fingers gripping psilocybin mushroom by stem

Hope in Unlikely Places

After Decriminalization, What’s Next for Colorado and Magic Mushrooms?

In 2019, Denver voted to become the first city in the U.S. to decriminalize psilocybin, also known as magic mushrooms. Initiative 301 passed narrowly with 50.6% of the vote after appearing to fail the night before.

This initiative directs law enforcement to treat psilocybin possession as their lowest priority. It further restricts the use of city resources to enforce criminal penalties.

Below, we’ll talk about what this means for Colorado workers, firefighters, and first responders. We’ll also address the initiative’s broader implications within the medical community, as early research suggests psilocybin may be an effective treatment for depression, anxiety, and post-traumatic stress.

What This Means

Since its passing, many people are wondering what the initiative might mean for employers. While based on a 2007 measure that decriminalized marijuana possession, 301 is not taking the same path.

The leaders of Decriminalize Denver, the group behind the initiative, told KUSA “We are not talking about a regulatory framework, we’re not talking about a recreational framework at all.”

<img src="mushroom.jpg" alt="psilocybin mushrooms growing in nature">

Naturally, there have been some misconceptions about this initiative. For one, this does not mean psilocybin mushrooms are legal in Denver. They remain classified as a Schedule 1 narcotic under federal law, making them illegal to sell or possess.

This is also the case under state law, which means employees and employers should continue business as usual.

The main argument, according to Decriminalize Denver, is that possession of this drug should not be a crime since it is non-addictive, among the least toxic controlled substances, and has medicinal potential.

However, critics are worried that this measure is mirroring what occurred with marijuana legalization, which went through two decriminalization votes in 2005 and 2007.

The results were very similar—with reformers viewing the votes as a pathway to legalization. Critics worry the discussion around psilocybin furthers the city’s “drug-friendly” reputation, potentially drawing the wrong people to the city.

One major outcome of this initiative is the creation of an 11-person “policy review panel” to review, assess, and report on the effects of this ordinance.

According to the Denver Post, this panel will comprise of city councilors, law enforcement, a defense attorney, prosecutors, addiction counselor, and others still to be determined.

Other Cities and States Following Suit

While Denver became the first city to decriminalize psilocybin, others have taken steps to do the same. In June, Oakland, California became the second city to decriminalize psilocybin.

Their City Council voted unanimously to decriminalize the adult use and possession of psilocybin and other psychotropic plants and fungi, including peyote and ayahuasca.

<img src="prescription bottle" alt="psilocybin inside orange prescription bottle">

This vote occurred after a group of speakers testified that psychedelics helped them overcome depression, drug addiction, and PTSD.

As with Denver, this measure means that no city funds could be used to enforce laws, and that the Alameda County District Attorney would stop prosecuting people who have been arrested for use or possession.

The activist group Decriminalize California regards this as a milestone in their own statewide effort for decriminalization. The group has campaigned in major cities to recruit volunteers and mobilize the movement.

Oregon is also leading the charge when it comes to moving toward statewide decriminalization.

Proponents of this issue are gathering signatures for a ballot referendum for 2020 which seeks to create a framework for legal access to psilocybin-assisted therapy.

According to their mission statement, the initiative envisions a “community based framework, where licensed providers, along with licensed producers of psilocybin mushrooms, blaze trails in Oregon in accordance with evolving practice standards.”

Breakthrough Therapy Status

Recently, Compass Pathways, a company focusing on mental health treatment, received Breakthrough Therapy Designation from the US Food and Drug Administration (FDA) to continue research on psilocybin.

This was due to clinical evidence showing the drug, coupled with therapy, may provide substantial benefits over other available treatments.

<img src="depression" alt="silhouette in sitting position fading away">Selective Serotonin Re-uptake Inhibitors (SSRIs) are the most common type of treatment path for individuals suffering from depression and other illnesses, but psilocybin may prove to be a more effective alternative to current pharmaceuticals.

Currently, psilocybin is undergoing two separate phase II clinical trials. These trials are studying single-dose use as a treatment in patients with major depressive disorder.

Researchers are also analyzing the use of psilocybin in those with treatment-resistant depression. Both studies are looking at the safety and efficacy of the drug.

Researchers at Johns Hopkins published the results of their study of the safety of psilocybin in 2018. They suggest that if it clears phase III trials, psilocybin should be re-categorized to a schedule IV drug.

Psilocybin is now Schedule I, which means it has no medical potential. Heroin is another example of a Schedule I drug. Schedule IV drugs include prescription sleep aids.

Psilocybin and PTSD Treatment

These developments hold tremendous promise for first responders.

In a survey of 26 agencies across Virginia, eight percent of first responders reported experiencing recent thoughts of suicide, and those with suicidal thoughts were more susceptible to having a negative reaction to traumatic experiences.

