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MDMA, psilocybin, and ketamine are often grouped together as psychedelic medicines. But pharmacologically and therapeutically they are very different tools. → Download our free microdosing guide for practitioners: https://edu.psychedeliccoaching.insti... In this solo explainer, Paul F. Austin walks through a practical framework for choosing between these three medicines based on context, client profile, legal access, and neurobiological effects. Rather than treating these substances as interchangeable, this framework helps practitioners and curious learners understand when each medicine may be most appropriate and why. WHAT YOU’LL LEARN • The key differences between MDMA, psilocybin, and ketamine • Why these medicines are not interchangeable tools • When each medicine may be appropriate for different client profiles • Legal accessibility and treatment planning considerations • Key contraindications and safety factors • Why integration windows differ across medicines CHAPTERS 00:00 The Psychedelic Decision Framework 00:44 Mapping Three Different Medicines 02:33 Why These Medicines Are Not Interchangeable 03:19 Different Keys for Different Locks 05:05 Contraindications and Medication Interactions 07:03 Nervous System Readiness and Experience 08:19 Understanding the Integration Window 09:31 Client Examples 11:09 Ketamine’s Addiction Risk 11:58 The Real Job of Psychedelic Work ABOUT PAUL F. AUSTIN Paul F. Austin is the founder of Third Wave and the Psychedelic Coaching Institute, and host of The Psychedelic Podcast. For more than a decade he has explored how intentional psychedelic use can support personal growth, leadership, and cultural transformation. Through education, research, and professional training programs, Paul helps individuals and practitioners develop responsible frameworks for working with these powerful tools. RESOURCES MENTIONED Psychedelic Coaching Institute https://psychedeliccoaching.institute... Third Wave Microdosing Guide https://thethirdwave.co/microdosing/?... ~~~~~~~~~~~~~~ Join our weekly newsletter covering the most important updates in the psychedelic space. Get new podcast episodes, upcoming events, exclusive discounts, and curated spotlights on retreats and providers, all in one place: 👉 https://thethirdwave.co/newsletter/?r... Our flagship Certification Program at The Psychedelic Coaching Institute: https://edu.psychedeliccoaching.insti... Mushroom Grow Kit & Course: https://thethirdwave.co/sp/mushroom-g... Third Wave's directory of trusted practitioners, retreats & clinics: https://thethirdwave.co/directory/?re... Third Wave on Social: 🖤 Instagram: / thirdwaveishere 🖤 Facebook: / thirdwaveishere 🖤 Twitter: / thirdwaveishere 🖤 LinkedIn: / third-wave-psychedelics Disclaimer: The content shared by Third Wave is intended for educational, informational, and entertainment purposes only. We aim to provide evidence-based, harm-reduction-oriented content to support informed public discourse. We do not provide medical advice, legal advice, diagnosis, or treatment, and content here is not an endorsement of or an encouragement to use any substance. Always consult with a qualified healthcare professional before making decisions regarding your mental or physical health. Third Wave’s content may discuss functional mushrooms, entheogens, or other emerging therapies, however, nothing posted on this account is intended as an attempt to buy, sell, trade, donate, gift, or ask for entheogens or any other substance. This account does not advocate for illegal activity.