The Latest on Oregon’s Psychotherapy Measure

The year 2020 was, without question, a year nobody living today will forget. It brought a lot of terrible actions and conditions that impacted the globe. 

However, in Oregon, there are two things that came from that tumultuous year which may provide a glimmer of hope for the future of mental health care. The first is Measure 109, the approval to develop and implement psilocybin therapy sessions within state boundaries.

As a reader of Michael Pollan’s New York Times Bestseller How To Change Your Mind, I had a great deal of interest in what 109 could do and its potential impact on our society as a whole when it comes to understanding and treating various issues regarding our brains. 

As a result, I was curious to discover more details and what others thought. As months into 2021 went by, however, I felt like there was a real emptiness on the topic. Few people knew any of the details on it’s status and how things were going, so I went digging for answers. Given how little others knew of what was going on with 109, I was surprised to find that I actually didn’t have to dig far, if much at all.

What is 109?

Measure 109 is an Oregon measure that was voted on, and passed, in November 2020 to “license and regulate the manufacturing, transportation, delivery, sale and purchase of psilocybin products and the provision of psilocybin services”.  

To clarify, though, the measure will not allow the use and sale of psilocybin products for recreational consumption.The psilocybin services soon to be offered are exclusively for therapy.

So, don’t expect to see doses packaged in trippy designs for sale at your local dispensary at any point. 

As mentioned earlier, I’ve been reading Michael Pollan’s book since before 109 was publicly introduced—don’t judge me, I’m not a fast reader. In it, Pollan goes over the various methods implemented for these kinds of therapy sessions. 

The most consistent and reliable method mentioned has been one where a patient is given a humble dose–enough to break mental barriers but not so much that they lose the ability to be articulate–given a pair of shades to wear during their session, and are alone in a room with a single therapist. For everyone’s safety and peace of mind, acknowledgements must be made before a session can begin, such as limitations on physical contact and that sexual behavior of any kind is strictly prohibited. All of this put together paints a vastly different image than your stereotypical portrayal of hippies tripping at an outdoor concert, rolling around in a cartoonish-pit of limbs, piled on top of each other while babbling incoherently about “one love”. 

The field of psychedelic therapy treatment, and the Oregon Psilocybin Advisory Board, have intentionally distanced themselves and their work from the likes of those like Timothy Leary who—let’s face it—simply went too far.

To ensure that the work is taken seriously and to avoid any abuses, 109 is currently under a two-year development phase from Jan. 1, 2021 to January 2023. The first licenses given to approved clinics won’t be handed out until after that endpoint when OHA starts taking applications. Until then, during the two-year development, OPAB and its subcommittees will discuss and determine how everything will be regulated, the limitations of services, safety measures, and how to ensure equitability and affordability for those who need the services the most.

Who is running it?  

The OPAB, put together by Governor Kate Brown, was developed to inform OHA on the latest research and studies involving psilocybin use in therapeutic settings. Such research includes Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression, Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder  and Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study among others.

The Oregon Psilocybin Advisory Board consists of:

• Public Health Director Designee: Andre Ourso, OHA
• State Health Officer Designee: Dr. Tom Jeanne, OHA
• Oregon Health Policy Board Designee: Barb Hansen
• State Employee w/ Public Health Expertise: Ali Hamade, OHA
• Local Health Officer: Dr. Sarah Present, Clackamas City
• Addictions Medicine Specialist: Kevin Fitts, Portland
• Licensed Psychologist: Dr. Kimberley Golletz, Corvallis
• Licensed Physician: Dr. Todd Korthius, OHSU
• Mycologist: Dr. Jessie Uehling, Oregon State University
• Harm Reduction Specialist: Angela Carter, Portland
• Psychopharmacologic Specialist: Dr. Atheir Abbas, OHSU
• OLCC: Nathan Rix
• Oregon DOJ: David Hart
• Chief Petitioner Designee: Tom Eckert
• Public: Stephanie Barrs, Bend
• Public: Dr. Rachel Knox, Portland
• Academic Researcher: Mason Marks

The board meets on a regular basis to discuss guidelines and recommendations regarding the safety and efficacy of psilocybin services within the state of Oregon while also maintaining an awareness and study of Federal Law. An attempt to work with the federal government will also be made, according to Healing Advocacy Fund, a nonprofit born with the sole purpose of aiding the construction of Oregon’s psilocybin therapy sessions. This may be more easily accomplished thanks to the Food and Drug Administration designating the use of psilocybin on treatment-resistant depression as a breakthrough therapy. 

In addition to the advisory board, there are subcommittees that are dedicated to specific areas of main concern with 109. These subcommittees are Equity, Training, Research, Products and Licensing.  Each subcommittee determines how frequently they meet outside of the main advisory meeting; all meetings are made publicly available through the OHA website with time left for public comments at the end.

Current Phase: Rule-Making

109’s development phase is broken up into separate chunks, Planning, Research, and Rule-Making. The final, and longest, phase of development was reached after several months were spent reviewing and collecting the latest studies and findings on psilocybin therapy. On July 31, 2020 Oregon Psilocybin Advisory Board Rapid Evidence Review and Recommendations was published and added to the OHA website. The 39-page document is summarized into three paragraphs, the effectiveness of psilocybin as a therapeutic tool, safety concerns, and the exact species of mushroom (Psilocybe cubensis) that is best for production. 

Because the rule-making phase has only just begun, this means that nothing is set in stone and any suggestions made on how to tackle issues pertaining to each relative subcommittee can change. It will not be until June 2022 that the Advisory Board will come to an end on rules developed and make their final recommendations to OHA. The current timeline shows OHA not officially adopting those recommendations until December of that same year.

Once set into motion clinics, after obtaining their licenses, will be able to treat patients who qualify for Psilocybin treatment. Among those who would qualify are anyone 21 and older who suffer from mental health conditions such as PTSD, depression, anxiety and addiction.

Why does it matter?

If I may be permitted to theorize for a moment, I believe this could be the most impactful option for not just the everyday individual who struggles with their mental health, but also in tackling houselessness.

Recall that I stated that there were two things that were produced out of 2020 in Oregon? Well, the second is Measure 110. 

110 does a couple things, like setup a state fund to produce grants for addiction recovery centers. Most notably is that it decriminalized all illegal drugs. 

To a degree.

For large quantities of illegal drugs, enough to classify intent to sell, a felony charge is reduced to a Class A misdemeanor. This results in a jail time of 364 days and a fine of just over six thousand dollars. Smaller quantities, enough for personal use only, would receive a Class E misdemeanor with a $100 fine or the option to undergo a health assessment at an Addiction Recovery Center. 

It is at this point where I believe the two are intended to work in tandem with each other. In Lane County alone, there were 167 houseless Veterans, 277 houseless with substance abuse of some kind, and 467 adults with severe mental illness, according to the county’s 2020 Point-In-Time count. 

These numbers were published prior to COVID-19’s global impact, which gives reason to believe that these numbers have likely increased since.

Although 110 has already been in effect since early 2020, it’s too early to see what has resulted from its implementation. As for 109, time will tell how much of an effect future psilocybin therapy will help Oregon’s houseless, or attitudes toward mental wellbeing as a whole. 

But if the research and studies are to be taken seriously, then the future looks promising.