President Trump's nominee for surgeon general has recently written that unproven psychedelic drugs could be considered for therapy, and suggested in a newsletter that using mushrooms helped her find a partner.

Dr. Casey Means suggests exploring therapy that involves psilocybin, which is interesting because it's against federal law. Psilocybin is classified as a Schedule 1 drug, meaning it's considered to have no accepted medical use and a high risk of misuse. However, Oregon and Colorado have made psychedelic therapy legal, although some cities in Oregon have since prohibited it.

The Surgeon General is responsible for giving Americans the most reliable scientific advice on improving their health and avoiding diseases and injuries. Previous Surgeons General have used their role to raise awareness about health issues such as AIDS and suicide prevention. Notably, the 1964 Surgeon General's warning about the risks of smoking played a key role in transforming public health in the United States.

Some people, such as Dr. C. Everett Koop, who was the surgeon general under President Ronald Reagan, became famous and had a big influence on official rules, while others were easily forgotten.

Means' appointment reflects a trend under Trump to favour candidates with strong public images over those with deep policy experience. Trump stated he selected Means based only on Health Secretary Robert F. Kennedy Jr.'s advice, admitting he didn't know her personally, but that "Bobby thought she was fantastic."

Means, a Stanford University graduate in arts and medicine, started a medical residency in Oregon but didn't finish it. Her medical license is currently inactive. When contacted by phone, Means refused to give an official statement.

In her 2024 book, “Good Energy,” she suggested considering psychedelics, a topic she explored with her brother, Calley Means, an entrepreneur now advising on health matters in the Trump administration, who has also stated he invested in psychedelic drug companies.

The book largely explores metabolic health, or "good energy," as Casey Means puts it, offering advice on how to deal with stressors, past traumas, and negative thought patterns that can harm our metabolic health and overall well-being.

One approach involves "psilocybin-assisted therapy," which uses a substance found in magic mushrooms. She explains her views on this topic in a 750-word piece.

She mentioned that if people feel drawn to it, they should consider well-planned and supported psilocybin therapy. She added that solid research indicates this type of therapy can be a very important and positive experience for some, as it has been for her.

Although some studies suggest psychedelics might be helpful, it's not clear if the benefits are greater than the risks. Psilocybin can cause hallucinations lasting for hours, which can be either enjoyable or frightening. It has been studied alongside therapy as a possible treatment for mental health issues and alcohol dependence, but there's limited research on its effects on healthy individuals. Side effects may include a faster heart rate, feeling sick, and headaches. Using it without professional supervision can be risky, as hallucinations could lead someone to act dangerously, like walking into traffic.

Means stated that psilocybin and similar psychedelic drugs have been unfairly judged. She highlighted the potential of MDMA, also called ecstasy, in assisting individuals with post-traumatic stress disorder (PTSD). However, last year, the Food and Drug Administration refused to approve MDMA as a PTSD treatment because a group of experts considered the research to be weak and raised concerns about the dangers of its use.

In her book, Means calls psychedelics "plant medicine" and recounts taking mushrooms for the first time around January 1, 2021, after being prompted by "an internal voice that whispered: it's time to prepare."

She expressed feeling connected to a vast lineage of mothers and children throughout history. In her opinion, psilocybin could offer a glimpse into an altered state of reality, unrestricted by personal biases, emotions, or past experiences.

In a newsletter from October, Means mentioned using psychedelics to help her "find love" as she turned 35. She explained that she worked with experienced guides on "plant medicine experiences" to prepare herself for a relationship, adding a mushroom emoji. She clarified that she wasn't telling others to do the same.

In a recent article outlining her desired health policies for the White House, Means expressed her desire for healthier school meals and suggested warning labels on highly processed foods. She also called for inquiries into vaccine safety and the elimination of conflicts of interest. While she didn't directly mention psychedelics, she noted that researchers have limited motivation to investigate "common, natural, and unpatentable drugs and therapies," and proposed allocating a part of research funds to alternative healthcare methods.

Calley Means has also publicly supported the use of psychedelic drugs. In a 2021 blog post, he described his first experience with psilocybin as profoundly impactful during a difficult period. He further stated in 2022 that he had invested his entire 401k savings in two companies involved in the development and research of psychedelics. He has not yet responded to requests for comments.

Casey Means is still waiting for her confirmation hearing to be arranged. Trump nominated Means after concerns were voiced about the experience of his initial choice for surgeon general, Janette Nesheiwat, who used to appear on Fox News, leading to her nomination being withdrawn.