Decrim & Medical Models
A lot of marijuana consumption occurs in the way that people buy and consume coffee, alcohol, and food; regularly. Weekly. Daily.
Psychedelics on the other hand, with the exception of micro-dosing protocols, are not commodities but services.
Future regulatory frameworks better recognize this unique aspect of psychedelics and entheogenic plants and fungi.
The four paths forward:
Decriminalization or de-escalation— Denver Psilocybin Initiative and Decriminalize Nature as the prime examples
Legalization: sale/tax/regulate— DecrimCA
Legalized Medical Plant Medicine—Oregon’s Psilocybin Services Initiative and Hawaii’s state measure
Medicalization: FDA, EMA, Health Canada approved, physician-prescribed— MAPS, COMPASS, Usona, etc.
The Psychedelic Ecosystem will have the best chance of ensuring access, establishing robust businesses, and mitigating existential risk by eschewing legalized consumer models and promoting psychedelics as medicine and enacting decriminalization measures.
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.
To mix metaphors, this is the ‘boulder’ of the elephant in the room when discussions about cost and access come up.
Decriminalization makes sense simply because prohibition amplifies all of the problems associated with drug use including treatment of addiction, crime, violence. (If I could coach MindMed and Mr. Wonderful on how to think about this topic I would direct them to The Beckley Foundation and Drug Policy Alliance for the scientific support for this approach to drug policy.)
When we talk about decriminalizing we mean allowing for possession, cultivation, and non-monetary exchange (grow-gather-give).
The Denver initiative focused on Psilocybin.
Decriminalize Nature focuses on naturally occurring entheogenic plants and fungi.
These efforts do not change the legal status or reschedule them within the confines of the cities. Rather it reclassifies them as the lowest level priority for local police and stipulates public funds cannot be used to prosecute violations.
Local Decriminalization efforts definitely do not impact how a state or federal agency would treat these substances.
Denver’s psilocybin council met for the first time in February. Decriminalize Nature Oakland, the spiritual hub of the Decriminalize Nature movement will be rolling out its framework by September.
From what I understand, the goal is to forego a sales/tax/regulation framework and instead put forward a model whereby the gathering, growing, gifting, guiding, and trip sitting is “legal”.
This framework makes sense.
This would allow personal possession for recreational, spiritual, creative work, and perhaps most importantly reduces the risk of therapists, guides, and facilitators working with psychedelics.
Medical models fill the other end of the spectrum.
On the opposite end of the value chain, is the medicalization model with the involvement of insurance, state legislatures, FDA/EMA, medical providers, etc.
There are two routes of medicalization on the table at the moment.
By Top-Down I am referring to the efforts by MAPS, COMPASS, Usona, MindMed, and others to create FDA/EMA approved pharmaceuticals. These will be administered in facilities and by providers that have achieved federally mandated licenses and will be synthetic, GMP produced products.
Bottom-Up refers to proposals like Oregon’s Psilocybin Services Initiative which will make psilocybin assisted therapy and experience, legal without FDA approval. The substances in this instance will likely be both natural and synthetic products and the criteria for the facility, licenses professional, and administration will be mandated by the state and not the FDA.
(***Top-down/bottom-up are not the best descriptors, but I am leaving them for now, we’ll come back to this idea***)
Medicalization, however, could pave the way for federal decriminalization efforts as molecules like MDMA and psilocybin could be rescheduled in accordance with their medicinal utility.
These two flavors of medicalization would not allow for patients to take products home or use them outside of the sanctioned facilities. In both cases, the delivery of services makes up the bulk of the costs once the research is completed.
A sale, tax, and regulatory framework that considers psychedelic plants, fungi, and other molecules as consumer products should come after decrim and medical models.
Such a model would attract (more) sketch balls, create a race to the bottom, and erode a level of accountability that we should ascribe to producers.
A legalized framework that decouples product from experience increases the existential risk to the psychedelic movement/renaissance/whatever you want to call it.
Legalization represents the bottom of the curve where the least amount of value is created (and captured as a result of hefty regulatory pay-to-play processes, race to the bottom dynamics, and post-bubble value collapse) both economically and socially.
While there are many ex-cannabis folks hopping on the shroom-boom hoping to retail consumer packaged gods I hope they are disappointed and are forced to do the long, arduous and expensive route of drug development.
The future of psychedelics should come from decentralized grow-gather-give models in conjunction with the first generation of psychedelic pharmaceutical assisted therapy and state-level initiatives that create plant medicine frameworks.