R. Cameron Wolf

Use of psychedelic substances is increasing across unregulated, state-regulated, research, ceremonial/religious, and medical settings in the United States. Concurrently, a growing body of clinical research signals the potential for therapeutic applications for specific psychedelics in the treatment of depression, post-traumatic stress disorder, substance use disorders, and other health conditions. This evolving landscape presents both promise and complexity. From a public health perspective, a structured public health preparedness approach is needed to prioritize safety, workforce readiness, and data infrastructure in a manner that promotes individual and collective well-being while supporting responsible evidence development. This commentary proposes priorities for public health preparedness for psychedelics: (1) education and prevention of adverse events; (2) behavioral health workforce development; and (3) strategic information and data analysis. Educational efforts should emphasize clear risk communication, substance-specific messaging, prevention of adverse events, and practical guidance to support policy decision-making. Workforce considerations include defining core competencies, clarifying ethical boundaries and informed consent, establishing training and technical assistance infrastructure, strengthening capacity across the behavioral health workforce, and preparing providers to respond to patients using psychedelics outside regulated systems. Strategic information priorities include strengthening data systems and improving coordination and harmonization of epidemiologic monitoring related to patterns of use, adverse events, treatment-seeking behaviors, and the implications of evolving policy environments. As psychedelics enter mainstream discourse, public health institutions must adopt a balanced approach that considers both benefits and risks. A proactive, health-promoting, and data-driven framework can help ensure that policies and practices are grounded in safety and core public health principles.