MDMA and psilocybin are moving through FDA therapeutic trials in the USA. While MDMA is expected to be approved next year there is still no legal therapeutic use of psychedelic medicines in the USA outside of research settings. That is, there was not until the state of Oregon made psilocybin therapy legal in selected treatment settings. Oregon Psilocybin Services is a new section of the Oregon Department of Health. This agency is responsible for licensing and regulating the manufacturing, transportation, delivery, sale, and purchase of psilocybin products and the provision of psilocybin services.
Legalization of Psilocybin in Oregon
In an article titled Psilocybin 101, the Oregon Health News Blog explains how Oregon passed Measure 109 in 2020. This law ordered the setup of a regulatory framework for using psilocybin for medicinal purposes. Four types of licenses are involved in this effort. This includes licensing of those who cultivate and process psilocybin as well as laboratories that test psilocybin. Then both facilitators who provide client support during treatment sessions and treatment centers that both sell psilocybin and provide settings for treatment must be licensed as well. Roughly 90 pages of administrative rules govern all of this.
Access to Psilocybin Treatment in Oregon
As of late 2023 there are five licenses for cultivation and processing of psilocybin in Oregon under the new law. There are thirteen treatment hosting sites. According to The New York Times, a single treatment session includes preparatory meetings, taking the psychedelic medicine with a guide, and follow-up. The cost for this is about $15,000. This is about the same as psychedelic treatment in Australia where both MDMA and psilocybin are legal for treatment with certified psychiatrists. In Oregon a licensed physician, psychologist, or psychiatrist is not required. But the individual who supervises sessions and acts as a guide needs to be licensed by the Oregon Board of Health Psilocybin Services folks. Facilitators need to go through training and pass an exam to qualify.
Treating PTSD With Psilocybin in Oregon
The Food and Drug Administration is likely to approve the psychedelic medicine MDMA for treating post-traumatic stress disorder or PTSD next year. Psilocybin is likely to follow in a couple of years for treatment of depression. The point is that the best evidence we, and the FDA, have to this point is that the best treatment among psychedelics for PTSD is MDMA and not psilocybin. And the best psychedelic for treating depression is psilocybin and not MDMA. Both psychedelic medicines work for both conditions. When MDMA is approved for treating PTSD it may well be used “off label” to treat depression. Likewise, when psilocybin is approved by the FDA it may well be used “off label” to treat PTSD. In the meantime, in the state of Oregon we are already seeing psilocybin being used to treat PTSD as noted in the Times article we referenced.
How Well Will the Oregon Psilocybin Experiment Work?
A concern voiced by researchers in the field of psychedelic medicines is this. There can be significant side effects when using psychedelics like psilocybin. Hope or the placebo effect can cause people to feel better. How we know when any medicine works for a specific condition and does not cause problems is when we keep track. This is best done with what are called controlled trials in which patients are pre-selected to participate and results are tallied afterward. It is unclear to us how the folks in Oregon plan to keep track of how this experiment is working out. In the world of standard pharmaceuticals the FDA does follow-ups after a medicine goes into general use and modifies the rules for its use as required.
A concern voiced by a psychedelic researcher in California is that there will be some sort of big problem which will torpedo the Oregon psilocybin experiment and as collateral damage reverse all of the progress made in psychedelics generally over the last couple of decades.
Let People Decide Regarding Psilocybin
The seems to always come a point when the government regulates things where people are expected not to be able to use common sense. The Times article features an ex-Marine with PTSD who was already getting treatment for PTSD but had not had any access to psychedelics. He was of the opinion after psychedelic treatment that hit helped. So long as there is adult supervision of the Oregon program by its Department of Health we think that it is time to let people decide regarding psilocybin treatment for their PTSD, depression, or substance abuse problems.