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March 28, 2024

Psychedelic therapy supporters make argument in favor of ballot initiative as opponents claim lack of evidence

A woman in a blue suit speaks at a microphone during a hearing Image | Courtesy of Sam Drysdale, State House News Service Emily Oneschuk, U.S. Navy veteran and the campaign director for Massachusetts for Mental Health Options, speaks to lawmakers at a hearing on a ballot question to decriminalize some psychedelics at the State House on Tuesday.

Psychedelics such as psilocybin found in "magic mushrooms" have helped people heal from trauma, recover from addiction, and treat chronic pain, but opponents of a ballot question to decriminalize the substances say there is not yet enough research for them to be widely available."

A flood of supporters came to a public hearing at the State House on Tuesday, sharing stories with the legislative committee tasked with reviewing the field of proposed 2024 ballot questions about how using psychedelics such as psilocybin, which appears in "magic mushrooms," peyote, ibogaine and MDMA have helped them overcome the darkest moments of their lives.

Those who support the 39-page Natural Psychedelic Substances Act (H 4255), which would decriminalize personal use of the drugs and create a regulatory framework to make the substances available in "therapeutic settings through a regulated and taxed system," range from veterans, to survivors of sexual abuse and people who have long suffered from mental illness.

One testifier said two therapeutic sessions using psilocybin helped him process sexual abuse he experienced as a child, and realize the assault had affected him well into his adult life.

"And it wasn't my fault. That abuse was not my fault," he said.

He'd like to do another session, and his therapist recommended doing so, but he said he's afraid to while there is no "safe and legal program."

Emily Oneschuk, a veteran and the first woman candidate for the Navy Seals, said a weeklong psilocybin retreat in Jamaica with other women veterans was a turning point in addressing her PTSD and depression.

Oneschuk directs "Massachusetts for Mental Health Options," the local name for the D.C.-based PAC called New Approach which successfully pushed similar psychedelic ballot questions in Oregon and Colorado.

After she was honorably discharged from the military, Oneschuk said she quickly realized the resources available to her through Veterans Affairs were not enough to help her address the trauma she experienced both from service and her brother's recent death.

"It didn't seem to matter what I did, where I went, who I was with. The vivacious, caring person I had always loved being was gone and I didn't know if she'd ever come back," Oneschuk said.

After other treatments failed, she turned to The Hope Project, which connects female veterans and wives of servicemembers who died overseas to "psychedelic healing journeys."

"I was finally able to feel and process the depth of my pain in a way I couldn't do anywhere else," Oneschuk said. "I left Jamaica with a glimmer of hope that I hadn't had in years. Psychedelics did not magically solve all my problems. But they were the key to unlocking parts of my brain and self that I couldn't access before. And once these parts were unlocked, I could finally feel the anger I had been pushing down for so long and admit to myself that I had been hurt. Psychedelics let me take off the armor that had been protecting me and finally reengaged with the joyful, peaceful parts of myself I had become so distant from."

Several other veterans and first responders also testified in favor of the ballot question on Tuesday, saying psychedelics helped them address PTSD where other treatments failed.

Peter Lakov, a software engineer and father of two daughters, said a psilocybin session helped him quit smoking cold turkey after 20 years of addiction.

"I had tried multiple times to quit smoking, and every time I had to apply really strong willpower to persist for weeks or months, or in some cases, a year of not smoking. It took a lot of willpower ... after that one session, it felt like smoking just didn't matter anymore. Like there was a hole in me before and that hole doesn't exist anymore," he said.

Lakov told lawmakers about driving his daughters to birthday parties and his many years working as an engineer to "thwart any stereotypes or preconceived notions you may have about who supporters or users of psychedelics might be."

"I'm basically a regular dad," he said.

Despite the dozens of personal stories of how the drugs have helped some, lawmakers also heard stark warnings Tuesday against making them more accessible.

Dr. Nassir Ghaemi, a professor of psychiatry at Tufts Medical Center and the incoming president of the Massachusetts Psychiatric Society, said psychedelics can be dangerous for people with certain mental health conditions and worried about widespread use without enough research or education.

For people with psychotic diseases like schizophrenia or bipolar illness, psychedelics can trigger psychosis or manic episodes, Ghaemi said.

