American Medical Association assigns billing code for psychedelic therapy; Can psychedelics alter colorblindness?; How should Oregon collect data on psilocybin service users?
Plus: Clarifying “decriminalization,” and The State of Psychedelics
Happy Friday, and welcome back to The Microdose, an independent journalism newsletter brought to you by the U.C. Berkeley Center for the Science of Psychedelics.
American Medical Association assigns billing code for psychedelic therapy
In a press release, psychedelics company COMPASS Pathways announced that the American Medical Association has approved a new Current Procedural Terminology (CPT) III code for psychedelic therapies. The coding system is standard in the U.S. healthcare system and is used by healthcare providers to seek reimbursement from insurance companies for their services. There are codes for medical procedures like vaccines, stitching up wounds, and physical exams. This new code would allow healthcare providers to bill for psychedelic therapy services, which COMPASS says will “facilitate reimbursement and ultimately access to psychedelic therapies in the U.S., if approved by the U.S. Food and Drug Administration.”
COMPASS partnered with the Multidisciplinary Association for Psychedelic Studies Public Benefit Corporation (MAPS PBC) to submit an application to create the new code, and more details are expected from the AMA by July. The AMA updates its CPT codes annually, and the new psychedelics therapy code would go into effect on January 1, 2024.
Can psychedelics alter colorblindness?
A 35-year-old man reported difficulty differentiating between red and green, which is one classic symptom of color vision deficiency (CVD) or, as it’s called colloquially, colorblindness. The condition is inherited and thought to be chronic, but according to a case study published in Drug Science, Policy and Law, psychedelics seemed to improve this man’s color vision.
The man at the center of the case study is a colleague of the three authors of the study, who are professors at the Cleveland Clinic and the University of Alabama. He’d previously experimented with a variety of psychedelics, including MDMA, psilocybin, LSD, and DMT. After psychedelic use, he noticed his color vision seemed to improve. He experimented on himself by self-administering the Ishihara Test, a common test of color vision, then dosing himself with psilocybin and taking the test again at various points after the trip. His score on the vision test peaked about a week after psilocybin use, and the researchers say his self-collected data echo findings from the 2020 Global Drug Survey in which nearly two dozen participants with colorblindness also claimed psychedelics helped their symptoms.
The mechanisms explaining how psychedelics might change color vision are unknown, but the paper’s authors point to a hypothesis from a 2020 paper reporting the results of the Global Drug Survey: “Since the brain can alter experience of color beyond optic nerve input, alterations in higher-level visual processing induced by psychedelics likely underly their ability to improve CVD in some individuals,” they write. “Since CVD typically results from a genetic defect and psychedelics likely do not alter the actual visual signal coming from the retina, they may produce an expanded spectrum of color perception in people with CVD by inducing new neural connections between cortical regions that ‘link new photisms to pre-existing concepts of colors, thus facilitating a new color experience.’”
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The Latest in Oregon: How should the state collect data on psilocybin service users?
Since its introduction in early January, Oregon’s Senate Bill 303 has been hotly debated among psilocybin advocates, lawmakers, scholars, and business owners. The bill directs the Oregon Health Authority to require all psilocybin service centers and facilitators to collect and report anonymized and aggregated data about their business and clients. After much discussion, State Senator Elizabeth Steiner has proposed a second set of amendments to the bill that would prohibit the collection of some types of demographic data, including veteran status, sex, and education level. On Wednesday, the House Committee on Behavioral Health and Health Care held a somewhat messy public hearing to discuss the bill.
Throughout the hearing, Oregon lawmakers appeared under-informed about key aspects of Measure 109, as well as the new proposed bill. In the hearing, members of the house committee asked questions about basic logistics of implementing psilocybin services, and their questions to Oregon Psilocybin Services section leader Angie Albee suggested they mistakenly believed that SB 303 was proposed by Oregon Psilocybin Services rather than Senator Steiner. Meanwhile, Senator Steiner and members of the committee repeatedly referred to Oregon’s psilocybin services as “therapeutic” even though Oregon Health Authority rules explicitly prohibit making medical claims or treating physical or mental health conditions with psilocybin services.
Of the seven people called on to give testimony in the hearing, four were affiliated with the Oregon Psilocybin Services Collaborative Group, an organization representing over a hundred potential service center operators, facilitators, and other advocates. The group has proposed additional amendments, such as ensuring no individual data ever leave service centers, and changing the bill to require clients to opt-in to sharing their data, rather than just giving clients the choice of opting out. Others also raised concerns about identifiable data falling into the wrong hands, like those of federal authorities looking to crack down on state-legal use of a federally illegal drug. The group also suggested that aggregated data should be made public rather than being only available to researchers at Oregon Health and Science University.
