Push to legalize psychedelics in Mass. met with caution

AP PHOTO/STEVEN SENNE

AP PHOTO/STEVEN SENNE AP PHOTO/STEVEN SENNE

By RUIHAN YANG

For the Athol Daily News

Published: 05-27-2024 11:42 AM

A ballot initiative and a proposed substitute version are pushing for the legalization of psychedelics in Massachusetts within the next year, but opponents said “it’s too premature.”

The ballot initiative promoted by Massachusetts for Mental Health Options, an organization affiliated with the Washington, D.C.-based New Approach PAC, could soon be put on November's vote. The initiative would allow Massachusetts voters to determine if the state should legalize, regulate, and tax certain psychedelics for therapeutic use. It also proposes the creation of a new regulatory commission to facilitate access to natural psychedelics. 

In 1970, the United States Drug Enforcement Administration passed the Controlled Substances Act. This statute legally classified and banned a variety of drugs including psilocybin, the psychoactive drug found in Psilocybe mushrooms. 

“Psychedelics didn't magically solve all my problems, but they were the key to unlocking parts of my brain itself that I couldn't access before,” said Emily Oneschuk, a U.S. Navy veteran and the grassroots campaign director for MMHO, before the public hearing on the ballot initiative last month. “This won't fix their whole system, but it will help people and it's an important piece in a complex solution. Massachusetts needs more mental health options, which is why I strongly endorse this initiative. ”

Meanwhile, the opponents to the ballot questions — Bay Staters for Natural Medicine, New England Veterans for Plant Medicine, and Parents for Plant Medicine — requested an alternative ballot question to lawmakers, calling for a psychedelic ballot question to be changed to protect the affordability of future treatments. 

According to a document provided by Colomba Klenner, communication director of Bay Staters, the common price point for individuals to access facilitated experiences could be $3,500 excluding the cost of lodging and travel, which can add thousands in expenses. 

“If it costs thousands of dollars, like the PAC wants it to, like they've created in Oregon, then people won't have access to that quality advice on how to have the best experience for them,” said James Davis, founder of Bay Staters for Natural Medicine.

“The biggest drawback of access to psychedelics is that people just need education on how to use them safely. And if that education costs thousands of dollars, a lot fewer people are going to have access to it.”

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Despite opposing the ballot initiative, Davis said they have long supported the legalization of plant medicines because it “saved people’s lives.”

“A lot of people who don't formally have depression, don't have a diagnosable problem can still benefit a lot from psilocybin. Spiritually, it can help us process grief because we all lose people we love. Life is short for everybody, even for people who don't have diagnosable PTSD. We're trying to design a program that's flexible and still offers services to people who don't have a formal mental illness.”

Potential harms not ‘well-understood’

Jerrold Rosenbaum, director of the Center for the Neuroscience of Psychedelics at Massachusetts General Hospital, said the situation is “nuanced.” 

“Given the many millions of people that have used psychedelics, and many of them who have testimonials to describe their experience as positive in some cases, it doesn't seem appropriate for governments to limit people's access to that experience or to criminalize it,” he said. “But they do have the potential for harms that are not entirely well-understood.”

John A. Fromson, the president of the Massachusetts Psychiatric Society, and associate professor of psychiatry at Harvard Medical School, said psilocybin has “a significant optimism and excitement” within the scientific medical community as it can be helpful for mood disorders. However, the results of treating PTSD and depression with these agents are “not yet conclusive.”

“We really don't know enough about dosing, limitations, and guidelines, and how it fits in with the overall treatment plan that includes therapy and other supports that this ballot initiative calls for, and short and long-term long term side effects,” he said. 

Nine communities in Massachusetts have passed measures legalizing psychedelics, Somerville being the first. Davis said the “sky doesn’t fall.”

“When people have decriminalized access, when people can grow and share their own, there’s been no incidents of people having bad experiences,” he said. “It’s just people finally able to talk about this openly with their friends, loved ones, their therapists, their doctor. It just means that people are able to not face as much stigma and waiting to give it a try to grow and work on themselves spiritually.”

Anthony Rothschild,  professor of psychiatry at UMass Chan Medical School and editor-in-chief of the Journal of Clinical Psychopharmacology, said psychedelics is an “exciting” area of research, but it will be a “huge mistake” to make it legal because the side effects are not clear.

“There are side effects from these drugs. They can range from mundane things like having a headache to more serious things like people becoming psychotic during the administration of the medication,” he said. “We don't understand fully all their side effect profile. That's why we're studying them.” 

MDMA to get federal review

One psychedelic drug, MDMA, also known as Ecstasy, used in combination with therapy to treat PTSD, was submitted to the FDA for approval. Rothschild said that at present, there are no approved pharmacological treatments for PTSD, but the data indicates that MDMA-assisted therapy effectively addresses this condition.

“There isn't really like one medication that really can treat the whole thing; instead the treatments are more psychotherapy right now for PTSD,” he said. “If the FDA approves MDMA in August or September, it would mean a lot for the treatment of people with PTSD.”

MDMA would be the first treatment of its kind. Rothschild added it's necessary to have trained therapists for the administration of MDMA, and he hopes the treatment can be approved in the manner it was studied.

“Just to emphasize, it's done with a trained therapist,” he said. “It would probably only be administered by certain centers that had permission to do it and it would have to do it with the trained therapists and so forth. If you could just walk into a store like you buy cannabis and take it home, there's going to be no trained therapist presence if something goes wrong.”

He added that apart from PTSD, many people support legalizing psychedelics to treat depression and anxiety, but the efficacy of these substances in treating these disorders is still in question. 

“We don't know whether they work, except maybe in PTSD,” he said. “But we don't know if it works for depression, we don’t know if it works for anxiety, and I suspect that people want this to be legalized or trying to self-medicate themselves for those kinds of conditions, but I don't know [about the effectiveness].”

Rosenbaum said he anticipates that there will come a time when psychedelics will be available to people, but it would require a lot of preparation, and access to sites that allow individuals to experience these things safely.

“It'll be complicated and it will require a lot of spots to protect the vulnerable, and make sure that we don't face unintended consequences,” he said. 

The psychedelic initiative petition was heard last month. A special legislative committee declined to act on it, meaning supporters must collect an additional 12,429 voter signatures to win a spot on the November ballot. That decision eliminated the potential for a substitute question proposed by Bay Staters for Natural Medicine.

Ruihan Yang writes for theAthol Daily News from the Boston University Statehouse Program