Giving voters the opportunity to make Oregon the first state in the U.S. to legalize psilocybin therapy, otherwise known as magic mushrooms, ballot Measure 109 is a real trip.
But the ’60s aren’t back quite yet.
Psychotherapists Tom and Sheri Eckert, the measure’s chief petitioners, told Oregon Public Broadcasting last year that they’re not trying to replicate Oregon’s marijuana legalization. This effort is specifically focused on treating mental illness in a safe, controlled setting.
Patients wouldn’t be able to purchase psilocybin at a dispensary and bring it home with them; instead, they’d consume it in a dedicated facility with a licensed practitioner who would guide them through the experience.
Psilocybin is a non-addictive, psychoactive compound produced by more than 200 fungal species, some of which grow naturally throughout the Pacific Northwest. The body converts the compound to psilocin, which has a chemical structure similar to that of the neurotransmitter serotonin. It’s believed to affect serotonin receptors in the brain’s prefrontal cortex, an area responsible for abstract thinking, analysis, mood and perception.
Scientific research on psilocybin began in the 1950s but was halted once the substance was scheduled in the 1970s. Over the last 20 years, that research has resumed with promising results.
The measure stems from the petitioners’ belief that psilocybin was wrongly scheduled (it’s currently listed as a Schedule I drug along with heroin, marijuana and peyote) and that it could be a pivotal treatment for those struggling with anxiety, depression, PTSD and terminal illness.
One of those people is Mara McGraw, a Portland resident who was diagnosed with terminal cancer in 2017. Various surgeries and treatments alleviated some of her pain, but the fact that her life still had an end date made her anxious and depressed. Prozac didn’t help, and the next step seemed to be opiates until she discovered psilocybin therapy. She found a trained facilitator who helped her through her hallucinogenic experience, after which she said she felt an “immediate release” from her fear of dying.
“I was able to get to the root cause of my fear in a way that talk therapy didn’t address,” McGraw said. “My body remembered how to relax again.”
On top of general feelings of euphoria, subjects of psilocybin studies also reported hallucinations, synesthesia and profoundly spiritual experiences. Scientists attribute those effects to the fact that psilocybin forged new connections between parts of the brain that had never “talked” to each other before. Psilocybin also reduced activity in the brain’s “ego center,” which scientists say could help treat depression.
“A lot of these issues that psilocybin is really helpful for, you can kind of distill to getting stuck,” Tom Eckert said. “Psilocybin helps to break those loops and patterns of thought and emotion.”
McGraw’s testimony spoke to that reorganization of thought.
“I’m able to work through this in a way that feels less cluttered,” she said.
A 2016 study at Johns Hopkins’ Center for Psychedelic and Consciousness Research administered psilocybin to 51 cancer patients with life-threatening diagnoses who had all exhibited symptoms of depression and/or anxiety. Six months later, 80% of the participants showed sustained decreases in those symptoms. Earlier this year, a similar follow-up study from New York University found that the majority of its participants showed “clinically significant” improvements in anxiety and depression — four years after taking psilocybin.
The results of psilocybin research have been so promising that the FDA has given the drug “breakthrough therapy” designation to treat major depressive disorder, meaning that it has the potential to treat the illness far more effectively than what’s currently available to patients. The new status will help psilocybin drug trials progress more quickly.
“For people suffering with debilitating mood disorders, the available treatments are not enough,” Tom Eckert said.
Measure 109 would kick in a two-year program development period, during which no psilocybin therapy would occur and a specially formed Oregon Psilocybin Advisory Board (part of the Oregon Health Authority) would lay out requirements for how individuals or companies can produce psilocybin and how they can administer it. Thus, the measure doesn’t include many specifics about how the therapy would work.
“We are going to take our time to get this right,” Sheri Eckert said.
But the measure did lay out a general structure for the therapy. Only people over 21 would receive clearance from a doctor to seek it out, after which they would meet with a licensed facilitator to discuss goals and intentions for the therapy. In a separate session, the facilitator would administer the patient psilocybin in a specialized facility, where they would remain supervised for as long as the drug is active in their system (between four and six hours). Following the treatment, the patient would be encouraged to schedule another talk session to help make sense of their experience.
“We followed the science, we kept safety at the forefront and we emphasized equitable access,” Sheri Eckert said. “The result is Measure 109.”
Veterans Exploring Treatment Solutions, which aims to improve quality of life for veterans with mental illnesses, has endorsed the measure, along with the ACLU of Oregon and several state legislators. There’s no organized opposition campaign to Measure 109, but the Oregon Psychiatric Physicians Association came out against it. In a statement, the organization expressed concern with the fact that, while psilocybin has seen promising results in smaller studies, it has not completed FDA trials.
“Arguably the most important stage of the FDA approval process, the Phase 3 trials, have yet to start for psilocybin,” the statement read. “These trials involve several thousand patients that are monitored in clinics and hospitals to carefully determine effectiveness and identify side effects.”
Portland psychiatrist Jonathan Betlinski, program committee chair for OPPA, said he doesn’t think the research is quite promising enough to warrant legalizing the therapy in Oregon — and he’s not sure it’ll progress enough during the two-year development period the measure outlines.
“The excitement outpaces the available evidence,” he said. “One would hope that we have the evidence when we sit down to actually hammer out the safe and reasonable way to do this as opposed to hoping the evidence comes in by the end of that session.”
But for patients like Thomas Hartle, a man with terminal cancer who was part of a small group of Canadians granted permission to use psilocybin therapy, a life-changing experience is enough of a reason to open up this treatment to people he believes could benefit from it.
“If Oregonians are going to be able to get even a portion of the type of relief that I’ve been able to get from using psilocybin-assisted therapy, it is very much in your best interest,” he said.
