Donald Trump's choice for surgeon general has recently written that people might think about using untested psychedelic drugs for therapy. She also suggested in a newsletter that using mushrooms helped her find a partner.

Dr. Casey Means suggests thinking about therapy that uses psilocybin with guidance, which is interesting because, according to federal law, psilocybin is illegal. It's considered a Schedule 1 drug, meaning it's believed to have no accepted medical use and a high risk of being misused. However, Oregon and Colorado have made psychedelic therapy legal, although some cities in Oregon have since prohibited it.

The Surgeon General's role is to give Americans the most reliable scientific advice on improving their health and lowering their chances of getting sick or injured. In the past, Surgeons General have used their position to teach the public about health issues such as AIDS and preventing suicide. The 1964 Surgeon General's warning about the dangers of smoking played a key role in changing America's health habits.

Some individuals, such as Dr. C. Everett Koop, who served as surgeon general under President Ronald Reagan, achieved significant fame and influenced policy considerably, while others were quickly forgotten.

Means' selection fits a trend under Trump, where well-known figures are picked over those with deep policy experience. Trump admitted he chose Means based only on Health Secretary Robert F. Kennedy Jr.'s praise, saying he didn't know her personally but trusted Kennedy's judgment.

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

In her 2024 book, “Good Energy,” she suggested exploring psychedelics, a recommendation made alongside her brother, Calley Means, an entrepreneur now advising on health matters in the Trump administration. He has also stated that he invested in biopharmaceutical firms focused on psychedelic medicines.

The book largely explores metabolic health, or "good energy" as Casey Means terms it, offering strategies to help people handle the pressures, past hurts, and thinking habits that hold them back and worsen their metabolic health.

One approach could be "psilocybin-assisted therapy," which involves using the substance found in magic mushrooms. She explains her ideas on this in a detailed 750-word section.

She added that if you feel drawn to it, you might want to consider trying psilocybin therapy with professional guidance. She noted that research indicates this type of therapy can be a very significant experience for some, as it has been for her.

Although some research suggests psychedelics might be helpful, it's not clear if the advantages are greater than the dangers. Psilocybin can lead to hallucinations lasting for hours, which can be either enjoyable or frightening. It has been researched as a treatment for mental health issues and alcohol addiction when combined with therapy, but there's limited research on its effects on healthy individuals. Possible side effects include a faster heartbeat, feeling sick, and headaches. Using it without supervision can be risky, as hallucinations could cause someone to put themselves in dangerous situations, like walking into traffic.

Means stated that psilocybin and similar psychedelic drugs have been unfairly judged. She highlighted the potential advantages of MDMA, also called ecstasy, in supporting individuals dealing with post-traumatic stress disorder (PTSD). However, the Food and Drug Administration decided against approving MDMA as a PTSD treatment last year, after a group of experts raised concerns about the quality of the research and the possible dangers of its use.

In her book, Means calls psychedelics "plant medicine," recounting her first experience with mushrooms around January 1, 2021, prompted by "an internal voice" that urged her to prepare.

She described feeling connected to all mothers and children throughout history. She also wrote that, in her view, psilocybin could open up a new perspective, free from her usual self-doubt, emotions, and past experiences.

In a newsletter from October, Means mentioned using psychedelics to help her "make space to find love" as she turned 35. She explained that she participated in "plant medicine experiences with trusted guides" to prepare herself for a relationship, adding a mushroom emoji. She clarified that she wasn't necessarily suggesting others should do the same.

In a recent post discussing her ideal health policies for the White House, Means expressed her desire for healthier school meals, suggested warning labels on highly processed foods, and requested inquiries into vaccine safety, as well as the removal of conflicts of interest. While she didn't directly mention psychedelics, she noted that researchers have limited motivation to investigate "generic, natural, and non-patentable drugs and therapies," and proposed that some research funds should be allocated to alternative health approaches.

Calley Means has also promoted the use of psychedelic drugs. In a 2021 blog post, he described his first experience with psilocybin during a difficult period, calling it "the single most meaningful experience of my life" on a personal, professional, and spiritual level. In 2022, he stated that he had invested his entire 401k in stocks of two companies involved in developing and researching psychedelics. He has not responded to requests for comment.

Casey Means is still waiting for her confirmation hearing to be arranged. Trump nominated Means after doubts appeared about the experience of his first choice for surgeon general, Janette Nesheiwat, who used to work for Fox News. Nesheiwat then had her nomination removed.