I first wrote on “psychedelic renaissance” studies pointing to potential medical benefits of these drugs back in 2016, but I ended up going deeper a year later almost by chance. I heard two academics talking about how it costs around $7,000 per gram of psilocybin (the psychedelic compound in magic mushrooms), and that one story paved the way for much more ambitious work, uncovering the business dealings behind psychedelics. Those story threads of money and drugs are endlessly fascinating, and have led me deeper into the pharmaceutical side, the characters who care so much about how these drugs should be rolled out, and the people controlling this brand new industry. I’ve reported on efforts to create the first magic mushroom monopoly, sexual abuse allegations within a clinical trial, and work to create an alternative therapy system in Oregon. Over the years, the stories and ideas became too big to fit into a series of articles, and I realized this major turning point in our understanding of mental health needed to be told as a book.

There are no easy answers. Developing and researching drugs, even those that exist in nature, is incredibly expensive, and companies inevitably expect to regain their costs post-approval. This can create incentives to sell as much of a drug as quickly as possible, and there are questions about how psychedelics will fit into a system that often prioritizes profits over patients. At the same time, there are regulatory bodies in the medical industry that can provide safety and standards. Whatever happens, there’s no doubt psychedelics will change once they enter this system. Even though research predominantly combines both psychedelics and therapy, the FDA—as a body that only regulates drugs—has created considerable pressure to disentangle the two. Psychedelics can be messy and wild and unpredictable, and I think it’s going to be difficult to make them neatly fit.

I want to reach people who care about mental health, whether they love psychedelics or have never heard of them. This story is important because it’s such a rare challenge to our mental health system. We may not have another chance in our lifetimes to develop a fundamentally new treatment, and to change the way we think about and treat mental illness. Much of my work highlights the huge power of the mental health industry over the centuries, long before pharmaceutical psychedelics, to transform not just treatment options, but theories of mental illness and our understanding of our own minds. Many contemporary narratives, including the theory that depression is caused by chemical imbalances, were first popularized by pharmaceutical companies as sales tactics for SSRIs. And so psychedelics are a once-in-a-generation opportunity to upend everything we think we know.