Psychedelic & Spirituality Research; Insurance Coverage in Canada; Psychedelic Services-Not Shops

Dec 16, 2022

Greetings friends, I hope this dispatch—the last of 2022!—finds you well and heading into restful days.

I, for one, am excited to take a break, recharge, and get ready for what is sure to be a pivotal year.

Today, we are leaving 2022 with a look at a few developments that are perhaps instructive for where the field is heading.

First up is the Roland Griffiths Endowed Research Fund, which will support research on psychedelics, spirituality, and well-being. Then a look at a report that physician-assisted psychedelic therapy was reimbursed in Canada. And finally, the case of several ‘shroom shops’ getting shut down by local law enforcement.

Let’s get to it.

Roland Griffiths Endowment, Secular Spirituality and the Need for Cultural Institutions

Several months ago, Roland Griffiths, pioneering psychedelic researcher and the founder of the Johns Hopkins Center for Psychedelic and Consciousness Research, announced he was given a stage IV cancer diagnosis.

He offered a wonderful reflection1 in a presentation at the Interdisciplinary Conference on Psychedelic Research back in October.

This week, he and Johns Hopkins are announcing The Roland Griffiths Research Fund in Psychedelic Research on Secular Spirituality and Well-Being (emphasis added):

“The fund will support experimentally rigorous studies involving administration of psychedelics in humans... These studies will examine how psychedelic experiences relate to aspects of spirituality, worldview, well-being, and prosocial behavior.”

In an email correspondence, Professor Griffiths wrote (emphasis added):

“Almost all current psychedelic research is focused on medical therapeutics in patients. While we can expect this therapeutic research to continue to grow, fueled by increasing commercial and NIH funding, there is virtually no support for what I believe to be the most consequential direction for future psychedelic research, namely the impact of psychedelic substances on broadly defined spirituality and well-being in healthy volunteers.”

Despite the overwhelming amount of investment, activism, and policy work for developing medical treatments, the use of psychedelics as therapeutics can’t be separated from the fact that these compounds are, first and foremost, tools that reveal—or manifest—the nature of mind.

Thus, the other use case that gets less attention and funding is the use of psychedelics for spiritual inquiry and development.

While I am excited this endowment fund will create an incredible body of scientific literature at the intersection of psychedelics and spirituality, it is Dr. Griffith’s idea of Cultural Institutions that can support the safe and appropriate use of psychedelics that I find most interesting.

This week, Dr. Griffiths appeared on several podcasts, speaking about this endowment fund and the scientific work investigating secular spirituality as it differs from the medicalization of psychedelics.

He expressed his misgivings about legalization and decriminalization efforts but also noted the need for cultural institutions that can support the adoption of psychedelics in the culture.

From Making Sense with Sam Harris:

“What we need to develop are cultural institutions that are going to be supportive of appropriate use of psychedelics and I almost see it as a coevolutionary process, that if we're going to reintroduce psychedelics into culture we need some constraints or some wisdom in how they're used. I don't quite know what form that takes. Medicalization is one form, but I think it rankles a lot of people... hopefully, we're going to develop [other] cultural institutions that will incorporate psychedelics”

Despite the risks inherent with legalization and decriminalization at state and local levels, it is precisely under these circumstances that such cultural institutions can flourish.

In fact, they have already started forming—they are the local societies and meetup groups, spiritual teachers, and groups hosting ceremonies, integration circles, and peer support.

As focused research on the use of psychedelics for spiritual development in nonmedical settings emerges from Johns Hopkins and elsewhere, it can inform these grassroots organizations, and over time, they will mature into cultural institutions that can increasingly meet the needs of the broader and broader populace coming into the psychedelic sphere.

