Postcards from the Rogue Valley

Here in Oregon, the tug of war between “progressives” and “patriots,” that sometimes plays out on the streets, shows up at the bottom of the election ballot, too. In 2018, it was the Militia Men that claimed a spot. This year, it’s the psychotherapists.

When I cast my first ballot as an Oregonian two years ago, I gasped when I saw a measure that would award residents in ten Oregon counties (including mine) the right to own firearms, including high capacity magazines, with no registration requirement. The measure deputized county sheriffs to decide whether state and federal gun laws were constitutional.  

Ah, the Wild West, I thought to myself.

The gun rights measure passed in eight of the ten counties (not mine), though all agreed it was largely symbolic. Whew.

This year, magic mushrooms are on the ballot. Measure 109 would set up a state-licensed psilocybin-assisted therapy system—psilocybin is the active ingredient in hallucinogenic mushrooms.

The push is not entirely from left field. Science (for those who believe in it) appears to be on the measure’s side. 

Over the past decade, research at several prominent universities, including Johns Hopkins and Oxford, has shown psychedelics may be a better way of helping people with treatment-resistant depression, anxiety, addiction and PTSD. Doctors treating terminally ill patients are finding that psilocybin can offer a new way of coming to terms with death.

Recently, the U.S. Food and Drug Administration granted “breakthrough therapy” designation for psilocybin.   

Supporters for Measure 109 include the Democratic Party of Oregon, the Veterans of Foreign War, the ACLU, even the California soap manufacturer Dr. Bronner, who has committed $2 million to the measure, saying modern pharmaceuticals often fail to help people.

“Psychedelic-assisted therapy is life-saving medicine that the world needs now, especially highly traumatized populations like veterans, first responders and marginalized communities generally,” said Bronner.

The measure has no significant public adversaries.

A secret history

In his book, How to Change Your Mind, non-fiction writer Michael Pollan (perhaps best known for saying “Eat food. Not too much. Mostly plants.”) describes research  on LSD eight decades ago. It was first synthesized (from a grain fungus) in 1938 by a chemist in Switzerland. After accidentally dosing himself, with apparently spectacular results, the chemist spent the next decade sending out free samples to researchers on request. A 2018 NY Times review of Pollan’s book recaps Pollan’s story:

By the 1950s, scientists studying LSD had discovered serotonin, figured out that the human brain was full of something called neurotransmitters and begun inching toward the development of the first antidepressants. LSD showed such promise in treating alcoholism that the A.A. founder Bill Wilson considered including LSD treatment in his program. So-called magic mushrooms — and the mind-altering psilocybin they contain — arrived a bit later to the scene, having been reintroduced to the Western world thanks to a 1957 Life magazine article, but they proved just as rich in therapeutic possibilities.

All this ended thanks to the antics of Timothy Leary and other self-styled prophets of acid. By 1970, LSD had been outlawed and declared a Schedule 1 substance. Countercultural vanguards didn’t stop taking LSD, and “bad trip” entered the English lexicon. Psychedelics, it was concluded, sundered rather than opened minds, and any research that suggested otherwise was buried. Pollan describes several addiction scientists in the 1990s and early 2000s rediscovering early psychedelic studies and realizing the field to which they’d devoted their professional lives had a fascinating secret history. Before long, these taboo substances once again seemed less a malign narcotic than a potentially powerful medication.”

How psilocybin works

In the past couple of years, scientists have begun to understand how psilocybin changes the brain. There’s no reset button on your brain, they explain. Magic mushroom may be as close to a reset button as we can get. 

During your average day in the human brain, neurons are constantly firing and neurotransmitters are traveling well-trodden paths through the brain, somewhat like cars on a freeway, explains science writer Emma Betuel. A recent article in the Proceedings of the National Academy of Sciences describes how on magic mushrooms, those paths or networks are “destabilized.” 

Previous research suggests that new networks appear in tandem with this destabilization. “It’s as if those cars on the freeway were given free rein to stray from the highway and take back roads towards new destinations,” says Betuel.

The drugs foster new perspectives on old problems, Michael Pollan believes. 

“One of the things our mind does is tell stories about ourselves. And if you’re depressed, the stories may be that you’re worthless, that no one could possibly love you, that life will not get better. These stories trap us in ruminative loops that are very destructive patterns of thought.”

How do the drugs intervene? They disable for a period of time the part of the brain where “the self talks to itself.” They dissolve the self or ego, helping the person realize that they needn’t be trapped in those stories, that they might actually be able to write new stories about themselves. This seems to be true for people suffering from PTSD and addiction as much as depression.

