Donald Trump's latest nominee for surgeon general has courted controversy with statements in his recent publications suggesting the exploration of unverified hallucinogenic drugs as potential treatments, and further implied in a newsletter that his own experimentation with psilocybin mushrooms facilitated the discovery of a romantic partner.

It is noteworthy that Dr. Casey Means advocated for guided psilocybin-assisted therapy, especially considering psilocybin's classification as a Schedule I controlled substance under federal law, denoting its illegality, lack of accepted medical application, and high potential for abuse; while Oregon and Colorado have legalized psychedelic therapy, certain cities within Oregon have subsequently prohibited it.

The Surgeon General's mandate is to furnish the American populace with cutting-edge scientific insights, fostering improved health outcomes and mitigating the incidence of disease and injury. Historically, Surgeons General have leveraged their position to educate the public on critical health issues, such as AIDS awareness and suicide prevention. The precedent set in 1964, when a predecessor issued a warning regarding the perils of smoking, was instrumental in reshaping the trajectory of public health in America.

While some figures, like C. Everett Koop, the Surgeon General under President Ronald Reagan, achieve widespread recognition and exert considerable influence on policy, others fade readily from public memory.

Means's nomination aligns with President Trump's penchant for selecting figures known more for their public image than their policy stances. Regarding Means, the Republican president admitted to choosing her solely on the recommendation of Robert F. Kennedy Jr., stating, "Bobby thought she was terrific," while adding that he did not know her personally.

Dr. Means, who holds a bachelor's degree and medical doctorate from Stanford University, commenced but did not complete her medical residency in Oregon; her medical license is currently listed as inactive, and when contacted by phone, Dr. Means declined to comment on the record.

In her 2024 publication, "Good Energy," she advocated for the use of psychedelics, a recommendation made in collaboration with her brother, Curry Means, an entrepreneur currently serving as a health advisor within the Trump administration, who has reportedly invested in biopharmaceutical companies specializing in psychedelic substances.

Many books focus on metabolic health, which Dr. Means terms "Good Energy," and she proposes numerous strategies for managing and healing the stressors, traumas, and thought patterns that limit us and contribute to declining metabolic health.

One strategy under consideration involves exploring psilocybin-assisted therapy, which leverages a compound found in psychedelic mushrooms; she elaborated on this topic in a comprehensive 750-word discourse.

She wrote, "If you feel a calling, I recommend exploring intentional, guided psilocybin therapy; compelling scientific evidence suggests this psychedelic treatment can be among life's most profound experiences for some, as it was for me."

While some studies suggest potential benefits of psychedelics, it remains unproven whether these outweigh the inherent risks. Psilocybin, for instance, can induce several hours of hallucinatory experiences, ranging from euphoric to terrifying. Though investigated as a therapeutic adjunct to psychotherapy for conditions like mental illness and alcohol dependence, research on its effects in healthy individuals is exceedingly limited. Potential adverse effects encompass elevated heart rate, nausea, and headaches. Unsupervised consumption poses significant dangers, as hallucinations can lead users to place themselves in perilous situations, such as walking into traffic or engaging in other risky behaviors.

Dr. Means contends that psilocybin and other psychedelics are unfairly stigmatized, highlighting the potential benefits of MDMA, also known as ecstasy or molly, in aiding individuals with post-traumatic stress disorder (PTSD), despite the FDA's rejection last year of its approval as a PTSD treatment, citing flawed research and significant risks.

In her book, Dr. Means refers to psychedelics as "plant medicine," recounting how her inaugural experience with psilocybin mushrooms around January 1, 2021, was prompted by an inner voice that whispered, "It is time to prepare."

She wrote that she felt herself to be part of an endless, unbroken cosmic matryoshka doll of countless mothers and babies stretching back to the very origin of life, adding that, in her experience, "psilocybin can be a doorway to an alternative reality, free from the constricting beliefs of my ego, emotions, and personal history."

In her October newsletter, Dr. Means recounted using psychedelics at 35 to cultivate "space for love," clarifying that plant medicine experiences, undertaken with a trustworthy guide, prepared her for partnership, a sentiment she concluded with a mushroom emoji; she explicitly stated, however, that she does not necessarily advocate similar practices for others.

In a recent post outlining her healthcare policy wishlist for the White House, Dr. Means advocated for improved nutritional standards in school meals, the implementation of warning labels on ultra-processed foods, and further investigation into vaccine safety, alongside the elimination of conflicts of interest; while she did not explicitly address psychedelics, she argued for the allocation of research funding towards alternative health approaches, highlighting the lack of incentive for researchers to study "common, natural, and unpatentable medicines or therapies."

Curry Means also advocates for the use of psychedelic drugs, noting in a 2021 blog post that his initial experience with psilocybin during a difficult period was "the most meaningful experience of my life, personally, professionally, and spiritually." In 2022, he stated that he "sold all of his 401k to buy stock in two companies developing and researching psychedelics." He did not respond to requests for comment.

Casey Means' confirmation hearing remains unscheduled, following President Trump's withdrawal of Janet Nesheiwat, a Fox News medical contributor initially nominated for Surgeon General, due to concerns surrounding her qualifications, which subsequently led to Means' selection.