The Current Shroom Boom: A Recap of Psychedelic-Assisted Psychotherapy Across the United States

The use of psychedelic substances to heal the mind and body is anything but new. For millennia, Indigenous peoples across the globe have used plants with psychedelic properties for “medicinal, ceremonial, and divinatory purposes.” However, Western medicine has been slow to embrace psychedelics and psychedelic-assisted psychotherapy (PAP).

The United States’ Tense History with Psychedelics

Psychedelics are psychoactive substances defined by their ability to induce altered states of consciousness, including changed or enhanced sensory perception, cognitive process, and mood. Common psychedelic substances include lysergic acid diethylamide (LSD), psilocybin (aka, magic mushrooms), 3,4-methylenedioxymethamphetamine (MDMA), dimethyltryptamine (DMT), ketamine, ayahuasca, ibogaine, and mescaline (the active compound in the peyote plant).

The United States started researching potential therapeutic uses of psychedelics in the mid-twentieth century. Between the 1950s and 1970s, researchers administered psychedelics like LSD and psilocybin to thousands of patients to treat conditions like addiction, depression, anxiety, and end-of-life distress. However, research came to an abrupt halt when President Nixon signed the Controlled Substances Act and categorized psychedelics as Schedule 1 drugs, declaring they had no acceptable medical use and had a high potential for abuse. This Act started the infamous war on drugs and stilted scientific research on the therapeutic uses of psychedelics. These substances remain classified as Schedule 1 drugs and it is still a felony for individuals to possess or use these substances.

The Re-Emergence of PAP in the United States

Inspired by the national wave of successful measures to legalize cannabis for medical and/or recreational use, psychedelics have recently made a comeback. Recognizing the positive effects of psychedelic drug use on treating depression, anxiety, substance use disorders, and post-traumatic stress disorder (PTSD), advocates are successfully changing the conversation about PAP becoming an accessible treatment option.

Across the country, one psychedelic substance is making localized headway at an impressive speed: psilocybin. In May 2019, Denver, Colorado became the first city to decriminalize psilocybin. This opened the floodgates for states and localities to embrace similar policy changes or authorize work groups to research possible medical use. However, the movement did not stop at decriminalization or work groups. Two states have taken significant strides to make PAP accessible within their borders: Oregon and Colorado. 

The Oregon Model

In November 2020, Oregon became the first state in the Country to legalize PAP when voters approved Ballot Measure 109, (now codified as ORS 475A), authorizing the Oregon Health Authority (OHA) to create a program permitting administration of psylocibin-producing mushroom and fungi products to persons at least 21 years of age. Importantly, the law allows anyone over 21 to self-select to receive treatment without requiring a prescription, medical referral, or proof of state residence.

The Colorado Model

In November 2022, Colorado voters passed Proposition 122, which adopts a framework similar to Oregon’s and establishes a regulatory structure and timeline for other psychedelics, including DMT, ibogaine, and mescaline, to be considered for decriminalization and use for PAP. This would further revolutionize access to PAP as it means that people seeking treatment could select the psychedelic substance they believe is best for them.

Will This Boom Also Bust?

With broad public support, the DEA and FDA on board with permitting research on psychedelic substances, and with the worsening mental health crisis in the United States, it is unlikely that the current state-led shroom boom will bust. While there will undoubtedly be legal battles over patentsinequitable access to treatment, and a need for more training for therapists, facilitators, physiciansnurses, and social workers, the nation can look to Oregon and Colorado to assess the benefits of PAP in real time

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