In her testimony, Albee, from Oregon Psilocybin Services, highlighted the need for additional funds to properly support the data collection efforts, which she estimates will cost more than $200,000 to start. However, the House’s fiscal committee categorized the bill’s financial impact as “minimal.” As a result, the health committee proposed that its next step for considering the amended bill would be to confer with the fiscal committee.
Clarifying “decriminalization”
Many municipalities and states are introducing legislation or policies to decriminalize psychedelics. But there is no standard definition for what the term “decriminalize” actually means, writes ethicist Joseph Holcomb Adams in the newsletter Ecstatic Integration. “For example, most of the people I spoke with here in the Bay Area were aware that the city of Oakland had ‘decriminalized mushrooms,’ but nearly all were very surprised when they found out that Oakland’s policy allows for people to open up psilocybin mushroom distribution operations,” he writes. “Many people have told me that they changed their positions on particular ‘psychedelic decriminalization’ policy proposals once they found out what these proposals would actually do.”
In his piece, Holcomb Adams reviews what activities drug laws address, particularly what he calls the “big three”: possession, production, and transfer of psychedelics. While some laws explicitly ban the sale of psychedelics, Holcomb Adams points out that there are many ways to skirt the law, either by giving people substances for free and charging for services, accepting “suggested donations,” or through churches.
Holcomb Adams also reviews the different forms so-called decriminalization can take, from making enforcement of existing drug laws the lowest priority for law enforcement to redefining consequences for offenses. He presents a chart of existing policies and proposals and what, exactly, each would allow for. “I consider this to be an ‘informed consent’ issue,” Holcomb Adams writes. “In order to give consent to supporting a particular psychedelic policy proposal, a person must be informed about what they are signing up for.”
The State of Psychedelics: Colorado’s SB 290 passes, Minnesota proposes psychedelic task force, Washington’s Jefferson County resolves to deprioritize drug law enforcement
Representatives in Minnesota passed an omnibus bill that would establish a psychedelics task force “to advise the legislature on the legal, medical, and policy issues associated with the legalization of psychedelic medicine in the state.” The bill defines “psychedelic medicine” as including MDMA, psilocybin, and LSD.
In Washington’s Jefferson County, commissioners passed a resolution last Friday requesting that the county not spend any further resources enforcing laws related to the use, cultivation, possession, transportation, or distribution of psychedelic plants and fungi. The resolution does not authorize “commercial sales of entheogens.” The Peninsula Daily News reports that the commissioners’ discussion included debate over whether their resolution should decriminalize substances rather than fully legalize them. The county’s only incorporated city, Port Townsend, passed a nearly identical resolution back in January 2022.
Colorado’s SB 290, which amends the Natural Medicine Health Act (NMHA) that voters passed in November 2022, was approved by the state legislature. The bill passed the state House last Saturday with amendments, which included allowing the state licensing authority to request data on law enforcement incidents, adverse health effects, and psychedelic products and businesses. Those amendments were passed back to the Senate, which granted final approval on Monday evening. The bill was approved by the Colorado house and senate less than two weeks after its introduction. It now heads to the governor’s desk for a signature.
VICE reports that on Wednesday, a man in Vancouver, B.C. opened the Drugs Store, which sells psychedelics including MDMA, as well as heroin, meth, and cocaine. The proprietor opened the store “because he wants to give people drugs that have been tested and are free from adulterants, including fentanyl.”
Beginning in July, healthcare practitioners in Australia will be able to legally prescribe psilocybin (only for treatment-resistant depression) and MDMA (only for PTSD), but the logistics around the supply of and payment for the drugs is complicated, according to three Monash University researchers. In The Conversation, they write, “The upshot of all this means, in practice, Australia is still a way off from offering a public subsidy for these psychedelic treatments. Which means, come July 1, the number of Australians able to afford these treatments will be small.”
“As mainstream curiosity around psychedelics grows, a gray market around psilocybin-based products is finding its footing among customers who are rising in numbers and becoming more diverse,” Lucid News reports. That customer base? Women, especially young, professional women interested in wellness.
In Psychedelic Alpha’s last piece for its 2022 Year in Review series, the organization’s medical advisor Michael Haichin reviews the top five psychedelic clinical trials in 2022.
Psymposia premiered a new series investigating the Church of Psilomethoxin.
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