'A big responsibility': Oregon rolls out psilocybin framework as nation watches

Laurencio Lopez Nuñez wants students to take psilocybin seriously.

“For us, as healers, another person’s life is sacred. And you don’t play with life. We love life. We take care of life,” Lopez Nuñez said in Spanish. “It’s a big responsibility.”

He’s an author, botanist, traditional medicine practitioner and one of many around Oregon helping inform future facilitators as the state unrolls the nation's first legal system for psilocybin.

Oregon voters passed Ballot Measure 109 in 2020, legalizing the use of state-regulated psilocybin, sometimes called magic mushrooms.

By the end of their state-approved training, students will be able to apply for a license with the Oregon Health Authority. Once licensed, they can guide people through psilocybin experiences.

Residents won't be able to walk into a store and purchase psilocybin, like they can cannabis in many states. Oregon is building policy that frames legal use as more of a health service than a product.

“People have been under the assumption that this is a dispensary model, similar to cannabis,” said Angela Allbee, who manages Oregon Health Authority’s Oregon Psilocybin Services. “The only time psilocybin can be sold to and consumed by a client is at a licensed service center. We have over 70 pages of regulations related to this.”

Psilocybin service centers in Oregon could open their doors as soon as late summer. But qualified, licensed facilitators make up just one piece of an intricate puzzle.

Under the Oregon Psilocybin Services Act, anyone old enough to legally drink can access psilocybin services. Clients don't need a doctor’s note or a prescription, but they are required to complete a preparation session with a licensed facilitator before participating in an administration session at a licensed center.

Before anyone receives a psilocybin session in the state, there also must be licensed manufacturers to make the product, licensed laboratories to test the product and licensed service centers where participants would receive the psilocybin. Nearly everyone involved with the emerging industry must also get a Psilocybin Worker Permit.

Training to be a facilitator

So far, the state has approved 20 facilitator training curriculums, some of which are located out of state. OHA set the minimum requirements for these programs. These requirements include modules on safety, ethics, law and responsibilities; historical, traditional, and contemporary practices; and applications and cultural equity in relation to psilocybin services.

“That is basically the floor and it's up to the training program how much more they're going to build out their programs,” Allbee said. “Many training programs have gone over those minimal requirements.”

Some programs emphasize client safety and being trauma-informed. Others are focused on equity, Allbee said. Those looking to be licensed to administer psilocybin can compare programs to find the best fit.

In the Eugene, Oregon, area, Subtle Winds is the only group approved to train facilitators so far.

According to it's website, the curriculum is rooted in "contemporary healing modalities, respect for traditional wisdom, and decades of experience in psychedelic harm reduction approaches."

Many of the program's 20 teachers and guest presenters have experience working in the area of crisis response.

Subtle Wind's founders Benjamin Brubaker and Kate Gillespie each previously worked for White Bird’s crisis response team CAHOOTS. They also volunteered with the clinic’s Rock Medicine program, which provides medical, mental health, substance abuse and first-aid intervention at festivals and concerts. With Rock Medicine, the two supported people during psychedelic experiences that sometimes unintentionally became a deeper journey than those who partook anticipated.

The training program tuition is $9,000 plus the cost of food and lodging for the in-person weekends and books. Students can either pay in full by the start or in six-month installments. Discounts are available on a limited basis for people coming from historically-marginalized communities and low-income applicants.

The group’s first cohort gathered in early February to begin training.

The cohort is made up of 34 students ranging in age from 21 to 70 and representing a variety of occupational backgrounds including massage therapy, licensed mental health therapy, food service, wellness and law.

“I want to be a part of something that can heal,” said Franshesqua Perez, a Subtle Winds student.

Psilocybin allowed her to access new parts of herself, Perez said, and she’s excited to offer that to others in search of healing. Perez worked in the cannabis industry before and is now a bartender. As a woman of color, she said, she’s aware of the voices that may be lost in the newly-sanctioned industry.

“I want to be able to offer my perspective and be a voice for others to offer anything that might be missed,” Perez said.

All kinds of diversity among those providing services are needed, she and others said, because there will be so much diversity among those who will seek help.

“Being a part of a marginalized community, we have a unique opportunity to see what it's like to be in the fractured community, and not to be part of a greater whole of humanity,” said Jade Stay, another student and part of the LGBTQ community. “This medicine really transcends those boundaries.”

Stay is a waitress and describes herself as “very much a customer service person” who enjoys engaging in small talk that grows into a deeper connection.

Stay and Perez both pointed out the ways this industry is taking shape differently than cannabis. The emphasis among many of those involved seems to be the well-being of people rather than the potential profitability of the product, they said.

"Real medicine isn't just sold to one," Stay said. "It is experienced."

