Barriers and Facilitators for Psychedelic Research and Regulation in Brazil: Insights From Diverse Stakeholders.

The interest in psychedelics for health-related purposes has grown significantly over the past decade. However, there is an insufficient representation of stakeholders (eg, Indigenous groups, activists, policymakers) in discussions about research and regulation. Many psychedelics originate from traditional practices historically developed in low- and middle-income countries, but these regions are seldom represented in stakeholder perspectives research. The present study will examine the barriers, facilitators, and perspectives identified by a wide array of key stakeholders regarding the research and regulation of psychedelics in Brazil. Twenty-six stakeholders, including Indigenous leaders, formal industry actors, clinicians, activists, policymakers, and informal sellers, were interviewed. The data were analyzed using inductive thematic analysis. Code-group co-occurrence indexing was used to capture the relevance of each theme across stakeholder groups. Thematic analysis revealed 4 barriers ("accessibility," "regulation," "limited knowledge," and "risks"), 3 facilitators (1need for innovation," "scientific advancements," and "legal loopholes"), and 4 perspectives ("integration of ancestral knowledge," "idealization, mysticism and scientific rigor," "user autonomy," and "tangible social benefits"). Themes were similarly present among stakeholders' discourse, though with varying frequencies and weights, allowing comparisons of the particular relevance of themes for each group. We detail cultural, political, scientific, and clinical barriers, facilitators, and perspectives for psychedelic research and regulation within a region with a rich history of traditional psychedelic use, and discuss their ethical, regulatory, and clinical implications.