It’s Your Last Chance to Have a Say in What Oregon’s Psilocybin System Will Look Like

There are just six days left to weigh in on what the country’s first legal psilocybin program will look like—and public comment is open to everyone. The Oregon Health Authority (OHA), overseeing the rulemaking process, will hold three public hearing sessions from November 16 through 18, with the final day for written public comment on November 21st at 5 pm. The proposed rules are here (and there’s more info on them below to help people interested in getting involved). In addition to attending a virtual public hearing, people can email their comments to: [email protected]. 

Issues available for comment include: how much it will cost to become a licensed service provider, how your personal data is used, whether people other than licensed facilitators (such as shamans and friends) will be allowed to be present during a session, and whether people will be required to stay in service centers for a long period of time when given a dose of psilocybin that amounts to a microdose.

The current draft rules are the product of two years of work from a governor-appointed, volunteer advisory board, along with comments from the public and the Oregon Health Authority. Once finalized, the rules will determine the future of the next two years of Oregon Psilocybin Services, which will be available to people who do not live in Oregon and are visiting the state as well.

The implications extend beyond Oregon. Psychedelic advocates, government officials, and the public more broadly will be watching closely as other states look to follow. Colorado became the second state, after Oregon, to legalize facilitated psilocybin sessions last week, and will soon be moving into an implementation phase, too. 

Oregon voters legalized facilitated psilocybin sessions in 2020 through the passage of Measure 109. The measure allows adults 21 and over to legally take psilocybin at licensed locations under the guidance of a trained facilitator, without a diagnosis. There were a number of groups in the state who opposed the measure due to concerns about the high costs of services and the continued criminalization of underground guides and cultivators.

Oregon’s Psilocybin Services Act is not a decriminalization bill. Instead, Oregonians decriminalized the personal possession of small amounts of many illicit substances via Measure 110, which also passed in 2020. Under Measure 110, the personal possession of under 12 grams of psilocybin mushrooms is a misdemeanor, potentially punishable by a $100 fine. Neither Measures 109 nor 110 expressly decriminalize gifting and home cultivation of psilocybin mushrooms.

Read: How Oregon is Leading the Country in Drug Policy Reform

The Oregon Health Authority will begin licensing service centers, where the psilocybin sessions will take place, in January of 2023. Service centers will be open to the general public as soon as businesses can build facilities, access psilocybin products, and hire trained facilitators. 

These facilitated sessions differ from psilocybin-assisted psychotherapy, a federally-regulated therapy that requires approval and oversight from the Food and Drug Administration (FDA). Instead, Oregonians legalized “supported adult use.” Activists Tom and Sheri Eckert—architects of the bill—intended Measure 109 to be a “non-medical model.” 

Measure 109 requires clients to consume psilocybin onsite at a licensed service center, which employs trained facilitators. Any adult with a high school degree can become a licensed facilitator, so long as they pass a background check and complete a training program from an approved institution. 

Hot Ticket Draft-Rule Discussions 

The draft rules regulating Oregon’s psilocybin service industry are comprehensive; the current document spans 70 pages. The rules cover everything from legal dosages to informed consent to licensing fees—and everything in-between.

The following are some—but not all—of the issues local community organizers and activists have focused on for public comment. Further, the comments included in this article are just a small sampling of those who have worked on comments for Measure 109. We encourage you, no matter your perspective, to get involved in the public comment period to make your voice and ideas heard.

Equity and Access 

The accessibility and costs of services have been central topics of concern and debate throughout the rulemaking process. The Oregon Health Authority does not set the price for psilocybin services, yet activists, community members, and small business owners worry that the costs of meeting Measure 109’s regulations will limit access to psilocybin services for low-income and underserved communities. 

“The biggest equity discussions have involved a couple overarching concepts that will sound quite familiar,” says Dr. Rachel Knox, a physician who serves as co-chair of the Oregon Psilocybin Board Equity Subcommittee. “First is access–equitable access to opportunity on the business side of Oregon Psilocybin Services and access to local, affordable services on the other.” 

Knox told DoubleBlind that “there is much concern that historically excluded communities will remain excluded from OPS’ operator opportunities due to the sheer expense of preparing for licensure.” And this concern is present in all stages of the pipeline, from the cost of facilitator training to the cost of running sustainable manufacturing and service center businesses. 

The high costs associated with the program mean less diversity and limited representation for underserved communities among service providers. In turn, this affects clients, who may have trouble finding providers that align with their culture, language, and community traditions, as well as their racial, gender, and sexual identities and socioeconomic backgrounds. “This is ultimately a problem for clients as well, as I would be surprised to find that historically excluded communities seek psilocybin services at a greater rate than they are represented amongst licensees,” she says. “You understand the conundrum.”

