A Case for Legally Regulated Psilocybin Therapy

Oregon’s Measure 109 Provides the Model

Oregon’s Mental Health Crisis

If you happen to live in Portland, Oregon, you see it every day. Real people, abandoned to the streets, living in tents, sinking deeper into addictions and despair. The situation throughout our state, while less visible, is no less severe. One in six Oregonians struggle with mental illness, the highest rate in the country, according to Mental Health America.

Depression is rampant. PTSD decimates our veterans. Addictions have so ravaged our communities that the Governor has declared a public health crisis. While the situation here in Oregon is especially dire, it is not unique. Mental wellness across the country is on the decline, and the cascading effects of Covid-19 will only make matters worse.

Even before Covid, our models of mental healthcare were deficient. In Oregon, only 50 percent of those receiving care report satisfaction with their services, according to the Oregon Health Authority. The pharma-driven approach to psychiatry feels stagnant, unable to meet the challenge of the current moment. Our medical system is suited to fix broken arms, but not broken spirits.

But we need not lose hope. In fact, we have some good news to share. A growing body of research suggests that “psilocybin”—a natural compound found in many species of mushrooms—can, as part of therapy, help relieve a variety of mental health issues, including depression, existential anxiety, addictions, and the lingering effects of trauma.

The psilocybin solution has shown such promise that the United States Food and Drug Administration (FDA) has granted it a “Breakthrough Therapy” designation for the treatment of Depression. That means psilocybin, when administered under supportive conditions, demonstrates an excellent safety record and may well deliver substantial improvement over available therapies.

Oregon should take the lead on psilocybin

Despite the science, the Drug Enforcement Agency (DEA) continues to classify psilocybin on Schedule I, as if it were a dangerous drug of abuse with no medical benefits. In reality, psilocybin is not toxic and not addictive, and appears profoundly beneficial as an adjunct to therapy. Nonetheless, current law bars us from harnessing the healing power of psilocybin. In light of a growing body of clinical research that shows the efficacy of psilocybin therapy, its prohibition seems unscientific, outdated, even inhumane.

The rationale for reforming these laws is simple: people are suffering who could otherwise benefit from this well-tolerated and very promising form of treatment.

That’s why we want to make everyone aware of Oregon’s Measure 109, the only legislation of its kind in the world. It is a ballot measure that has already qualified for this November’s statewide election, on the strength of over 164,000 signatures from Oregon voters. The measure advances a carefully crafted regulatory framework to allow Oregonians legal access to professionally delivered psilocybin therapy. Trained facilitators, adhering to careful practice standards, will offer these services at licensed facilities. It’s a statewide initiative with global implications.

A New Paradigm of Mental Wellness

Whatever your take on the bigger questions of drug policy, this particular piece of the puzzle really shouldn’t be controversial. Under the Oregon model, no one will legally buy psilocybin to take home or to use in public. No minors will be involved. No providers will conduct sessions in residential neighborhoods. No one will be allowed to drive home altered. Psilocybin will not be branded or marketed to the public. Every precaution is taken to keep the focus where it belongs: on compassionate care, safety, and healing.

Of course, introducing psychedelics back into society is an extremely delicate project. We founded the Oregon Psilocybin Society and began work on Measure 109 back in 2015, giving ourselves a long runway because we wanted to do things right. We wanted to let the science develop and public opinions evolve, which continues to take place.

Since the early days of the campaign, we’ve seen a steady stream of promising data coming from leading research institutes around the globe, suggesting that just one or two psilocybin sessions can produce impressive and long-lasting improvements in mental health—with no lasting adverse effects reported. In several studies involving individuals with advanced cancer, psilocybin therapy led to marked improvements in symptoms of both anxiety and depression (Griffiths et al., 2016; Grob et al., 2011; Ross et al., 2016). Psilocybin shows similar promise in addressing Major Depressive Disorder, with benefits lasting months after treatment (Carhart-Harris et al., 2016). In relation to addictions, Bogenschutz et al. (2015) found that psilocybin therapy significantly decreased alcohol consumption for people with Alcohol Use Disorder, while 67% of heavy smokers who had received two to three psilocybin assisted sessions reported continued abstinence from tobacco at 12-month follow up (Johnson et al., 2017).

