Interview with Sa'ed al-Olimat, PharmD: The Case for Pharmacists as Stewards of Ethical Psychadelic Care

As psychedelic therapies moved closer to adoption in 2025, questions of safety, access, and ethical use continue to emerge. Sa'ed al-Olimat, PharmD, co-founder of Psychedelic Pharmacists Association, believes his colleagues in pharmacies across the country are ideally positioned and ideally suited to help set high standards for how these therapies are introduced. In part 2 of his interview with Pharmacy Times, he discussed balancing cultural humility with addressing unmet medical needs.

Q: How would you summarize the current evidence for various psychedelics such as MDMA, ketamine, or others to treat different health conditions?

Sa'ed al-Olimat: The evidence for MDMA, psilocybin, and ketamine continues to mature, and each compound brings something different to the psychedelic therapeutic landscape.

MDMA has demonstrated meaningful benefit in reducing PTSD symptoms, particularly among individuals with treatment-resistant PTSD. In the MAPS-sponsored phase 3 trials, a substantial proportion of participants no longer met diagnostic criteria for PTSD following treatment. These are not subtle improvements. They represent clinically significant change for patients who have often exhausted current treatment standard options. Despite this, the FDA’s concerns around bias, blinding, and adverse event reporting suggest that additional studies will likely be required before approval is reconsidered.

Psilocybin has shown transdiagnostic potential, most notably in major depressive disorder and treatment-resistant depression, but also in substance use disorders, end-of-life anxiety, and obsessive-compulsive conditions. There is strong interest in its ability to create lasting change after just one or two sessions, which contrasts sharply with daily-dose models of antidepressant therapy.

Ketamine is already approved for depression in the form of esketamine and has an established role in clinical practice. Its mechanism is distinct from serotonergic psychedelics, and it is generally compatible with most psychiatric medications, including SSRIs and mood stabilizers. It also has particular value in situations requiring rapid symptom relief, such as acute suicidality.

Together, these therapies suggest a shift toward new models of mental health treatment. Pharmacists will be essential in helping ensure these treatments are used safely, appropriately, and within evidence-based frameworks.

Q: What are the biggest safety concerns that pharmacists should pay attention to?

Sa'ed al-Olimat: Drug interactions remain a primary concern, particularly combinations involving MAOIs, lithium, or certain psychotropic agents, which can increase the risk of serotonin toxicity, seizures, or cardiovascular complications.

Cardiovascular effects, especially with MDMA, also warrant attention, particularly in patients with hypertension or underlying heart disease.

Beyond pharmacology, psychological safety is critical. Psychedelic experiences can be destabilizing for individuals. Pharmacists can help identify when someone may not be an appropriate candidate and encourage additional screening or support.

Q: What steps should be taken to ensure psychedelic therapies are accessible beyond a small, privileged population?

Sa'ed al-Olimat: Without deliberate planning, psychedelic therapies risk becoming limited to expensive, self-pay clinics. Ensuring broader access will require payer coverage, public investment, and scalable care models. These may include community-based preparation and integration, telehealth touchpoints, and expanded roles for pharmacists and other healthcare professionals across the continuum of care.

It also requires training a diverse workforce, including some non-clinicians, and addressing long-standing disparities in our existing healthcare system. Pharmacists can play an important role in advocating for access-oriented policies and inclusive models of care.

Q: You have spoken about the ethical considerations of psychedelic care. Where are pharmacists best positioned to contribute?

Sa'ed al-Olimat: Pharmacists are well-positioned to support ethical practice through enhanced & informed consent, medication safety, and patient education. As some of the most accessible healthcare professionals, pharmacists may be the first point of contact for individuals considering psychedelic therapies, especially outside formal clinical settings.

Pharmacists can also advocate for transparency, equity, and higher standards of training. Ethical psychedelic care requires attention not only to safety, but also to fairness, cultural humility, and patient empowerment.

Q: How can pharmacists help shift public perception of psychedelics?

Pharmacists can help by providing clear, evidence-based education without sensationalism. By presenting both benefits and risks honestly, they can help normalize psychedelics as legitimate medical tools rather than framing them solely through recreational or countercultural lenses. This is not to dismiss the power of community-based healing or the importance of historical context, but rather to help move the conversation toward science and documented outcomes.

If these novel agents, which have received FDA breakthrough therapy designation, were not classified as psychedelics, it is possible we would be further along the regulatory approval pathway than we are today. Pharmacists can help reframe the narrative by focusing on clinical data, therapeutic need, and patient safety.

As trusted healthcare professionals, pharmacists are uniquely positioned to foster informed, balanced conversations that build public understanding and trust.

Q: Is there anything else you would like to add?

Sa'ed al-Olimat: Despite recent setbacks, we are still in a pivotal moment for psychedelic medicine. The FDA’s rejection of MDMA-assisted therapy should not be viewed as a final verdict, but rather as a call for greater clarity, scientific rigor, and interprofessional collaboration. Pharmacists have a critical role to play in shaping how these therapies are evaluated, implemented, and ultimately accessed, and the time to prepare is now.

Schools of pharmacy should begin integrating psychedelic science, policy, and therapeutic frameworks into their curricula to prepare future pharmacists for this emerging area of care. There are many challenges ahead in developing a safe and regulated approval pathway, and solving them will require collaboration across disciplines.

While regulatory pathways for psychedelic therapies continue to evolve, it is important to acknowledge that community-based and informal models of psychedelic care have persisted for a long period of time. These settings, though outside the formal healthcare system, have accumulated a great deal of experiential knowledge about preparation, integration, and set-and-setting. Clinicians, while remaining within legal and ethical boundaries, have much to learn from these real-world practices, particularly when it comes to understanding patient experiences, cultural context, and nontraditional models of care.

Engaging with this knowledge through research, education, or dialogue can help inform safer, more inclusive approaches to psychedelic care. Pharmacists are uniquely positioned to contribute by bringing clinical insight, harm or risk reduction principles, and a patient-centered mindset to emerging frameworks that bridge medical and community settings.