Read: Native Tribes Should Have More Say in the Psychedelic Movement

Jon Dennis, attorney and host of the Eyes on Oregon podcast with Psychedelics Today, advocates for greater community access in Measure 109. He’s also the Executive Director of Vital Oregon, a training program founded by Psychedelics Today, and sits on the Chacruna Council for the Protection of Sacred Plants. From a legal perspective, he explains, “one of the main issues affecting affordability, particularly of the medium to higher dose sessions, is the facilitator-to-client ratio.” 

In the current rules, the number of clients a facilitator is legally allowed to monitor decreases with higher dosages of psilocybin. For example, there needs to be one facilitator present for every two clients taking 35 milligrams of psilocybin or higher. In contrast, the laws require a ratio of one facilitator to every 25 clients for those taking under five milligrams of psilocybin. 

“What it amounts to is a one-size-fits-all program that would lump tourist resorts and luxury tourist resorts into the same category as sincere religious communities,” says Dennis.

“What it amounts to is a one-size-fits-all program that would lump tourist resorts and luxury tourist resorts into the same category as sincere religious communities,” says Dennis. “The state really isn’t providing any flexibility for responsible communities to select an appropriate amount of facilitation that’s proportionate to the needs of a group.” He notes that for communities who are well-versed and experienced with psilocybin—like churches and cultural communities that historically use entheogenic plants—this ratio will drive up costs without necessarily increasing safety. 

Earlier this year, the board received attention for rejecting a proposal to create rules for “entheogenic practitioners” that use psilocybin. For millennia, psilocybin mushrooms and other plant medicines have been by indigenous communities. Entheogenic churches and other spiritual communities also use psychedelics in community settings, sometimes utilizing high doses. Yet, this type of cultural, religious, and spiritual use is not protected by Measure 109.

Licensing fees are another area of concern, says Dennis. “They attempt to give a 50 percent reduction in licensing fees to people who are on food stamps, on Social Security, or Medicaid,” he says. The fee reduction may be helpful for those hoping to become facilitators, he says, but this kind of reduction won’t help low-income individuals open service centers or become manufacturers. 

Even with equity discounts, the lowest licensing fee for manufacturers and service centers is $5,000. The lowest licensing fee for facilitators is $1,000.

Even with equity discounts, the lowest licensing fee for manufacturers and service centers is $5,000. The lowest licensing fee for facilitators is $1,000. These fees do not address the cost of training or other business startup costs. Veterans qualify for reduced fees, yet individuals with tribal affiliations do not. Spiritual leaders from indigenous cultures who historically use psilocybin fungi are still required to obtain a training certificate and pay a licensing fee under these draft rules. 

“For all these other low-income license types, it’s almost insulting,” Dennis continues. 

Some non-profit training programs are attempting to improve access by offering lower-cost facilitator training. “It’s very important to those of us who will be providing services to clients that we get these rules right and that we establish a final set of rules that will serve as the foundation of the program, deeply rooted in client safety and equitable access,” says Rebecca Martinez, founder and director of Alma Insitute, a facilitator training program serving systematically oppressed and low-income communities. “The program rules should include screening protocols that help reduce risk, empower choice, and center informed consent.”

Additionally, there is no specific language regarding additional guests during the administration, including musicians, performers, friends—or culturally-specific individuals like shamans, elders, or religious leaders. To attend an administration session, you’d have to be a client or a facilitator. There are no in-home options for people who cannot travel to a service center.

Personal Data Collection

Measure 109’s current draft rules allow facilitators and service centers to share “de-identified” data to outside sources “for research or other purposes,” which is distinct from standard data reporting for safety. There is currently no client opt-out option written into the rules.

“Many privacy experts believe there is no such thing as de-identified data,” says Mason Marks, law professor and Lead of the Project on Psychedelics Law and Regulation at the Petrie-Flom Center at Harvard Law School. Marks previously served on Oregon’s Psilocybin Advisory Board before moving out of state.

Measure 109’s current draft rules allow facilitators and service centers to share “de-identified” data to outside sources “for research or other purposes.” There is currently no client opt-out option written into the rules.

“Even after personal identifiers are removed, it is often easy to re-identify people who contributed the data,” he says. Potentially re-identifying data may concern some clients, as psilocybin remains illegal under federal law. 

Knowing this risk or re-identification, Marks says that the Oregon Psilocybin Advisory Board voted to warn clients with a statement on data collection, but the health authority did not follow the recommendation and deleted the board’s statement.  