"In Massachusetts with a population of about 7 million, just back of the envelope guessing that I did while sitting here, that's 200,000 people. 200,000 people who if this is legalized and available to everyone, if they get these medications, drugs, whatever you want to call them, they will have psychotic reactions, or are very likely to have them. So in terms of harm, that's important," he said.

Ghaemi also warned that there was not enough research about the drugs' interactions with other medications, such as SSRIs -- which about 10 percent of the adult population takes.

There's a lot of research being done on the benefits of psychedelics to treat mental illness, he said, noting that there are promising outcomes particularly in studies about PTSD. But Ghaemi said those studies should still be done in clinical settings.

"You're experimenting with people in the real world," he said.

Dr. John Fromson, president of the Massachusetts Psychiatric Society and psychiatrist at Brigham and Women’s Hospital, also said there was successful research being done in the area but urged lawmakers to wait until the Federal Drug Administration approved the use of the psychedelics for treatment.

"These are powerful compounds that should be reserved for physicians, nurses, social workers, psychologists, and certified mental health practitioners. It's really not clear what's going to happen with the professional liability risk," Fromson said.

He criticized Massachusetts for Mental Health Options' presentation to lawmakers, which mainly focused on how the legal regulation model would work and how to make the treatment more accessible. The Oregon model, which the Massachusetts ballot question is based off of, has received criticism from local groups for being inaccessible for most people. Treatments can range in the thousands of dollars and the regulation of licensure is controlled by an unelected commission similar to Massachusetts' Cannabis Control Commission.

The initiative-backers focused their presentation on ideas to make the treatment more affordable, such as piloting new community-based programs.

"I didn't hear anything, maybe you did, about informed consent?" Fromson said, about the Massachusetts for Mental Health Options' presentation. "How are these people going to be shown that they have the decisional capacity to be able to be made aware of the benefits, risks, side effects? What would happen if no treatment was given at all? What are alternative treatments?"

He continued, "I heard nothing about perinatal health and women's health and the effect on an unborn fetus, or what sort of screening processes are going to be for women who are at reproductive age. We don't know the outcomes of the use of these powerful substances on reproductive health. I didn't hear anything about that today."

Fromson urged lawmakers to build more regulation into the process if the ballot measure is passed by voters this fall.

"I think there's great excitement and hope within the context of the medical community that these very powerful chemicals will work very much the way they've worked for native Americans and other aboriginal groups for thousands of years. We hope that they work in the same way. But hope is very different from expressed scientific data," he said.

Jared Moffat, with the D.C. PAC New Approaches, later pushed back against Frosman's testimony.

He said even if voters approve the initiative, it would take 18 months to two years before the services are first provided to people, and during that time experts would convene to come up with models for training programs and informed consent.

"I just want to assure you that there is going to be a lengthy and thoughtful process to address all these things," he said.

Other supporters of the question also pushed back at Fromsan and Ghaemi's remarks, arguing that researchers have been looking into these processes for decades and other experts -- including Dr. Franklin King of Massachusetts General Hospital who also testified on Tuesday -- support the idea.

King, who is the director of training and education at MGH's Center for Neuroscience of Psychedelics, said the number of patients at the hospitals' psychiatric emergency room has exploded over the past decade, while research shows "psychedelics when therapeutically administered in thoughtful settings... produce significant and nearly invariably dramatic shifts in disorders ranging anxiety, depression, PTSD."

"The accumulation of data over many years is, at this point, simply undeniable," King said. "The evidence that they show absolutely immense promise in addressing many of the various conditions we're facing right now -- the epidemic of suicide, depression, substance use disorder, burnout in health care workers and others -- is unquestionable."

If lawmakers and voters are looking to state agencies with experience in public health or mental health for guidance on the proposals, they won't find any, at least not now.  The News Service reached out to learn whether the Department of Public Health or the Department of Mental Health would weigh in on the two initiative petitions, as legislators consider their options.

"DMH and DPH do not have a role in the legalization of natural psychedelic substances," a spokeswoman for the Executive Office of Health and Human Services told the News Service, suggesting people try to obtain information from "research institutes."

Michael P. Norton contributed reporting.

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