Oregon just legalized psychedelic mushrooms. Here’s how California can do better

Oregon voters last week approved a ballot initiative legalizing use of psilocybin — the psychedelic component of “magic” mushrooms — in a therapeutic setting.

Although some western US cities, including Denver, Oakland and Santa Cruz, had effectively removed threat of arrest or prosecution for possession of mushrooms last year, Oregon’s statewide vote could signal things to come in California.

This policy route — from city ordinances to statewide voter referenda and from decriminalization of possession toward licensed therapeutic use — should generate some flashbacks here. It’s very similar to how cannabis policy changed. That decades-long evolution paved the way for legalized commercial cannabis, which has now been approved in 15 states.

The question for California isn’t really if psychedelic policy will change, but more likely how — and how quickly. There’s already been an attempt to put a psychedelic initiative on the California ballot, but it failed to collect enough signatures by the time the COVID-19 lockdowns hit last spring.

For many reasons, ballot initiatives are a poor way to set drug policy in general, and for psychedelics especially. Such referenda often get written by people who prioritize repealing prohibition and generating revenue — not those interested in balanced approaches to regulating supply and use.

And as we’ve seen with previous drug policy initiatives in California, it can be difficult for the state legislature to make major changes to them after the voters approve.

If they don’t want to risk letting voters decide on potentially flawed ballot initiatives, policymakers in Sacramento (and other state capitals) could deliberately tackle psychedelics through the traditional legislative process.

Psychedelics have been used for spiritual and healing purposes for thousands of years in some communities. Many current medical investigations into these substances show therapeutic promise.

There are ongoing FDA-approved phased clinical trials for using psilocybin and MDMA (or ecstasy) under supervision and in conjunction with psychotherapy to treat major depression or PTSD. Other recent studies have documented long-lasting relief from anxiety and depression in cancer patients and even help overcoming addiction to other drugs such as tobacco.

This is still a nascent area of investigation, however. For decades, research was stalled by fear and reluctance on the part of funders and investigators. There is still a lot to learn — both in terms of benefits and risks — about psychedelics.

That’s not stopping some advocates from trying to expand access to adults. California’s shelved initiative would’ve allowed any adult to use mushrooms without having to establish a therapeutic need — skipping straight ahead to non-medical use. A busy voter might not dig into such regulatory details, but they matter a great deal.

Psychedelics are unlike many other mind-altering drugs. The primary concerns aren’t fatal overdose or addiction, but impairment and psychological harm. This will require new, tailored approaches to any legal use. Practices that mitigate risk could include screening and supervising users in a controlled setting and consulting with guides before and after the experience.

If decision-makers in Sacramento want to be deliberate — and avoid a potential public backlash that could once again stifle research — they could begin facilitating conversations with proponents of psychedelics, health officials, law enforcement and researchers.

For instance, the California State Legislature could hold hearings about how use and access is governed in other countries and traditions. Or, as he did with cannabis while lieutenant governor, Gov. Gavin Newsom could create a commission to assess regulatory options, paying special attention to the implications of allowing profit-maximizing businesses to get involved.

Letting psychedelics get on the ballot in California may not result in thoughtful or comprehensive regulation; instead the state could be stuck with poor policy with limited ability to fix it. If policymakers seek to shape these discussions, they may want to do so in a deliberate manner — and soon.

This story was originally published November 10, 2020 at 5:00 AM.