Psilocybin-related calls to poison control centers increasing; former Kentucky ibogaine advocate to continue his work in Ohio; Colorado issues draft psilocybin rules
Plus: MDMA-assisted couples therapy and controlling behavior, and a new Connecticut bill
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.
Psilocybin-related calls to poison control centers increasing
As states across the U.S. have decriminalized psilocybin and even created programs to allow its legal access, the drug is more available now than it has been in decades. Researchers at the University of Virginia School of Medicine wanted to know if these changes to supply and access have led to more psilocybin poison center reports in adolescents and young adults. To examine this question, they searched for psilocybin exposures in the National Poison Data System, a database that logs reports to poison centers in real time. Their search included all cases involving people between the ages of 13 and 25 over the period between 2013 and 2022. Their report was published this week in The Journal of Adolescent Health.
In those nine years, there were over 4,000 reports; around 66 percent involved psilocybin alone, while 31 percent of reports also included marijuana or alcohol. Three-quarters of people who called poison control received medical attention, and two deaths were reported. While there were no significant changes in the number of psilocybin-related calls between 2013 and 2018, the researchers report notable changes starting in 2019. The researchers compared numbers of reports made in 2018 to those reported in 2022; they found that cases involving young adults (people between 18-25) more than doubled from just over 100 to nearly 300, while cases involving adolescents (people between 13-18) tripled from roughly 150 to over 450. The researchers write that the increase in adolescent cases is particularly alarming “since states and cities that have decriminalized psilocybin do not allow individuals aged less than 21 years its access or use.”
Former Kentucky ibogaine advocate to continue his work in Ohio
Last week, the REID Foundation — a non-profit dedicated to funding initiatives to fight addiction — announced a new partnership with former Kentucky Opioid Abatement Advisory Commission chairman W. Bryan Hubbard. During his 18 months as the Kentucky commission’s chair, Hubbard led efforts to use $42 million of the state’s settlement money from opioid manufacturers and distributors to study ibogaine as a potential opioid addiction treatment. In early 2024, a new State Attorney General took office, who replaced Hubbard with a former Drug Enforcement Agency official named Chris Evans. It’s unclear whether the $42 million ibogaine proposal will move forward without Hubbard.
For his part, Hubbard is now continuing the effort to fund ibogaine research in Ohio, where he is working with REID and Results Ohio, an arm of the Ohio’s Treasurer’s office which combines public funds and private investments to support “projects aimed at tackling the most pressing social and public health challenges facing Ohio.” Ohio, like Kentucky and all U.S. states, has received billions in its settlements with opioid manufacturers and distributors; Hubbard’s work aims to use some of that money in Ohio to spearhead clinical trials studying ibogaine.
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Colorado releases draft of psilocybin program rules
Colorado’s psilocybin program is set to launch early next year, and the state’s Department of Regulatory Agencies has published its first draft of program rules, based on recommendations submitted earlier this year by the Natural Medicine Advisory Board. The 40-page document marks a departure from some of Oregon’s rules: most notably, Colorado’s draft rules lay out directives for different kinds of licensure. (For further background on this, read our interview with Healing Advocacy Fund’s Colorado director Tasia Poinsatte.)
In addition to training requirements for a general facilitator license, which is what Oregon has, Colorado’s rules include other avenues for licensure. There’s an accelerated training option for “legacy healers,” where people who have been working in the underground can receive licensure if they demonstrate they have equivalent training to some of the basic facilitator standards. There’s also what’s called a “clinical facilitator,” which allows licensed psychologists, social workers, therapists, physicians, and nurses to receive licensure so that they can incorporate “natural medicine services” within the scope of their professional practice. (Oregon’s rules, on the other hand, disallow the therapeutic use of psilocybin, and instead refer to the use of psilocybin with the more agnostic term “services.”) Colorado officials are accepting public feedback on the proposed rules via email, as well as in a webinar to be held March 8.
MDMA-assisted couples therapy and controlling behavior
MDMA-assisted therapy is already available in Australia, and it may soon be approved in the U.S. as well. University of Sydney researcher Kayla Greenstien authored a piece for a psychedelic symposium at Harvard Law School Petrie-Flom Center exploring the history of MDMA in couples therapy and probing the fact that clinicians have overlooked the potential roles of domestic abuse and coercive control in MDMA-assisted couples therapy. Greenstien highlights examples that illustrate how MDMA-assisted therapy could exacerbate coercive dynamics in romantic relationships. Two researchers who study MDMA-assisted couples therapy also published a scale in 2014 measuring the accommodating behaviors of people partnered with someone with PTSD, which includes items like “tiptoe around a partner so as not to anger him/her” or “give up control to their partner because of his/her desire to be in charge.” Those things “may be indicative of accommodating behaviors,” Greenstien writes, but “also mirror common descriptions of being in an abusive relationship.”
Greenstien also raises concerns that clinical trials investigating MDMA-assisted therapy for couples don’t take into account these potential abuse factors. “Of the protocols that I have reviewed, none include mention of coercive control,” Greenstien writes.
The State of Psychedelics: New Connecticut bill proposes lowering psilocybin penalties
On Monday, Connecticut representatives David Michel (D) and Travis Simms (D) introduced House Bill 5297, which would allow people to possess, cultivate, or ingest up to a half-ounce of psilocybin (or any amount of marijuana) without consequence. Possession of more than a half-ounce would be a class A misdemeanor, which in Connecticut could result in up to a year in jail and a fine of up to $2,000. Last year, Michel, Simms, and five other representatives introduced a similar bill that passed the House but stalled in the Senate. Even if the bill passes in both chambers, Governor Ned Lamont may not give his final approval. Recently, a spokesperson for Lamont told the Hartford Courant that “the governor has concerns about broad decriminalization of mushrooms.”
Prominent psychedelics researcher and psychiatrist Ben Sessa is under investigation by the UK Medical Practitioners Tribunal Service (MPTS) for misconduct. A patient alleged that Sessa “discharged her from his care in order to pursue a sexual and/or emotional relationship with her.” Sessa co-founded psychedelics company Awakn (which has issued a statement that the company had “no prior knowledge of the allegations”), and was featured in the Netflix docuseries How To Change Your Mind. Sessa’s hearing began Thursday and is expected to last a week; documentation provided by MPTS indicates that the five allegations brought forth have been “admitted and found proved.” We will report updates on the case next week.
The Daily Montanan profiles Montanans using ketamine-assisted therapy to treat their mental health issues.
So much of psychedelic-assisted therapy research relates to depression treatment. A meta-analysis published in the British Medical Journal compared depression interventions in over 200 studies that did not include psychedelics studies but did include research on other treatments, including antidepressants, Cognitive Behavioral Therapy and a variety of exercises and physical activities. The analysis found that some of the largest reductions in depression resulted from dancing.
Dissociation is often seen as a negative side-effect of drugs like ketamine — but could a dissociative state be pleasurable, or have therapeutic value? Journalist Shayla Love explores in Psyche.
The Berkeley Center for the Science of Psychedelics is looking for a new Executive Director.
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