on the initiatives falling outside the EC’s powers. The first registered ECI, “Fraternité 2020,” aimed to enhance EU exchange programmes like Erasmus to strengthen solidarity, but it failed to reach the required threshold for further analysis. At the beginning of the century, distrust and disinterest in EU politics, decreasing adherence to EP elections, the Irish rejection of the Treaty of Nice – were all symptoms of a hiatus between the EU and its people (European Commission, 2001). Such led the Commission to identify, in the 2001 white paper, a democratic deficit and open EU governance as one of its main objectives. It was the goal to open up “the policy-making process to get more people and organisations involved in shaping and delivering EU policy” (European Commission, 2001, p.4), combining different tools such as legislation, social dialogue, funding, and action programs. Twenty years later, some of the existing tools and mechanisms in place can be reasoned back to this white paper. The increased powers attributed to the EP, and citizen involvement in policy-making through instruments like ECI, EP petitions, and public consultations. All these provided citizens with a mechanism to influence EU legislation and actively participate in shaping European policies. 8 When it comes to the ECI process, the initiative must (i) establish a citizens' committee, a group of seven organizers, residing in seven different EU countries; (ii) follow the registration requirements – having a title, subject matter, objectives, and stating all sources of funding and support. Only then, they’ll be able to initiate the (iii) signature collection (at their chosen date) and then gather, at least, one million statements of support (signatures). There is a minimum limit of signatures for each country, depending on its population. For instance, the threshold for Portugal is 15,120, for Germany 69,120, and for Malta 4,320, and these thresholds must be achieved in at least seven different member states within a period of twelve months since the campaign launch. After this, (iv) the statements of support are verified and (v) submitted. The Commission examines it within three months and decides on the appropriate action, whether that means legislative action or not (European Commission, European Citizens' Initiative, n.d.). As an instrument that allows citizens to propose a legislative change, the question is raised whether ECI reflects a broader social shift, one that is outpacing the legal frameworks. In other words, does it point to a possible lag between social and legal? According to Neil Mahoney (2022), in the same lines as Savigny’s (1831) idea of law existing in the “consciousness of people” (Mahoney, 2022, p.25), legal evolution keeps “at peace behind social evolution” (p.113). Proposing that law follows society as it changes. So is the ECI a mechanism that seeks to “correct” the lag between the social and the legal? On the one hand, it can be argued that Savigny and Mahoney are referring to a broader legal change, perhaps a change in legal culture1, that the legal change proposed by an ECI likely won’t trigger. Another possible argument is that one million citizens are not necessarily a big enough sample to call it social evolution, but instead, maybe a politically engaged or intellectual elite, proposing some sorts of change, within a specific topic. Whether the ECI captures a social evolving consciousness or merely channels the ambitions of a vocal minority remains an open question, discussed later on the specific case of PsychedeliCare. 2.2. ECI as Bottom-up, Grassroots, Legal Mobilization Nonetheless, regardless of whether the number of supporters is perceived as large or limited, the success of the ECI is dependent on the social movement behind. Given the scale of coordination and public engagement, it represents a significant act of collective mobilization. In this sense, the ECI can be understood as a form of legal mobilization, wherein the law is deliberately and strategically employed in an explicit, self-conscious way, through the invocation of a formal institutional mechanism (Lehoucq and Taylor, 2020). Additionally, McCann’s (1994, 2006) broader view on legal mobilization is perhaps more adequate to describe the ECI. Not solely focusing on the litigation side but also legislative advocacy, with ability to shift public perception, reframe public debates, generate awareness, empower marginalized groups (by providing them with the resources to influence the political arena – in theory), and perhaps even influence the legal culture. According to Bouza Garcia & Greenwood (2014) “Citizens’ initiatives are by nature a form of mobilisation of grassroots” (p.249). A grassroots organization is according to David H. Smith (1997) a “locally based, significantly autonomous, volunteer-run, formal non-profit groups that manifest substantial voluntary altruism and use the associational form of organization” (p.2). As seen in Zeegers (2016) work, not every existing ECI qualifies as a grassroots organization, but its importance remains 1 Considering Cotterrell’s idea of legal culture as the general environment, the law, ideas, behaviours of people. 