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Psychedelics are challenging the standard of randomized controlled trials


How do you study mind-altering drugs when every clinical-trial participant knows they’re tripping?

In clinical trials, participants (and the researchers studying them) generally aren’t supposed to know whether they’re getting the actual drug or a placebo, to avoid allowing people’s expectations about a treatment to shape their response to it. In cancer-drug trials, participants won’t know the difference between a saline IV drip and medicine; to test new surgical procedures, control groups sometimes get cut into and sewed up without the actual treatment. Yet in practice, antidepressants are effective for many people, suggesting that RCTs aren’t quite capturing what these drugs can offer—and that limiting ourselves to treatments that can be perfectly blinded could mean ignoring helpful mental-health interventions.

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