“If people cannot afford these treatments, then they’re not truly legal. That means they’re only legal if you have extreme levels of wealth.”
By Bhaamati Borkhetaria, CommonWealth Beacon
In Oregon, any person can walk into a “service center” to go on a supervised hallucinogenic trip on mushrooms.
A group called Mass. for Mental Health Options has gathered the necessary signatures to put a question on the November ballot that would make it possible for Massachusetts residents to do the same. However, the measure in Massachusetts is much more expansive than the one that legalized psilocybin therapy in Oregon in 2020. In addition to creating a service center model like the one in Oregon, it would decriminalize five different psychedelics including psilocybin, mescaline and ibogaine. It would allow anyone over the age of 21 to cultivate, possess and consume these substances. Selling psychedelics would be illegal, but people who grow them would be allowed to “share” the substances.
Research indicates psilocybin has shown promise in treating anxiety, depression, end-of-life distress, post-traumatic stress disorder and a myriad of psychiatric and behavioral disorders that do not respond to other interventions. Advocates in Massachusetts have cited the mental health benefits of psilocybin therapy as a reason to set up a therapeutic model.
In Oregon, psilocybin therapeutic centers have been operating since June 2023, with over 7,000 psilocybin products sold. The drug can only legally be administered under the supervision of licensed “facilitators,” who are trained to guide and support clients through psychedelic therapy.
Andreas Met, a licensed facilitator and owner of Satya Therapeutics, a psilocybin service center based in Ashland, Oregon, said that having regulated therapeutic spaces where clients can go to consume the drug is important. The approach, he says, can yield mental health outcomes that personal use of the substance doesn’t.
“There are plenty of people who come visit us who have tried it at home but it just didn’t work right,” said Met. “They understood why it didn’t work. The idea that you’re gonna be completely safe, completely supervised and there’s a human connection as well with a facilitator makes a huge difference.”
Someone seeking to take mushrooms in a therapeutic setting must first set up a “preparation session” with a licensed facilitator and answer a set of screening questions. Clients must speak to the facilitator about their past history of trauma, drug use, medical history and any trigger points they have.
“The average client comes in with very serious mental health conditions,” said Met. “Usually decades of treatment-resistant depression, often times coupled with alcoholism or other substance abuse. They typically have OCD, really deep anxiety or existential crisis because they’re gonna die soon.”
The client can choose to do an individual session or a group session. The group session generally costs less because it allows a single facilitator to take care of multiple clients at the same time. Clients get to pick a room—typically furnished with a comfortable couch, pillows, a coffee table and maybe a view of the outside if they are willing to pay extra.
The client also decides how much psilocybin to take. Some choose to take a smaller dose, which generally costs less. Once the preparation session is out of the way, it’s time for the client to schedule another session to actually take the psilocybin.
The psilocybin is usually given to a client in the form of tea, according to Met. A regular trip can take six to eight hours, with a facilitator always in the room.
Psychedelic drugs appear to encourage the growth of new connections between neurons in the brain. This is said to promote brain plasticity, which allows those taking the substance to effectively “rewire” their brain.
“The way we look at a person’s psychedelic experience is that everything they do in that experience is normal,” said Met. “Most people are trying to escape prior harms done to them, such as abuse when they were young, or maybe assault, sexual assault, rape, those kind of things. And typically people will respond to that. There could be purging or vomiting. You could have screaming and lots of crying. Any behavior that happens during a journey is very normal.”
Met said that the sessions can be intense in his service center but never dangerous.
After the session, the client can choose to attend a follow-up session where they can talk with the facilitator about their experience and their plan to support their mental health in the future.
There are over 20 licensed service centers in Oregon. The whole system is regulated by Oregon Psilocybin Services, which is made of a staff of 20 people housed within the Oregon Health Authority. They oversee the licensing and compliance for the psilocybin industry. They license manufacturers, facilitators, the service centers where the drug is administered and laboratories where the psilocybin is tested.
The Oregon therapeutic model has not been without its problems.
Angie Allbee, the head of the regulatory body that oversees the licensing and operations of the centers, said that a single session can cost anywhere from a couple hundred dollars to the fat price tag of $15,000.
“I think the biggest issue [with the Oregon model] is equity, access and affordability,” said Allbee. “We’ve been able to really focus on safety, but the one piece that really has been a gap is creating opportunities for affordability so that people can access services who are appropriate for services, and to ensure that diverse communities can access services.”
Met said that his service center is one of the most affordable, with prices averaging around $1,500.
Oregon Psilocybin Services requires every service center to submit a “social equity plan,” which can include making services more affordable to lower income people. There are also nonprofits like the Sheri Eckert Foundation that provide grants for facilitated psilocybin therapy to people who can demonstrate financial need or belong to an “underserved” population.
Health insurance companies do not cover psilocybin treatments because psilocybin is currently illegal under federal law, just as marijuana is.
Oregon Public Broadcasting has reported that the majority of the clients who have taken advantage of the centers have come from out of state. Met said roughly 80 percent of his clients are from out of state.
The Massachusetts ballot measure sets up a regulatory framework similar to what exists in Oregon but, unlike in Oregon, it calls for the creation of a five-member commission like the Cannabis Control Commission to oversee the system of service centers. The commission model has come under fire at the Cannabis Control Commission; the state’s Inspector General has called for the agency to be placed under receivership.
Some psilocybin advocates in Massachusetts are worried the ballot measure will replicate the high price points of Oregon and are pushing for a bill that would decriminalize psilocybin. Instead of creating a licensed service center model, this bill would task the Department of Health with issuing facilitator licenses the same way the agency issues licenses for counselors with a far lower licensing fee. Licensed facilitators would be allowed to provide services at home and “in nature.” The bill would also allow for individuals to grow and possess a larger amount of psilocybin than what the ballot measure proposes.
“If people cannot afford these treatments, then they’re not truly legal. That means they’re only legal if you have extreme levels of wealth,” said James Davis, the head of the Bay Staters for Natural Medicine, a grassroots organization pushing for the legalization of psilocybin which has come out in opposition to the ballot measure. “The better model is allowing people to grow and share. We don’t need a whole other unelected agency.”
Jennifer Manley, a spokesperson for the ballot campaign, said that the high prices quoted in the early days of psilocybin service centers in Oregon were due to a scarcity of service centers. She said initial prices were in the neighborhood of $3,500 per treatment, but now therapy at centers like Satya Therapeutics is about half that.
“We obviously want to make this accessible to everyone,” said Manley. “So we want to keep a close eye on what [Oregon] is doing and they have already been able to bring costs down dramatically.”
But the high cost is not the only concern being raised about the ballot question.
A legislative committee set up to review all of the Massachusetts ballot questions cited concerns that the hallucinogenic measure, in seeking to both decriminalize a series of psychedelics and to set up a therapeutic model, would create two separate systems for the use of psychedelic substances that would undercut each other. The committee said that allowing personal use and the “sharing” of psychedelics would create a loophole that would allow people to subvert any safety regulations imposed on the licensed therapeutic model.
The Massachusetts ballot measure is much more similar to the one that passed two years ago in Colorado, where the therapeutic model is yet to come online but there are already people exploiting the gray areas in the law by “sharing” psychedelics alongside support services that they charge for.
This article first appeared on CommonWealth Beacon and is republished here under a Creative Commons license.
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