Bridging traditional and modern medicine

The Subtle Winds training program is 168 hours. All OHA-approved programs are at least 120 hours of instruction plus 40 hours of hands-on practicum.

Brubaker said the Subtle Winds curriculum focuses on justice, equity, diversity, inclusion, empathy, being trauma-informed and an overall "humanistic" model.

“We're trying to build bridges between a more therapeutic medical lens and the lens of the traditional plant medicine practitioner,” Brubaker said.

Lopez Nuñez, a guest speaker, is one of many contributing to Subtle Winds’ program. His hope is to create healers with sensitivity, respect, honesty and sincerity.

While academics and policymakers are just beginning to explore the potential uses and benefits of psilocybin, there are people like himself who have kept the traditional practices alive. He first studied plant medicine with his grandmother in Oaxaca, Mexico.

Psychedelic drugs can affect all the senses — altering a person’s thinking, sense of time, emotions, what they see and sometimes causing hallucinations. The hallucinogenic effects typically last four to six hours, but a person’s psilocybin experience can vary widely depending on the type consumed, the quantity, the setting and their pre-existing mental health conditions.

For centuries, Indigenous groups around the world have used psilocybin for a mix of purposes.

A paper led by an Oregon State University researcher published last year in the journal Fungal Biology summarized the history and contemporary use of psilocybin by traditional healers for mental health ailments and spiritual endeavors as well as physical pain relief for joints, toothaches and stomach issues.

According to the paper, the oldest evidence of ritualistic consumption of Psilocybe species is in Mesoamerica and is recorded in the ancient manuscript “Yuta Tnoho” or “Vindobonensis Mexicanus I." This codex, belonging to the Mixtec culture, was painted in the early 1500s and depicts a sacred ceremony where Mixtec deities consume sacred mushrooms prior to the first dawn. Psilocybin use in ancient times outside of Mesoamerica has been speculated, according to the research.

As the training began, Lopez Nuñez asked students if they were ready to answer an ancient call to healing. He told them to leave if they were not.

“(I want) to awaken in each of them the root of this traditional medicine,” he said. “It’s an ancient medicine and it’s always been there to help human beings.”

After their training is complete, Subtle Winds students will have a final exam in early May. Then, applicants must apply to become a licensed facilitator through the OHA.

In addition to completing a state-approved training program, there are a few additional requirements for applicants, including a social equity plan. This plan must describe how the licensee will incorporate diversity, equity, justice and inclusion principles into their practices and policies.

Applicants must also take a regulations exam, which should take 30-60 minutes and can be retaken until passed. It costs $150 to apply and the annual license fee is $1,000 to $2,000.

None of the trainings are complete yet so no one has applied for a facilitator license. But as of late February, the state had 93 pending applications, meaning many have begun the process.

Made in Oregon: Magic mushrooms

Legal psilocybin products must be cultivated and processed in Oregon by licensed manufacturers and tested by licensed, accredited testing laboratories before being sold to licensed service centers.

Service centers are the only licensee authorized to sell psilocybin products to clients for consumption during administration sessions.

Psilocybin is a psychedelic compound that can be found in more than 200 species of mushrooms. However, Oregon manufacturers can only cultivate, manufacture or possess fruiting bodies of the fungi species psilocybe cubensis and psilocybin products derived from psilocybe cubensis.

The Oregon Psilocybin Advisory Board made this recommendation because of the amount of existing research on this particular species, Allbee said.

“We wanted to make sure that as we're implementing this work, we're … demonstrating that we can do this safely,” Allbee said. “We also wanted to make sure that we had the means to be able to test for the species type and that we understood as much as we could about it.”

Mushroom cultivation requires much less space, water, time and electricity than cannabis cultivation. Cultivation will be indoors only.

In most cases, a manufacturer may only possess a total of 200 grams of psilocybin. Service centers may possess a total of 100 grams of psilocybin. A serving of a psilocybin product may not contain more than 25 milligrams of psilocybin.

“A lot of people that have had difficult experiences with cannabis production are concerned about this new body of work and don't understand that psilocybin-producing mushrooms are grown in a very different environment,” Allbee said.

If approved for licensure, manufacturing businesses and service centers will be required to pay an annual licensure fee of $10,000. Until 2025, both types of businesses must be at least 50% owned by Oregon residents. Nonprofit entities will pay less in fees.

The state requires applicants for manufacturer licenses to request a land use compatibility statement from the city or county where the proposed business is located. The statements must be completed as a condition of licensure, and must show that the location's zoning is consistent with the proposed use.

As of late February, OHA received 13 manufacturer applications and 44 were pending. Eugene has received three requests for psilocybin manufacturing land use compatibility statements so far.