Additionally, the draft rules allow facilitators to video record their administrative sessions, with consent. A service center must retain the video recordings for five years. No language in the draft rules requires a service center to delete the video recordings. Video recordings must be available to the Oregon Health Authority upon request.

Read: Consent is Psychedelic: Here’s Why

Microdosing 

The draft rules for Measure 109 currently require that individuals remain on-site for one hour when taking up to five milligrams of psilocybin. Five milligrams roughly equates to 0.5 grams of dried Psilocybe cubensis mushroom—although the amount of psilocybin in whole mushrooms varies from sample to sample. 

The need to stay on-site for sub-hallucinogenic doses—and also the need for a transportation plan after a sub-hallucinogenic dose—raises costs and decreases accessibility, advocates argue. Advocates suggest that one potential solution is creating another dosage category for two milligrams of psilocybin or less. 

Supportive Touch 

Sexual contact of any kind is prohibited between facilitators and clients. Sexual contact between facilitators and clients’ family members is also prohibited for one year following the last date of psilocybin service. This rule is unquestioned and is an essential safety and harm reduction measure included in the draft rules for Measure 109. 

Facilitators, however, may provide a “supportive touch” during administration sessions so long as the client has provided prior written consent and requested touch. The draft rules define supportive touch as “limited to hugs or the facilitator placing their hands on a client’s hand or shoulder.” The rules also state that “a facilitator shall not use any other forms of touch, nor permit another person to use any other form of touch during an administration session.” 

Some commenters suggest that limiting touch to this definition of “supportive touch” can be limiting. Practitioners trained in yoga, ecstatic dance, massage, and other modalities occasionally use consenting touch.

Read: Sexual Abuse in Psychedelic Therapy: Important Steps Being Taken to Support Survivors

Maximum Dosage

The maximum dose allowed by the OHA in the current draft rules is 50 milligrams of psilocybin, roughly equating to five grams of dried mushrooms. This dosage is what famed ethnobotanist Terence McKenna dubbed a “heroic dose.” The OHA draft rules require psilocybin clients to sign a consent form acknowledging that dosages of greater than 35 milligrams of psilocybin are not typically administered in clinical trials. Still, some argue that maximum dosage limits interfere with harm reduction efforts as folks who want to do more may just end up doing so without support.

Animals 

Under the current draft rules, no animals are allowed in licensed service centers. The only exception is service and support animals. 

Production Limits 

The draft rules place limits on the amount of psilocybin product manufacturers can produce. Currently, manufacturers can produce the “equivalent of up to 20 kilograms of dried mushrooms at a time. This amount is expected to allow a small number of large producers to supply the whole Measure 109 program,” but some in the state would prefer to see smaller limits to encourage more growers. “Smaller limits would encourage the proliferation of smaller craft producers,” says Dennis. 

How to Get Involved

OHA will accept public comment through November 21. You can email comments to [email protected].

“[The OHA] has to read everything that they get,” says Kayci Marie Mitchell, an integration coach and former president of the Portland Psychedelic Society. “All the emails that go in, they are required to read them.”

Mitchell, along with Heidi Venture, is also a co-organizer of the Oregon Psilocybin Services Collaborative Community (OPSCC). The OPSCC is a community group organized in late October to collaborate on public comment recommendations. Venture hopes to start a small service center in Hood River.

“I think that that was the thing that drove it is the sense of urgency, like, ‘Oh, geez, we need to get this information in, get as many people on board with speaking up about these really important issues and the draft rules’,” Mitchell told DoubleBlind. The group has 60 members in a Google Group. Mitchell and Venture announce meetings on MeetUp. “We want to be as inclusive as possible,” Mitchell says. 

Right now, says Venture, the community is mostly made up of small business owners, advocates, and potential clients. Mitchell says one of the big issues is that there are “all these different groups that have influence and are doing this work, but there’s no place where all of them can come together and collaborate.” Mitchell and Venture hope that OPSCC will be that space. 

The group worked together on a public comment document that includes specific changes the community identified as important. Those interested in collaborating in the future can view the comment documents and learn more about OPSCC’s process here. The Portland Psychedelic Society also hosts regular listening and information sessions with a variety of local groups and stakeholders in Measure 109. The OPSCC discusses many of the above hot-ticket items in more detail.

You can also attend or view a virtual public hearing with the Oregon Health Authority on one of the designated dates: 

• Tuesday, November 15th, from 6:00-8:00 p.m. PST
• Wednesday, November 16, from 12:00 PM-2:00 p.m. PST
• Thursday, November 17, from 10:00 AM-12:00 p.m. PST