PORTLAND – The curriculum was in place, students were enrolled and Oregon officials approved nearly every detail of training for the first class on “magic” mushrooms for those seeking state certification.
But when session four began in a hotel conference room in early December, an important pedagogical tool was missing: mushrooms.
That’s because state officials, two years after Oregon voters narrowly approved the use of psilocybin in adults, were still crafting the regulatory framework for the production and sale of the hallucinogenic mushrooms.
Instead, the students, most of whom are experienced mental health professionals, would have to role-play with one another through meditation or intensive breathing practices that could lead to altered states of consciousness, the closest thing to the kind of psychedelic trip they would find. as authorized guides.
Like many of the two dozen students who paid nearly $10,000 for the course, Jason Wright, 48, a psychiatric nurse at a hospital in Portland, said he was excited to be part of an experiment with national implications.
“It’s amazing to be at the forefront of something that has the potential to change our relationship with drugs that should never have been criminalized in the first place.”
On Sunday, Oregon became the first US state to legalize adult use of psilocybin, a natural psychedelic that has shown great promise for treating severe depression, post-traumatic stress disorder and anxiety among the terminally ill. . among other mental health conditions.
Although scientists are still working to understand their therapeutic dynamics, psilocybin and other psychedelics are believed to promote neuroplasticity, a new circuitry in the brain that gives patients new perspectives on long-standing psychiatric problems.
A recent study on alcohol use disorder, for example, found that two doses of psilocybin combined with talk therapy led to an 83 percent decrease in binge drinking among participants, with nearly half of them they had stopped drinking completely by the end of the eight month trial.
The long-term benefits, however, remain unclear.
Oregon Measure 109, as it is called, authorized the creation of psilocybin service centers where anyone over the age of 21 can consume the mushrooms in a supervised setting. A key requirement is that a state-certified facilitator must be present during drug-induced trips, which can last five to six hours.
Unlike cannabis, which can be sold in dispensaries, Oregon will not allow retail sale of psilocybin; Consumption must be carried out at an authorized service center.
For supporters of drug policy reform, Oregon’s passage of the measure is groundbreaking, a policy change they hope will inspire other states and municipalities, and persuade federal authorities to remove historic bans.
Oregon voters also made history in 2020 by voting decisively to decriminalize the personal possession of small amounts of drugs like heroin, cocaine, and methamphetamine.
The Oregon experiment has not been without its setbacks. The approval of the ballot measure generated a violent reaction in the rural and more conservative areas of the state. A subsequent ballot measure in November resulted in 25 of the state’s 36 counties voting to opt out of the program for now.
The protracted regulatory vacuum provided an opportunity for entrepreneurs who rushed in. In early December, police raided Shroom House, a Portland retailer that authorities say was illegally selling psilocybin mushrooms and drawing long lines of customers.
State officials say they are not discouraged, even as they acknowledge the new regulatory and logistical challenges. Psilocybin use is legal in a handful of countries, including Brazil, Nepal and the Bahamas, but none have sought to create a system of supervised use.
Angela Allbee, a policy analyst with the Oregon Health Authority who oversees the state’s psilocybin services section, noted that the process had been bumpy at times, in part because officials sought to maximize public participation through advisory panels, public hearings and meetings with officials.
The greatest tensions arose over the issue of affordability, since psilocybin sessions will not be covered by insurance, at least as long as the federal government lists the drug as a Schedule 1 substance with no “currently accepted medical use.”
A single session is likely to cost hundreds or thousands of dollars.
A debate centered on whether to adopt a therapeutic model that would require more intensive and expensive supervision by a psychotherapist, or a less rigorous approach that would allow anyone over the age of 21 to access the drug, with or without a health diagnosis. as long as there are trained facilitators present during the session. Health officials opted for the latter, which they call a “non-targeted” approach.
“Being first in the nation means we have a responsibility to get it right, and that sometimes means learning as we go,” Allbee said.
There was a palpable sense of excitement as students gathered at the Dossier Hotel in downtown Portland for a 160-hour course run by Fluence, an education and training consultancy offering certification in the nascent field of psychedelic-assisted therapy. .
“It feels like I’m dreaming,” said Brian Pilecki, 43, a psychotherapist who was one of the instructors. “I never imagined this would happen in my life.”
The first day of the Fluence course was largely devoted to self-reflection, with many students expressing frustration with the limitations of psychotropic medications like Xanax or Zoloft that are used to treat the symptoms of mental illness, not the underlying causes. Others gushed about their own experiences with psychedelics.
The current model of psychiatric care, Wright said, revolves around calming patients who present to the ER in the midst of a psychotic or manic episode.
Wright noted that the current list of drugs was effective in stabilizing a patient, but many simply returned because the precipitating trauma, anxiety or depression went untreated.
“I’m happy to be here,” he told the group, “so I can stop selling ineffective drugs to my patients.”
