EDITORIAL NOTE: I think it is vital that Oregonians be closely involved in implementing psilocybin therapy in our state.
To help facilitate this discussion, I will be publishing summaries of the committee and subcommittee meetings of the Oregon Psilocybin Advisory Board to this mailing list, along with other news and commentary about this topic. I hope you will subscribe.
Over 250 people applied to serve on Oregon's Psilocybin Advisory Board, highlighting the intense interest in bringing cutting-edge psychedelic therapy to Oregon.
Made up of an impressive roster of leading experts in medicine and treatment, both board members and Governor Brown pledged to focus on making sure that psilocybin therapy is affordable, accessible, and safe.
To be ready to provide services to the public in early 2023, the board will initially focus on creating the criteria for the training programs for facilitators and publish research about the safety and efficacy of psilocybin therapy.
Introducing the Oregon Psilocybin Advisory Board
When voters approved Measure 109 last November, they created the Oregon Psilocybin Advisory Board to plan the regulatory structure for the supervised, therapeutic use of psilocybin products.
Jeff Rhoades, representing Governor Brown's office, noted that they received over 250 applications for this board, an unprecedented level of interest that he had never seen for any state board or commission.
Members of the board each provided a quick introduction, with many expressing hope that the board's work will be informed by the best in scientific research and the need to make sure equity is at the forefront of all discussions. Most board members fill a specific role outlined in the ballot measure (e.g., harm reduction specialist, mycologist, local health officer, etc.), and all are Oregon residents.
The board's collective breadth and depth of experience is impressive. Their professionalism makes the warning by Big Pharma company Compass Pathways that Oregon might legalize "psilocybin without regulatory oversight" seem laughably hyperbolic.
In a very moving moment, Tom Eckert spoke about his late wife Sheri. The couple was the driving force behind the successful ballot measure to legalize psilocybin therapy in Oregon.
It's also a bittersweet day for me, you may know that my beloved wife, Sheri, had died in December, we were 100% together every step of the way on this project, and you know, and in life in general, and put simply, I guess what I want to say is the Sheri should really be on this board. Sheri should really be on this board instead of me.
Governor Brown's Thoughts on Measure 109
Ultimately, the board members serve at the pleasure of the governor, and implementation of the program is up to the state's chief executive. The governor's office communicated these chief points:
- Equity must be at the center of the Oregon approach to psilocybin therapy. Governor Brown directed the board to prioritize making this cutting-edge and promising treatment available to all Oregonians regardless of circumstance.
- While primarily giving broad leeway to the board to organize internal matters, she did call for the formation of a subcommittee centered around equity and access.
- Governor Brown charged the board to use the best available science and data to create Oregon's regulatory framework for the supervised, therapeutic use of psilocybin products for anyone who might benefit from treatment.
The Oregon Model of Psychedelic Care
Tom Eckert outlined his and Sheri's vision behind Measure 109. It was an attempt to "end the 50-year unscientific prohibition of psychedelic therapy." But more broadly, it was an attempt to create a unique space for psilocybin therapy.
It is a model different from the approach being taken by Big Pharma but also not the same as how recreational cannabis has unfolded. Eckert highlighted some of the most important principles he thought should be at the forefront of the Oregon model of psychedelic care.
Anyone who can safely benefit from psilocybin should be able to access these services. Therefore it's not strictly a medical model in the sense that access isn't exclusively based on prescriptions or qualifying psychiatric or medical diagnoses.
- Plant Medicine is Unique
Psilocybin is not exactly a pharmaceutical drug; it shouldn't necessarily be regulated like it's some new pill that's created in a lab with unknown side effects. We should respect the deep history and knowledge of psychedelic use dating back hundreds, if not thousands of years.
- Balanced Approach
The Oregon model is rational and recognizes risk. At the same time, it doesn't bend to stigma. It is careful and embraces science, safety, and ethical standards. It ultimately supports a healthy community-based marketplace while protecting against more unhealthy agendas, such as big corporate profit motives that tend to undermine access and quality of care.
- Human-being Centered
The psilocybin experience itself is what affects change and integration afterward. And so this is an individual experience—that's the agent of change. That is also why this is a deeply therapeutic, humanistic, and person-centered model.