In addition, almost one in four reported experiencing depression as a result of their line of work.

These results indicate a correlation between public safety work and the development of trauma-related illnesses, the latter of which psilocybin-assisted therapies looks to alleviate.

<img src="first responder" alt="firefighter PPE leaning on fire engine">

According to Medical News Today, psilocybin is a hallucinogen that works by activating serotonin receptors in the prefrontal cortex. This part of the brain affects mood, cognition, and perception.

Possible effects include: euphoria, peacefulness, changing emotions, distorted thinking, and more. These effects vary between people. Psilocybin is not chemically addictive and no physical symptoms occur after stopping use.

According to a study from Imperial College London on psilocybin, patient-reported benefits last up to five weeks after treatment. The current belief is that psilocybin may reset the activity of brain circuits that play a role in depression.

Through the use of MRI imaging, researchers revealed reduced blood flow in areas of the brain, including the amygdala, which is a small region in the brain known to be involved with processing emotional responses such as stress and fear. They also noted an increased stability in another brain network that is linked to depression.

This research indicates that psilocybin can be used to treat PTSD, a disorder linked to the brain’s fear response. In a 2013 study, researchers trained mice to fear an auditory tone by following it with an electric shock.

The mice’s fear was documented as they were observed to be immobile for prolonged periods of time, similarly to PTSD victims as they react to trauma.

Once the mice were conditioned, they were split into three groups—one was given a small dose of psilocybin, one a large dose, and the third was given saline.

The mice were then exposed to the tone again, and the mice that received the low dose of psilocybin were the most successful in overcoming the fear response.

Depression and Anxiety Treatment

In 2018, researchers at Johns Hopkins urged the federal government to make psilocybin legal in clinical settings, citing studies showing psilocybin’s effectiveness in treating depression and anxiety.

Currently, traditional treatments for those illnesses are often rife with side effects or wholly ineffective. That has led researchers to pursue psilocybin and other alternative treatments.

<img src="researcher" alt="researcher writing notes about drug trial">

In 2016, a study looked at 29 cancer patients who reported feeling depressed or anxious due to their diagnosis. The patients went through psychotherapy and received a small dose of psilocybin or niacin.

Patients who received psilocybin had an immediate reduction in both anxiety and depression. This was still the case at a six month follow up, even with only one dose.

In another study, researchers gave 36 mentally and physically healthy patients a 30 mg dose of psilocybin. At a two month follow up, 50% said psilocybin improved their well being moderately. Another 29% said it improved their satisfaction “very much.”

These early trials show promise for people suffering from anxiety and depression (both of which factor into the diagnosis of PTSD), especially considering the current depression treatments on the market today, which can take weeks to work and might not target all symptoms.

In fact, according to a 2015 report from the National Institutes of Health, only about 40 to 60 out of 100 people notice an improvement in depression symptoms after using antidepressants for six to eight weeks.

Beyond Psilocybin

There has also been news regarding the use of Ketamine and MDMA (ecstasy) to treat severe depression and PTSI, respectively, in conjunction with therapy.

Recently, Esketamine, a chemical cousin to Ketamine, has been found to reduce depression symptoms in patients within hours, based on the results of two studies done on suicidal patients.

<img src="therapy" alt="doctor and patient in therapy session">

These studies are being used in an attempt to win FDA approval for treating depressed patients who are also suicidal, a high-risk group that are often excluded from clinical trials.

In March, the FDA took a step forward by granting approval for treating severely depressed patients who didn’t respond to other drugs. This represented the first new type of depression drug since 1988 when Prozac arrived on the market.

In 2017, MDMA was granted Breakthrough Therapy Status by the FDA and is now undergoing phase III clinical trials in an effort to treat PTSD, despite its current listing as a Schedule 1 controlled substance within the US.

After the conclusion of the phase II trials, researchers found that 54% of patients who took MDMA in conjunction with psychotherapy have improved to the point that they no longer fit the diagnosis for PTSD.

On top of that, the benefits of treatment appeared to increase over time. A year after the conclusion of treatment that initial percentage rose to 68%. If it clears all clinical trials, MDMA will be the first new drug to treat PTSD in 17 years.

Takeaways

Since Initiative 301 passed in Denver, the city has not prosecuted anyone for the possession of psilocybin. In previous years, the city averaged about 52 arrests per year.

As mentioned above, psilocybin remains illegal to possess according to federal and state law. Employers are still expected to observe these laws, as well as their current internal drug policies.

Denver’s appointed “policy review panel” has yet to issue any advice, but the city has taken a big step in de-stigmatizing psilocybin and its potential medicinal uses.

As a result, other states appear ready to have similar conversations about its efficacy and risks. This, in turn, could have influence on the federal level and open the door to further research.

More importantly, it could offer relief to those that suffer from PTSI, anxiety, and severe depression.

 

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