Psilocybin-Assisted Therapy Comes To Oregon. What You Need To Know.
Starting next year, licensed facilitators in Oregon will have the ability to provide psilocybin-assisted therapy. The Oregon Health Authority, guided by an expert advisory panel, will issue final regulations at the end of this year, but the most crucial components have already come into focus—both for how psilocybin-assisted therapy will work and the guardrails that will be imposed on these treatments.
Here’s what you need to know:
Psilocybin is a natural psychedelic medicine that the U.S. Food and Drug Administration has designated a “breakthrough” therapy for depression, which means that its use as part of a treatment plan could produce significantly better outcomes than currently available medications.
Promising research from scientists at institutions like Johns Hopkins University, University of California-San Francisco School of Medicine, and New York University demonstrates that psilocybin can be effective in treating end of life anxiety, among other conditions.
Chad Kuske, a Navy Seal from Lake Oswego, embodies the promise of psilocybin-assisted treatment for combat veterans suffering from treatment-resistant PTSD:
“I believe psilocybin therapy saved my life. I was a Navy SEAL for 18 years and spent most of these years in combat deployments. My years of service took a toll on me. After being medically retired in 2017, I realized that I was suffering from post-traumatic stress disorder … I felt dead inside, like I wasn't able to live anymore … When I was finally done with the side effects and disappointment of antidepressants, I went searching for something more effective … [I started] psilocybin therapy in a regulated and controlled setting, under the watch of a trained and certified facilitator … my life forever changed for the better.” --Chad Kuske
How Oregon made treatment possible:
The speed of the scientific research has outpaced the creation of a legal and regulatory framework for administering psilocybin-assisted treatment. Therefore, today, access to psilocybin, even in controlled settings, remains illegal.
That is changing in Oregon. By an eleven point margin, voters passed a 2020 ballot measure that creates a regulatory scheme, trains and licenses facilitators to administer psilocybin therapy, and accredits facilities throughout the state where these treatments take place. The Oregon Health Authority, the agency responsible for regulating how the treatment is administered, is nearing completion of a two year study and preparation period, and will issue final regulations by the end of this year. The expectation is that licensing will be completed, and facilitators can start providing psilocybin-assisted therapy, by Fall 2023.
How psilocybin-assisted therapy works:
Screening. Like you would before taking any medication, you first complete an expert screening process to ensure that psilocybin therapy is right for you. Unlike with most other treatments, the screening process includes more detailed information about your specific situation and goals, which allows for a better match between you and your licensed facilitator.
Preparation Session. You meet with the licensed facilitator to iron out other details for how the psilocybin-assisted session itself will unfold. At this session, the licensed facilitator will cover the most salient reasons for receiving psilocybin-assisted therapy and map out the goals that you can hope to gain from the session. Importantly, this preparatory meeting builds trust and familiarity between you and your provider.
Supervision. The psilocybin is administered in a carefully controlled therapy session — you’re reclining in a dimly-lit, quiet room. Oregon law requires that your licensed facilitator stays by your side throughout the session.
Follow-up Session. You and your licensed facilitator will talk about the therapy session, including the effect of the medication on your thoughts and mood. Together, you’ll work to take insights from the session and integrate them into your thinking and daily activities going forward. You’ll review the goals that you set to see how closely the experience matched your expectations. Finally, you’ll work to integrate the lessons from this therapy into your broader treatment plan.
The most important guardrails already are in place even as final regulations aren’t expected until the end of this year:
The retail sale of psilocybin is prohibited.
You must be 21 years-old or older to undergo therapy.
The psilocybin used in therapy can only derive from a state-licensed producer. All of the psilocybin produced is both safety tested in a licensed state laboratory and tracked in a state database.
Only state-licensed facilitators can administer psilocybin treatment. Traditional healthcare credentials are not sufficient. Providers must undergo specialized training and pass a licensing exam before obtaining their license.
The treatment itself can only occur in a state-accredited facility. That means that your licensed facilitator cannot give psilocybin for you to use at home; the medicine must be consumed on-site and under active supervision.
