Hallucinogen use on the rise nationally; What do Oregon’s psilocybin stakeholders want?
Plus: Survey suggests psychedelics help people with eating disorders; Could Mississippi be the next state to embrace ibogaine? and Psychedelics could ease the pharmaceutical industry’s “patent cliffs”
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.
Hallucinogen use increased between 2023 and 2024
On Monday, the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within the U.S. Department of Health and Human Services, released the results of their 2024 National Survey on Drug Use and Health. The data from the survey are frequently used in psychedelics researchers’ studies on mental health and drug use.
Results from 2024 suggest that overall, hallucinogen use in the U.S. has increased from the previous year, and has been steadily rising since 2021. (The survey’s definition of “hallucinogen” includes classic psychedelics such as LSD and psilocybin, as well as MDMA, ketamine, salvia, and PCP.) While 3.1% of respondents reported using hallucinogens in 2023, that percentage increased to 3.6% in 2024. It appears that people over 26 accounted for that change; the percentages of people 12 to 17 or 18 to 25 reporting hallucinogen use increased by only 0.1% over the last year. Additional data showed that approximately 1.6 million Americans over 12 years old used hallucinogens for the first time in 2024, about the same number as first-time cigar smokers, but still a relatively small figure compared with the 5.4 million first-time nicotine vapers and 4.2 million first-time alcohol drinkers.
What do Oregon’s psilocybin stakeholders want?
As Oregon’s state-regulated psilocybin program enters its third year of operation, Oregon Psilocybin Services (OPS), the division of the Oregon Health Authority overseeing the program’s rules and regulations, recently held a series of public listening sessions for stakeholders to voice their feedback. OPS released a summary of feedback received during those sessions. Some requests were outside the agency’s jurisdiction - for instance, in response to concerns about high psilocybin session costs, OPS noted they did not have control over those costs. Other comments give an interesting glimpse into business owners’ and consumers’ hopes for the program, such as reducing advertising requirements so that businesses could market to tourists, or revising safety requirements for low-dose psilocybin sessions (i.e., microdoses), because they are theoretically sub-perceptual. “Some proposed expanding access to low-doses through a retail model similar to cannabis,” OPS writes. “It is important to understand that this is currently not allowable by law and would require a change in statute.”
OPS was initially established as a fee-based division, meaning that fees for licensure and psilocybin sessions would pay for its operations. It has also asked for additional funding from the Oregon State Legislature to support the program while it is still being established. So far, fees have not been enough to cover its expenses. While many licensees are already concerned about high fees, it’s possible those fees could increase even more, according to a section of OPS’s report about its on-going budget shortfall. OPS writes that the regulated psilocybin industry is growing slowly, as training and applying for licenses takes time. Additionally, they write, “the slow growth of the industry is partly due to property challenges that applicants are experiencing due to local government ordinances that prohibit OPS from issuing licenses and restrictive zoning requirements for psilocybin businesses.”
Meanwhile, OPS’s operating costs also increased due to several unanticipated events, including the passage of SB 303, which required OPS to direct businesses to collect data about clients without earmarking any funding for implementing this new data collection, as well as “costs associated with Oregon Department of Agriculture (ODA) for third party validation testing for psilocybin products, including speciation, potency, microbials, pesticides, and heavy metals in accordance with statutory and rule requirements.”
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Survey: psychedelics helped people with eating disorders
In a survey of over 5,200 people surveyed about their eating disorders, slightly more than 1000 said they’d used psychedelics in the last 12 months — and a qualitative analysis of responses from 200 of those participants, published in Journal of Eating Disorders, suggests that the drugs helped them.
Among the survey respondents who reported psychedelic use, nearly 80% said they’d tried psilocybin, and 47% said they’d used LSD. Smaller percentages of respondents also said they’d tried other psychedelics, including 2-CB, a phenethylamine that is often compared to LSD or MDMA, mescaline, ayahuasca, DMT, ibogaine, and Salvinorin A, a hallucinogenic compound found in Salvia divinorum. “All psychedelics were overall rated favourably for improving [eating disorder] symptoms, mental health and tolerability except for 2-CB and Salvinorin A,” the researchers, all affiliated with the University of Sydney, wrote.
