Flow state? Psychedelics’ effect on periods, new bills in Massachusetts, Missouri, Oklahoma, Oregon’s contentious new legislation

Plus: Barriers to vets seeking psychedelic-assisted therapy, and 2022 in review

Happy Friday, and welcome back to The Microdose. 

Flow state? Psychedelics’ effect on periods

Clinical trial data suggests psychedelics might help treat depression, anxiety, and PTSD — and new studies in the works are investigating uses for a variety of other conditions, like addiction, eating disorders, and even irritable bowel syndrome. A new paper published this week in Journal of Psychoactive Drugs asks about an underexplored area: what do psychedelics do to the menstrual cycle?

Johns Hopkins researchers Natalia Gukasyan and Sasha Narayan present three case studies of women who say psychedelics changed their cycles. One said she had stopped getting her period, but it resumed after taking psilocybin and a component of ayahuasca. Another said that after an LSD trip, her usually-irregular cycle became regular again. A third said that a small dose of psilocybin caused her period to come eight days early. 

Natalie Gukasyan, MD @N_Gukasyan

Our new case series on menstrual changes associated w/ psychedelic use is out, including a case of inducing menses in someone with amenorrhea. First literature on this since the 1950s. Interesting psychoneuroendocrine and sex difference q’s to be explored

tandfonline.comMenstrual Changes and Reversal of Amenorrhea Induced by Classic Psychedelics: A Case SeriesThere has been little research on the effects of psychedelics on menstrual and reproductive function, though anecdotal evidence suggests that these compounds may have striking effects on menstrual...

These findings echo those from a series of reports published in a 1957 paper published in the Spanish-language journal La Semana medica. “Taken together, these cases suggest that a variety of classic psychedelics including LSD, psilocybin, ayahuasca, and mescaline may all produce striking changes in menstrual function,” Gukasyan and Narayan write. “Given their shared mechanism of 5-HT_2A agonism or partial agonism, we suspect that this is either the direct or indirect cause of menstrual changes and that these effects likely occur somewhere along the hypothalamic-pituitary-gonadal axis.” It may be that these cases are rare, but further research is warranted, especially as more people who menstruate seek psychedelic treatment.

The State of Psychedelics: New bills in Massachusetts, Missouri, Oklahoma

The community group Bay Staters for Natural Medicine (BSNM) partnered with Massachusetts legislators to draft legislation to decriminalize the possession, ingestion, obtaining, growing, giving away, and transportation of less than two grams of psilocybin, psilocin, DMT, ibogaine, and mescaline. Last week, state representative Lindsay Sabadosa (D) introduced HD.1450 in the House while senator Patricia Jehlen (D) introduced SD.949 in the Senate. The text for both bills is identical; filing in both chambers is “a signal to the committee it will be assigned to that this bill is a priority and a big deal,” James Davis, a legislative director working with BSNM, told The Microdose. 

In Missouri, representative Tony Lovasco (R) introduced House Bill 869 last week, which would allow people over 21 with treatment-resistant depression, PTSD, or a terminal illness to receive psilocybin therapy. The bill also would establish an advisory committee to make recommendations about how such therapy would be delivered.

And Oklahoma representative Daniel Pae (R) introduced House Bill 2107, which explicitly states that researchers in the state would not face legal prosecution for conducting studies and clinical trials using psilocybin to treat conditions like PTSD, depression, traumatic brain injury, chronic pain, and opioid use disorder, among others. The bill would also require researchers to register any studies using psilocybin with the State Department of Health and the Oklahoma Department of Agriculture, Food, and Forestry. In addition, the bill stipulates that patients participating in such studies would not face legal prosecution. 

Two weeks ago, we reported on Virginia’s HB 1513, which would allow psilocybin to be used to treat depression, PTSD, and end-of-life anxiety; the bill was referred to the House Courts of Justice subcommittee. That subcommittee voted 5-2 against the bill last week, according to the AP.

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The Latest in Oregon: Contentious new legislation 

Measure 109 officially took effect at the beginning of this year, and now the hard work of implementing that legislation begins. In early January, we reported on Oregon’s Senate Bill 303, which would mandate that the Oregon Health Authority require all psilocybin service centers and facilitators to collect and report data about clients, including demographic information and their treatment details. 

In his newsletter, attorney and former Oregon Psilocybin Advisory Board member Mason Marks explains that the advisory board debated including data collection provisions in the Oregon Psilocybin Services’ final rules, but ultimately decided not to. He writes that SB 303 “ignores the will of the voters, who approved Measure 109 with robust confidentiality protections, and those who devoted countless hours to its subsequent rule making process.” He argues that SB 303 endangers clients, putting them at risk for prosecution should the federal government take an interest in cracking down on Oregon’s psilocybin services, and that it increases the costs of implementing Measure 109. 

