President Trump's nominee for Surgeon General has recently advocated exploring the therapeutic potential of unverified psychedelic drugs in her book, while a newsletter reveals her suggestion that psilocybin mushrooms facilitated her romantic pursuits.

Dr. Casey Means' suggestion to explore supervised psilocybin-assisted therapy warrants attention, given the federal prohibition of psilocybin as a Schedule 1 drug, characterized by its purported lack of accepted medical application and significant potential for misuse, despite Oregon and Colorado having legalized psychedelic therapy, albeit with subsequent municipal reversals in Oregon.

Charged with disseminating cutting-edge scientific insights to the American public, the Surgeon General plays a pivotal role in promoting well-being and mitigating health risks; historically, this office has been instrumental in raising awareness about critical public health issues, as exemplified by campaigns addressing AIDS and suicide prevention, and most notably, the landmark 1964 warning regarding the perils of smoking, which catalyzed a transformative shift in the nation's health trajectory.

While figures such as Dr. C. Everett Koop, who served as surgeon general under President Ronald Reagan, achieved widespread recognition and exerted considerable influence on policy, others faded into obscurity.

Means's appointment exemplifies a trend under Trump of prioritizing individuals with prominent public profiles over those with established policy expertise; in Means's case, the president admitted his selection stemmed solely from Secretary Kennedy Jr.'s endorsement, confessing he lacked any prior acquaintance with her.

Means, a Stanford University alumna with degrees in both arts and medicine, commenced a residency in Oregon but subsequently abandoned it, her medical license currently listed as inactive; when contacted, she declined to offer any official statement.

Her 2024 book, “Good Energy,” co-authored with her brother, Calley Means—an entrepreneur currently advising the Trump administration on health matters and who has disclosed investments in biopharmaceutical firms specializing in psychedelics—contained the aforementioned recommendation regarding psychedelic substances.

A significant portion of the book delves into metabolic health, or what Casey Means terms "optimal energy," proposing various strategies to mitigate the impact of stressors, traumas, and detrimental thought patterns that impede well-being and undermine metabolic function.

One potential avenue, she posits, involves "psilocybin-assisted therapy," referencing the active compound in psychedelic fungi, a line of reasoning she elaborates on in a 750-word exposition.

"She added that those who felt drawn to it should consider exploring structured, professionally facilitated psilocybin therapy, citing robust scientific findings that indicate this psychedelic treatment can represent a profoundly significant and transformative experience, as it has proven to be for her."

Despite preliminary research indicating potential advantages of psychedelic substances, a conclusive demonstration of benefits outweighing inherent risks remains elusive. Psilocybin's capacity to induce prolonged hallucinatory states, ranging from euphoric to profoundly disturbing, necessitates careful consideration. While its integration with psychotherapy has been explored as a therapeutic avenue for psychiatric disorders and alcohol dependency, limited investigation in healthy individuals warrants caution. Furthermore, adverse physiological effects, including elevated heart rate, nausea, and cephalalgia, have been documented. Unsupervised consumption poses significant dangers, as hallucinatory experiences may precipitate hazardous behaviors, such as impaired judgment leading to accidental injury.

Means posited that psilocybin and other psychedelic substances have been unfairly stigmatized, and extolled the potential benefits of MDMA, commonly known as ecstasy, in alleviating post-traumatic stress disorder (PTSD), despite the Food and Drug Administration's recent rejection of its therapeutic application for PTSD due to concerns raised by an advisory panel regarding research flaws and significant risks.

In her book, Means euphemistically terms psychedelics "plant medicine," recounting her inaugural psilocybin experience around January 1, 2021, prompted by what she characterizes as "an internal voice that whispered: it's time to prepare."

She articulated a sense of interconnectedness, envisioning herself as inextricably linked to an unbroken lineage of mothers and infants stretching back to the dawn of existence, further suggesting that, in her subjective experience, "psilocybin may furnish access to an alternate reality, unconstrained by the ego's habitual limitations, entrenched emotional patterns, and circumscribed personal narrative."

In an October newsletter, Means disclosed that psychedelic experiences, facilitated by experienced guides, had been instrumental in her journey to emotional availability for a relationship at 35, adding a disclaimer that she was not advocating similar practices for others.

In a recent commentary outlining her healthcare priorities for the White House, Means advocated for improved nutritional standards in schools, proposed mandatory labelling for ultra-processed foods, urged rigorous inquiries into vaccine safety, and emphasized the need to eliminate conflicts of interest; while not explicitly mentioning psychedelics, she argued that the current research landscape provides insufficient motivation to investigate "generic, natural, and non-patentable drugs and therapies," and proposed allocating a segment of research funding to alternative healthcare modalities.

Means has also championed psychedelic drugs, recounting in a 2021 blog post his initial psilocybin experience during a period of personal difficulty as "the single most meaningful experience of my life – personally, professionally, and spiritually," and further disclosing in 2022 that he liquidated his entire 401k to invest in the burgeoning psychedelic drug development and research sector, though he has not responded to requests for clarification.

Casey Means' confirmation hearing remains unscheduled, her nomination arising after Trump withdrew Janette Nesheiwat, a former Fox News medical contributor initially chosen for Surgeon General, amidst scrutiny of her credentials.