Time for another Oregon psilocybin licensing discussion update.
We have now crossed the halfway point of the Oregon Health Authority (OHA) two-year development phase to create regulations based on Ballot Measure 109. As a reminder, there are five subcommittees covering different aspects of the emerging psilocybin industry. They include: research, health equity, manufacturing, training, and licensing. Our own Mason Marks chairs the Licensing Subcommittee.
In this post we will explain what the Licensing Subcommittee covered in its recent meeting on January 6, 2022.
Licensing Subcommittee Schedule and Timelines
The Licensing Subcommittee meets every month to develop licensing requirements for psilocybin businesses and professionals. So far, it has developed recommendations regarding informed consent documents, professional codes of conduct, and licensing requirements for psilocybin facilitators. We have covered some of these topics in previous updates, here and here.
Additionally, Board members have discussed requirements for group facilitation sessions, service center advertising, and service center safety measures. Once the Licensing Subcommittee decides on a relevant issue, it offers a recommendation to the entire Board. The Board will propose regulations to the OHA by June 2022.
Psilocybin storage, outdoor sessions, security at service centers, social equity, and service center personnel are among the complex issues discussed so far. The Licensing Subcommittee has already made several recommendations to the Board on these matters. For instance, the Subcommittee recommended extra trained personnel both on-call and in the service center during psilocybin sessions. The Subcommittee plans to complete its recommendations by March 2022.
January Licensing Subcommittee Updates
The Licensing Subcommittee’s January 6 meeting covered: the facilitator code of conduct, guest speakers, preparation and integration sessions, client-to-facilitator ratios, facilitator training, and licensing exam, security video, and work permits.
Facilitator code of conduct
Reporting Facilitator Misconduct
The Subcommittee began by discussing recommendations on appropriate facilitator conduct regarding misconduct by other facilitators, interacting with emergency first responders, and directive versus nondirective facilitation. When a facilitator knows another facilitator is engaging in misconduct, reporting the misconduct is mandatory. Thus, the Subcommittee will recommend facilitators have seven working days to report any observed or ratified misconduct by another facilitator. Working days, as opposed to calendar days, will ensure no one is required to report misconduct on weekends or holidays.
Contacting Emergency Services
Second, facilitators will need to acknowledge that due to the stigmatization and current legal status of psilocybin, contacting police and other emergency responders can pose unique risks to client safety and privacy. Emergency first responders require pertinent information to adequately respond to an emergency, such as allergic reactions or a description of the events leading up to the emergency. However, it is possible that a person calls 911 when there is no emergency and invites unnecessary interactions with law enforcement and medical personnel.
For example, it would be inappropriate for a facilitator to call 911 on a client who is illegally parked in the parking lot. This would interrupt sessions, distress clients, and invite outsiders to a client’s private psilocybin experience. To protect client privacy and avoid conflicts with first responders, the Subcommittee will recommend facilitators must learn to determine proper medical bases for contacting emergency services and call 911 to ensure client safety.
Non-Directive Facilitation of Psilocybin Services
Third, psilocybin services will primarily use a non-directive approach to facilitation. Nondirective facilitation means the facilitator maintains a consistent, warm, and affirming disposition with a client, providing a general presence during the session. In contrast, directive facilitation means giving a client direct advice, directly interpreting the client’s statement or behaviors, or subjectively guiding the client’s experience. Directive facilitation can be highly exploitative.
Thus, the Subcommittee will recommend that facilitators must use non-directive facilitation during all three sessions (preparation session, administration session, and integration session) of psilocybin services. The only exception is for safety, allowing facilitators to be directive with a client who poses a risk to safety.
Upcoming Guest Speakers
The Licensing Subcommittee will discuss the licensure of religious organizations during the February 3 meeting. To gain insight and expertise in religious psilocybin services, the Subcommittee nominated two guest speakers to attend the February 3 meeting, Jonathan Dennis and Bob Otis.
Jonathan Dennis is a consultant and principal at Psychedelics Go, an Oregon lawyer at Sagebrush Law, and the co-host of “Eyes on Oregon,” a podcast by Psychedelics Today exploring the latest developments in Oregon’s legal psilocybin landscape. He has a BA in Religious Studies from the University of Kansas and a law degree from Lewis & Clark Law School.
