Psychedelic State Policy Bonanza; Mandatory Data Collection in OR?; Need for Psychedelic Integration

Welcome back to The Trip Report by Beckley Waves—after several weeks of sound rest school vacation, we’re ready for a big year in the psychedelic business, science, and policy fronts.

Today, we’re looking at the following:

• Psychedelic Policy Action Goes to 11 in 2023

• Mandatory Data Collection is back on the table in Oregon

• Integration: Psychedelics are a great window, but a lousy door

But first, a message from Beckley Academy:

Applications are open for Beckley Academy’s flagship course for mental health professionals, Foundations of Psychedelic-Assisted Therapy. Our course is designed for mental health professionals interested in working with clients in non-ordinary states, facilitated by ketamine, MDMA, and psilocybin. This 13-week, online course will prepare you to practice authentic and ethical Psychedelic-Assisted Therapy (PAT). 

Our next cohort begins on March 13, 2023, and ends on June 30, 2023.

Learn more by joining one of our upcoming info sessions with our Director of Education, Deborah Gardner, and course facilitator, Danielle Herrera, LMFT.

2023: The Year Psychedelic Legislation Goes to 11

From Marijuana Moment:

“From Connecticut to California, it’s become quickly apparent in the first few weeks of the new year that psychedelics policy will be a major issue in legislatures across the country this session. What started as a local decriminalization movement is now rapidly evolving at the state level, as well as in Congress.”

There are several “flavors” of state-level policy reform.

• California and New York see proposed legislation that would decriminalize the possession, cultivation, and non-monetary exchange of certain naturally occurring psychedelic substances.

• Connecticut and Missouri are exploring ways to use psilocybin in specific clinical situations absent FDA approval or DEA rescheduling.

• Several states are proposing legislation to form “task forces,” such as Illinois and Minnesota.

• Virginia, Montana, and Connecticut each have two pieces of psychedelic legislation.

So there is a lot of variety.

While several cities have been able to pass decriminalization legislation, I wonder if the gauntlet of the state legislative process may be too onerous and fraught with political hangups for any of these to make it to the Governor’s desk and ultimately signed into law.

Remember that the two state-level policies enacted came from ballot initiatives, not legislative processes.

What do we make of this?

I sense that the only type of policy that can make through a state legislature is the so-called “East Coast” approach—which uses state funds to develop research programs and work within previously established frameworks such as investigator-initiated clinical trials, Expanded Access Programs, and possibly the Right to Try Act.

Decriminalization and Adult Use legalization frameworks are too fraught with cultural baggage and unknowns to make any headway outside of ballot initiatives—except for maybe Washington State, where Senate Bill 5263 would create an Oregon-style legalization framework, which has support from 22 state senators.

Who’s Your Data?

Oregon state senator Elizabeth Steiner has introduced new legislation, SB 303, that would require state-licensed psilocybin service centers to collect detailed data about operations, protocols, dosing, and, most controversially, personal client data and supply it to the Oregon Health Authority.

The legislation comes just weeks after the Oregon Health Authority put the kibosh on such a data collection program as part of their final rules for the historic state legalization framework.

Lucid News’ Ken Jordan and Psychedelic Week’s Mason Marks have been tracking this development, and I encourage you to have a read. The basic gist is that Measure 109 was crafted so as not to require personal data collection—but SB 303 would reverse that and create an arduous process for service centers to adhere to and require clients to disclose specific personal information/

The breadth of the data collection scheme is below, and I’ve highlighted the personal data that would be required.

As you can see, in addition to the personal demographic and health data—which does not include personal identifying data—it also mandates the collection of data about the dosing, protocols, workflows, and processes.

On the one hand, this would be precious data for understanding best practices and adverse events, but on the other hand, it forces psilocybin service centers to become ad hoc clinical research sites.

Furthermore, the last rule opens the door to actual surveillance— “May include any other rules as necessary to carry out this section.”

The concern is that data can be traced back to individuals, and the framework would be an overwhelming burden to the already precarious business models of psilocybin service centers. Moreover, forcing compliance with these mandates will drive more people away from legal services and make it harder for service centers to operate.

“It’s the Economy Integration, Stupid”

The Challenging Psychedelic Experiences project published its first paper—Psychedelic integration challenges: Participant experiences after a psilocybin truffle retreat in the Netherlands—in the Journal of Psychedelic Studies, which looked at short-term integration challenges.

“nine out of thirty participants (30%) spontaneously reported a post-experience integration challenge. These challenges included: mood fluctuations, ‘post-ecstatic blues’, disconnection from community, re-experiencing symptoms, spiritual bypass and perceived lack of support. Integration challenges were transient; they occurred immediately after the psilocybin experience (once the main psychedelic effects had worn off) and in the days and weeks following the retreat, and resolved with time.”

The most interesting signal from this paper, in my opinion, is the finding that:

“Integration challenges were also correlated with positive after-effects including long-term remission of significant health conditions.”

Ram Dass is attributed with the saying that “psychedelics make great windows, but lousy doors”—or something along those lines.

The implication is that the psychedelic experience might offer a glimpse into another way of being, but one is still required to walk a path, one way or another.

Delivering preparation, support and integration is a logistical challenge for all modes of psychedelic access.

And the rise of psychedelics will inevitably lead to an increasing number of Spiritual Emergencies—a process that will look like mental illness to many conventional healthcare providers—so, to what extent are psychedelic service providers—shamans, therapists, clinics, retreats, etc.—obligated to provide appropriate wrap-around care? And how can high-quality services remain accessible?

Further Reading

🍄 I had the good fortune of speaking with Dr. Rachel Yehuda, director of Mt. Sinai’s Psychedelic Research Center, and Mattias Serebrinsky of PsyMed Ventures on the Business Trip Podcast

🧠 Robin Carhart-Harris and colleagues published a new paper on a new theory of mental illness—Canalization and plasticity in psychopathology—it is an exciting account of mental illness as it combines several concepts—neuroplasticity, Bayesian dynamics, trauma-informed practice—but also points to common pathways of treatment.

💉 Cybin and neurotech startup, Kernel announced preliminary findings from a feasibility study that used the novel brain imaging technology to evaluate the effects of ketamine on the brain. More on this soon.

Thanks for reading, and see you next time!

Zach