EXECUTIVE SUMMARY: The Potential Use of Psilocybin for the

Treatment of Mental Health Disorders and Current Political Trends

Prepared For​: Dr. Richard Pan, Chair of the CA Senate Committee on Health
Prepared By​: Carina Brackett
Date: ​October 28, 2019

Audience Profile
I will address Dr. Richard Pan, Chair of the CA Senate Committee on Health. He has
served in the State Senate since 2014 as a Democratic representative of District 6 including
Sacramento, Elk Grove, and other areas of Sacramento county. One of Dr. Pan’s top priorities is
addressing California’s Mental Health Crisis, so he has requested an Executive Summary outlining
the latest research and political implications regarding the use of Schedule I drug Psilocybin for
treatment of mental health disorders. As Chair of this Committee, Dr. Pan is responsible for being
up to date on the current research and political attitudes relating to public health, alcohol and drug
abuse, and mental health in order to guide the Committee hearings and jurisdiction discussions.
Recently, there has been heightened focus and efforts by cities and states on drug policy
reform regarding the use of psilocybin for medical purposes. Dr. Pan’s State of CA is a leader in
this agenda, with the city of Oakland becoming the second community to decriminalize its use.
Through this Executive Summary, he will also learn about the past, present, and future policies
surrounding the clinical use of the Schedule I drug psilocybin so that he can prepare for important
future jurisdiction discussions in the CA Senate Committee on Health.
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Purpose:​ ​to outline the current research on the effectiveness of psilocybin, the active agent in
“magic mushrooms,” for treating psychiatric disorders and to present its current political situation.

California is currently facing a mental health crisis. 1 in 6 adults suffer from mental illness, with
depression, anxiety, and addiction among the most common disorders (“Mental Health in California”).
Traditional measures to treat these disorders, especially depression and addiction, have had low rates
of effectiveness (Carhart-Harris et al.​2​). Untreatable psychological suffering has caused suicide rates in
California to rise 50% in the past two decades (Wiener).

Recent private research in the US, UK, and Switzerland found psilocybin to be more effective at
treating certain mental disorders over traditional options. Unfortunately, psilocybin’s current legal
status limits the availability of public funds for more expansive research and restricts its utilization in
clinical medicine (Compass).​ ​Statewide poll findings report: “the top health issue Californians want
their governor and Legislature to address is making sure treatment is available for people with mental
health problems: 88 percent called it extremely or very important” (Wiener).

Regulation History of Psilocybin

Mid-20th Century​:​ Research programs for naturally-occurring psychedelics including psilocybin
were legal and well-funded (Drug Policy Alliance). In the 1960s, psilocybin was the main active
ingredient in the marketed drug Indocybin, which was used as an “adjunct to psychotherapy” for the
treatment of anxiety, depression, and other mental illnesses in the US (Johnson).

1970 Controlled Substances Act:​ ​After societal backlash and political movements like “The War on
Drugs”, psychedelics, along with marijuana, were classified as Schedule I drugs. It is illegal to possess
or cultivate these drugs for personal consumption or distribution. They may be used in research, but
only after an extensive approval process, expensive special license, and strict DEA regulation.
Consequently, research on psychedelics’ medical benefits has been limited (Johnson).

21st Century:​ Private and nonprofit organizations worldwide including Johns Hopkins University,
Multidisciplinary Association for Psychedelic Studies, and Heffter Research Institute have been
studying the potential clinical effectiveness of psychedelics for mental disorders (Drug Policy
Alliance). In 2018, the FDA granted Compass Pathways “Breakthrough Therapy” designation for
psilocybin treatment for treatment-resistant depression because the drug “demonstrates substantial
improvement” over existing treatment (Compass).

Potential Medical Effectiveness of Psilocybin

Treatment-Resistant Depression:
Numerous studies have shown promising results for psilocybin’s effectiveness in treating depression.
Findings from a 2017 Imperial College London study involving psilocybin treatment for 19 patients
with treatment-resistant depression include:
● Crucial changes in brain activity linked with lasting decreases in depressive symptoms
● All 19 patients met criteria for reduced depression one week after the study
● Half of the patients maintained this status 5 weeks after the study

The research concluded that the compounds in psilocybin “reset” parts of the brain, enabling patients
to break out of depressive states (Carhart-Harris et al.​1​).
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Anxiety/Depression with Life-Threatening Disease:

Patients with life-threatening diseases often experience severe anxiety and depression, resulting in
“poor psychiatric and medical outcomes.” A 2016 study of 29 patients with cancer-related
anxiety/depression administered psilocybin found:
● “Immediate, substantial, and sustained” improvements in anxiety and depression levels
● 80% of patients had “clinically significant” levels of decreased anxiety and depression with
“sustained benefits in existential distress and quality of life” after 6 months (Ross et. al).

