Q: Eli Lilly just spent $3.8 billion buying into psychedelics. Is Big Pharma’s involvement actually good for the public, and who benefits most from it?
A: A pharmaceutical company doesn’t put $3.8 billion behind something unless it believes it will be profitable. For-profit health care hardly ever benefits the public, but this question goes deeper than that.
The Deal
In mid-July, Eli Lilly announced it would acquire AtaiBeckley for up to $3.8 billion, the largest deal yet in the psychedelic sector. The prize is BPL-003, a fast-acting DMT nasal spray in Phase 3 trials for treatment-resistant depression, built for a two-hour, in-clinic administration, with review timelines sped up by an April executive order. Lilly’s legal obligation is to grow shareholder value, a fundamentally different starting point than the one this work grew out of.
Who Loses First
Indigenous communities lose first, as they always do. They’ve stewarded these plants and practices for generations, often while being criminalized for it, and they’re seeing the least benefit as investment money pours into this space. Underground facilitators are next. They built the bridge between the sacred and modern practices that made this attractive to a $300 billion company, and pharma’s pathway largely routes around them. Then come people without insurance, an easy diagnosis, or a medicalized interest who find the door open in theory, closed in practice.
The Profit Model
Spravato is the warning sign, and it deserves to be named directly. Ketamine is addictive. Its mechanism isn’t identical to an opioid’s, but the pattern around its therapeutic pathway is a mirror of the one that built the opioid crisis we are still in. A substance legitimized through prescribing, marketed as safe, driven largely by rampant telehealth clinics prescribing it online with little client contact or oversight. People become dependent and their prescription ends, leading to underground acquiring of an unregulated and often fentanyl-contaminated supply. Meanwhile, independent reviews put esketamine’s benefit at a modest effect, not the breakthrough it’s sold as. Nobody has good long-term data on what happens once someone stops treatment, because the pivotal long-term trial wasn’t built to test that. It was built around people staying on it indefinitely, dosed weekly or monthly, for years. A drug that only works while you keep taking it is a far better model for profit than one that resolves someone’s depression. I don’t think it’s a coincidence that the first “psychedelic” Big Pharma fully embraced is addictive and has limited effectiveness. This doesn’t bode well for the future of these substances in the hands of corporations.
What is “Medicine”
Why has “healing,” specifically the clinical, diagnosable, billable kind, become the only story we tell about psychedelics in Western culture? These practices didn’t start as simply treatments for mental or physical health. They started as rites of passage, structured around a threshold they helped you cross. When access requires a diagnosis, a doctor and a medicalized pathway, we’ve decided suffering is the price of admission and that health care systems get to define what’s legitimate and who is granted access.
It also ascribes ownership to natural resourecs. A U.S. patent was granted on the ayahuasca vine in the 1980s, and it took Indigenous organizations years of organizing to get it challenged as biopiracy. A biotech company patented specific forms of psilocybin more recently, drawing the same backlash. “Medicine” can be owned and sold. Sacrament and rite of passage are not marketable, which is why this shift serves corporations and shareholders, and costs everyone else.
Traditional practitioners have never taught that these plants exist to make life easier or more comfortable. Many teach the opposite: that they’re conscious, that they ask something of you, that it’s an active not passive process and that discomfort is often the crucible. A model built around speed, convenience and reduction of symptoms is a rejection of ancient understanding, not a gentler version of it. Who is granted access and what counts as a valid reason is not a small point. The words we use and the lens we apply to these substances and experiences is not a small thing, it is a great co-option of power.
I don’t have a tidy answer, and I’d be suspicious of anyone who does. Keep watching who’s funding the research and who’s being handed authority. That authority is being assigned right now, and Indigenous people, traditional healers and community facilitators are being intentionally kept outside of this conversation.
—This column is for educational purposes and isn’t a substitute for medical or legal advice. Have questions about navigating psychedelics? Send them to Mary@Myco.Vision for future columns.
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