Researchers have long believed that psilocybin could provide powerful benefits for many mental health conditions, such as depression and anxiety. But opportunities to potentially use psilocybin as a treatment dissolved when it was added to the Drug Enforcement Administration’s list of Schedule I illicit drugs in 1970. Now, Oregon’s new law is opening the door for the creation of a psilocybin-assisted therapy program, which could become a template for similar programs in other states if legality is expanded. Here’s how the program will work and how psychedelics could play an important role in treating certain mental health disorders. Follow Now: Apple Podcasts / Spotify / Google Podcasts
Oregon’s Psilocybin-Assisted Therapy Program
A new Oregon law allowing for the state’s health authority to start a program for licensed therapists to administer psilocybin as a mental health treatment passed with nearly 56% of votes in November. Governor Kate Brown has since appointed a number of public health experts, doctors, mental health professionals, and other specialists to serve on a new Oregon Psilocybin Advisory Board, which is tasked with figuring out how this program will work by the end of 2022. “I am very excited about the new psilocybin program in Oregon,” says Keith Heinzerling, MD, internist, addiction medicine specialist, and director of The Pacific Treatment & Research in Psychedelics Program for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California. “Psychedelic therapy, including with psilocybin, is critically important. Although we have many effective treatments for mental health conditions, including medications and psychotherapies, there are still many patients who do not respond to the existing treatments.” The use of psilocybin as part of this program in Oregon will be heavily regulated. Professionals must be specially licensed to grow the mushrooms, extract the psilocybin, synthetically produce the drug, and/or provide therapy with psilocybin. The treatment will only be offered to people age 21 and up. It will involve three sessions for preparation, administration, and integration. The second session—administration—is when the participant will take psilocybin. The advisory board has yet to decide exactly how this will work, but experts say psilocybin can be administered a number of different ways (including in a pill, tea, or whole mushrooms). After taking psilocybin, the participants will then return for an “integration session” with the therapist to reflect on the experience. The board will be releasing more details about how Oregon’s program will work in the coming months. The Oregon Health Authority will begin accepting applications to license therapists and manufacturers for the program no later than January 2, 2023.
What Psilocybin Treatment Is Like
A psilocybin “trip” usually lasts up to 8 hours, but the experience can vary significantly from person to person, says Dr. Heinzerling. “Psychedelics do not produce a specific effect as much as amplifying whatever is going on in the mind at the time and opening the mind to deeper levels of consciousness,” he says. “As a result, some patients have a beautiful, blissful, or mystical experience while for others it may be challenging or even frightening and often a single session may include multiple different emotions.” Therapists administrating the treatment usually take a number of steps to keep the participant comfortable. “Set and setting are crucial to an ultimately helpful experience,” says Lauren Taus, LCSW, a psychotherapist with a specialty in psychedelic assisted therapies and cofounder of The Psychedelic Coalition for Health, a company that provides psychedelic medicine education, professional healthcare training, and advocacy. She continues: “The therapy usually contains several components, such as a way to block the patient’s vision, usually with an eye mask, to encourage inner exploration, and headphones that can play evocative music or block out sound. Sometimes a blanket is used because our bodies become more sensitive to temperature on psychedelics. All of these things are to help the patient feel more secure and relaxed as they do the work inside to heal and whole.” But even if the participant experiences negative emotions while taking psilocybin, they may ultimately still reap mental health benefits, says Dr. Heinzerling. “The best predictor of a therapeutic response is the intensity of the experience, not whether it is experienced as positive or negative,” he says. “In psychedelic therapy we do not talk about ‘bad trips,’ as even a difficult experience may be highly therapeutic, especially when patients are working with skilled psychedelic therapists.”
Mental Health Benefits of Psilocybin
Researchers are still studying exactly which conditions could be treated with psilocybin. However, the Oregon Psilocybin Advisory Board has reviewed existing studies and found that psilocybin is likely to be effective at reducing depression, anxiety, and “problematic alcohol and tobacco use.” “Though psilocybin treatment does not offer a cure for mental and behavioral disorders, it does provide relief for the patient to better manage their symptoms as they work with a trained professional to better understand their triggers and symptoms,” explains Parag Bhatt, PhD, pharmacologist and chief science advisor at Silo Wellness, a company that provides functional mushroom products and psychedelic wellness retreats in Jamaica and Oregon. He adds: “In many cases, psilocybin was found to be as efficacious in treating mental health [conditions] as traditional antidepressants were with far less negative side effects and greater long-lasting positive therapeutic effects.” Oregon’s move toward offering psilocybin as a treatment could allow for a deeper understanding of the potential benefits of psychedelic therapy and provide a framework for other states to develop similar treatment programs. “Oregon has taken the first step. As with cannabis laws, other states are likely to follow suit particularly if no untoward consequences of Oregon’s legislation become apparent,” says Geraldine Kuo, MD, chief scientific officer at Aphrodite Health, a women-focused psychedelic biotech company. “The specific language of Oregon’s ballot measure is a template for other legislatures to model theirs after. Public support for the repeal of psychedelic prohibition laws seems very high.” While the program is specific to Oregon, it could provide benefits to people across the country. It will allow therapists to better understand the potential therapeutic benefits of psilocybin. Plus, the framework for this program could be used as a template for other states to create their own psychedelic therapy programs.
