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February 15, 2024

Supporters of psychedelics ballot initiative say Oregon serves as a model

A small retail building Image | Courtesy of Google Maps Life Trek LLC in Albany, Oregon, is one of the 200+ licensed businesses in the state that is authorized to facilitate psilocybin therapy. Drug policy reform advocates are pushing for a similar medical psychedelic law in Massachusetts.

Massachusetts voters may get the chance to cast ballots to legalize access to some psychedelic substances this fall. And though advocates say the Oregon psilocybin therapy program that would be used as a model for Massachusetts is beneficial for veterans suffering from PTSD and others with mental health issues, the price tag for treatment in the Beaver State makes the therapy inaccessible for most.

Mass. for Mental Health Options, the campaign pursuing the ballot question, hosted a briefing Tuesday to discuss legal psychedelic substances in Oregon and their use in behavioral health treatment, and how Oregonians' experience could help inform Massachusetts' legalization effort.

Advocates argue that psilocybin, the active compound in "magic mushrooms," has shown promise in treating mental health conditions like depression, PTSD, and addiction, citing a growing body of research supporting their therapeutic benefits.

If approved by voters, Massachusetts would join a growing number of states and cities across the country in reevaluating the legal status of psychedelics. In recent years, Oregon, Colorado, and Washington, D.C. have enacted measures to decriminalize or legalize these substances, reflecting a shifting cultural and political landscape surrounding psychedelic drug policy.

Tommy Wisdom, a Marine Corps veteran, said using psilocybin through therapeutic treatment helped him address depression, survivor's guilt and complex PTSD after leaving the military.

"During my time in the military, and even after, I spent a number of years self-medicating with alcohol. It was culturally acceptable, not just in our country, but also in the Marine Corps. And it was really my only option for dealing with what I was going through," Wisdom said at Tuesday's briefing.

He continued, "However, I was able to gain access and use psychedelics as part of my own healing. The basis of that is, I'm not perfect and my healing is going to be lifelong ... These substances and these therapies are tools, and what they've done is helped me access the best version of myself that I'm capable of being and give me insight into who I want to be."

Ben Kramer, another veteran and facilitator of psilocybin therapy at a center in Oregon, said the therapy usually involves preparation sessions before a session that includes use of the drug. Kramer said they do a safety assessment and develop a plan to integrate what they learn during the psychedelic session into their life.

Clients come into the center, lie down wearing an eye mask and headphones, take the drug, and the facilitator stays with them for what can be up to several hours to guide them through the journey. He added that, though they aren't still under the influence of psilocybin by the time they leave, clients are required to have a plan to get a ride home so they don't drive afterwards.

Kramer said this therapy has been transformational for him and other veterans -- but it costs in the thousands of dollars.

According to the Healing Advocacy Fund, costs start at $750 for a group session and $1,250 for individuals. These represent some of the lowest costs since this treatment became legal in Oregon, as prices have fallen as more service centers come online. Still, certain sessions can also cost far more.

"I want to acknowledge these numbers, these costs are still out of reach for a lot of people," Healing Advocacy Fund Executive Director Sam Chapman said. "Those are things that we need to continue to work on in spite of federal illegality, and that's where we're really starting to pave some of the different paths for affordable access both short term and long term."

He mentioned several new initiatives, including a "community impact model" in Portland, Oregon that would cover some of the costs for those who can't afford the therapy.

Grassroots coalition Bay Staters for Natural Medicine have advocated for legislation that would focus on decriminalizing psilocybin in Massachusetts, rather than on creating a regulated therapy model similar to Oregon. Advocates from that group have mentioned concerns over the licensed therapy model making the natural psychedelics inaccessible for some people.

"In Oregon, three years after voters approved that ballot measure, the average cost of a psilocybin facilitation session is almost $4,000. An average, or even upper-middle class family in the commonwealth is paying for school, they're paying for their medical bills, they have transportation costs. That is ridiculous," James Davis, the chief local organizer for Bay Staters for Natural Medicine, said in September. "And the Oregon Health Authority has been bailed out to the tune of $6.2 million by taxpayers, because they set fees so high, almost $10,000 a month to open up a business that gives facilitation services, that they can't even afford to maintain the regulatory structure of that program."

Jarad Moffat, the Massachusetts director of New Approach -- the D.C. outfit that is running the Mass. for Mental Health Options campaign -- responded at the time that the sessions cost between $1,500 and $2,000, as of the latest reports in September.

"There's no denying that this is an issue that needs to continue to be worked on. We're looking at ways to address that," Moffat said. "This is a totally new program, no state has ever done anything like this, Oregon is the first. There will be some kinks to be worked out, and that's to be expected. But as the process moves forward, I hope people will see these kinks will be worked out."

Asked by reporters about taking lessons from Oregon's legalization process and making the treatment more affordable in Massachusetts, Chapman said new options to build on and change the Oregon model were under review.

"We have a lot of lessons learned. From an affordability standpoint, I think there's a lot of different areas that we can look at. If we're going to talk about affordability for clients, we actually need to first talk about affordability for the licensees who are going to be providing access to those clients," Chapman said.

Becoming a licensed therapist is expensive in Oregon, especially where there are financial hurdles because psychedelics are still federally illegal.

"There are no specific one-size-fits-all answers to affordability when something like this is still federally illegal," he said. "How can we incentivize additional pipelines of funding to get involved in the program? We're not waiting around as an organization for the state to come out and say we're ready to fund this ... You can make access more affordable by directly funding it through philanthropic endeavors."

He added that any philanthropy should be accompanied by data to show the efficacy of the treatment.

The Oregon law does not allow for homegrown psilocybin, as Bay Staters for Natural Medicine support.

Moffat said he sees the ballot question going hand-in-hand with decriminalization of the drug.

Bay Staters for Natural Medicine has been a driving force in agreements between Massachusetts municipalities and their local police forces to decriminalize psychedelic plants.

Somerville, Cambridge, Northampton, Easthampton, Provincetown and Salem have all passed such measures, making Massachusetts the state with the most decriminalized cities in the country, according to the coalition. In Worcester, the substance is decriminalized for veterans and first responders, and the Amherst Town Council passed a resolution supporting decimalization.

"In the case of Massachusetts, having both a regulated framework where there is an infrastructure to build out safety protocols to build in education to train facilitators, that's an important pathway for many people. And I think also, you know, the fact is a lot of folks are using psychedelics in unregulated contexts right now and maintaining criminal penalties for those activities does not serve a public health goal," Moffat said. "States are going to continue to iterate and we're in sort of a new era of how to create safe access and so it's exciting to see different states take different approaches."

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