This article was first published yesterday on Harvard Law School’s Petrie-Flom Center Bill of Health Blog.
On Tuesday, Washington State legislators filed SB 5660, a bill that would legalize the supported adult use of psilocybin by people 21 years of age and older.
Washington Psilocybin Services Wellness and Opportunity Act
Sponsored by Senators Jesse Salomon and Liz Lovelett, the bill, known as the Washington Psilocybin Wellness and Opportunity Act, includes many innovative features including a Social Opportunity Program to help address harms caused by the war on drugs, a provision to support small businesses, and accommodations for people with certain medical conditions to receive the psychedelic substance at home.
I had the privilege of helping to draft the Washington Psilocybin Services Wellness and Opportunity Act with input from the Psychedelic Medicine Alliance of Washington and my colleague John Rapp here at Harris Sliwoski. We had previously collaborated on the psychedelic decriminalization resolution adopted unanimously by the Seattle City Council.
Passage of the Act would enable the Washington Department of Health to issue licenses to psilocybin manufacturing facilities, testing labs, service centers, and facilitators. It will also create the Washington Psilocybin Advisory Board to advise the Department on creating rules for the Act’s implementation.
Though psilocybin is non-addictive, the bill’s sponsors recognize the benefits of supported adult use. In this model of regulation, trained and licensed professionals called facilitators administer psilocybin under supportive conditions at licensed service centers.
Under supported adult use, psilocybin services are made available to people 21 and older for nearly any purpose – the Act specifies that clients need not have a medical condition to participate, and psilocybin services in Washington will not constitute medical diagnoses or treatment. Psilocybin is known to enhance feelings of connectedness, and some clients may seek psilocybin services to feel more connected with nature or see their interpersonal relationships in a new light. Others may wish to enhance overall wellness, have a religious experience, or boost creativity.
Though psilocybin can cause mild side effects such as transient nausea, and anxiety, it has an impressive safety record, and Indigenous communities in Mexico, such as the Mazatec, have used it in religious rituals for centuries.
View the US Map of Psilocybin Legality by State
In the 1950s and 60s, medical researchers studied psilocybin’s therapeutic properties, and they made substantial progress, publishing their observations in prestigious medical journals. However, since the 1970s, when Congress passed the Controlled Substances Act and President Nixon launched the war on drugs, psilocybin has been banned. Until recently, the Drug Enforcement Administration prohibited even scientific research on this Schedule I controlled substance. Nevertheless, a scientific and legal renaissance has emerged in the past few years.
What started with a handful of small research studies in the early 90s has grown to include publicly traded companies, infusions of millions in venture capital, and multiple clinical trials sanctioned by the Food and Drug Administration (FDA). Because psilocybin has the potential to treat depression more effectively than existing therapies, such as selective serotonin reuptake inhibitors (SSRIs) like Prozac and Paxil, the FDA calls it a Breakthrough Therapy.
Alongside medical research and the commercialization of psilocybin, grassroots legal reform movements have formed. Unwilling to idly stand by as rates of suicide and mental illness climb in their communities, activists across the country are passing innovative legislation. Denver was the first U.S. city to decriminalize psilocybin in 2019 when voters passed Initiative 301, which made psilocybin possession the city’s lowest law enforcement priority.
At least a dozen other cities have since followed suit. Many jurisdictions, like Seattle, which became the largest city to decriminalize in October, added other naturally occurring psychedelics to the list of decriminalized substances. During the 2020 presidential election, Oregon voters passed Measure 109, creating a legal psilocybin industry in the state. Governor Kate Brown assembled the Oregon Psilocybin Advisory Board, which includes five subcommittees focused on psilocybin research, health equity, products, licensing, and facilitator training. I chair the Licensing Subcommittee, which drafts rules on licensing requirements for psilocybin businesses and facilitators.
One concern raised by Oregon’s Health Equity Subcommittee is the ability of people with disabilities to access psilocybin if they cannot travel to a licensed service center. During public comment periods, the Oregon Board has heard from people like Eileen Brewer of Cluster Busters, an organization representing the interest of people with cluster headaches. Evidence suggests that people with severe headaches may benefit from psilocybin services, and Eileen explained that it would be cruel and impractical to require people with severe headaches to travel to a service center. Others may be unable to travel due to strength, pain, or mobility issues. To address this concern, Senators Salomon and Lovelett included a provision in SB 5660 to allow people who are medically unable to travel to receive psilocybin services at home.
Similarly, to accommodate working professionals, people with disabilities, and others for whom traveling to in-person courses may be burdensome, Washington will allow facilitators in training to complete the bulk of their training remotely. The training curriculum will also be modular, and trainees will be able to piece together their own customized program by selecting from courses that best fit their needs. This approach will create a competitive market for training programs that will drive innovation and help keep costs down.
In Washington, SB 5660’s Social Opportunity Program will help address the harmful impact of the war on drugs on many marginalized communities. It will offer reduced licensing fees to residents of distressed areas of Washington, including those where the three-year unemployment rate is at least twenty percent higher than the statewide average, and those where at least twenty percent of households participate in the federal supplemental nutrition assistance program (SNAP). Participants will also benefit from technical assistance and receive points that supplement their license application score. In a similar vein, the SB 5660’s Micro Tier license designation, called an endorsement, will help aspiring psilocybin manufacturers access the emerging industry.
Other features include the potential for some psilocybin services to be provided remotely, including preparatory sessions, which help establish rapport between facilitators and clients and prepare clients to receive psilocybin, and optional integration sessions that help clients process their psilocybin experiences after an administration session.
These are only a few innovations included in the Washington Psilocybin Services Wellness and Opportunity Act. Fundamentally, SB 5660 is a novel approach to the supported adult use of psilocybin. It will allow clients to receive safe psilocybin products from licensed professionals and create economic opportunities for people statewide.
