Negligible effects of microdosing at home; Usona researchers challenge Church of Psilomethoxin’s claims; and will Massachusetts’ proposed cost cap on MDMA treatment actually help equity?

Plus: The Latest in Oregon, and around the world

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. 

Negligible effects of microdosing at home 

The scientific evidence for the efficacy of microdosing psychedelics is fairly weak and has swung back and forth as new studies are released. While people have reported in surveys that microdosing improves their mood, randomized controlled trials conducted in lab settings have only found minor effects. In a new study published in Biological Psychiatry, a study led by University of Auckland researchers say lab-based studies might mask the real-world effects of microdosing. People who microdose usually do so in their own homes, and there is evidence, the researchers write, that the environment in which people microdose contributes to its overall efficacy. 

To investigate whether environment might play a role in the efficacy of microdosing, the researchers conducted a randomized controlled trial in which 80 participants self-administered treatment every three days for six weeks, mostly in their own homes (the first dose was provided in a lab). Half of the participants received 10 micrograms of LSD, while the other half received a placebo. 

Each day of the trial, participants filled out questionnaires about how they felt, which included reports on their mood and anxiety levels, as well as adverse physical effects. Researchers reported that the setting does seem to matter. When participants received microdoses in a lab setting, they were less likely to say they were feeling creative, energetic, or anxious. But in general, there were no sustained long-term positive effects of microdosing LSD, though participants reported being in a better mood immediately after taking the drug. Despite the lack of long-term effects, those in the LSD group reported that they believed the drug had improved their energy levels, happiness, and wellness over the course of the study, even if the data the researchers collected during the study didn’t indicate significant change over time. The researchers write that though effects of microdosing were minute in this population of healthy participants, there could be larger effects in clinical populations. 

Usona researchers challenge Church of Psilomethoxin’s claims

In late 2021, four men in the U.S. founded the Church of Psilomethoxin. Psilomethoxin is a somewhat mysterious and novel psychedelic tryptamine. The group’s namesake is also its sacrament, and its founders claim that the psilomethoxin given to its members is created by feeding 5-MeO-DMT to psilocybin mushrooms. Members must apply to join, and if accepted, they pay $55.55 to gain access to psilomethoxin and church events. 

According to analysis in a research paper posted this week to ChemRxiv, a sample from the Church of Psilomethoxin did not actually contain psilomethoxin. The sample did, however, contain psilocybin, as well as an analog of psilocybin called baeocystin, and psilocin (of which psilocybin is a so-called prodrug, a compound that becomes a different, pharmacologically active compound once it’s metabolized in the body). It is worth noting that this paper is what’s known as a pre-print — meaning it has not yet been peer reviewed. The paper details a chemical analysis of a Church of Psilomethoxin sample, completed by Samuel Williamson and Alexander Sherwood, two chemists working at the Usona Institute, a Wisconsin-based non-profit organization that conducts psychedelic research. While there are anecdotal reports that the psychoactive effects of the church’s sacrament feels different from regular psilocybin, the chemists say there is no evidence that the material they analyzed actually contained psilomethoxin. To see whether there might be some other substance driving effects, they tested the sample for further adulterants, but found nothing. “These data lead us to consider the likely possibility that the reported unique effects could be attributed to the placebo effect,” the authors write. The Church of Psilomethoxin did not respond to The Microdose’s request for comment.

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Will Massachusetts’ proposed cost cap on MDMA treatment actually create more equitable access opportunities?

Last week, we reported on Massachusetts House Bill 3574, which would remove MDMA from the state’s list of controlled substances if the federal government approves it for treating PTSD, and cap the cost of an MDMA treatment at $5,000. Given concerns from experts about the potentially high costs of psychedelic treatment, setting an upper limit on costs seems like a step toward equity — but two analyses published this week argue that HB 3574’s price cap likely won’t improve access to MDMA. 

In his newsletter On Drugs, attorney Matt Zorn points out that the bill could drive companies to avoid doing business in Massachusetts altogether, and that a $5,000 cap would potentially benefit insurance companies, who typically pay a large share of the costs of FDA-approved drugs and treatments, rather than consumers. He also details how providers can get around the cap by spacing out appointments to maximize payout for sessions. 

Psychedelic Alpha founder Josh Hardman also believes the bill won’t adequately address equity concerns. Therapists need to be properly compensated for their work, and based on his math, the cost just to employ two therapists for a standard MDMA treatment would be over $4,000 — and that doesn’t even factor in the drug itself. “There is no arguing whether cost will be an issue: it will,” Hardman writes. “But, artificially fixing the cost of MDMA-assisted therapy is likely misguided.” 

The Latest in Oregon: Pricey treatments, and new rules

Meanwhile in Oregon, psilocybin service centers are hoping to open soon. There are not yet any service centers licensed by Oregon Psilocybin Services (OPS) — though the agency’s weekly report says 14 applications have been submitted. Still, there are some early indications that treatment will cost thousands of dollars. Given the significant cost to open a service center — which includes a $10,000 licensing fee, paying trained facilitators, and liability insurance — it’s not surprising that treatment costs might be high.

In their latest newsletter, OPS also announced that they plan to open their rules-making process again later this year for “minor adjustments and technical fixes,” which will include public listening sessions and the establishment of a 2023 Rules Advisory Committee. Next year could see more significant changes to the rules as psilocybin services get underway. 

Governments of Uruguay and the Netherlands consider psychedelics

In Uruguay, senator Juan Sartori introduced a bill that would allow the medical use of psychedelics to treat depression and anxiety. If approved, people would be able to take psilocybin, psilocin, ibogaine, DMT, mescaline, or MDMA under the supervision of a physician, according to El Pais. 

The Dutch are considering their own changes in psychedelic policy. The government has created a commission to review the scientific evidence for medicinal MDMA and the legal landscape around its use. The committee, which includes legal scholars, physicians, and drug policy experts, was formed at the recommendation of Minister of Health Ernst Kuipers, who attended a presentation at University Medical Center Groningen in March on the therapeutic applications of psychedelics.

• New archaeological evidence from the Mediterranean island of Menorca suggests that people were using hallucinogenic drugs in rituals 3,000 years ago. 

• On Thursday, psychedelics mental health company TARA Mind announced its public launch and detailed its plans to build a network of psychedelic-assisted therapy providers that employers could use to provide such therapy as an add-on to employees’ healthcare benefits. TARA was co-founded by Marcus Capone, a veteran who also founded psychedelic organization VETS.

• The Church of Ambrosia is known for running Oakland’s Zide Door church, which Oakland police raided in 2020 for illegally selling cannabis and psilocybin mushrooms. They’ll soon be opening another location in the Bay Area — and people are wondering whether authorities will intervene again. 

• Is it ethical to ask study participants or patients for testimonials after psychedelic treatment? Jules Evans explores that question in his newsletter Ecstatic Integration (formerly the Challenging Experiences Project newsletter).

• VICE profiles the people and organizations working to decolonize psychedelics. 

• Lucid News asks: will ibogaine fit into the world of medicalized 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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