Oregon’s psilocybin industry will focus on fine-tuning first-in-the-nation program in 2025

By Mike McInally, Oregon Capital Chronicle

SALEM, Ore. (KTVZ) -- Advocates of psilocybin treatment say 2024 was the year when Oregon’s psychedelic program started to stand on its own.

This was the first full year of the program. Hundreds of specialists are now trained to guide patients in supervised psychedelic trips in Oregon. And thousands of people have gone through treatment with few ill effects.

In 2025, the industry will focus on fine-tuning the program and closely studying the impacts and outcomes of the state’s first-in-the-nation psychedelics program, according to a briefing this week by Oregon’s Healing Advocacy Fund, a nonprofit organization that works to expand state-regulated access to psychedelics.

Psilocybin is a naturally occurring psychedelic compound found in over 200 species of mushrooms. Research suggests that psilocybin may help address depression, anxiety, trauma and addiction.  The Food and Drug Administration has designated psilocybin a breakthrough therapy for the treatment of depression.

Oregon voters in 2020 approved a ballot measure allowing the use of psilocybin in clinical settings. The Oregon Health Authority, the state agency in charge of the program, spent years working out the details, and the first psilocybin service centers in Oregon opened in the summer of 2023. This year marks the first full year that the service centers have been open.

Heidi Pendergast, the Oregon director of the Healing Advocacy Fund, said 31 licensed psilocybin service centers have set up operations throughout the state, most of them near Interstate 5. As of Dec. 11, 356 psilocybin facilitators had been licensed by the state. By the end of the year, about 8,000 clients will have gone through a psilocybin session.

“We know a lot of people are utilizing psilocybin for mental health issues from depression to PTSD, sometimes just for grief,” Pendergast said.

Military veterans are able to access psilocybin for the first time in the U.S., she said, and the Healing Advocacy Fund has partnered with the Heroic Hearts Project, which connects veterans with psychedelic therapy programs. Eight cohorts from the project have received psilocybin therapy in Oregon.

Of those 8,000 clients who have received the therapy, she said, five required some sort of emergency call after taking psilocybin. 

“I think it does speak to the training, the regulation, the screening and, really, the process that OHA has developed that that number is so small,” Pendergast said.

Problem of cost and availability

Statewide access and affordability remain issues, she said. A quick check of licensed service centers on the health authority’s website didn’t find any located east of Bend — eastern Oregon counties all voted in 2020 against Measure 109, which allowed the health authority to establish a licensing program and regulate the drug, which can only be used in approved facilities . 

And psilocybin therapy can be costly – an individual session might run $1,000 or more, Pendergast said, although group sessions might cost less. Insurance doesn’t cover the therapy — in part because the compound still is illegal federally but also, she said, because insurers are awaiting more evidence on its efficacy.

Additional evidence beyond studies done by researchers at Johns Hopkins University in Maryland and elsewhere might also help persuade other counties and communities in the state to think about allowing psilocybin services, participants at the briefing said. In the November election, voters in more than a dozen Oregon cities, including in the Portland area, voted to ban the regulated sales and use of psilocybin mushrooms. 

“One of the reasons that some of these jurisdictions cited as not wanting these services in their regions was a lack of evidence,” said Adie Rae, co-director of the Open Psychedelic Evaluation Nexus, a research and evaluation effort that seeks to measure the impact of legal psychedelic services in Oregon. The effort is housed at Oregon Health & Science University.

Rae said the effort is recruiting volunteers for a study that will follow clients for up to a year after their psilocybin therapy. She said the research will benefit not just people considering the therapy, but also help legislators in crafting further policy and insurers considering coverage. 

Preliminary results of the research should be available as early as the first quarter of 2025, she said. 

The 8,000 people who have received psilocybin therapy in Oregon provide a rich field of potential study subjects, said Pendergast, adding that the number is “three times the number of clients served in all (previous) psilocybin clinical trials combined. This is absolutely monumental.”

Advocates said they will be approaching the state Legislature next year with a “Psilocybin Program Improvement Bill.” The bill likely would include legal protections for licensed health-care providers who discuss psilocybin service with their clients. 

The bill also is likely to include a “dual licensure” provision, which would allow health care providers who also are licensed psilocybin facilitators to participate in both the preparation session that comes before a client ingests psilocybin and the “integration” session, which comes after the experience. In the integration session, the client works with the facilitator to integrate insights from the psilocybin experience into daily life. Under dual licensing, for example, clients could have their own licensed therapists sit in on both the preparation and the integration sessions. 

The dual licensure provision would allow for “continuity of care” with a client’s longtime health-care providers, said Tal Sharabi, a licensed psilocybin facilitator at Portland’s InnerTrek, and a licensed professional counselor.