NE states consider legalizing Psilocybin

Bills that could decriminalize psilocybin for therapeutic purposes are under consideration in several New England states.

Psilocybin is the primary psychoactive compound in magic mushrooms. Recent studies from Yale, Massachusetts General Hospital, Johns Hopkins and others have shown that, in a controlled therapeutic setting, psilocybin can be beneficial for a number of mental health issues such as post-traumatic stress disorder (PTSD), treatment-resistant depression, obsessive compulsive disorder (OCD), and alcohol and drug addiction.

Christopher Pittenger, MD, PHD, co-director of the Yale Program for Psychedelic Science, noted that while there is promising research evidence of psilocybin’s potential benefits, it is important to note that the studies were done under very controlled circumstances.

“People in the studies have a very clean [mental health] diagnosis, are usually low risk for psychosis, and are usually on no other psychiatric medications,” Pittenger said. “This is typical for early studies, because the more complicated a sample is, the harder it is to show that anything works.”

As psilocybin becomes decriminalized and moves out into more “real world” therapeutic settings, there will be more variables. While he does not foresee a high-risk of lasting problems or medical events, he cautioned this could lead to reduced benefits or more side effects. In a non-research setting, the dose of psilocybin may not be as exact and the drug itself may not be as pure. Still, the potential of the drug when administered by a medical professional is encouraging, according to Pittenger.

“We do know that when people use psilocybin or LSD recreationally, they report about 30 percent negative outcomes. When they use it in carefully controlled medical settings, [negative outcomes] are way lower,” Pittenger said. “But anecdotally, we’ve had people in our own studies who have tried psilocybin or LSD on their own and found it to be a little bit helpful for a few days. Then they’ve tried it with us and found it to be helpful for months.”

Bills in play

Oregon became the first state to decriminalize psilocybin in 2020. Five New England states currently have bills under consideration to decriminalize the drug for therapeutic purposes:
• In Rhode Island, H 5923 has passed the House; the Senate version of the bill — S 0806 — is being held for further study.
• In Vermont, H.371 has been assigned to a judiciary committee for review, with a report due in November 2024.
• In Maine, L.D. 1914 has been referred to the Committee on Veterans and Legal Affairs. A similar bill, L.D. 1582, passed the Maine Senate in 2022 but was rejected by the House.
• In Massachusetts, three bills related to decriminalizing psilocybin are under consideration — H 1754, S 1009, and H.3589. Six communities in Massachusetts (Somerville, Cambridge, Northampton, Easthampton, Amherst, and Salem) already have decriminalization measures in place.
• In Connecticut, H.B.6734 passed the House in May and moved to the State Senate for consideration.

In New Hampshire this spring, the House of Representatives killed HB328, which would have legalized possession of certain controlled substances — including psilocybin — for persons 21 and older.

Rep. Joseph “Chip” Troiano (D-Caledonia-2) introduced the bill to decriminalize psilocybin in Vermont this spring after looking at the research done on its therapeutic benefits and speaking with medical professionals. Troiano, a Vietnam combat veteran who suffers from PTSD, is encouraged by the clinical trials done by the U.S. Department of Veterans’ Affairs on the benefits of psychedelic medications for mental health and substance abuse.

“This is an important issue to me. There have been a lot of therapeutic modes for post-traumatic stress, and anything that doesn’t come out of a pill bottle is a [positive] to me.”

Rep. Brandon Potter (D-Cranston), who introduced the bill that passed the Rhode Island House, said he is in favor of drug decriminalization in general.

“I believe that the war on drugs has been a total failure,” said Potter. “We need to look at drug policies through a modern lens.”

Insurance and access concerns

Potter noted that one concern relating to psilocybin is ensuring that if it is decriminalized, everyone who needs it can access treatment. He is hopeful there will be an adequate number of clinicians in Rhode Island trained to administer psilocybin in a controlled setting if the bill to decriminalize it passes.

A major concern is the fact that psilocybin is not covered by insurance, because it is still a schedule 1 drug at the federal level and is not approved by the Federal Drug Administration.

“I don’t think state legalization will have any impact on insurance coverage,” Yale’s Pittenger said. “When or if it ever becomes legal at the federal level, that will be an interesting conversation with insurers. I’m concerned that psilocybin may be super effective, but the therapy and support that goes around the drug could be so expensive and difficult to access that it will be a boutique treatment for the wealthy.”

In other areas where it has been decriminalized, Potter said he has heard of therapists and mental health professionals charging rates as high as $6,000 to $10,000 for psilocybin experiences.

“It’s outrageous,” he said. “The last thing we want to do is create a treatment that would only be available to affluent and or privileged people.”