President Trump's nominee for surgeon general recently advocated for exploring the therapeutic potential of unverified psychedelic drugs in a published work, and, in a newsletter, alluded to using mushrooms to facilitate finding a romantic partner.

Dr. Casey Means' suggestion to explore supervised psilocybin-assisted therapy warrants attention, particularly given psilocybin's Schedule 1 status under federal law, classifying it as a substance with "no currently accepted medical use and a high potential for abuse," despite Oregon and Colorado legalizing psychedelic therapy, a move subsequently partially reversed by several Oregonian cities.

Tasked with furnishing the American public with cutting-edge scientific insights on health optimization and risk mitigation regarding illness and injury, the Surgeon General's role has historically been leveraged to spearhead nationwide health education initiatives, addressing critical issues such as AIDS and suicide prevention; indeed, the landmark 1964 Surgeon General's warning concerning the perils of smoking demonstrably altered the trajectory of public health in America.

Figures such as Dr. C. Everett Koop, who served as surgeon general under President Ronald Reagan, achieved considerable prominence and exerted a significant influence on policy, whereas others faded into relative obscurity.

Means's appointment aligns with a discernible trend under Trump, favouring individuals with prominent public profiles over those with demonstrable policy expertise; in this instance, the president openly admitted his selection of Means rested entirely on Health Secretary Robert F. Kennedy Jr.'s endorsement, stating he chose her based on Kennedy's high opinion despite admitting to a lack of personal acquaintance.

Means, a Stanford University alumna with both undergraduate and medical degrees, commenced a medical residency in Oregon, which she ultimately abandoned, and her medical license is currently listed as inactive; she declined to provide any on-the-record comments when contacted.

In her 2024 publication, “Good Energy,” co-authored with her brother Calley Means—an entrepreneur currently serving as a health adviser in the Trump administration and who has openly acknowledged investing in biopharmaceutical firms specializing in psychedelics—she advocated for their potential use.

A significant portion of the book delves into metabolic health, which Casey Means characterizes as "optimal energy." She proposes several strategies designed to enable individuals to effectively manage and address the stressors, traumas, and cognitive patterns that impede their potential and negatively impact their metabolic well-being and overall vitality.

One potential avenue involves exploring psilocybin-assisted therapy, referencing the active compound inherent in psychedelic fungi, a rationale she elaborates upon in a substantial 750-word exposition.

"She added that those who felt so inclined should consider exploring structured psilocybin therapy, citing robust scientific evidence indicating that this psychedelic intervention can represent a profoundly significant experience for certain individuals, as it has for her."

Despite preliminary research indicating potential advantages of psychedelic substances, a conclusive demonstration that these benefits surpass the inherent risks remains elusive. Psilocybin, for example, may induce extended hallucinatory episodes, which can range from euphoric to profoundly disturbing. While its integration with psychotherapy has been explored as a treatment modality for certain psychiatric disorders and alcohol dependence, empirical investigation into its effects on healthy individuals is notably limited. Adverse reactions may encompass elevated heart rate, nausea, and cephalalgia. Furthermore, unsupervised consumption poses considerable hazards, as drug-induced hallucinations could precipitate perilous behaviors, such as exposure to traffic or engagement in other imprudent activities.

Means posited that psilocybin and other psychedelics have been unjustly stigmatized, and championed the potential therapeutic benefits of MDMA, commonly known as ecstasy or molly, in alleviating post-traumatic stress disorder (PTSD); however, the Food and Drug Administration recently rejected the approval of MDMA as a PTSD therapy following concerns raised by an advisory panel regarding methodological flaws in the research and significant risks associated with its use.

In her book, Means characterizes psychedelics as "plant medicine," recounting her inaugural experience with psilocybin mushrooms around January 1, 2021, prompted by what she describes as an "internal voice" urging her to prepare.

She articulated a profound sense of interconnectedness, envisioning herself as an integral link within an immeasurable lineage of mothers and infants extending back to the genesis of life, further noting that, in her perception, "psilocybin has the potential to unlock a divergent reality, liberated from the restrictive constructs of ego, emotional biases, and individual past."

In an October newsletter, Means disclosed using psychedelics to cultivate the emotional availability necessary for finding love at 35, specifying that she engaged in "plant medicine experiences with trusted guides" to prepare for a relationship, an assertion playfully emphasized with a mushroom emoji, while explicitly stating she wasn't advocating similar practices for others.

In a recent post outlining her desired White House health policies, Means advocated for improved nutritional standards in schools, proposed mandatory warning labels on ultra-processed foods, urged investigations into vaccine safety, and emphasized the need to eliminate conflicts of interest; while she didn't explicitly mention psychedelics, she noted the lack of incentives for researchers to explore "generic, natural, and non-patentable drugs and therapies," suggesting that a segment of research funding should be allocated to alternative healthcare modalities.

Means has also championed the therapeutic potential of psychedelic substances, recounting in a 2021 online publication that his initial experience with psilocybin during a period of personal adversity proved profoundly impactful, catalyzing significant growth across his personal, professional, and spiritual life; furthermore, in 2022, he declared having liquidated his entire 401k to invest in the burgeoning psychedelic pharmaceutical sector, specifically acquiring shares in two companies engaged in their development and research, although he remained unresponsive to requests for clarification.

Casey Means' confirmation hearing remains unscheduled, her nomination arising after Trump retracted his initial selection for surgeon general, Janette Nesheiwat, a former Fox News medical contributor, amidst scrutiny of her qualifications.