A 2023 Psychedelic Retrospective

Welcome to the first dispatch from The Trip Report by Beckley Waves of 2024!

Today, we will look at some of the seminal developments from last year; in our next post, we’ll look ahead to what will surely be a bizarre and unpredictable 2024.

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A 2023 Psychedelic Retrospective

Have you ever tried to hold a fully inflated beach ball underwater? Maybe at the beach or local pool when you were a kid.

It’s challenging—requiring strength, coordination, timing, and precision.

The ball’s buoyancy (upward force) grows as more of it is submerged, making the task more difficult the deeper it is pushed down.

I think this is an excellent metaphor for the cultural and regulatory prohibition against psychedelics forcing them underwater underground over the last 50+ years.

But recently, we’ve seen these forces of submersion growing fatigued as the upward force grows.

2023 was a year of incredible progress in the psychedelic world—a deepening of the scientific literature and federal access to funding, advances in policy liberalization, and a growing cultural embrace.

However, there were also setbacks as macroeconomic headwinds contracted investment and company valuations and forced several organizations to close, and promising policy efforts were defeated. 

The stage is set for 2024 to be the most bizarre, unpredictable, and consequential year in history. 

With the advent of Generative AI, a flaring and volatile geopolitical situation in several regions, and the most unprecedented US presidential election in history, the prospect of legal MDMA-assisted Therapy—and psychedelic liberalization in general—feels like seeds sprouting from scorched earth.

With this frame in mind, I want to share what I see as the more significant developments of 2023 that set us up for both progress and setbacks in 2024.

Let’s start with the seeds of hope.

MAPS Completes MDMA Research Program & Submits New Drug Application

In September, MAPS published the peer-reviewed results of the second Phase III clinical trial of MDMA-Assisted Therapy in the Journal Nature that showed promising results in the treatment of PTSD.

From the Discussion section:

“In this confirmatory phase 3 study of participants with moderate to severe PTSD, MDMA-AT significantly improved PTSD symptoms and functional impairment, as assessed by CAPS-5 and SDS, respectively, compared to placebo with therapy over 18 weeks. Notably, 45 of 52 (86.5%) participants treated with MDMA-AT achieved a clinically meaningful benefit, and 37 of 52 (71.2%) participants no longer met criteria for PTSD by study end.”

This study was the capstone of 30 years of research and teed up the final administrative task of submitting their findings to the FDA for approval.

In December, MAPS submitted its New Drug Application (NDA) to the FDA, which should decide before the end of the year.

From the Press Release:

“The filing of our NDA is the culmination of more than 30 years of clinical research, advocacy, collaboration and dedication to bring a potential new option to adults living with PTSD, a patient group that has experienced little innovation in decades,” said Amy Emerson, chief executive officer, MAPS PBC. “If approved, MDMA-assisted therapy would be the first psychedelic-assisted therapy, which we hope will drive additional investment into new research in mental health.”

As we noted in Preparing for MDMA Assisted-Therapy:

“This marks the final leg of a nearly 40-year journey that Rick Doblin and MAPS have been on since the founding of the non-profit in 1986 to salvage MDMA-AT as a treatment option for a devastating condition.”

Psychedelic Science 2023: The People Want Psychedelics

In June, MAPS hosted the largest gathering of psychedelic enthusiasts, researchers, clinicians, entrepreneurs, investors, guides, therapists, and more.

Twelve thousand people attended the weeklong event at the Denver Convention Center. It was an overwhelming, inspiring, and galvanizing event that provided the first in-person, experiential appraisal of this movement since it climbed into higher gears.

And it was wild.

Forbes called it Society For Neuroscience Meets Burning Man.

Axios Denver put it this way:

“Why it matters: Consider the conference an unofficial launch party for what's predicted to be a multi-billion-dollar industry, putting Colorado at the heart of "magic mushrooms" moving mainstream.”

And Reason Magazine created a 30-minute documentary on the spectacle:

All in all, it was a bellwether event for perhaps the most heterogeneous ‘industry’ one could imagine.

The size and scope of the event indicate a growing segment of society will revere and employ psychedelic substances, the experiences they potentiate, and the insights they afford regardless of any future commercial, policy, or scientific outcomes.

In other words, psychedelic culture is here to stay.

States Rights: The Oregon & Colorado Experiments

2023 was the first year that state-sanctioned legal psychedelic services were rolled out in Oregon.

At the 2020 ballot, voters approved the Oregon Psilocybin Services Act (Proposition 109). After a two-year-long rule-making process, the first licenses were awarded for facilitators, healing centers, cultivators, and testing.

At the last count, the state has approved licenses for nearly two hundred facilitators, twenty service centers, seven manufacturers, and two laboratories. At the same time, more than 500 people experienced psilocybin trips under the Supported Adult Use framework enacted in the state.

Meanwhile, Colorado became the second state where voters passed a similar ballot initiative. 

The significant difference between the two state programs is that the Colorado ballot initiative included a decriminalization provision allowing residents to cultivate, consume, and exchange several naturally occurring psychedelics.

Under such rules, events like a psilocybin exchange hosted by the Denver Mushroom Cooperative seemed to go without a hitch. 

These pioneering efforts pave the way for other states to enact similar laws through ballot initiatives and legislation. In my home state of Maine, organizers are working with lawmakers to put forward LD 1914, modeled off of the Colorado and Oregon experiments.

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And now for some worrying developments.

Promising Policy Measures Gone South

In 2023, we saw three rather high-profile state-level psychedelic policy approaches falter, two in California and one in Kentucky.