Lessons Learned from the 109 Campaign
Sam Chapman, campaign manager for the psilocybin ballot measure, spoke about what they learned and how their new non-profit, the Healing Advocacy Fund is working to ensure that Oregon's voter-created psilocybin therapy program is affordable, accessible, and equitable.
If you have not already seen this presentation before, I urge you to watch it as it is a valuable overview of why we need new therapeutic modalities:
- The depth of the mental health crisis (particularly post-Covid)
- The impressive body of research on how psilocybin can help treat depression, anxiety, and addiction.
What the measure does:
- Establishes a regulatory framework within the Oregon Health Authority, which will design and administer the program.
- Establishes the Oregon Psilocybin Advisory Board, appointed by the governor.
- Requires a training and licensure system for therapy facilitators, psilocybin manufacturers and testing laboratories, and requires a tracking system for psilocybin products.
- Imposes a two-year development period before initial licenses can be granted.
What the measure doesn't allow:
- Retail sales.
- Off-site consumption or possession.
- Branding or advertising of psilocybin products.
- Unregulated or untracked psilocybin production, inventory, or delivery.
- Access to minors.
Psilocybin services modality
- Informed consent with health and safety warning
- Standardized risk assessment, contraindication screening required
- Mental health review, the goodness of fit assessment
- Must occur at psilocybin service center
- Facilitator present throughout the entire process
- Facilitator must certify completion
- Must be offered by facilitator after completion of the administration session
Campaign lessons for implementation
Many Oregonians knew very little about how psilocybin, but educating the public on the following subjects increased support for psilocybin therapy as the campaign progressed.
- What is psilocybin?
- What does the research say?
- What does the measure do and not do?
- Who stands to benefit from psilocybin therapy?
Formation of Subcommittees
Given the tight time frame statutorily required in the ballot measure, the committee has decided that subcommittees will be leaned on heavily to do much of the work in between monthly meetings of the entire board.
The board agreed to the formation of three initial subcommittees.
This is the one subcommittee Governor Brown explicitly called the board to form. Making sure everything the board does is centered around access will undoubtedly be one of their most important tasks.
As Dr. Rachel Knox noted:
There is a real danger that, if lawmakers and regulators do not center Oregon's psilocybin regulatory framework in health equity—from treatment access to leadership and representation to economic opportunity to education to harm reduction––that Indigenous people and communities of color will not have equitable access to its therapeutic benefits.
Eckert spoke about the need to prioritize the formation of a facilitator training subcommittee. If facilitators are to be licensed by early 2023, training programs will have to start this fall.
He argued that the state would have to begin developing rules very soon, so that board can consider the criteria for the training programs by this summer. David Hart, from the Oregon Department of Justice, expressed concerned that the training be evidence-based. Eckert noted that there is already an existing body of research about proper training for psychedelic therapists and that he and others were already working with world-class experts on developing criteria for training programs.
By the end of June, the board is required to present research on the safety and efficacy of psilocybin in treating mental health conditions.
Eckert stated he did not intend for this to be a massive research project but rather an attempt to start sharing already available research to the public early on in the rulemaking process.
Other board members expressed concern about optics, wanting to showcase that the research is balanced and comprehensive. They noted that Oregonians and experts worldwide will scrutinize their work.
Many board members also wanted to be sure to include non-western research on psychedelics from indigenous cultures.
It was proposed that the board might consider publishing a preliminary report by the June deadline and then hiring an outside firm to help with a larger report once the legislature appropriates funding for implementation of the measure later in the summer.
Dr. Knox pointed out in addition to reporting on research, the board could help facilitate the collection of data from clients so that Oregon itself could serve as a real-life observational study on psilocybin therapy.
The board also discussed a host of other potential subcommittees, including but not limited to:
- Testing and quality control
- Licensing (facilitators, service centers, producers)
- Public education on psilocybin therapy
- Assessment of clients and potential medical oversight for people with certain medical conditions
However, having already exhausted the allotted 3-hour session, board members agreed to table the formation of additional subcommittees until the next meeting in a month.
Psilocybin Oregon Newsletter
Join the newsletter to receive the latest updates in your inbox.