What Means Means for Mushrooms and Marijuana: Trump’s Surgeon General Nominee Could Reshape the Psychedelics Conversation, But Cannabis Reform May Lag Behind

Earlier this month, former President Donald Trump nominated Dr. Casey Means to be the next U.S. Surgeon General, drawing both applause and criticism. A Stanford-trained physician turned wellness influencer, Means has gained a following for her work on metabolic health and holistic medicine. She also happens to have close ties to Health and Human Services Secretary Robert F. Kennedy Jr., a fellow wellness advocate and key voice in the Make America Health Again (MAHA) movement.

Trump praised Means as having “impeccable credentials,” but her nomination has sparked intense debate not just because of her unconventional background and lack of an active medical license, but also due to her vocal views on substances like cannabis and psychedelics. As the country eyes a potential second Trump presidency, many are wondering what Means’ appointment could mean for future drug policy. Her past statements offer intriguing clues—and some cause for concern.

A Psychedelic Shift: Means’ Public Embrace of Psilocybin Could Signal a Pro-Reform Stance

Those advocating for the therapeutic use of psychedelics have reason to be cautiously optimistic about Means’ potential confirmation. In her 2024 book Good Energy: The Surprising Connection Between Metabolism and Limitless Health, Means doesn’t shy away from sharing her own personal experiences with psychedelic substances—particularly psilocybin, the active compound in “magic mushrooms.”

Rather than taking a distanced, clinical view, Means frames her encounter with psychedelics as deeply transformative. She discusses the emotional and spiritual benefits of intentional, guided use, describing her journey as one of unity with nature and profound existential understanding. Her embrace of psychedelics appears not only sincere but grounded in the language of science, neuroplasticity, and healing.

On her personal blog, she has reiterated her support for “plant medicine,” specifically highlighting psilocybin as a modality she has explored deeply. This kind of personal and public advocacy from a potential U.S. Surgeon General could normalize discussions of psychedelic therapy within government, medical, and public spheres.

The political context only adds momentum to the psychedelic cause. Bipartisan interest in expanding access to psychedelic therapy—especially for veterans—is rising. In a recent cabinet meeting, Department of Veterans Affairs Secretary Doug Collins reportedly told Trump that his agency was exploring the potential of psychedelic treatment for military personnel. Lawmakers from both sides of the aisle have called on the administration to accelerate access. Even RFK Jr. has openly discussed his own youthful experience with LSD in a positive light.

Means’ alignment with the MAHA movement and her promotion of psychedelics as a tool for mental, emotional, and spiritual health makes it likely that, if confirmed, she will support research and access initiatives—at least within medically guided, therapeutic frameworks.

A Sobering Stance on Cannabis: Means’ Anti-Weed Views Could Hinder Reform Momentum

While Means’ views on psychedelics suggest potential progress, her statements about cannabis tell a different story. In Good Energy, Means categorically groups marijuana with tobacco, soda, sugar, and social media as harmful substances that reduce metabolic efficiency and “hurt your mitochondria.” Her solution is simple and severe: stop using it altogether.

Her blog continues this line of criticism. While she makes allowances for things like psilocybin therapy under professional guidance, her stance on marijuana appears moralistic and dismissive. Cannabis users, in her framing, are lumped together with people chasing cheap dopamine fixes through porn, gambling, or junk food. There’s little nuance in her characterization, and even less room for medical or therapeutic exceptions.

This could present real challenges for cannabis reform advocates. Although Trump has, at times, expressed openness to certain cannabis reforms—such as supporting a federal rescheduling of the drug, promoting banking access for cannabis businesses, and even backing a Florida legalization ballot measure—these efforts have largely stalled. Key officials in his circle have deprioritized cannabis in favor of other health and regulatory issues. A Surgeon General with a staunchly anti-cannabis perspective would only reinforce that inertia.

A Divided Legacy: Means Embodies the Tensions Between Holistic Health and Drug Policy Reform

Means’ nomination underscores a broader conflict within wellness and health movements: the simultaneous embrace of some forms of alternative medicine (like psychedelics) and the rejection of others (like cannabis). It’s a contradiction that reflects a growing divide between data-driven reform efforts and ideological health narratives.

That contradiction could complicate policymaking. If Means is confirmed, she may act as a champion for psychedelic science, lending institutional credibility to research and pilot programs. Her voice could help push through long-awaited reforms in therapeutic psilocybin, MDMA, and similar compounds, especially for trauma and depression treatment.

However, her influence may be more obstructive when it comes to cannabis, a substance already burdened with legal and social stigma. Without high-level advocacy for descheduling or federal legalization, cannabis policy could remain in limbo, even as more states move toward legalization and public support for reform continues to grow.

A Contentious Road to Confirmation: Questions of Qualification Could Derail the Nomination

Of course, all of this assumes Means makes it through a confirmation process that’s already drawing fire from multiple sides. Critics have pointed to her lack of a current medical license, with some former Surgeon Generals questioning whether she meets the basic requirements for the role. Others within the MAHA-aligned movement argue she hasn’t taken strong enough stances on certain health issues to lead the nation’s public health strategy.