In their qualitative analysis of written replies from the survey respondents, the researchers identified several themes. For some, psychedelic experiences served as a “defining moment” in their recovery, reducing their eating disorder-related behaviors and thoughts, helping them feel more connected to themselves and others, and delivering lasting effects. “When I did acid [LSD] I felt cured of my eating disorder,” one respondent wrote. “I felt so good about how I looked and it felt like my brain and my body finally connected.” However, 15 respondents said they’d had a bad trip, with eight respondents reporting that their symptoms worsened while on psychedelics: “Only used once [psilocybin] (so far), went well until I looked in a mirror, which was the worst my body dysmorphia had ever been,” one respondent wrote.
Overall, the study authors write, “these reports reflect the complexity of experiences following psychedelic use and highlight the importance of robust safety protocols in psychedelic assisted psychotherapy with thorough screening, preparation, supervision and integration, to minimise the risk and severity of adverse events.”
Could Mississippi be the next state to embrace ibogaine?
Last week, the Mississippi House Public Health and Human Services committee published a schedule that included a late August hearing on ibogaine, a psychoactive substance found in plants including the iboga bush native to Central Africa. According to Mississippi news site the Magnolia Tribune, the committee’s chair, representative Samuel Creekmore (R), is “hoping to partner with Texas and allow the same FDA trials to happen in the state of Mississippi.” The Texas legislature recently passed the nation’s first bill supporting ibogaine research; Senate Bill 2308, signed by Governor Greg Abbott in June, created a public-private partnership to fund clinical trials using ibogaine to treat substance abuse disorder.
The hearing, reports the Tribune, “will include testimony from patients, medical professionals and veterans concerning the efficacy of ibogaine,” and will also include members of the Mississippi Senate’s Public Health and Human Services committee.
Psychedelics could ease pharmaceutical companies’ “patent cliffs”
In Neuroscience Meets Entrepreneurship, a newsletter launched this week by atai co-founder (and former CEO) Florian Brand and COMPASS co-founder Lars Wilde, the two analyze the “massive patent cliffs” faced by big pharmaceutical companies in the next two to three years. When companies develop a drug, it retains patent protections for generally 10 to 15 years after it’s FDA approved. But Brand and Wilde point out that the top five psychiatric drugs, all generating billions of dollars annually, will soon lose exclusivity, meaning big pharmaceutical companies like AbbVie, Otsuka, and Johnson & Johnson will need to find new cash flow somewhere.
“Based on their public statements, cash reserves, strategic fit and activities in the psychedelics space to date - which of these pharma companies might be the first one to announce a major late-stage psychedelic deal, potentially as early as this year,” they posit. These pharmaceutical giants have already made some smaller moves towards psychedelics: Otsuka acquired psychedelic drug discovery company Mindset Pharma in 2023, AbbVie announced a collaboration and licensing agreement with clinical stage psychedelic company Gilgamesh, and Johnson & Johnson brought Spravato, an esketamine medication, to market in 2019.
For Business Insider, journalist Katie MacBride investigates a case of alleged sexual misconduct at Atlanta-based psychedelic organization The EAST Institute. “A growing number of people who have signed up to get care or serve as caregivers in the budding new industry say they've been harmed while taking the very drugs whose healing powers they were being taught to harness,” she writes.
In his newsletter Ecstatic Integration, Jules Evans reports on a recent death at the Peru retreat center Ayahuasca Foundation, allegations of inappropriate behavior from facilitators, and inadequate screening practices for retreat attendees leading to psychotic episodes.
CNN podcast One Thing covers the changing culture around psychedelics, including some perspectives from yours truly.
Denver officials say they’ve found psilocybin chocolate bars for illegal sale at local gas stations and vape stores, reports The Denver Post’s Tiney Ricciardi.
Journalist John Semley recaps the last few years of ups and downs of MDMA-assisted therapy in WIRED.
In a USA Today op-ed, public health professional and psychedelic harm reduction advocate Kristin Nash, whose college-aged son died while under the influence of psilocybin and LSD, argues that psychedelic risks must be made clear to the public. “As access grows and the public becomes more curious – if not enthusiastic – we must urgently pair this moment with clear-eyed public health safeguards and education,” she writes.
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