Bend resident Ryan Reid is one of OHA's 13 applicants. He’s planning to set up a manufacturing facility and two service centers. He’d like to set up one center that is a for-profit model and then offer a smaller nonprofit therapeutic model that would be free.

“My hope is to make it as broad and accessible as possible,” Reid said. “Bachelor parties are not out of the question."

Psilocybin has the potential to be healing for those struggling with mental illnesses, but it also presents "the opportunity for the betterment of well people," Reid said, referring to an idea from author and journalist Michael Pollan.

Pollan’s popular book and TV series "How to Change Your Mind" has been among the tsunami of media about psychedelics in recent years.

Because it’s easier to produce than cannabis and will have a smaller customer base, he doesn’t think manufacturing mushrooms will be a huge money maker.

Like others, he notes a sense of caution among those involved. All eyes are on the state as different groups set up a new structure to provide an ancient medicine.

People want to get it right, he said.

“This has never been done before. So, no one has this exact experience,” Reid said. “The fun thing now is to try and piece together the people who have experience in little ways.”

He plans to apply for service center licensure soon.

The state had five services center applications to review and 11 pending in late February.

Just like manufacturers, service centers must request a land use compatibility statement from the city or county where the proposed business is located. Eugene has received three statement requests for service centers so far.

Big swaths of Oregon will not be able to host the new businesses. Measure 109 allows for local jurisdictions to opt out of allowing psilocybin services within their borders. In the last general election, more than 100 of the state’s cities and counties voted to ban psilocybin businesses in their jurisdiction, including Cottage Grove and Creswell in Lane County and the unincorporated areas of Marion and Polk counties.

Psilocybin won’t get from the manufacturer to the center without a licensed laboratory to verify the product.

The state has two laboratory applications to review and three applications are pending. Eugene has not received land use applications for labs so far.

'Building this new ecosystem together'

Brubaker, with Subtle Winds, said he felt excitement, humility and trepidation among the students, teachers and staff as they set out to establish this new framework.

“It’s all so new,” Brubaker said. “We're all going to be building this new ecosystem together.”

Being the first state in the country to implement psilocybin access is exciting, many said. For some, it’s also scary.

The work is still stigmatized. Some facilitator students fear they’ll lose their jobs if their employers find out what they are doing. Some people hoping to become manufacturers were wary of sharing their full name with the Register-Guard out of fear of pushback in their communities.

While some states and cities are gradually decriminalizing the use of it, psilocybin remains a Schedule I substance under the Federal Controlled Substances Act passed in 1971. This makes it harder for businesses to set up and for people to talk openly about their involvement with the industry.

Business owners also will have trouble banking with federally-insured banks and face extra taxes, similar to legal marijuana businesses.

A lot of misconceptions remain about what it will look like, industry leaders said, across the country and within Oregon. Many involved are eager to fight psilocybin's reputation as a party drug.

Service centers will not be big, noisy, mushroom-fueled raves, Allbee said.

“This is about healing and wellness,” Allbee said. “This is about going inward.”

Many studies have found psilocybin a useful tool in the treatment of depression, anxiety disorders, obsessive-compulsive disorder, trauma-related disorders including PTSD, substance use disorders, and end-of-life care, among other conditions, as well as spiritual pursuits, according to information compiled by the Oregon Psilocybin Advisory Board.

A few years ago, the FDA designated psilocybin therapy as a breakthrough therapy after two clinical trials on its effects on severe depression and major depressive disorder.

Like any medicine, it has potential side effects. The use of psilocybin can sometimes cause nausea, vomiting, headache, increases in heart rate, increases in blood pressure and QT interval, a change in electrical conduction in the heart, according to the Psilocybin Advisory Board’s Rapid Evidence Review and Recommendations.

Potential psychological effects include grief, anxiety, feelings of insanity, feelings of isolation, preoccupation with death, transient thought disorder and transient paranoia. Experts note that some of the adverse effects can co-occur with the benefits.

Advocates around the country are hopeful about more potential applications of psilocybin. Upcoming studies at Johns Hopkins will seek to determine its effectiveness as a therapy for opioid addiction, Alzheimer's disease, post-traumatic stress disorder, post-treatment Lyme disease syndrome, anorexia nervosa and alcohol use in people with major depression.

There are a lot of moving parts that need to come together for services to become available in Oregon. Allbee believes this could happen as soon as late summer and will definitely happen by the end of the year. She encouraged people to check Oregon Psilocybin Services' website to stay up-to-date.

Many are anxiously and excitedly waiting to see how the services take shape.

“This is going to be really good medicine,” Lopez Nuñez said. “If it’s carefully directed.”

Contact reporter Tatiana Parafiniuk-Talesnick at Tatiana@registerguard.com or 541-521-7512, and follow her on Twitter @TatianaSophiaPT.