9 ● addressing a less technical issue, making it easier for public engagement8 The insider institutional knowledge, coupled with grassroots mobilization and an easy-to-grasp narrative, is then highlighted. Additionally, drawing reflections from participant observation, reflective research diaries, and informal discussions in PsychedeliCare, some of the following practices are highlighted: ● having clear, common online platforms and tools for shared work, defined beforehand – such as a calendar, document sharing, and daily chat – to facilitate communication within the organization ● robust fundraising plan for collection and implementation, from the outset ● having compensated roles alongside voluntary positions ● translation of communication material (website, social media, flyers, etc) in each national language Together, these point to a model of successful ECI campaigning that combines being legally precise, having narrative power, grassroots agility, and institutional engagement, suggesting that campaigns which strategically balance these elements stand a better chance of achieving more visibility and impact. 2.6. Evolution and Critical Reflections The most recent changes to the ECI were introduced through Regulation (EU) 2019/788, which came into effect on 1st of January 2020. These changes were introduced as a result of a call for revision by the EP, the European Ombudsman, the CoR, the EESC, ECI organisers, and scholars (Salm, 2018). The most serious problems pointed out were the “1. lack of legal status for the ECI citizens' committee; 2. a rigid and non-transparent admissibility check; 3. difficult conditions for the collection of signatures; 4. a high number of invalid signatures; 5. the European Commission's weak follow-up provisions for successful ECIs” (p.4). The Regulation (EU) 2019/788 then aimed (5) to make the European citizens' initiative more accessible, less burdensome and easier to use for organisers and supporters, and to strengthen its follow-up in order to achieve its full potential as a tool to foster debate. It should also facilitate the participation of as many citizens as possible in the democratic decision-making process of the Union. (L 130/55) The reforms tackle the problem of difficult conditions for signature collection by improving the user-friendliness of online collection. Furthermore, it introduces the ECI Forum to better support and guide organisers and implements communication activities to increase citizens’ awareness of the ECI (European Commission, Review, 2023). These reforms were analysed in a 2023 Review by the EC, where ECI organisers voiced some contributions. They state that they perceive the ECI as more effective than other participatory mechanisms – such as public consultations, petitions, or voting – in terms of visibility and citizen engagement. However, they simultaneously highlighted the ECI’s limited political impact, along with ongoing challenges related to campaigning and communication, which continue to pose significant barriers to its 8 Although the author mentions STOP-TTIP! ECI has an example that broke through this barrier, by presenting a technical issue in an amenable form, raising public debate. 16 success. Many described the ECI as a "weak instrument," noting that large, established organisations are often reluctant to invest time and resources in supporting initiatives. This reluctance may be partly explained by the institutional positioning of the tool. As Commissioner Maroš Šefčovič – then responsible for the ECI – emphasised, the instrument was designed “not for NGOs, but for all citizens” (EurActiv, 2011). Empirical evidence also suggests that campaigns led by larger, well-resourced organisations have been notably fewer than those initiated by emerging or ad hoc citizen groups (Bouza García & Del Río Villar, 2012). Additionally, the report reveals some organizers critiquing the one million threshold as too high, warning that the ECI, paradoxically enough, risks becoming a tool accessible only to well-resourced civil society actors. So the EC seems to ignore the structural inequalities in the mobilization capacity of smaller advocacy groups, creating an institutional double bind. In parallel, some scholarship has been critical of the ECI, similarly pointing to its weakness, but