Guest Column

There are many misconceptions about psilocybin therapy. In his recent column, “Let voters decide if they want psilocybin treatment centers”, Dr. David Coutin highlighted several. I’d like to address them here.

Dr. Coutin calls for controlled clinical trials of psilocybin. This has been done. Dozens of controlled clinical trials have been conducted and shown that when administered in a facilitated session, psilocybin is both safe and effective in treating a variety of mental and behavioral health conditions. These include treatment-resistant depression, anxiety, PTSD and addiction. Furthermore, research shows that psilocybin is not addictive (so comparing it to fentanyl or other street drugs is baseless) and there have been no documented overdoses on it. Let me say that again: psilocybin is not addictive and a person cannot overdose on it.

This research comes at a time when our county and state are facing a severe mental health crisis. This crisis exists, in part, because of the lack of current efficacious treatments. Many people do not respond to the medications that psychiatrists and primary physicians prescribe, leaving them with chronic conditions that continue to perpetuate suffering. Mental health professionals badly need more tools to help address this. Psilocybin is a safe, effective, and non-addictive option for our patients.

In fact, if psilocybin therapy were accessible to more people in our community, it’s very possible that we would see a decrease in rates of mental crises and, given its potential for treating drug addiction, even a decline in drug overdoses. This would reduce the burden on our hospitals and on our emergency responders, including our sheriff’s department.

Accessibility is related and important issue when considering whether or not to permit services throughout the county versus having them concentrated in Bend. County residents who live in rural areas may not be able to travel into Bend to access services and therefore would be denied a safe and effective treatment option. In addition, service centers located in a more expensive area like Bend will have higher operating costs which translates into higher costs for clients, making these services less accessible.

Dr. Coutin also mentions the risk of potentially serious adverse events for patients taking this therapy. There is little evidence of this happening with thorough preparation and guided sessions combined with the follow-up that is built into the therapy process. The OHA protocols entail safeguards and close monitoring of the treatment in the post-treatment phase. These are at a level that is much higher than the type of management often accompanying the use of anti-depressant and anti-anxiety medication, which have far greater adverse events.

Moreover, written into the law, people with a history of psychosis (who are most at risk for an adverse event) are deemed inappropriate for this type of treatment and will be screened out by the service centers.

Psilocybin therapy will be administered by facilitators. Dr. Coutin incorrectly states that they will not be licensed. Facilitators must, by law, be licensed by the state. For licensure, applicants must complete a 160-hour Oregon Health Authority (OHA)-approved training program, including a 40-hour practicum, and also pass an exam.

Finally, Dr. Coutin suggests that only “hipsters and activists” are seeking these services. That is not only false, it is disrespectful to the dozens of Deschutes County residents who testified recently about the need for this therapy in our community. They included veterans struggling with PTSD, people suffering from debilitating depression, therapists desperate to be able to offer something else to their patients, and hospice nurses wishing to help alleviate their patients’ anxiety and depression.

Our community’s need for safer and more effective mental and behavioral health treatments is enormous. We now have a therapy that has been proven to be safe and effective when administered in a facilitated session and a heavily regulated program with appropriate safeguards. I urge Deschutes County voters to vote against the opt out measure in November.

Do you have a point you’d like to make or an issue you feel strongly about? Submit a letter to the editor or a guest column.