Tobacco/Alcohol Addiction:
A 2014 Johns Hopkins study found that psilocybin administered to fifteen longtime-smokers resulted
in 80% smoking abstinence. Today’s most common smoking cessation treatment (verenicline) had
only 35% abstinence (Garcia et. al)

A 2015 study using psilocybin to treat ten alcohol-dependence patients found clinically significant
abstinence from alcohol throughout the 36-week long check-in sessions (Bogenschutz et. al).

Obsessive Compulsive Disorder:

When administered to nine patients in a controlled clinical environment in 2004, psilocybin showed
acute reductions in symptoms in patients with OCD with improvements lasting beyond the 24-hour
timepoint (Moreno et. al).

Post Traumatic Stress Disorder:

A 2013 study at the Lieber Institute for Brain Development conditioned lab rats to develop a fear
response similar to that of PTSD in humans, then treated them with psilocybin.
● Result:​ extinction of the “fear conditioning” as psilocybin rewired parts of the amygdala
(responsible for fear and PTSD condition in humans)
● Implication:​ Psilocybin could effectively treat PTSD and related conditions (Catlow et. al).

It should be noted that these results are not conclusive and the sample sizes of these studies are small,
which is a result of the lack of public funding for larger research projects.

Potential Adverse Effects During Psychedelic Treatment​ ​(Byock)

● Nausea and vomiting ● Anxiety
● Aynesthesia (heightened senses and ● Impaired motor functions
confusion)

Protocols to Mitigate Risks​ ​(Byock)

1. Screening​: Patients should be screened before treatment to ensure they do not have any
“cognitive and emotional conditions associated with disorganized or diminished ego,” which
might inhibit the effectiveness of the treatment.
2. Supervision & Setting​: Psilocybin should be administered under the supervision and guidance
of a trained clinician in a protected space to mitigate risks.

The Deschedulization Movement

Extensive efforts are underway federally to remove psilocybin from Schedule I (meant for drugs with
no medical benefits and high abuse potential). This can only occur if a drug is approved by the FDA
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for therapeutic use through an extensive process involving a New Drug Application (NDA). Compass
Pathways and Johns Hopkins University are currently working on submitting NDAs. Increasing
evidence of therapeutic benefits and low abuse potential suggests that they have a strong case, but
more evidence is still necessary. The approval process and eventual descheduling appears to be years
away. Once descheduled, psilocybin could be approved for treatment nationwide and research into
further benefits will be federally funded (Johnson et. al).

Medical Psilocybin Decriminalization/Legalization Movements Around the US

Movements are emerging as community groups voice concerns over the lack of effective treatment for
mental health disorders in light of psilocybin’s promise to aid in the solution (Wiener). They seem to
be following a similar pattern to medical marijuana: beginning at the city level through ballot measures
and progressing to state legislation.
1. Denver, CO (May 2019):​ Denver decriminalized the use and possession of naturally-occuring
psilocybin and forbids the use of city resources in related prosecutions (Kenney).

2. Oakland, CA (June 2019):​ Decriminalize Nature Oakland (DNO) drafted the successful
resolution that passed unanimously to decriminalize psilocybin in Oakland (Lekhtman).

3. Los Angeles, San Diego, Berkeley, Seattle, Detroit:​ Activist groups are drafting resolutions for
their respective City Councils to decriminalize/legalize medical use psilocybin. They have been
consulting with DNO, who created the resolution that passed in Oakland (Lekhtman).

4. Oregon:​ The Psilocybin Service Initiative is a 2020 Oregon ballot measure to legalize medical use
psilocybin and reduce penalties for growing and possession. If passed, Oregon will be the first
state to legalize medical use psychedelics.
○ Polls show 47% of participants would vote yes, 46% would vote no and 7% undecided.
○ The petition still needs over 100,000 signatures to qualify for the ballot (Jaeger​1​).

5. California:
○ Decriminalize California is leading efforts for a 2020 CA ballot Initiative to decriminalize
psilocybin for medical and religious purposes. They hope its successful passage will “build the
framework for eventual legalization” (Jaeger​2​).
○ DNO is also lobbying CA State Representatives to introduce legislation in the Assembly and
Senate. CA reps claim to support such measures, especially after seeing the unanimous vote in
the city of Oakland (Lekhtman).

Conclusion / Recommendations
Amidst California’s growing mental health crisis and need for more effective treatment, the supervised
use of psilocybin emerges as a strong potential solution. A few recommendations:
1. Present the latest evidence to the CA Senate Committee on Health.​ It will be crucial for
these leaders in CA public health policy to understand the promises and risks associated with the
medical use of psilocybin. The committee can then strategize political outlook.
2. Propose the creation of a Public Education Program.​ There is a great need to increase
public awareness/education on psilocybin’s medical potential to revolutionize mental health
treatment in CA. This will increase support from voters and legislators in the impending ballot
initiatives to make psilocybin more readily available for treatment and research.
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