Three Lanes, One Road: Why Medical, Spiritual, and Recreational Psychedelics Must Coexist

I am biased.

Let me say that straight out, no dancing around it: I am institutionally biased toward the medical model of psychedelics. Twenty years of living with cancer will do that to you. Twenty years of depending on rigorous clinical trials and FDA-approved medications and evidence-based medicine to keep me alive... this creates a lens. This creates assumptions. This creates a preference for white coats and peer-reviewed studies and controlled settings where everything has been measured and quantified and blessed by the appropriate authorities. Yes, those white coats and clinical trials kept me alive. But they also shaped by perspective on psychedelics. 

This is my lane. The medical lane. And I need to own that bias even as I argue for something bigger.

Because during my recent podcast conversation with Matt Zemon, I was reminded of a crucial truth: there are three lanes on this road to psychedelic healing, and all of them matter. All of them serve. All of them deserve to coexist. All three lanes need to co-exist because they are all part of one road leading to wider access to psychedelics for people living with cancer. 

The Three-Lane Highway

Matt helped me explore this three-lane road. One road. But three distinct purposes. Three different contexts. Three lanes on the psychedelic superhighway:

Medical lane: Psychedelic-assisted therapy in clinical settings, guided by trained professionals, supported by rigorous research, designed to treat specific indications like PTSD, depression, end-of-life anxiety.

Spiritual lane: Entheogenic practices in ceremonial contexts, often rooted in indigenous traditions, focused on communion with the sacred, supported by thousands of years of continuous use.

Recreational lane: Social and exploratory use in festival settings, concerts, group settings where the goal is celebration, connection, consciousness expansion, and yes—recreation in the truest sense of re-creating ourselves.

All three exist. All three serve different human needs and ways of approaching psychdelics. And all three must continue coexisting together. 

The question isn't which one is right. The question is: will our legal frameworks be broad enough to accommodate all three?

The Underground Reality

Here's what Matt helped me understand: these approaches already coexist in practice. The question is whether our government will catch up to what's happening in reality.

The truth is that millions of Americans use psychedelics outside clinical settings each year. Meanwhile, clinical trials have served far fewer people over decades of research.

The math suggests that the vast majority of psychedelic experiences are happening outside the medical system I'm most comfortable with. And perhaps that's as it should be.

Respecting Indigenous Wisdom

One of the most powerful moments in our conversation came when Matt described attending an all-night prayer circle—a psychedelic ceremony where children were present, going to sleep as the adults engaged in sacred practice, then waking as the group prayed to the rising sun.

This is family. This is community. This is a tradition that has never been broken.

As Matt reflected: "The medicine carriers using this for religious purposes have never stopped. They've just carried the medicine at great personal risk to themselves and their families. They weren't looking for approval. They were just doing what they had been taught to do and what they felt called to do."

When I think about the systematic suppression of indigenous ways of knowing, I realize that insisting on the medical model risks perpetuating cultural harm. It suggests that thousands of years of accumulated wisdom don't count unless they're validated by Western science.

We need both/and thinking, not either/or.

Legal Frameworks Already Exist

Here's something encouraging: we already have legal structures that could accommodate all three lanes.

For spiritual use: We have indigenous practices and entheogenic churches organized around natural psychedelics as sacraments. Religious freedom laws provide constitutional protections that predate drug prohibition.

For medical use: Right to try laws and compassionate use programs. The same frameworks that give me access to experimental cancer therapies also apply to psychedelic medicines.

For recreational use: We regulate alcohol. We're learning to regulate cannabis. We have models for how adults can make informed choices about consciousness-altering substances in social settings.

As Matt said: "Let's bring this above ground, let's get back to collaboration between medical professionals and spiritual professionals."

Confronting My Own Medical Bias

I need to be honest about my concerns with non-medical use. When I hear about people taking substances from unknown sources in uncontrolled settings... my cancer-patient brain immediately goes to: What about drug interactions? What about underlying medical conditions? What about proper screening and medical oversight?

This is my bias talking. This is my twenty-year relationship with the medical system creating caution about healing that happens outside institutional control.

But my concerns don't invalidate other people's paths to healing. My preference for clinical trials doesn't make indigenous ceremonies less valid. My need for medical oversight doesn't diminish the meaningful experiences people have at concerts or in ceremonial settings.

As Matt reminded me: "We all know people who go to concerts and use psychedelics and have beautiful experiences."

Beautiful experiences. Therapeutic experiences. Valid experiences.

Yes, healing can happen outside of a hospital.

The Big Tent Vision

What I'm advocating for is a big tent approach. Room for modern doctors and indigenous shamans. Space for clinical trials and ceremonial circles. Recognition that healing comes in many forms and through many doorways.

This doesn't mean abandoning standards or safety protocols. It means recognizing that different contexts call for different approaches. The safety measures appropriate for a clinical trial might be excessive for an experienced practitioner in a ceremonial setting. The spiritual preparation valued in indigenous traditions could greatly enhance therapeutic outcomes in a medical setting.

We can have rigorous medical research and respect for traditional wisdom. We can have appropriate oversight and religious freedom. We can have harm reduction at festivals and therapeutic protocols in clinics.

All at the same time. All serving different needs. All part of the same larger movement toward healing.

When Underground Goes Above Ground

The real challenge isn't in the diversity of approaches—it's in forcing psychedelics underground. As Matt pointed out: "When we have an underground economy we can't talk freely, we can't give proper guidance, we can't have the level of transparency that I think is in everyone's best interest."

When psychedelics are illegal across all contexts, people can't access quality-controlled substances. They can't get proper guidance or support. They can't seek help if something goes wrong. They're pushed into unregulated markets where safety cannot be guaranteed.

This impacts everyone—medical patients who can't access legal treatment, spiritual practitioners who must hide their traditions, recreational users who can't make informed choices about what they're consuming.

Building Bridges, Not Walls

My vision is highways, not walls. Multiple lanes of traffic moving in the same direction—toward healing, toward understanding, toward expanded possibilities for human flourishing.

I'll always advocate for rigorous research and medical oversight, especially for cancer patients who are often dealing with complex medical situations. That's my lane, and I'm staying in it.

But I also want to celebrate the shamans and the ceremonialists and the festival-goers and the psychedelic churches and everyone else who has kept these medicines alive during prohibition. I want to learn from indigenous wisdom traditions and I know that I have a long way to go. I want to acknowledge that healing sometimes happens in ways that don't fit neatly into medical categories.

Most of all, I want to recognize that we're all on the same road. Different lanes, same destination: a world where psychedelic medicines are legal, accessible, safe, and available to anyone who might benefit from their healing potential.

The psychedelics tent is big enough for all of us. The road is wide enough for medical, spiritual and recreational lanes.

Let's journey together.

To connect with our diverse community of cancer patients exploring all paths to healing, reach out to community@healingcancerjourneys.org