As therapists, we especially appreciate that these studies highlight the safety and efficacy of psilocybin when used within an affirming therapeutic context. Following the science, Measure 109 defines a sequence of therapeutic sessions, powered by the carefully cultivated alliance between a facilitator and a client. It’s a modality that emphasizes the key ingredients of successful therapy, including the helping relationship, the healing setting, and the therapeutic frame.

It also represents an underlying philosophical shift, away from a more prescriptive, medicalized approach, and toward a more therapeutic, client-centered model. The language of psychedelic therapy draws from humanistic, existential, psychospiritual, somatic, experiential, and transpersonal orientations.

What these psychotherapeutic models have in common is that they attempt to address the human condition, the root causes of suffering. Rather than aiming to suppress symptoms, these models aim to facilitate our potentials, our inner resources, our innate capacity to grow and mature and even transcend. They center the healing energies squarely within, while connecting us to something greater than ourselves. Psilocybin is an incredibly potent accelerant to this kind of integrative therapy, often catalyzing outcomes in short order that might otherwise elude us for a lifetime.

Experience the Change

With psilocybin therapy, the mechanism of change is an actual experience! Psilocybin works because of an astonishing experience it temporarily opens up, which makes this treatment quite different than conventional therapeutic approaches. A typical pharma regimen might involve daily doses of psychiatric medications that often come with negative side effects, with the goal of continuously and subconsciously modulating brain chemistry. With psilocybin, it is the singular psychedelic experience which makes a deep and lasting impact on the psyche. The client, immersed in the experience, is the protagonist in this improbable story, finding new freedoms in the space of his or her conscious journey.

And if the goal is to heal deeply, then it must be that way. Real change requires real experience. You are not going to change your overall disposition, your long-entrenched perspectives on self and world, without a strongly felt experience. That is the revolutionary aspect of this treatment. Simply put, psilocybin, combined with the affirming presence of a trained facilitator, can catalyze life-changing experiences. It is an assertion that would seem to strain credibility if it were not right there in the research, jumping off the page. At 14 month follow up, 67% of subjects in a Johns Hopkins study rated the psilocybin-occasioned experience as being among the five most personally meaningful, and among the five most spiritually significant, experiences of their entire lives (Griffiths et al, 2008).

What is the quality of a potentially life-altering psilocybin experience? Well, we can’t quite say. We could try, but verbal descriptions, while colorful, are pretty futile. The psilocybin experience transcends the limits of language, as language merely reflects our default cognitive architecture. When asked about his psilocybin experience during a psilocybin therapy segment on 60 Minutes, bestselling author Michael Pollan, a master wordsmith, paused before breaking into laughter and deferring… “you really had to be there.”

It is perhaps not surprising that researchers at Johns Hopkins identify “ineffability”—or the inability to describe the experience in words—as a core element, one of several that comprise what they call the “mystical type experience” that psilocybin often occasions, the intensity of which positively correlates with good treatment outcomes. The authors of the research developed this “mystical type” measure to accurately reflect the experiences described by mystics and spiritual teachers throughout the ages and from different traditions around the world.

The research further shows that this kind of experience—which includes an overwhelming sense of awe and connectedness, sacredness and truth—not only correlates with successful outcomes along a spectrum of mental health measures, but also a lasting sense of overall well-being, eco-mindedness, and spirituality (Griffiths et al, 2016; Carhart-Harris, 2018). Among otherwise healthy individuals, such an experience, with integration sessions afterwards, can even shift personality (which is, by definition, resistant to change), in the direction of “openness”—a core characteristic associated with positive traits like creativity and empathy (MacLean et al., 2011).