regarding institutional responsiveness9, which turns it into a rather symbolic instrument (Bouza García & Del Río Villar, 2012; Greenwood, 2018) with structural inequalities in mobilization (Weisskircher, 2019). Moreover, at PsychedeliCare, it’s pointed out that the Commission's insufficient communication efforts, as the ECI lacks visibility among EU citizens, despite the Eurobarometer results showing 64% of awareness (European Commission, Review, 2023). I add that a significant part of our efforts has been focused on explaining the ECI itself. In a resource-constrained campaign, every action and communication effort counts, and campaigners have been undertaking foundational educational work that arguably should have been the responsibility of the Commission itself. 3. Psychedelics & PsychedeliCare 3.1. Background This section will elaborate on – Why are citizens coming together to demand psychedelic policy reform? Beginning with the definition and origins of psychedelics, including some necessary discursive clarifications of the terms “psychedelic” and “drug”. It will then offer a definition and discussion of Psychedelic-Assisted Therapy (PAT) and, from there, trace the historical use of psychedelics – in and outside clinical practice – from Indigenous use to their introduction to the West. This is followed by an exploration of the history of prohibition, beginning with colonial suppression and leading into the prohibitive legal frameworks that emerged in the 1960s. A narrative analysis of media will be included to highlight how public discourse was shaped. To understand the deeper socio-legal dynamics at play, the chapter then draws on the theoretical contributions of Michel Foucault and Sally Falk Moore. It proceeds then to examine the current global and European contexts regarding psychedelic regulation and discourse, before introducing the central case study of this thesis: the PsychedeliCare. Today, "psychedelics" remains a fluid and contested term, "a blank canvas onto which all manner of biases, agendas, and beliefs can be projected" (Harvard Divinity School, 2025, p. 62). This openness invites both hype – many recent articles pose psychedelics as a cure or miracle drug – and unimpressed scientific skepticism – dismissing psychedelics as merely inducing a psychotic-like state of delirium. According to the European Union Drug Agency (EUDA, 2024), psychedelics in clinical contexts are 9 As previously seen, none of the ECI’s with a positive response from the Commission were actually able to trigger full legislative changes. 17 divided into classical serotonergic substances (such as lysergic acid diethylamide (LSD), psilocybin mushrooms, mescaline, and 5-MeO-DMT) and atypical substances (like ketamine and 3,4-Methylenedioxy-methamphetamine (MDMA)). Classical psychedelics primarily act as 5-HT2A receptor agonists, producing altered states of perception, mood, and cognition – commonly resulting in visual distortions, sensory shifts, and expanded awareness. Research shows psychedelics such as LSD and psilocybin are also physiologically safe, presenting no toxic known quantities and do not have an addictive profile (Johnson, 2008). This differs significantly from other well-known “drugs.” Nonetheless, for the purpose of this thesis, the terms will often be conflated and, though imprecise, psychedelics considered a category within the broader umbrella term “drugs.” It is important to note that the term “psychedelic” itself lacks clear consensus. Atypical substances often defy standard classification yet are still grouped under the psychedelic label; as a result, a new subcategory has emerged to accommodate them. Ketamine, for instance, is frequently described as a psychedelic despite differing in both structure and mechanism of action. Joralemon (2024) opens the debate further by considering the inclusion of substances like methamphetamine (“meth”), which is never typically referred to as a psychedelic but has shown effects similar to MDMA in some studies (Molla, 2023, as cited in Joralemon, 2024). Likewise, PCP (“angel dust”) functions similarly to dissociative psychedelic ketamine. These substances, however, are largely excluded from the popular category of psychedelics, possibly due to their associations with criminality, danger, and social stigma. Joralemon argues that what currently counts as a “psychedelic” goes beyond neurochemical mechanisms, legal status, or subjective experience. Rather, the term now serves to differentiate – signaling that certain drugs are “good” or “healthy” enough to be endorsed, while others are deemed too “bad” or “dangerous” to include. Ideally, more precise categorization would be used, as each psychedelic substance operates in distinct ways. However, given