Oregon Legalizes a Breakthrough Treatment: Magic Mushrooms

Oregon will license and regulate psilocybin-assisted therapy by 2023. Some health care professionals aren't willing to wait.


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"I always had this kind of idea that, 'Oh, magic mushrooms just grow like deep in the forest and they're hard to identify and all this stuff," says Sean, a Portland-based social worker who asked that we use only his first name in this story.

In 2016, he and his girlfriend were foraging for psychedelic mushrooms in a nearby state park, where the mushrooms were plentiful and easy to find, contrary to his expectations. But he was stopped by a park ranger.

"[The ranger] saw me bending down and screeched to a halt and came up and started questioning me," says Sean. "I knew it was illegal, but I thought, like, 'Oh, they'll give me a ticket or something.'"

He was arrested and spent the weekend in county jail.  He pled guilty to felony possession, which derailed his career. He was fired from his job at a community mental health agency, and it made him ineligible to receive insurance in his private practice.

"It was professionally kind of devastating, personally, it was devastating… It is still impacting me to this day," says Sean.

Four years later, Oregon voters decriminalized low-level drug possession. If that law had been in place in 2016, the park ranger would probably have ticketed Sean $100.

In a separate 2020 ballot initiative, Oregon voters also opted to legalize psilocybin—the psychoactive compound in magic mushrooms—for use in therapeutic settings. Regulators have until January 2023 to begin issuing licenses.

"It's a great thing to be able to start to have this system in place [where] we'll be able to do that work above ground with legal protections," says Sean. 

But Sean didn't wait around for the state licensing program. He started treating his clients with psychedelics after his felony conviction destroyed his traditional practice, under the condition that the clients supply the drugs.

"Psilocybin from magic mushrooms has real potential to revolutionize mental health treatment," says Sean. "[Mushrooms] allow the sort of deep work that otherwise in therapy can take years to do effectively."

There's robust evidence that therapy with MDMA, or Ecstacy, is an effective treatment for post-traumatic stress disorder. And the FDA has deemed psilocybin a "breakthrough therapy" for treating severe depression.

Sean says that psilocybin has helped many of his clients overcome traumatic episodes, including a middle-aged man whose life was upended after he was robbed at gunpoint. No other treatment options had worked.

"He was desperate for some relief when he came to me," says Sean. "He considered [psilocybin-assisted therapy] a complete cure." 

Researchers have resumed studying the use of psychedelics in therapeutic settings—picking up on promising research that began nearly 80 years ago but that was halted by drug prohibition.

"When psychedelics were first discovered in the early '40s and then really distributed to psychiatrists around the world in the '50s, it quickly became apparent that psychedelics had the potential to become the cutting edge of psychiatric research," says Harbor-UCLA Medical Center psychiatrist Charles Grob, who published a seminal pilot study finding that psilocybin demonstrably alleviates the end-of-life anxiety of terminal cancer patients.

"Our [test] subjects, to begin with, were in great existential crisis," says Grob. "What we found over time with these psychedelic experiences, individuals found that they were able to re-establish that sense of self… and strengthen their sense of meaning and purpose."

Denver decriminalized psilocybin in 2019. Oakland decriminalized all naturally occurring psychedelics later that year, and Santa Cruz followed in early 2020. The California legislature is considering legalizing several psychedelics statewide. But Oregon is the first state that will establish a legal framework for the sales and use of psychedelics in a therapeutic setting.

"I don't believe that the state should have anything to do with what's going on in my mind," says Joe Eaton, a retired counselor who now works as a psychedelic sitter, taking care of his clients while they're tripping. "I never signed off, nor do I know anybody else who signed off and said, 'Yeah, you get to control what I put in my brain.'" 

It's unclear whether someone like Eaton will be eligible for a state license, and he says he isn't sure he wants one.

"I come to the substances with the idea that whatever you want to do with them is fine. You just want to party? That's fine. And then you want to hire me to keep you safe. That's fine. You want to do a search for God? Great. Let's do that. You want to do psychodynamic kind of work on your trauma issues? Sure. Let's do that."

Some psychiatrists, including Grob, are concerned that if psychedelic use is unregulated, it could put some patients, such as people with schizophrenia or bipolar disorder, in danger.

"The [psychedelic] experience, particularly under adverse conditions, may push them over the edge into a psychotic state," says Grob.  

But Eaton says that a regulatory apparatus isn't necessary to protect this population.

"I don't think [we need to] keep it in the hands of the professionals who have clearly shown that they're going to screw it up… They listened to Nixon for the past 40 years. I just don't have a lot of respect for any of the professional organizations," says Eaton.  

Oregon's law created the Oregon Psilocybin Advisory Board to work with the health department to create licenses and training programs for manufacturing, selling, and testing psilocybin as well as providing broadly defined "psilocybin services."

"I can at least kind of imagine certain kind of training programs," says Sean. "But I don't think that somebody needs to have gone to, uh, uh, you know, through a master's program in social work, through an MD program in psychiatry, to be able to safely and effectively dispense and guide the use of these substances to facilitate their therapeutic use."

The good news is that practitioners like Eaton, who may not be obtaining an official license, will likely be protected thanks to Oregon voters' decision to decriminalize low-level drug possession.

Sean plans to apply for a license as soon as he can.

"I already had pretty strong opinions about the drug war, and having that personal experience, you realize just how severely it can impact a person's life to get tangled up in the criminal justice system like that," says Sean. 

Produced by Zach Weissmueller. Camera by John Osterhoudt. Graphics by Tomasz Kaye and Isaac Reese.

Photo credits: Martina Kovacova/Newscom