It’s official in Oregon, the latest in CO, CA, and NY, and psilocybin trip reports from people with bipolar disorder

Plus: Quebec pays for psilocybin therapy, and Indigenous ethical principles to guide Western psychedelic research

Happy New Year, and welcome back to The Microdose. Here’s what’s happened in the psychedelics world over the last three weeks:

The Latest in Oregon: It’s Official

In the last week of December, Oregon Psilocybin Services, or OPS, published its final rules for the implementation of Measure 109. The agency also published a document addressing public comment it received about draft rules released in November. Some of the revisions the agency made in the final rules are significant: for instance, it now allows clients to opt out of sharing de-identified data, among other amendments intended to better protect client confidentiality. The agency also creates a new dosage tier for “subperceptual doses” (i.e., a microdose) of 2.5 mg or less, which allows psilocybin providers to have sessions as short as 30 minutes with clients. The agency also now allows facilitators to provide “supportive non-sexual touch” to clients’ feet during psilocybin sessions rather than just their hands as stipulated in earlier rules. 

On January 1, those final rules took effect, making Oregon the first U.S. state to establish legal psilocybin services. On January 2, OPS began accepting licensing applications for testing labs, manufacturers, facilitators, and psilocybin service centers. However, as the state’s psilocybin industry takes shape, when, exactly, psilocybin businesses will open their doors remains unclear, as do a great many other things: the majority of Oregon counties voted in November elections to ban psilocybin services; entrepreneurs must navigate the complicated process of establishing a psilocybin business; and, of course, there is the looming question of how the federal government will respond to clear violations of federal law against psilocybin, which is unchanged by Measure 109. 

The State of Psychedelics

Meanwhile, Colorado is on its way to becoming the second U.S. state to establish psilocybin services. On December 27, Colorado governor Jared Polis filed an executive order to officially certify the results of the Natural Medicine Health Act, or Proposition 122. This is the November ballot initiative in which nearly 54 percent of Coloradoans voted to remove criminal penalties for possession of certain psychedelic plants and fungi and to establish psilocybin services. 

Now, the state’s Department of Regulatory Agencies and an advisory committee must create rules for the rollout of Prop 122. That structure is similar to Oregon’s, and it will also take months to establish; Colorado will begin accepting applications for psilocybin business licenses in September 2024. The state is currently taking applications from individuals who want to join the Natural Medicine Advisory Board. 

Though state legislatures have just started their sessions for the year, two new psychedelics bills are already in the pipeline. In December, California state senator Scott Wiener introduced Senate Bill 58, which would decriminalize the possession and personal use of plant-based psychedelics. Last year, a similar bill also introduced by Wiener failed in committee. (For more about that, read The Microdose’s 5 Questions for Scott Wiener.) Wiener’s new bill (SB 58) includes some significant changes from the previous one (SB 519); the new bill removes MDMA and LSD from its list of permitted psychedelics and no longer requires a working group to study harm reduction and drug education. The bill’s next stop will be a committee hearing. 

A similar bill was introduced in New York by four Assembly members. Bill A00114 would, “legalize adult possession and use of certain natural plant or fungus-based hallucinogens,” and would protect individuals that legally use hallucinogens from losing professional licenses, being denied mental health services, or being prosecuted for child abuse or neglect solely for using psychedelics. The bill was referred to the assembly’s health committee on Wednesday.

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Psilocybin trip reports from people with bipolar disorder

People with bipolar disorder are usually excluded from participating in the growing number of psychedelics studies; some clinicians believe the drugs could trigger mania. That has left a “dearth of published literature on the safety of psychedelic use in people with [bipolar disorder],” write seven psychiatrists in a paper recently published in PLOS One. The researchers collected survey data from over 500 people with bipolar disorder about their experiences using psilocybin, the results of which were published in a previous paper. One third of those participants said they experienced “new or increasing symptoms” following psilocybin use, but overall, participants indicated that they believed psilocybin was not harmful.

The researchers also conducted qualitative interviews with 15 of the participants who filled out the survey. While some participants reported that psilocybin helped alleviate depressive symptoms, many also reported experiencing trouble sleeping and manic episodes after using psilocybin. With some early studies using psilocybin to treat bipolar disorder in the works, the authors suggest precautions for future clinical trials like encouraging participants to get good sleep before a study, limiting stimulation in research environments, and making sure researchers monitor participants for symptoms of mania and suicidality. 

Quebec pays for psilocybin therapy

Quebec is now the first Canadian province to cover the cost of psilocybin therapy. In December 2022, the psilocybin advocacy non-profit TheraPsil reported that two doctors, Dr. Houman Farzin and Jean-François Stephan, billed the province for treatment of a patient treated in June 2022. In a letter signed by 15 of his colleagues, Stephan argued that the treatment should be covered, and the government amended medical codes to allow the Canadian health system to cover the costs of the treatment. 

“It’s encouraging to see them recognize the evidence available, and make the necessary adjustments to support the financial aspects of treatment so that it’s not an obstacle for patient access,” Stephan said in a TheraPsil press release. “I’m pleased this happened in Quebec, and I hope other provinces follow in their footsteps.”

Reverence, respect, responsibility, and more: eight Indigenous ethical principles to guide Western psychedelics

As the Western world’s interest in psychedelics grows, “Indigenous Peoples’ voices and leadership have been notably absent from Western psychedelic research and psychedelic-therapy spaces,” Indigenous scholars, activists, and practitioners write in a new paper in The Lancet Regional Health - Americas, outlining how principles of Indigenous medicine can be incorporated into Western psychedelic research and practice. 

The paper grew out of an Indigenous-led group that held discussions over six months in late 2021 and early 2022. The group writes that, over the course of that process, they identified eight ethical principles that could guide Western psychedelic research, including reverence for Mother Nature, acknowledgment of the relevance of Indigenous knowledge in psychedelic medicine, and reparation and sharing of benefits with Indigenous peoples. “Indigenous voices can be a powerful and beneficial solutions-orientated force for well-being derived from ancestral wisdom and insight,” the authors write.

• In a press release, MAPS announced the completion of MAPP2, their second phase 3 clinical trial using MDMA-assisted therapy to treat PTSD. “The results confirmed findings from MAPP1,” the organization wrote, and study participants did not report any serious adverse reactions. 

• The Daily Beast reports on growing concerns that the psychedelics industry “is utilizing biopiracy tactics to steal indigenous knowledge of new drugs.”

• NEO.LIFE explores the still-developing research on using psychedelics to treat eating disorders.

• Psychonauts and scientists are exploring the potential of extended-state DMT, The New Republic reports.

• How many likes does it take to be a psychedelic thought leader? In Lucid News, Dennis Walker points out the dangers of letting social media influencers lead conversations about psychedelics. 

You’re all caught up! Have a great weekend. We’ll be back in your inbox on Monday with a new issue of 5 Questions.

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