that the focus of this dissertation is on the socio-legal dimensions of psychedelics, the broader, less precise usage of the term will be adopted. PAT, on the other hand, is a modality of mental health treatment that combines psychotherapeutic interventions with psychedelic substances such as LSD, psilocybin, and MDMA. Research, supported by clinical trials, shows that psychedelics have genuine therapeutic potential, in offering long-term alleviation of symptoms in patients suffering from psychopathologies such as PTSD, TRD, major depressive disorder (MDD), end of life anxiety, obsessive–compulsive disorder (OCD), substance use disorders (SUD), psychotic conditions, and others (Perez Rosal, et al., 2024). Arguments in favor of PAT state that although psychedelics carry recognized risks, they present significant safety levels. One drug expert rating study (van Amsterdam, et al., 2015) performed in the EU, using the multicriteria decision analysis model for evaluating drug harms, ruled LSD, MDMA (Ecstasy), and Psilocybine (Magic mushrooms), substances with the least levels of harm, as shown in Figure 1. Figure 1 Graph showing the overall harm of substances 18 From “European rating of drug harms” (van Amsterdam, et al., 2015). It shows that alcohol (score: 72), heroin (55), and then crack (50) are the most harmful substances; psychedelics being the least harmful. On the other hand, research shows that psychedelic effectiveness, when compared to established depression treatments, shows no significant difference when it comes to patients’ improvement (Carhart-Harris et. al, 2021), as shown in Figure 2. Figure 2 Psilocybin versus Escitalopram for Depression From “Trial of Psilocybin versus Escitalopram for Depression” (Carhart-Harris et. al, 2021). These findings can, too, be read in two different lights, depending on the projected agenda. On one hand, psychedelics can be viewed optimistically – as safe, effective, and essential innovations that offer 19 treatment options comparable to established methods. Or, on the other hand, from a more skeptical viewpoint, the equivalent efficacy of psychedelics to existing treatments may be seen as insufficient justification for their clinical adoption. 3.2. Origins – History of Use and Prohibition The term “psychedelic” was first coined by psychiatrist Humphry Osmond in 1956, in a letter to Aldous Huxley: “To fathom Hell or soar angelic, just take a pinch of psychedelic.” Originally introduced in clinical settings – such as Osmond’s LSD research at Weyburn Mental Hospital with patients struggling with alcoholism (Dyck, 2008) – the term has since evolved in meaning. Osmond’s research materials were supplied by the Swiss company Sandoz, where Albert Hofmann discovered LSD in 1943 and later synthesized psilocybin. Between 1943 and 1970, LSD generated nearly 10,000 scientific publications, leading to its description as “the most intensively researched pharmacological substance ever” (Oxford University Press, as cited in Feilding, 2019). Beyond medical research, LSD attracted attention from civilians, the military, and the media. Former Harvard psychologist Timothy Leary became a prominent LSD advocate in the 1960s, promoting its use as part of a new spiritual movement that blended religion, philosophy, and psychedelics (Sessa, 2020). An accomplished academic, Leary discovered psychedelics during a trip to Mexico and began researching them in Harvard, alongside colleague Richard Alpert. Accounts say their research became increasingly unstructured, leading to accusations of unprofessional conduct. Both were eventually dismissed from the University. Leary went on to publicly advocate for psychedelics and their widespread use, becoming closely associated with the counterculture and anti-war movements (Sessa, 2020). Alpert later became the spiritual teacher Ram Dass. Around the same time, the West met the practice of ingesting psilocybin mushrooms with an article by J.P. Morgan’s Vice President, Gordon Wasson, Seeking the Magic Mushroom, published in LIFE Magazine (Williams et al., 2022). He described his experience taking the substance in 1955 with María Sabina, a Mazatec curandera, in Oaxaca. This drew widespread attention and sparked a wave of tourists visiting her town, from spiritual seekers, hedonists, to scholars, which ultimately resulted in significant difficulties for Sabina. She was arrested, her house burned, and she eventually died in poverty (Gerber et al., 2021), as a result of revealing these substances to foreigners, who disrupted the peace of the town. Introducing psychedelic mushrooms to the West earned Gordon Wasson both praise and criticism. On the one hand, journalist Michael Pollan, in his bestselling book How to Change Your Mind (2018), credits