Eli Lilly isn't investing in your mystical experiences.
The experience still belongs to clinicians and how they provide for their patients.
By Stephanie Karzon Abrams, Clinical Neuropharmacologist | Founder, Beyond Consulting
As Eli Lilly moves to acquire Atai Beckley, many are expressing concern about what it means for the future of psychedelic medicine. Those concerns are valid. But perhaps we can invest and focus more on the shaping the standard of care and patient experience, and remember that Eli Lilly is investing in pharmacology, not trying how clinicians offer support beyond the drug. And maybe that’s a good thing— square peg, round hole.
Atai Beckley’s 5-MeO-DMT drug candidate, BPL 003, will be an FDA approved drug, and field representatives from the company will be charged with training clinical teams, much like Spravato (esketamine nasal spray) from J&J. The manufacturer will support training for clinic staff, including the required REMS training and clinical education necessary for sites to become certified. Without meeting those requirements, clinics cannot offer the treatment.
I can't speak to the quality or depth of the training that will be provided. What I can speak to is the Spravato model, where the emphasis is appropriately on safety, REMS requirements, and clinical protocols. Beyond acknowledging that patients may have emotionally significant or psychologically profound experiences, there is relatively little guidance on how to hold those experiences therapeutically during or after treatment. Holding space is not in their vocabulary. That is where clinicians, therapists, and healthcare teams have an opportunity, and a responsibility, to fill the gap.
If a clinic believes integration is important, it will be their responsibility to build that into their model and ensure their staff are educated to deliver it. The same team will be charged with the patient education necessary to help them understand the benefit of additional psychotherapy or integration.
Importantly, Eli Lilly is not investing in the psychedelic-assisted therapy model. They're investing in a drug that they believe effectively treats a medical condition.
We all know the compound has psychedelic properties. We know why it’s called the god molecule. And for those seeking a 5-MeO-DMT experience where the psychological, mystical, or existential aspects are intentionally acknowledged and supported, there are retreat centers and other settings built around that model. This pharmaceutical clinic model is different. If a clinic wants to support patients beyond the medicine session itself, it will need to make that investment independently, both clinically and operationally.
Regardless of what many of us believe these medicines are capable of, REMS programs and pharmaceutical acquisitions are focused on demonstrating that a drug can safely and effectively treat a condition. Companies may acknowledge that psychotherapy or additional support is beneficial, but that is not what they're developing, regulating, or selling. Their responsibility is to demonstrate that the medication works. Whether that's the ideal model is a separate discussion, but this is how the pharmaceutical model is designed to operate.
This is where clinicians have an opportunity to lead. Pharma's job is to develop the drug. Our job is to build the model of care around it. It’s up to us to create the standard. We can't expect pharmaceutical companies to be something they’re not.
