Abstract

In August 2024, The U.S. Food and Drug Administration rejected Lykos Therapeutics, Inc.'s new drug application for midomafetamine with psychological intervention (MDMA-AT) to treat post-traumatic stress disorder (PTSD). Among the many issues raised during review was concern about a highly publicized case of alleged sexual misconduct by an unlicensed therapist during a Phase 2 study of MDMA and the potential risk of future abuse. This incident of misconduct, along with several other publicized cases of misconduct by guides, facilitators, and shaman offering psychedelic retreats, has raised the question of whether physical contact is ever appropriate during psychedelic-assisted therapy (PAT). Drawing on research about supportive touch in other clinical contexts and taking into consideration features of psychedelics that exacerbate the potential for harm associated with supportive touch, we advocate for a precautionary approach to harm-reduction while arguing that supportive touch ought not be thrown out whole-cloth.