Wasson with revealing to Western audiences that mushrooms could be more than just poison or food. Also, thanks to Wasson, Hofmann received and synthesized psilocybin, helping to pave the way for 50s psychiatric research, opening the medical field to the therapeutic potential of psychedelics. On the other hand, Gerber et al. (2021) reveal that Wasson shared the curandera’s identity without her consent. Initially, he used the pseudonym "Eva Mendez" to protect María Sabina’s identity and pledged not to publish her photographs. However, later, this agreement was breached and her real name was disclosed, along with images in Mushrooms, Russia, and History, each unit costing 125$ U.S. dollars, at the time (Stafford, 1992). Both views are important and mark the beginning of the West’s contact with psilocybin – an interaction still full of ethical complexities today. Yet, the implications of publicly sharing Indigenous 20 knowledge without consent or adequate contextualization, to Wasson’s benefit and Sabina’s detriment, reflect extractivist, colonial dynamics and remain a critical topic of discussion. In Europe, with the discovery of LSD, Czechoslovakia witnessed one of its most extensive and structured uses in clinical psychiatry, during the Cold War (Dyck & Elcock, 2023). Led by psychiatrist Milan Hausner in the 1960s and 70s, psycholytic therapy (Hausner, 1963) was practiced at state-supported clinics like Sadská, combining LSD with group therapy, occupational tasks, and psychoanalysis – over 3,000 sessions were reported. Also in Germany, psychedelic history dates back to the 1910s and 20s. MDMA was synthesized in 1912 by Anton Köllisch, and the first therapeutic experiments using mescaline happened during this time as well (Perez Rosal, 2024). Later on, Betty Eisner (German educated) introduced the therapeutic use of low-dose LSD combined with psychotherapy (a contribution that remains underrecognized), and Margot Cutner emphasized the role of the facilitator in PAT. So, the 50s and 60s, in general, marked a time when the interest of the West in the uses of psychedelics grew. But, according to Marlene Dobkin de Rios (2009), many Indigenous groups had used psychedelic substances long before. Just to name a few present in her research – the Australian Aborigines, the New Guinea Mushroom Users, the Fang of Northwestern Equatorial Africa, the Aztecs of Mexico, the Incas, and some Brazilian churches and religious groups. Dobkin de Rios was one of the first anthropologists stating that psychedelics played an integral role in some cultures, one of divinity, seen as god gifts, central to life rituals such as healing, marriages, funerals, harvest, battle victories, but also sacred practices like ancestor worship, fertility rituals, and healing ceremonies. Almost always, there is an individual – the shaman, often the psychedelic handler, who plays an important societal role in controlling nature, spirits, animals, but most importantly, giving hope to individuals. Almost always, there is a context created for the ingestion of these substances – a ritual – giving a sacred meaning to this moment of ingestion. Dobkin de Rios makes the argument that the use of drugs, within a ritualistic context, leaves very little space for abuse; thus, in traditional societies, both drug abuse and restrictions are rarely seen. PAT’s idea of set and setting10 is, perhaps, a medical manifestation of this important ritualistic contextualization for the ingestion of psychedelics. In the psychedelic field, this has become part of the argument for legitimizing contemporary psychedelic practices by linking them to a presumed universal tradition, long before the 20th-century prohibition. However, Singh (2025), in his recent book, argues against this. He notes that many of these stories are constructed or embellished to appeal to Western tourists and enthusiasts, rather than being grounded in actual historical evidence. Dobkin de Rios (1993) herself describes how, since the 1980s, drug tourism has led to farce shamans – often middle-class individuals with urban background – offering tourists non-traditional mixes of hallucinogens for mystical experiences. Additionally, he repeatedly emphasizes how colonialism has distorted anthropological records, a point that leads into the next section – the history of prohibition. 10Set and setting is a term some attribute to Timothy Leary (Hartogsohn, 2016) and some to Al Hubbard, after spending time with an Indigenous group in Mexico (Pollan, 2018), but there are also some other accounts attributing it to other professionals in the area. It is not consensual who came up with the term, but in any case, set means a person’s mindset – like mood and expectations. Setting is the environment, including place and people. Psychedelics are said to amplify both, highly impacting the experience one has, thus being a crucial concept. 