California Senate Bill 58

In October, California Governor Gavin Newsom vetoed a psychedelic decriminalization bill that would have been the most consequential psychedelic policy reform measure since the passing of the Controlled Substances Act. Senate Bill 58, introduced by state senator Scott Wiener (D-San Francisco), would have decriminalized several psychedelic substances on January 1st, 2025.

The bill made it all the way through the arduous state legislative process—with bipartisan support—and landed on his desk for his signature.

However, Newsom vetoed the bill.

But in his decision memo, he did ask the State Senate to return him a bill that would include treatment guidelines, dosing, and provisions to ensure patient safety.

The Treat California Initiative

Second was the TREAT California Initiative, a ballot initiative which, if approved, would have allocated $5 billion—through the sale of state bonds—dedicated to psychedelic research and investment.

The program was modeled after a similar initiative that succeeded in the 2004 ballot to create the California Institute for Regenerative Medicine (CIRM).

However, the campaign suspended its efforts just six weeks after the official launch.

Director Jeannie Fontana cited voter apprehension about the official language of the ballot initiative. As she told The Microdose:

“The process of the citizen ballot initiative is that you write the legislation and you submit it to the State Attorney General’s office. The Attorney General's office then writes the legal language that will appear on the ballot. That part is crucial — the Attorney General can write language that is favorable for you, or unfavorable. And I believe ours was written in the most unfavorable terms ever. 

The official language says that the initiative would authorize bonds and create a “state agency for psychedelic therapy research, initiative constitutional amendment and statute.” Bonds, statute — what do those terms mean to a voter? That’s a huge turnoff — who in their right mind would vote for that?”

Kentucky’s Ibogaine Proposal

In May of 2023, the chair of the Kentucky Opioid Abatement Advisory Commission, Bryan Hubbard, proposed allocating $42 million of the $842 million the state received in settlements from opioid manufacturers under the states’ opioid abatement fund to ibogaine research.

At first glance, this struck me as another example of an approach to state-level psychedelic policy reform that I dubbed the “East Coast Approach.”

Such efforts, rather than creating regulated legalization frameworks—like Oregon and Colordao—allocate funding for psychedelic research. Several states have dipped their toes into this approach, mainly on the East Coast, hence the name.

However, the Kentucky proposal immediately hit political headwinds as it was made public before informing the governor and other stakeholders.

According to reporting in the Daily Beast:

“No one on the commission had even discussed the ibogaine idea with members appointed by Cameron’s political opponent, Democratic Gov. Andy Beshear, until Cameron and Hubbard held a press conference proposing the deal in late May.

A person with knowledge of Beshear’s thinking told The Daily Beast that the ibogaine proposal was a shock to the governor and his staff, and it came against the wishes of the stakeholders in the state most familiar with these treatments.”

The inspired move turned out to be too inspired, and last week, Hubbard vacated his role as chair of the Advisory Committee. Reporting from Psychedelic Alpha points to the Kentucky Ibogaine proposal being dead in the water.

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These policy falters, to my mind, highlight the greater difficulty in creating psychedelic policy as compared to cannabis, to which such measures are inevitably compared.

A key reason for this is the fact that psilocybin, MDMA, and others are on the path to FDA approval. Except for the occasional isolated cannabinoid, the cannabis reform movement was never competing with a pharmaceutical strategy.

Backlash Watch: High Profile Bad Trips

Finally, we’ll conclude this 2023 Retrospective on a down note.

In Psychedelic Safety, Cultural Narrative, and Existential Risk, I wrote:

“The term “backlash” is often invoked in psychedelic circles to point to the threat of government action that would halt psychedelic scientific and policy momentum.

It alludes to the fragility of the scientific, political, and cultural progress made in recent years against the formidable obstacles of stigmatization, state-sponsored propaganda, and regulatory friction.

The implication is that such hard-won progress is at risk if we see a sufficient number of high-profile incidents of psychedelic use gone wrong.”

The year saw two high-profile incidents that called into question the safety and suitability of psychedelics.

Most recently, the Los Angeles County Medical Examiner deemed the cause of actor Matthew Perry’s death to be the “acute effects of ketamine.”

This, of course, brought quite the discourse and scrutiny to the practice of ketamine for the treatment of mental illnesses—something the FDA has also warned against.

Earlier this Fall saw another high-profile incident, this time involving psilocybin. From The New York Times:

“An off-duty Alaska Airlines pilot who tried to shut off the engines during a flight on Sunday told investigators that he thought he was having a nervous breakdown at the time and had consumed psychedelic mushrooms, court documents said.”

For several weeks, this story appeared in nearly every mainstream media outlet in the US.

Both the death of Matthew Perry and the ‘mushroom pilot’ sage are, of course, personal tragedies; one man is dead, and another’s life is irrevocably altered.

While risks can be mitigated with education, support, and safe supply, these stories are also inevitable and carry outweighed influence in public and political discourse.

The backlash risk to psychedelic science is not necessarily that it gets “shut down” and somehow made illegal and ceases altogether, but rather that proper funding from federal agencies like the NIH and others is never allocated, and scientific inquiry will be limited to commercial drug development and relatively small amounts of philanthropic funding.

The backlash to psychedelic policy liberalization is that wildly theatrical scenarios like the “mushroom pilot” and high-profile deaths will give politicians, agencies, and investors cold feet to approve such funding. In this regard, I see state and local legalization and/or decriminalization as in the crosshairs of such backlash as they are, by definition, political efforts with extreme exposure to the cultural zeitgeist.

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As both the positive and the negative major developments of 2023 point out, the buoyancy of the ‘psychedelic beachball’ appears to be winning against the downward force of prohibition—but it is not at all clear how it will resurface and under what resistant forces it will have to overcome.

In our next dispatch, we’ll look ahead to the year upon us, which is bound to be a wild ride.