'It's not medical': Oregon wrestles with how to offer psychedelics outside the health

PORTLAND, Ore. — Visitors to the fabric store, kitty-corner to a Whole Foods, are greeted by a sign on the glass front door. Outlined in red, it says: “NO drugs, NO money kept in this building.” Not for much longer.

Come early next year, if all goes according to plan, the rolls of cloth and sewing machines will be replaced by magic mushrooms. The century-old wooden building will become one of hundreds of locations across Oregon where people can come to take psychedelic drugs legally.

Starting in 2023, Oregon will be the first state with widely legalized psychedelics. Technically, the state didn’t approve psychedelic therapy, though the program is often interpreted as such. Ballot Measure 109, which passed in November 2020, gave the Oregon Health Authority (OHA) the job of overseeing magic mushroom consumption at “service centers,” in the presence of “licensed facilitators.”

Everything around the bill, though, is unavoidably focused on mental health. It was widely promoted as a way to treat depression and trauma and, even among those figuring out regulations, there is confusion and debate around how medical Oregon’s psychedelics will be. “I think there’s been a disconnect in what voters were told to expect when they voted and now. People will want mental health treatment but it’s not medical,” said Kimberley Golletz, a licensed psychologist and member of the Oregon Psilocybin Advisory Board giving guidance on the rules.

The psychedelic legalization movement is progressing parallel to a gold rush to develop these same drugs as medicine. Pharmaceutical companies and several nonprofits are studying psychedelics — including psilocybin, the active ingredient in magic mushrooms — as a way to treat psychiatric conditions, with the goal of getting these treatments approved and overseen by the Food and Drug Administration. A burgeoning network of businesses, including ones to train psychedelic therapists and operate clinics, view Oregon as an opportunity to gain a foothold in the industry, turning the state into a test case, both for legalized psychedelics more broadly and the medical development of these drugs.

Last month, the Oregon Health Authority issued its first set of draft regulations around training programs for facilitators, setting standards, for example, for the content and hours of training. In the months leading up to these decisions, discussions from advisory board members kept bumping into medical issues, including if it’s possible for licensed mental health professionals to work as practitioners, and to what extent facilitators should ask about a patient’s medical history. National and international psychedelic companies have participated in these conversations.