21 Both Singh and Dobkin de Rios (2009) write that what is often presented today as traditional psychedelic shamanism is, in many cases, a syncretic practice shaped by centuries of Christian missionary influence, colonial prejudice against Indigenous groups, and systemic repression of local knowledge. During colonization, psychoactive sacred substances, like coca leaves in Peru, for instance, were seen as an instrument of Satan (Hafso, 2019). Although condemned as superstition, associated with evil, author J. Hafso (2019) accounts for the failure to suppress this practice. The Spanish occupiers then shifted strategies, commodifying coca and using it, for instance, to pay Indigenous laborers in silver mines, turning what was a sacred plant into a tool of exploitation. Thus, colonial suppression marks the earliest accounts of prohibition and casts, I argue, a long shadow over how we see “drugs” today. The view of drug use as immoral, deviant, and degenerate established a narrative that has been repeatedly reinforced over time and was weaponized to further increase social inequalities. So much so that the first national U.S. drug prohibition linked specific drugs to particular racial groups, like opium with Chinese laborers. In the 1875 San Francisco ordinance against opium dens, it reads (see Figure 2). [The Committee on Health and Police], in relation to the opium-smoking dens kept by Chinese, reported that there are [...] eight opium-smoking establishments kept by Chinese for the exclusive use of white men and women. That these places are patronized not by the vicious and depraved, but are nightly resorted to by young men and women of respectable business avocations in the city; [...] there is great danger that it will become one of the prevalent vices of the city; that in the opinion of the Committee these places are unmitigated evil and call for immediate and rigid legislation. Rooted in racial prejudice, it framed Chinese opium dens as morally corrupting spaces, not because of the drug or who was consuming it, but because of who kept these spaces. This prohibition did not arise from an objective assessment of harm, but rather through a threat to bourgeois values and a racialized moral fear of corruption of citizens with “respectable” backgrounds. It portrays drugs as tools through which immigrant communities endanger social purity, thereby legitimizing state intervention to disrupt their economic activities. Figure 2 Newspaper article 22 From “THE OPIUM SMOKING DENS. What the Committee on Health and Police Found – New Order Prepos[e]d”, San Francisco Examiner, 1875, p. 3. In the public domain. Focusing back on 60s America, LSD’s popularity grew along with the worry regarding the black market surrounding it – at the time, only Sandoz had a legal authorization for production (Dyck, 2008). Certainly more worrying than the black market, Dyck (2008) notes, was the social and cultural impact the psychedelic had on the baby boomers (its main users). At the time, this generation grew into a large and influential demographic whose rising political power began to challenge the existing order. Their push for change was evident in widespread activism: the civil rights movement, feminism, American Indian movements, the protests against the Vietnam War, and the rise of counterculture movements, such as hippie groups. LSD was, at first, a pharmaceutical drug. It was synthesized by a pharmaceutical company and was extensively researched within psychiatric medicine. But was it really? Since the beginning, LSD has been a drug that fled labs and clinics. Starting from Albert Hofmann himself. The first ever recorded trip was more like a recreational one – Hofmann voluntarily tried it for the first time, on the 19th of April 1943, a day now celebrated every year, among psychonauts as “Bicycle Day”. 23 According to Siff (2015), one of the earliest groups of recreational users was in California, a “network of psychiatrists and cultural luminaries that spun outward from Huxley” (p.81) (Huxley having access to LSD through Osmond). So, from 1955 onward, as many, including some highly influential individuals, began accessing psychedelics, media coverage proliferated enthusiastically in the U.S. As Robert F. Kennedy, at the time Senator, said in the Hearings of the Subcommittee on the Executive Reorganization, 1966: “(...) the controversy over the use and abuse of the drug LSD [has] been the subject of cover stories in national magazines and news documentaries on network television, of widespread public debate”. People described LSD as having profoundly changed their lives. They