Canadian Province Covers Cost of Psilocybin Therapy

This week, Therapsil, the Canadian non-profit advocating for End-of-Life use of psilocybin for the terminally ill, reported that the Province of Quebec covered the cost of psilocybin-assisted psychotherapy for the first time:

“The province of Quebec made history this week by becoming the first governing medical body in Canada to publicly fund medical psilocybin-assisted psychotherapy. This marks a significant milestone for the use of psilocybin as a treatment for mental health conditions, and sets a precedent for other provinces to potentially follow suit…
two doctors, Dr. Houman Farzin & Dr. Jean-François Stephan, successfully billed for and were paid by the province of Quebec after completing psilocybin-assisted psychotherapy treatment for a patient with legal access granted through Health Canada. The patient, who has a medical exemption to use psilocybin, was treated in June 2022.”

In Canada, psilocybin for the treatment of anxiety or depression due to a terminal diagnosis is permissible for select patients through the Special Access Program (SAP).

The SAP provides access to certain medications or medical devices that are otherwise unavailable on the market or covered under publicly funded healthcare plans. These medications or devices may be experimental, rare, or specialized and may be used to treat serious or life-threatening conditions.

It seems that Health Canada has allowed a trickle of exemptions for psychedelic use through the SAP, but this appears to be the first instance in which the public health system has reimbursed for the cost of administration.

Why is this important? As we’ve seen in the US, there is a multifront effort—through the courts and legislation—to remove restrictions to psychedelics for the terminally ill.

Reducing the barriers to legal access through established programs like Expanded Access Programs, Right to Try, and State-funded research for limited populations before FDA approval is an absolute necessity.

The clinical development of psychedelics is relatively straightforward, but the infrastructure development is an entirely different beast—and where the medicalization paradigm has the most significant risk exposure if adequate infrastructure and best practices are not established before FDA approval.

Internally, at Beckley Waves, we are thinking about this quite a bit—what does the ‘ecosystem’ need? Where can we build that will provide the most benefit?—and others are too, most notably Reason for Hope, BrainFutures, and others working on state and federal programs that seek to create research-based-access models.

Let’s hope 2023 sees significant infrastructure development.

Shroom Shops are Getting Shut Down

On the opposite side of the spectrum from infrastructure, it seems that law enforcement around the US and Canada all got the same memo simultaneously and are choosing to shut down head shops selling psilocybin mushrooms.

Reports from Oregon, San Francisco, and Toronto show that local law enforcement is coming down on retail shops brazenly selling psychedelic compounds to the public.

In the mid-2000s, while living in San Francisco, I was surprised that there were several cannabis dispensaries in my neighborhood. My understanding of these early days was that law enforcement turned a blind eye to these operations, and eventually, state legislation caught up to the market. As a result, dozens of states now have regulated cannabis markets.

The mistake is to assume that psychedelics are following the same path.

As we noted in Psychedelics-as-a-Service:

For a commodity like marijuana, the primary contributor to the value chain is cultivation, that is to say, if you don’t grow the plant you don’t have a product.
No plant, no sale.
For psychedelics, the primary contributions to the value chain are research, set, and setting. Yes, a product must still be grown or made but the cost pales in comparison to the costs of everything that goes into its delivery, as we’ll examine.
I am arguing that for consumer goods like marijuana, the growth and cultivation take up the bulk of costs, time, and resources, but for psychedelics which would best enter the legality as services, the cost-constraints do not come from production but from pre-production (research) and set & setting.
Set and setting includes:
Physical space & allocated time
A guide, shaman, therapist or facilitator (and their training, credentialing, etc.)
The process of intention, education, pre-work, and integration
Unlike software, marijuana plants, and pharmaceuticals the marginal costs of psychedelics-as-a-service do not diminish with volume and therefore are not scaleable in the same sense of the word.

I get the sense2 that authorities are turning a blind eye to psychedelic practices but not commercial operations.

I have heard several accounts of guides, facilitators, and churches that have had run-ins with the law and have come away unscathed.

On the other hand, we’re seeing bold commercial operations—similar to those that may have been allowed in the early days of cannabis—get shut down.

In other words, it’s not worth it for authorities to concern themselves with underground practices providing some form of service (sitting, facilitation, ceremony, etc.) that uses psychedelic compounds, but commercial operations operating on busy streets—come on—of course, this is not going to fly.

The Trip Report by Beckley Waves

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