Psylocibin, a substance found in some mushrooms, is among the substances that may have a pathway to legalization in California. (Shutterstock photo)

Psychedelic Therapies Show Promise. Is California Ready to Bring Them Into the Mainstream?

Back CalMatters Aug 31, 2023 By Ana B. Ibarra, CalMatters

Psychedelics are having a moment. A nationwide push to bring magic mushrooms and other psychedelics into the mainstream is gaining traction, and some Californians want in.

While hallucinogens are often associated with the drug culture of the 1960s, today’s movement on psychedelics is largely about using them to help treat the nations’ ballooning mental health crisis. Growing research portrays the drugs as a promising tool in helping people heal from various mental illnesses, including depression and post-traumatic stress disorder. 

Now several proposals floating around in California seek to make psychedelics more accessible for therapeutic and personal use. These include one legislative proposal that would decriminalize use of certain natural hallucinogens and two pending initiatives for next year’s ballot, one that would legalize the use and sale of psilocybin mushrooms and a second that would fund a $5 billion agency to research and develop psychedelic therapies.

One recent UC Berkeley survey offers a glimpse of where the public currently stands on these types of reforms. For example, more than 60% of those surveyed supported psychedelics for therapeutic use. Seventy eight percent supported making it easier for researchers to further study psychedelics. Meanwhile, 49% said they supported removing criminal penalties for personal use. 

Some researchers, doctors and parents urge caution around personal use because psychedelics aren’t for everyone and potential risks are still not all that well understood. Use of these substances should be done with safeguards in place, they say.

The bill to decriminalize plant-based psychedelics faces a key test this week at a hearing that could determine whether it moves forward this year. Senate Bill 58, by Sen. Scott Wiener, a San Francisco Democrat, would ensure that people do not get arrested for possessing and ingesting specified quantities of psilocybin and psilocin, the psychoactive ingredient in hallucinogenic mushrooms; mescaline, found in peyote; or ibogaine and dimethyltryptamine, or DMT. 

The bill does not, however, legalize the sale of any of these substances.

“A huge number of people right now in California are using psychedelics, despite the fact that it is banned,” Wiener said during an Assembly Health Committee hearing last month. 

Decriminalizing these substances, he argued, promotes responsible use. “If you think you’re doing something wrong, you’re less likely to seek information or talk to someone about how to be safe,” he said.

His bill would also order the state’s health agency to form a workgroup that would make recommendations regarding supervised medical use of these psychedelics — although any psychedelic-assisted therapies first need approval from the U.S. Food and Drug Administration. 

This is the second time Wiener has tried to decriminalize psychedelics; the first failed last year. This time around his bill is more narrow in that it excludes synthetic psychedelics, such as LSD. 

If Wiener’s bill makes it through the Legislature and across the governor’s desk, California would follow Oregon and Colorado, where voters have already decriminalized psychedelics. Some cities in the Golden State are a step ahead — Oakland, San Francisco, Santa Cruz and most recently Berkeley, have already passed measures that order law enforcement to back off arresting people for using plant-based psychedelics. 

Benefits and risks of psychedelics

Supporters of decriminalization point to promising data about some psychedelic-assisted therapies now in end stages of clinical trials, such as the use of MDMA (commonly known as ecstasy) to treat symptoms in patients with post-traumatic stress disorder. 

Additionally, psilocybin, found in hallucinogenic mushrooms, is being studied for treating depression. For example, early data from The Johns Hopkins Center for Psychedelic and Consciousness Research, has shown that psilocybin therapy can reduce major depressive disorder symptoms for up to a year. 

Wiener has taken combat veterans and retired first responders to testify before the Legislature about their “transformational” experiences using psychedelics to help relieve suicidal thoughts and PTSD symptoms.  

According to the U.S. Veterans Affairs Department, about 6% of the U.S population will have PTSD at some point in their lives. About 1 in 5 adults live with a mental illness, according to some national estimates. 

Researchers believe public attention on the worsening mental health crisis during the COVID-19 pandemic may also play a role in this renewed interest in psychedelics. 