These debates make her confirmation anything but a sure thing. And even if she is confirmed, the Surgeon General’s power is largely persuasive rather than legislative. Her impact would depend on how much influence she can wield within Trump’s broader health policy apparatus—and whether lawmakers are willing to act on her recommendations.

The Future Is Uncertain, But the Psychedelics Conversation Is Evolving

So, where does this leave us? If confirmed, Means could become one of the highest-profile government figures to publicly embrace psychedelics, accelerating their shift from fringe therapy to mainstream treatment. Her views may help reshape the national narrative around psilocybin and similar compounds, moving public and political discourse toward cautious, science-based adoption.

Cannabis, however, appears destined to remain in a regulatory gray zone. With Means likely opposing its use on health grounds, and Trump’s team largely silent on the issue in recent months, meaningful reform may continue to stagnate.

Still, even incremental changes to how we talk about psychedelics and who’s talking about them can have ripple effects. And in a political era where few issues are ever truly settled, the conversation around plant medicines, both celebrated and stigmatized, continues to evolve.

As always, we’ll be watching what happens next so you don’t have to.

What impacts could Means have on public health policy?

If Dr. Casey Means is confirmed as Surgeon General, her impact on public health policy could be significant—especially given her unconventional background, outspoken health philosophies, and ties to influential figures like Robert F. Kennedy Jr. Here’s a breakdown of the potential impacts she could have:

1. Elevating Metabolic Health to a National Priority

Means has built her wellness brand around the idea that poor metabolic health is at the core of many chronic diseases. As Surgeon General, she could push for:

• Increased public awareness campaigns around metabolic syndrome, insulin resistance, and related conditions.
• Dietary and lifestyle policy recommendations aimed at reducing processed foods, added sugars, and sedentary behavior.
• Expanded preventive health initiatives focused on nutrition, exercise, and personal monitoring (e.g., wearable tech, continuous glucose monitors).

This could mark a shift in emphasis from reactive medical treatment to proactive health optimization.

2. Support for Psychedelic Therapy in Mental Health Treatment

Given her public support and personal experiences with psilocybin, Means could:

• Promote further research into psychedelic-assisted therapy, particularly for depression, PTSD, and addiction.
• Advocate for policy changes to allow controlled therapeutic use of psychedelics under medical supervision.
• Use the Surgeon General platform to destigmatize psychedelics and reframe them as medical tools rather than recreational drugs.

If paired with bipartisan momentum in Congress—especially for veterans’ mental health—this could accelerate federal approval for psychedelic therapies.

3. Resistance to Cannabis Normalization

While she supports psychedelics, Means is openly critical of cannabis, linking its use to metabolic dysfunction and dopamine-driven escapism. As a result:

• She may oppose federal cannabis legalization or rescheduling, at least for recreational use.
• She might influence public health messaging that highlights the risks of cannabis use, particularly in adolescents or vulnerable populations.
• Her views could slow down or complicate efforts to integrate cannabis into broader wellness or medical treatment frameworks.

4. Redefining Wellness in Public Health Messaging

Means’ background as a “wellness influencer” may bring a very different tone and style to the Surgeon General’s communications. Possible effects include:

• Increased use of social media and nontraditional platforms to spread health advice.
• Language focused on holistic and “energy-based” health concepts, which could appeal to younger or health-conscious audiences but raise concerns among traditional medical professionals.
• A more lifestyle-centric approach to public health—framing health as a personal optimization challenge rather than a systemic issue.

5. Tensions with Mainstream Medical Institutions

Her nontraditional career path (including leaving clinical practice, losing her medical license, and promoting lifestyle medicine) could create friction with:

• Mainstream medical associations like the AMA or CDC, especially if her advice deviates from established guidelines.
• Academic researchers who may be skeptical of her emphasis on anecdotal experiences and wellness branding.
• Public health bureaucrats wary of politicizing the Surgeon General’s office with a figure outside conventional public health channels.

This could make it harder for her to implement or influence large-scale programs especially those requiring agency coordination.

6. Advocacy for “MAHA”-Style Individual Responsibility

Aligned with the “Make America Health Again” movement led by RFK Jr., Means is likely to emphasize:

• Personal responsibility in health outcomes—encouraging people to make better choices around food, tech use, and substance consumption.
• Skepticism of pharmaceutical overreach and possibly public-private health partnerships.
• Health freedom rhetoric, which may resonate with some voters but complicate consensus-building on issues like vaccination, pandemic preparedness, or regulation of supplements.

7. Mixed Signals on Drug Policy Reform

Means’ contrasting stances on cannabis (critical) and psychedelics (supportive) may create an inconsistent drug policy approach from the Surgeon General’s office. This could:

• Complicate federal messaging around harm reduction and drug safety.
• Confuse public understanding of which substances are “safe,” “natural,” or “therapeutic.”
• Undermine coherent federal strategy if her views conflict with those of other officials in HHS or the FDA.

If confirmed, Casey Means could bring a major shift in tone, style, and focus to the role of Surgeon General—centering metabolic health, psychedelics, and lifestyle medicine while remaining skeptical of cannabis and traditional pharma. Whether that shift is seen as innovative or risky will depend on how she balances science, policy, and public perception in a very divided political and medical landscape.