President Trump's newly appointed Surgeon General has courted controversy by advocating, in a recent monograph, the potential therapeutic application of unvalidated psychedelic substances, and further insinuated, via a newsletter, that her own recourse to psilocybin-containing fungi facilitated her acquisition of a romantic partner.

Dr. Casey Means' suggestion to consider guided psilocybin-assisted therapy warrants circumspection, given psilocybin's illegality under federal statutes, classified as a Schedule I controlled substance defined as a compound with "no currently accepted medical use and a high potential for abuse," notwithstanding Oregon's and Colorado's legalisation of psychedelic therapy, the former of which has seen subsequent municipal prohibitions.

作为美国公共卫生署署长，外科医生长官肩负着向美国大众普及最前沿的科学知识的重任，以期增进国民福祉，降低罹患疾病和意外损伤的风险。 历任外科医生长官曾利用这一崇高职位，积极开展公众教育，就艾滋病防治、自杀干预等关键健康议题进行深入阐释。 尤其值得一提的是，1964年外科医生长官发布的关于吸烟危害的警示报告，堪称扭转美国国民健康趋势的里程碑式事件。

Figures such as Surgeon General C. Everett Koop, a prominent voice during the Reagan administration, achieved enduring renown and wielded substantial influence on policy through their considerable public platform, while others rapidly faded into obscurity.

Means's nomination cleaves to the well-trodden path of Trump's predilection for selecting individuals whose notoriety stems more from public persona than substantive policy platforms. In Means's specific instance, the Republican president avowed that her selection was predicated solely on the endorsement proffered by Robert F. Kennedy Jr., the Secretary of Health, exclaiming, "Bobby thinks she's fantastic," while concurrently conceding his own unfamiliarity with her.

Means, holding both a baccalaureate and medical doctorate from Stanford University, commenced but did not culminate her medical residency in Oregon. Her medical license is currently designated as inactive. Contacted via telephone, Means declined to offer commentary pertaining to the aforementioned record.

In her 2024 co-authored work, "Good Energy," penned with her brother, entrepreneur Calley Means—a figure of some note who has served as a health advisor within the Trump administration and disclosed investments in biopharmaceutical firms dedicated to the research and development of psychedelic therapies—she articulates counsel pertaining to the employment of hallucinogens.

The book's primary focus is metabolic health, or what Casey Means terms "optimal bioenergetics," advocating for a multifaceted approach to "managing and remediating the stressors, traumas, and cognitive schemas that constrain us, leading to compromised metabolic function and attenuated growth."

One proposed avenue involves psilocybin-assisted therapy, referring to the psychoactive constituent found in *Psilocybe* fungi; she explicates this proposition at length within a 750-word disquisition.

She penned, "Should you perceive an intrinsic summons, I would equally exhort you to explore intentional and rigorously guided psilocybin therapy. Compelling empirical evidence intimates that, for a subset of individuals, this particular psychedelic intervention may constitute a uniquely profound and existentially significant experience, mirroring my own."

Despite preliminary research suggesting potential benefits of psychedelic substances, the preponderance of evidence has yet to demonstrate that these benefits outweigh the inherent risks. Psilocybin, for instance, can induce multi-hour hallucinatory states, experiences that may range from the euphoric to the profoundly disturbing. While its adjunctive use with psychotherapy has been explored in the context of treating mental health disorders and substance use disorders, rigorous investigation in healthy populations remains exiguous. Potential adverse effects encompass tachycardia, emesis, and cephalalgia. Unsupervised use carries substantial risk, as hallucinatory experiences may precipitate perilous situations, such as inadvertent exposure to vehicular traffic or other hazardous conditions.

Means, in her treatise, posits that psilocybin and other psychedelic compounds are frequently subjected to pejorative characterizations. She ardently champions the therapeutic potential of MDMA, colloquially known as ecstasy or molly, in ameliorating the debilitating effects of post-traumatic stress disorder (PTSD). The United States Food and Drug Administration, however, declined to sanction MDMA as a sanctioned treatment for PTSD in the preceding annum, citing reservations voiced by a panel of consultants who identified methodological deficiencies within the pertinent research and underscored the inherent risks associated with MDMA consumption.

Means在其著作中将迷幻药界定为“植物性药物”，并详述了其在2021年元旦前后初次服用裸盖菇的体验，彼时她受到“源于内在的低语，仿佛预示着变革之期的到来：是时候做准备了”的启迪。

She penned, "At that juncture, I apprehended myself as an element within an infinite, uninterrupted Matryoshka of universes, encompassing myriads of mothers and infants stretching back to the genesis of sentience," appending that, within her experiential framework, "psilocybin possesses the capacity to function as a veritable *porte* to an alternative ontological domain, wherein I am afforded the opportunity to transcend the restrictive strictures of ego-centric convictions, affective states, and idiosyncratic historical narratives."

In an October communiqué, Means divulged her foray into psychedelics as a catalyst for recalibrating her priorities toward romantic partnership at the age of 35, detailing a "plant medicine journey under the auspices of trusted facilitators" undertaken to prime herself for cohabitation, an assertion punctuated with a mushroom emoji; she stipulates, however, that this path is not necessarily prescriptive.

In her recent disquisition on the White House's aspirational healthcare desiderata, Means articulated a multi-pronged agenda encompassing the provision of superior nutritional fare in scholastic settings, the imposition of cautionary labeling on heavily processed comestibles, a clarion call for rigorous investigation into vaccine safety protocols, and the eradication of conflicts of interest. While eschewing explicit allusion to psychedelics, she lamented the dearth of incentivization for researchers to scrutinize "off-patent, naturally occurring, and non-commercialized pharmaceuticals and therapeutic modalities," positing that a substantive tranche of research funding should be strategically allocated to the exploration of alternative avenues in healthcare innovation.

Calley Means亦提倡使用精神活性药物。其在2021年的一篇博文中自述，初次体验裸盖菇素疗法正值其人生困顿之际，并称之为其“毕生最具意义之体验——无论于个人、职业抑或精神层面皆然”。2022年，Means宣称已“清仓所有401k退休金账户”，转而购入两家从事精神活性药物研发与调研的企业之股份。针对媒体问询，其未置可否。

Casey Means's confirmation hearing remains unscheduled, a consequence of Trump's eleventh-hour pivot following his reservations regarding the curriculum vitae of his initial nominee, former Fox News medical pundit Janette Nesheiwat, whose nomination was subsequently rescinded.