“Suddenly you’ve got this discussion about mental health issues in a way that, at least in American culture, we really hadn’t been discussing,” said Jennifer Mitchell, a neurology professor at the University of California, San Francisco who has been working on the development of psychedelic therapies and collecting safety data.

Mitchell opposes Wiener’s decriminalization bill because she believes access to psychedelics for therapeutic use should come before personal use. 

“If you take a drug and think you can fly, you’re capable of self harm. If you take a drug and think you can breathe underwater, you are capable of self harm.”

Jennifer Mitchell, UCSF neurology professor

Currently, psychedelics are only allowed for clinical research. If and once therapies are approved by the FDA, those lessons, she argues, could then help inform safety guidelines for personal access.

“[Psychedelics] are actually exceedingly safe physiologically; psychologically, is where we get into trouble,” Mitchell said. “Because if you take a drug and think you can fly, you’re capable of self harm. If you take a drug and think you can breathe underwater, you are capable of self harm. And those are the types of reasons why when you take a psychedelic, we want you to be in a facilitated environment where you’re being watched and well maintained.”

A California mother’s campaign

One powerful voice opposing Wiener’s bill is a coalition led by mothers who have lost a child to an adverse reaction after ingesting psychedelics. Kristin Nash, for one, has widely shared the story of her son who died 21 months before his college graduation. In blogs and Op-Eds, Nash has shared that in 2020, Will took two grams of psilocybin mushrooms and in his altered state mistook a jar of protein powder for a water jug and suffocated.

Nash now runs a foundation named after son, William, through which she works to raise awareness and advocates for harm reduction efforts, such as better tracking of adverse reactions and training for college campus responders. Nash said she is not against allowing veterans and others to use these substances for treatment, but she’d like to see Wiener’s bill amended so it includes safety measures for personal use.

Nash, who also has a background in public health and most recently worked at an AIDS nonprofit, is a participating author in a Stanford-led study (yet to be peer reviewed), that showed emergency room visits in California linked to hallucinogens jumped 84% from 2,260 in 2016 to 4,161 in 2021. But that data includes a spectrum of substances, from plant-based psychedelics to MDMA and ketamine. Authors note that currently data is collected in a way that makes it difficult to comb for specific substances. 

“I don’t believe people should be arrested for possessing and using mushrooms,” Nash told CalMatters. “These are being used whether we legalize them or not. And so I would argue that we need these safeguards. When we make this policy shift, we know that use will increase further, that adverse events will increase further, and so I feel like we don’t have to choose between social justice, equitable access and safety, we can do all of those things.”

Mushrooms on the ballot

California voters may hear more about psychedelics next year even if Wiener’s bill fails as advocacy groups attempt to qualify ballot initiatives for the November 2024 election.

One group, Decriminalize California, is looking to legalize hallucinogenic mushrooms. Its proposal goes further than Wiener’s bill by legalizing not only possession, but also the sale and commercialization of these substances. If approved by voters the measure would go into effect in January 2025.

“Originally we wanted to go for all psychedelics, but the problem was there wasn’t enough public comprehension about what else was out there,” said Ryan Munevar, campaign director at Decriminalize California. Noting that voters are a lot more familiar and likely more comfortable with magic mushrooms than any other psychedelic drug.

A separate measure would ask voters to approve $5 billion in bonds to create a government agency that would focus on psychedelic research with the goal of developing therapeutics. The idea, according to proponents, is to dedicate more resources to research that shows promise but has for long been underfunded.

Dr. Jeannie Fontana, the chief executive officer of TREAT California, who is spearheading this initiative, said California’s lead on innovation makes it the ideal location for this type of research. TREAT stands for Treatments, Research, Education, Access and Therapies.

“The federal government is not there yet. They recognize the problem, but they just don’t know how to deal with this psychedelic hangover from the ‘60s and ‘70s,” Fontana said. “California is a progressive citizenry. We are innovators and leaders in many things.”

CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics. ​​

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