Three U.S. states, modeling themselves after trailblazing Oregon – which put in motion a legal framework for psilocybin-assisted psychotherapy – could be next to authorize therapists to facilitate sessions with psilocybin mushrooms for patients.
Bills inspired by Oregon’s Measure 109, which passed in November, 2020, have been introduced into the New York and Washington state legislature, and a ballot initiative, similar in respects to that of Oregon’s, is underway in Colorado.
They all include a version of Oregon’s bottom-up approach to legalizing psilocybin-assisted therapy, which is increasingly inspiring initiatives in other states as a wave of actions grows into what could become a tsunami of change.
“Grassroots community initiatives can best create models that reflect people’s actual needs,” says psychologist Andrew Tatarsky, founding director of the Center for Optimal Living and longtime advocate for psychedelic-assisted therapy. “As in Oregon, which is bringing together a diverse cross section of knowledgeable stakeholders, we think this approach will make these medicines as widely available as possible. A top down model risks violating community needs.”
In Colorado, voters in November could vote to provide regulated access to psilocybin therapy in wellness centers – including personal cultivation rights – alongside a system of licensed businesses which could provide psilocybin, DMT, ibogaine and mescaline for supervised use.
A coalition of advocates in partnership with New Approach PAC, which was behind the Oregon initiative as well as a number of state cannabis legalization campaigns, in the state recently filed the language for the initiative and will soon begin gathering signatures to get it on the ballot under a proposed Natural Medicine Healing Act.
“Colorado’s current approach to mental health has failed to fulfill its promise,” it says. “Coloradans deserve more tools to address mental health issues, including approaches, such as natural medicines, that are grounded in treatment, recovery, health, and wellness rather than criminalization, stigma, suffering, and punishment.”
Denver became the first U.S. city to decriminalize psilocybin mushrooms in 2019. A separate sister ballot initiative, while focusing on psilocybin, seeks to legalize natural psychedelics across Colorado.
It would require “the department of regulatory agencies to implement the program and regulate the manufacture, cultivation, testing, storage, transport, delivery, sale, and purchase of natural medicine.”
In Washington, two Democrat state lawmakers have introduced proposals to legalize “supported psilocybin experiences” overseen by a trained and state licensed facilitator in plans based on Oregon’s ballot initiative.
Washington Psilocybin Wellness and Opportunity Act co-sponsor Democrat Senator Jesse Salomon has conceded the bill would not pass this session and is focused on making the policies more palatable to health and justice officials to allay concerns among fellow lawmakers.
In New York, the bill introduced by Democrat Representative Pat Burke proposes the legalization of psilocybin mushrooms for medical use in patients with a whole host of conditions such as cancer and PTSD, plus “any other condition” certified by a doctor, and the creation of privately-owned facilities regulated by the department of health to grow and administer the psychedelic fungus – following in the footsteps of Oregon. A $2m grant program would help ensure access to psilocybin service centers for military veterans and emergency responders.
“The FDA recognizes psilocybin therapy as substantially better than present treatment options,” Burke wrote in the legislative justification. “Establishing a widespread route to provide New Yorkers with this medical treatment would be a monumental step in providing mental health care to improve lives. Oregon, Texas, and several cities have taken similar steps to increase access to psilocybin treatment.”
In Oregon, psilocybin therapy is in the process of being licensed following the ballot vote, and the state’s health department has been tasked with licensing psilocybin mushroom growers and training people to administer them. The production, sale and administration of psilocybin at approved and licensed facilities is on track to begin next year.
The Oregon framework is understood to limit the amount of psilocybin that any one producer can make, and effectively blocks pharmaceutical-model companies from providing synthetic psilocybin to approved facilitators.
Graham Boyd, co-founder of New Approach PAC, says that Oregon’s yes vote was the result of growing evidence that psychedelic medicines have “powerful potential” to ease the worsening mental health crisis in the US.
Increasing numbers of psilocybin trials have reported promising results for people with a risk of psychological issues. A study in the Lancet in 2020 found that a high dose of psilocybin significantly reduces depressive syndromes and markedly improves anxiety for sustained periods.
In November, biotech company Compass Pathways reported that its study — the largest to date with 233 patients — found that one dose caused an immediate reduction of depressive symptoms of up to 12 weeks.
“The ballot initiative effort in Oregon didn’t arise out of a vacuum,” Boyd says. “Different efforts are now coming together in different ways. Unlike many issues in our political system, this isn’t one where people are really dug into their positions. They’re curious, and they’re ready to listen.”
He says “there will certainly be further efforts at the state level” both this year and in 2024. His organization is also in “active collaboration with people in a handful of states exploring legislative opportunities” potentially for as soon as this year.
“We are working toward a world where the healing power of psychedelic medicines is safely and legally accessible to all who can benefit,” he adds.
Ismail Lourido Ali, director and counsel at the Multidisciplinary Association for Psychedelic Studies says the successes of the Oregon measures “spurred a tremendous and rapid expansion in psychedelic and broader drug policy experiments” across the US.
“Legislators and advocates across the political spectrum are now utilizing their states as labs to develop creative and innovative approaches to solving it,” he adds.
All eyes are now on how Oregon implements the measures. Salomon has said that the Washington bill “basically follows the thrust” of Oregon’s psilocybin initiative by using sections of almost identical language, “but incorporates some modifications to address problems Oregon encountered with implementation.”
The Washington bill states, using firmer language than the Oregon bill which also allows a two year implementation period: “During an 18-month program development period, the department 15 must adopt rules for the implementation of a comprehensive regulatory 16 framework that allows individuals 21 years of age and older in this state to be provided psilocybin services
“These are exciting developments but I think there’s still a great deal of work to be done,” says Charles Grob, a professor of psychiatry at UCLA who researches the use of psychedelics. “Oregon has authorized a committee to put together a plan and yet there appears to be a fair degree of disagreement. If other states get in on it, we’ll have to see how the new laws are structured.
“The success of the Oregon experience will be gauged carefully across the country. We shouldn’t hold a victory party just yet because there’s a lot of work to be done.”
There is concern among psychedelic medicine advocates over the potential corporate capture of these substances amid a deepening psychedelic patenting gold rush. They point toward the significance of grassroots models which might counterbalance corporate pharmaceutical actors and sketch an alternative way forward.
“These corporations are motivated by maximizing profit, not maximizing well-being; and the likely end point is restricted access to overpriced therapies and obstacles to research,” says Steve Rolles, senior policy analyst at Transform Drug Policy Foundation.
There was an outcry when pharmaceutical company Compass patented psilocybin formulations and filed for protections for simple aspects of psilocybin therapy which have since been challenged. There are fears that any end-to-end business model based on controlling the therapy process from medicine production to therapist session could seriously restrict patient access.
“Responsibility should sit neither with activists nor industry,” adds Rolles, “but a responsible regulatory agency able to balance the needs of all community stakeholders without their priorities being distorted by corporate profits.”
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