Bob Otis is Chief Garden Steward for Sacred Garden Community Church, was the founding Chairperson of Decriminalize Nature Oakland and is a Steering Committee member of the Sacred Plant Alliance, an organization incubated by the Chacruna Institute. He has explored traditional healing and entheogenic for over 35 years and has traveled to Guatemala, Brazil, Mexico, India, Indonesia, and Jamaica for healing practice and education. He has generated over 50 publications on healthcare and life science research, including peer-reviewed articles, an acknowledgment in “Nature”, contributions to academic texts, and multiple conference presentations.
Both guest speakers will help the Subcommittee make informed recommendations for religious organization licenses.
Preparation and Integration Sessions
Psilocybin service clients will generally engage in three sessions at psilocybin service centers.
- First is the preparation session, when facilitators provide information about psilocybin to a client, and screens the client to determine whether psilocybin is safe for the client to ingest.
- Second is the administration session, when the client ingests psilocybin to experience an altered state of consciousness.
- Third is the integration session, which is an optional meeting between the facilitator and the client after the administration session.
The Subcommittee strives to make recommendations that keep the psilocybin service industry accessible for both clients and facilitators. Allowing clients to attend sessions in groups, rather than strictly individual sessions, can cut costs for both facilitators and clients. Further, group sessions are preferable in religious and support environments.
The Subcommittee has previously recommended allowing groups for administration sessions, but preparation and integration sessions are different in nature. For instance, the screening process during the preparation session should be individualized, and simultaneously screening each individual in a group would be very difficult. Similarly, the integration session likely involves private and personal details about a person’s psilocybin experience.
Ultimately, the Subcommittee determined that facilitators could split the preparation session, giving general psilocybin information to a whole group at one. Then, the facilitators could meet one-on-one with each individual for screening. Clients could also opt-in to a group integration session if they wish to be open with the rest of their group. Thus, the Subcommittee will recommend allowing clients to choose group or individual experiences for all sessions.
Facilitator to Client Ratios
The Subcommittee previously recommended a three-to-one ratio of clients to facilitators during administration sessions. For example, a group of seven people would need at least 3 facilitators during the administration session. However, after commentary from the public, the Subcommittee sought to have a more nuanced conversation about ratios for different doses of psilocybin.
When a person takes a subperceptual dose, or “microdose” of psilocybin the person generally experiences no hallucinogenic effects. A person with a subperceptual dose thus requires less supervision than a person who took a perceptual level. Imposing the three-to-one ratio rule on a group of people with subperceptual doses would be unnecessary, and the added cost of additional facilitators puts a burden on service centers.
The Subcommittee discussed the risks and benefits of changing ratios for subperceptual dose sessions. Requiring fewer facilitators decreases costs and makes these sessions more accessible, but some service centers may become cavalier when supervising these sessions. In the end, members of the Subcommittee felt the three-to-one ratio was too restrictive.
The Subcommittee voted to recommend a maximum eight-to-one ratio for perceptual-level administration sessions, and ten-to-one for subperceptual-level administration sessions.
Facilitator Training and Licensing Exam
The Subcommittee discussed a controversial topic previously rejected by the Training Subcommittee: online, remote, and asynchronous training programs (such as zoom lectures and online videos). There are different learning styles, and some learn better through video lectures. Additionally, a training facility might be several hours away from a prospective facilitator and thus bar their access to the program.
Even though the Training Subcommittee recommended disallowing online, remote, and asynchronous training programs, the Subcommittee will nonetheless recommend allowing such training programs.
During the next meeting, the Subcommittee will draft a list of topic areas to be on the licensing exam, giving prospective facilitators notice of what the test may entail.
Security Camera Video Retention
Finally, the Subcommittee discussed security camera video retention. In the cannabis industry, some retail stores must retain video recordings for 90 days, and storing these recordings imposes an added cost to the store owners. The Subcommittee voted to recommend psilocybin service centers retain video recordings for only 30 days.
Future Oregon Psilocybin Licensing Subcommittee Meetings
These decisions are mere recommendations to the Oregon Psilocybin Advisory Board and are subject to change. The Board will submit its own regulation recommendations to the OHA in June 2022. Over the next several months the Licensing Subcommittee will be finalizing its recommendations for general licensing regulations.
Members of the public are welcome to watch the meetings via zoom and may give comments at the end of each meeting. The next Licensing Subcommittee meeting will be held on February 3, 2022 at 4:00 pm PST.