reported unprecedented relief through (e.g., Cary Grant, as cited in Siff, 2015), a sense of “cosmic significance” (Siff, 2015, p. 99), a “newfound happiness” (Siff, 2015, p. 101), and even described feeling “born again” (Joe Hyams, as cited in Siff, 2015, p. 100). But this enthusiasm was met with an equal degree of reluctance. Negative media accounts ranged from describing LSD users going blind after staring at the sun to linking it with crime and suicide (see p.87), inducing moral panic and public fear. Going “permanently insane after a single trip” (p.87) and describing users as mentally ill – “psychotic, schizophrenic, suicidal – became routine in news accounts” (p.95). Even within psychiatry, early views on psychedelics were shaped by what’s called the psychomimetic model (Dyck, 2015). While this model isn’t used today, it framed psychedelics as substances that mimic psychosis – helping to reinforce the idea that psychedelics and madness are closely linked. So, in 1970, Nixon’s administration launched the so-called “War on Drugs”, declaring drugs America's enemy number one (Richard Nixon Foundation, 2015). Psychedelics were classified as schedule I substances – the harshest category, excluding their medical potential. This marked the beginning of a national and international strategy, using the “UN as the international agency to create, spread, and supervise worldwide prohibition” (Levine, 2003). So in 1971, the UN Convention on Psychotropic Substances classified psychedelics – LSD, psilocybin, DMT, and mescaline – as “highly addictive and highly liable to abuse” (United Nations Office on Drugs and Crime, 2019, p.6). Most countries ratified these conventions, making them the foundation of many national drug laws. To this day, the UN has done more to defend and extend drug prohibition than any other institution, maintaining the ideal of achieving a “drug-free world” (Levine, 2003, p.148). In order to further expose and understand this problematic, which can be argued as an interplay between power, knowledge, and social control, Foucault’s work on madness and medicine (1965, 1973) will be used with three distinct arguments. His work suggests that (a) mental illness is not a neutral medical fact but a constructed label that serves to isolate and exclude – from established order since the 18th century medical practice (1965); additionally that (b) knowledge is power and medical knowledge is indeed inseparable from power – it produces truths that shape perception, justify discipline, and sustain authority; and (c) law and medicine, rather than operating in separate spheres, reinforce one another in the regulation of deviance. (a) It can be argued that the media-made connection with mental illness, as a label of unreason and the media accounts served a segregation purpose, for those seen as a threat to rational order. In this view, the psychiatric system did not merely treat illness, but it functioned to discipline and contain deviance of the unfit, reinforcing boundaries between “reason and unreason” (Foucault, 1965, p. 262) and reflecting society’s desire to control deviance. This same mechanism operated in the Western reaction to 24 psychedelics. The media-induced cultural panic surrounding these substances was not simply about their pharmacological effects but about what they symbolized: altered states, perceived irrationality, and a challenge to dominant norms. By associating psychedelics with madness, society invoked the fear of unreason, legitimizing the exclusion and demonization of users. Thus, the fear of madness became a basis for social control, driving prohibition and public panic. (b) Secondly, Foucault situates medical knowledge within the broader framework of power: it doesn’t simply describe reality, it helps to shape it. Such concepts like “highly addictive”, “highly liable to abuse” (United Nations Office on Drugs and Crime, 2019, p.6), “mental illness”, “drug user” or “drug use” (Rachel Lart, 1998, p.49) are not neutral; they are constructed categories that serve political and disciplinary purposes. Emerging from a medicalized discourse that framed these substances in pathological terms, even when evidence for harm was weak or inconsistent. These classifications functioned as techniques of control. However, it’s crucial to denote a nuance: the medical community itself largely did not advocate for the criminalization of psychedelics (Siff, 2015; Dyck, 2008), but the authority of scientific knowledge lent credibility to broader political narratives. The framing of psychedelics as dangerous or madness-inducing gave legal and political actors a rationale for regulation and exclusion, whether or not it reflected medical consensus. (c) An even deeper level, regards this