Evidence supporting the efficacy of guided psilocybin therapy with terminally ill patients is also mounting. In one of the most moving sections of How to Change Your Mind, Pollan describes a dying cancer patient named Patrick Mettes, who sat up during his psychedelic treatment and said, “Everyone deserves to have this experience.” Mettes’s widow later described to Pollan the scene at her husband’s deathbed: “He was consoling me.”

More startling, it appears that the positive effects are both immediate and long lasting. In a landmark 2016 study, researchers at NYU Grossman School of Medicine found that a one-time, single-dose treatment of psilocybin, with a trained psychotherapist, was associated with significant improvements in emotional and existential distress in cancer patients. Assessing these patients nearly five years later, the NYU researchers found that the positive effects persist. 

Not DIY

Supporters of Measure 109 are at pains to point out that it differs dramatically from Measure 91, the 2014 vote that made Oregon the first state in the nation to legalize cannabis. It does not allow people to buy psilocybin and take it home, nor to consume psilocybin without guidance or oversight from a trained mental health therapist.

“Dosing” with marijuana (and CBD) is strictly DIY.

Measure 109, it’s important to note, does not decriminalize psilocybin, a schedule 1 drug under federal rules and not approved for any medical uses. Instead, it puts forward a two-year process to set up a system to regulate its use.

People wanting to go through psilocybin-assisted therapy would not have to be ill, the measure says. (No doctor referrals required!) However, therapy recipients would have to go through a three-step process: a screening for risk factors (e.g., schizophrenia), a supervised therapy administration session, and an evaluation following the session

The measure is not expected to directly cost taxpayers, because it calls for psilocybin to be taxed to pay for the regulatory program. If psilocybin-assisted treatment proves successful, supporters say, it could eventually save the state money currently spent treating chronic conditions.

Different strokes

Included in Measure 109’s fine print, though, is language that could give not only “patriots” but also some “progressives” pause. It suggests that applicants could include people wanting to take the drug for spiritual reasons or if they are simply seeking a hallucinatory experience. 

Indeed, the creation of a legalized psilocybin-assisted therapy program in Oregon could generate tourism in the state, some supporters speculate. At least one psilocybin business has already moved some operations to Oregon. Synthesis runs psilocybin truffle trips in Amsterdam and its co-founder Myles Katz recently moved to Portland to support Measure 109. 

“There are movements around psychedelics happening around the world in a lot of different ways … ” Katz said. “And the Oregon initiative, it is the best framework.”

Kevin Sabet, a former drug policy advisor for Presidents Clinton, Bush and Obama and professor at Yale has weighed in too.  “Medical research should not be the purview of a popular vote,” Sabet recently said. “This isn’t elementary school choosing a class president. This is life and death for people.”

The larger picture

I opened this post with two Oregon memes: “progressives” and “patriots.” The hit mini-series “Portlandia” (which I’ve never watched) might be, for some, a stand-in for progressives and the Proud Boys (which I’ve never met) a poster group for patriots. Missing, though, is a face no one wants to popularize: Oregon’s chronic addicts. 

Ironically, just as the legalization of marijuana and celebration of CBD have brought new opportunities to Oregon’s small farmers, pockets of rural poverty, spreading homelessness, and youth unemployment have produced one of the highest rates of substance abuse of any state in the country. And with so little money allocated to it, Oregon is among the toughest places to get treatment. (Compare this with the 87 registered massage therapists in Ashland.)

Measure 110, also on the 2020 Oregon ballot, would erase criminal penalties for personal use amounts of drugs like cocaine, methamphetamine, and heroin. Tax revenues from drug sales would underwrite drug treatment. It would be one of the most radical drug-law overhauls in the nation’s history—and the most controversial.

“Oregon is far from alone in stepping out onto new terrain” when it comes to drugs, an October 26 article in the NY Times notes—although it may be travelling way farther than others.

Legal marijuana, stalled for years in politically conservative states even as more left-leaning areas plowed ahead, has found a place on the ballot this year in Arizona, Mississippi, Montana and South Dakota. National groups that have long dreamed of a federal overhaul of drug laws say that success in those states could bring Republican elected officials into Congress with constituents who have said yes to legalization, potentially tipping the balance in Washington.”

For the mental health professionals in Oregon championing magic mushrooms, the hopes are close to home. “Measure 109,” the campaign leaflet argues, “provides Oregonians access to a breakthrough therapy for anxiety and depression that offers hope and healing.”

Hope and healing. We can certainly use more of both.

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