Earlier this month in Oregon, Representatives Lily Morgan (R), Jami Cate (R), Rick Lewis (R), and Anna Sharf (R) introduced House Bill 2831, which seeks to repeal Measure 110, a bill passed at the same time as Measure 109 that reduced penalties for personal drug possession, effectively decriminalizing possession (but not sales) of small amounts of otherwise illicit drugs. On Harris Bricken’s Psychedelic Law blog, Vince Sliwoski writes that high costs for psilocybin services might exclude some potential clients, so repealing Measure 110 could further reduce Oregonians’ ability to legally access psilocybin. “If HB 2831 were to pass, these excluded individuals would be made to: a) risk arrest and prosecution for use of psilocybin outside of the stuffy OHA system; b) pay an outsized relative cost to access psilocybin within the stuffy OHA system; or c) do nothing in the psilocybin paradigm.” 

Barriers to vets seeking psychedelic-assisted therapy

Despite new funding, non-profit groups, and clinical trials aimed at supporting veterans’ access to psychedelic therapy, there are still barriers vets must overcome in seeking treatment. In a paper published in Military Medicine in late December, researchers and clinicians asked 21 service members and veterans with a history of traumatic brain injury and other cognitive symptoms about their attitudes towards psychedelic-assisted therapy. 

On average, the group was not very familiar with the concept of psychedelic therapy but became more interested in it after receiving some education about it from researchers. They reported that the biggest barriers for seeking such treatment would be the time commitment, fear that such therapy could result in long-term effects or personality changes, and worries that they would face workplace consequences or judgment from others. “Military-specific concerns or barriers need to be further evaluated and addressed if these treatments are FDA approved, given the identified concern of command support and logistical barriers,” the authors write.

While it’s unclear if the U.S. Department of Veterans Affairs (VA) is aware of those researchers’ papers, they made it clear this week that they are actively monitoring psychedelics developments, according to Marijuana Moment. In a RAND Corporation webinar, the VA’s Office of Mental Health and Suicide Prevention deputy executive director Ilse Wiechers spoke about the agency’s plans to recruit for psychedelics studies and how the agency is advising veterans on psychedelics. In his summary of the webinar, Marijuana Moment reporter Kyle Jaeger writes, “As a general rule, VA would discourage experimental use outside of a clinical trial, but she said the relationship between the agency’s doctors and patients must be preserved in a way that doesn’t deter people from being honest about their experiences.”  

2022 in review

With 2023 underway, Psychedelic Alpha is taking a look back at 2022 to understand how the psychedelics space has shifted in the last year. The psychedelics analysis site reports that the amount of money poured into psychedelics companies decreased from $2 billion in 2021 to around $520 million last year. When asked to describe 2022, venture capitalists called it “a harsh economic reality check” and “an overdue market correction.”  

Despite financial hiccups, many are hopeful that the research and development in progress will lead to improved psychedelic treatments. In an opinion piece published as part of Psychedelia Alpha’s review, MAPS executive director Rick Doblin anticipates FDA approval for prescription MDMA in 2024, and believes that “fully globalized access to MDMA-assisted therapy can lead to a world of net-zero trauma by 2070.” 

Meanwhile, in another op-ed reviewing 2022, journalist Shayla Love observes, among other things, that the psychedelics world will need to accept more criticism. “Some people are pursuing how psychedelics work, who they might treat, and for what conditions, and there will be mistakes made along the way. Others’ goal is to point out those errors. I don’t find these two modes incompatible,” she writes. “Rather, I think they need one another for the field to continue to grow.”

• LUCID News details the regulatory hurdles small businesses will face in trying to open psilocybin centers.

• You can buy and eat psychedelic mushrooms in the video game Skyrim now, according to The Gamer.

• The race to cash in on ibogaine treatment is on, The Guardian reports. 

• Previously, we’ve reported on the company Kernel, which has created a brain imaging helmet and partnered with psychedelics start-up Cybin to measure people’s brain activity during ketamine sessions. In Bloomberg, business journalist Ashlee Vance details Kernel founder Bryan Johnson’s quest to age in reverse.

• Despite its name and marketing, the product “Psychedelic Water” contains no psychedelics — rather, any effects people might feel as a result may be due to a placebo effect, Popular Mechanics reports.

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