power –biopower (Foucault, 2003) – extends into the social domain, shaping class, perception, and ultimately, laws. The legislative system, as an instrument of social control, draws from the medical discipline, mutually reinforcing one another. The prohibition of psychedelics illustrates this dynamic well. Legal restrictions cite medical terms (high abuse potential, no accepted medical use, safety concerns) to justify severe legal consequences for users. Yet, as Dyck (2008) notes, there was a growing body of medical research pointing to the therapeutic potential of psychedelics. Osmond, inclusively, who continued to be a leading figure in psychedelic research, confessed to being more and more frustrated with the political stance regarding these substances. In correspondence with one of his peers, in 1967, it reads – “We can take a hard line with the authorities. They have not consulted us. They have acted rashly, and things look as if they are going badly and likely to get worse. Young people don’t believe their lies and are consequently liable to disregard the truth at the same time to their detriment.” (as cited in Dyck, 2008, p.127). This points clash between the medical to the intersection of multiple social forces that collectively shaped public discourse and institutional response – prohibition cannot be fully understood through scientific or legal reasoning alone. Sally Falk Moore’s (1973) concept of Semi-Autonomous Social Field (SAFs) offers a valuable framework for analyzing this complexity. SAFs are social arenas – (a) such as the medical community, the media, or the legal system – that generate their own rules and norms, but do not operate in isolation. (b) They are constantly interacting and overlapping, (c) all while remaining susceptible to state-emanated law. (a) The scientific community can be understood as a SAFs that generated its own internal standards, research protocols, and ethical guidelines regarding psychedelic substances. Within this field, there was growing recognition of the therapeutic potential of psychedelics. Another field would be the media, portraying psychedelics both as healing or psychosis inducing, and a third one, the law, labeling psychedelics as unsafe, potentially addictive, and with no medical interest. Thus, several SAFs were at 25 through patent systems and commercialization. Additionally, our current policies around drugs remain morally biased and not at all evidence-based. So when it comes to the 60s baby boomers, challenging dominant norms through civil rights, anti-war, feminist, and other movements, many of which had blatant connections to psychedelic use, making these substances symbols of broader cultural and political dissidence. In response, a top-down repression movement frames psychedelics as dangerous, madness-inducing substances, even against the at the time clinical understanding. But madness, as Foucault argues, is not an objective clinical condition but a socially and politically constructed label used to marginalize those who deviate from normative behavior. Thus, the structures in power borrowed the medical arguments to control the masses. Despite the actual medical understanding of the time, which leads us to the normative conflict of S. F. Moore SAFs, between law, science, and media. This culminated in the sweeping prohibition of psychedelics spreading globally through the UN drug control conventions of the 1970s. However, recently there has been a growing resurgence of interest in psychedelics, reflected in both scientific research, media, public, and governments' attention. A number of countries have started to integrate psychedelics into medical practice, and the EU is taking cautious steps. The PsychedeliCare initiative is an ECI grassroots campaign calling on the EC to regulate PAT. It demands (a) clear standards of application, (b) increased research investment, and (c) a common EU position at the UN to support rescheduling. In aiming to answer why citizens are coming together to demand psychedelic reform, instead of looking at the individual motivations for joining PsychedeliCare (which would be a valid qualitative research that I very much welcome), I’m analyzing the broader socio-legal and historical dynamics that are spiking the social movement, offering a structural, rather than psychological or behavioral, analysis. Thus, I argue firstly, that LSD (and even more so natural psychedelics like psilocybin), for instance, was never a drug constrained to the labs, and since the beginning, it fled the clinics to curious citizens' circles and became even a tool for social transformation. Psychedelics are, perhaps, inherently political and cultural, not merely clinical. 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