Such findings are paradigm shifting, and perhaps help us to recognize more of what the therapeutic process was always meant to be about. Maybe the focus of psychiatry and psychology should be less concerned with diagnostic codes and symptom reduction, and more attuned to the evolution of human beings, real people, experiencing growth and connection within themselves and within the natural world from which we are all miraculously derived. This, we think, is why we see such remarkable outcomes in the psilocybin research. It is because the psychedelic experience—that ground-shifting sense of connection—is the agent of change. It is the experience that triggers the change, and it flows from within. That should come as welcome news in an ailing society like our own.

And so, with caution and care, we are privileged and amazed to see a percentage of addicts and alcoholics instantly transformed. In many cases, individuals who have long suffered from intransigent depression finally see the light. Heavy drinkers can find sobriety, and lifetime smokers, with startling frequency, put out their cigarettes for good. Otherwise healthy individuals become more conscious of the environment. And those who are dying from cancer can finally embrace their mortality and live their final days with peace in their hearts. That is the quality of experience made possible through psilocybin therapy.

An Ancient Medicine, A New Beginning

Of course, this is not a new medicine. Psychoactive mushrooms have dotted the savannahs and recycled the forests since the dawn of humanity. The modern drama surrounding psychedelics in the West is a tiny outlier on the timescale of human history. The bigger psychedelic story is more stable. Ancient artifacts often depict psychedelic plants and mushrooms as channels of sacred experience, centerpieces of ceremony. The Oregon initiative echoes the careful, ceremonial approach that indigenous cultures have upheld throughout the centuries, even millennia.

And yet, today, in this watershed moment for our country and world, it behooves us to apply the ancient wisdom in a manner befitting of our times. We need a fresh, new trajectory, informed by the ages, but built for the future. We should advance a container for psychedelics that feels sufficiently familiar to our modern, Western sensibilities, but decidedly breaks the boundaries of our failing systems.

Peering beyond the hoped for and historic legislative victory on the horizon in Oregon, we have our eyes trained upon the development of a robust and ethical infrastructure for psilocybin therapy to roll out across the country and the world. We are excitedly developing a suite of nonprofit projects called “Global Psychedelic,” which includes a member-based professional association—the “Global Psychedelic Association” (GPA)—as well as a 501c3 charitable organization called the “Global Psychedelic Institute” (GPI).

Global Psychedelic’s aim is to promote the advancement and application of psychedelic therapy for the benefit of humanity, by helping to set standards for safety, training, levels of care, data utilization for research, continuing education for practitioners, political advocacy, and, importantly, equitable access to education and services. GPA will advance the interests, competencies, and services of certified psychedelic practitioners within the newly emerging field, while GPI, guided by on-the-ground community leaders, will raise funds, strategize, and allocate resources to support training, community education, and psychedelic service delivery within traditionally underserved populations.

Of course, these projects hinge on success at Oregon’s ballot box in November. The race is very, very close. Our polling shows a potential path to victory. We’ve learned that when people receive just a little bit of education about our measure, a strong majority coalesces. So the formula for winning is surprisingly simple—it’s all about statewide education. That’s the good news. The challenge, however, is funding. Educating a whole state is no small endeavor. We need TV ad spots down the stretch. We want to put compelling spokespeople—healthcare professionals, influencers, and psilocybin-touched Oregonians of all stripes—into the living rooms of undecided voters. The goal is to educate tens of thousands of Oregonians who have never heard of psilocybin therapy before.

This will not happen unless everyone digs deep. We need everyone, in and outside of Oregon, to chip in and support this educational campaign. It was incredibly hard to get this far, and, suffice it to say, we are all a little transformed. Yet here we are, together, positioned to make history with Oregon’s Measure 109.

Let’s pool our resources, steel our focus, and together help usher in a healthier Oregon and a healthier world to follow.

Author Profile

Tom and Sheri Eckert

Residing in Portland, Oregon, Tom and Sheri Eckert are seasoned psychotherapists, founders of the Oregon Psilocybin Society, and architects of the Psilocybin Service Initiative of Oregon (Yes on 109), a statewide ballot initiative campaign to legalize psilocybin-assisted therapy.

See all stories by Tom and Sheri Eckert