The state of Oregon has finally given permission for the nation’s first legal psilocybin therapy clinic to begin business. This comes after over two years of rule-making—and waiting—after voters chose to legalize in November 2020. It ensures that doors will open to clients this year, as planned. But it also confirms, as has long seemed inevitable amid expensive regulatory requirements, that the cost of legal treatment will be high—leaving it out of reach for lower-income residents.
On May 5, the Oregon Health Authority (OHA) announced that it had granted a “service center” license to EPIC Healing Eugene.
“This is such a historic moment as psilocybin services will soon become available in Oregon.”
“This is such a historic moment as psilocybin services will soon become available in Oregon, and we appreciate the strong commitment to client safety and access as service center doors prepare to open,” said Angela Allbee, Oregon Psilocybin Services section manager, in a press release.
Allbee told Filter that she anticipates OHA will approve additional service center licenses throughout the remainder of the year.
At these service centers, a trained, licensed “facilitator” will meet with each client for an initial preparatory session at least 24 hours beforehand, discussing their health history and expectations. Then the client will take the drug while the facilitator supervises them, acting as a first line of defense for any issues—for as long as the trip lasts. No medical diagnosis is needed to obtain the drug. But there is no option to take it home, and service centers will be the only places you can legally buy it.
So far this year, OHA has issued at least one license for each of the other business categories that make up the system: product manufacturer, testing laboratory and facilitator. It now seems certain that OHA’s stated goal of having members of the public begin purchasing psilocybin this year will soon be met.
A high dose (2.5-4 grams) is $3,500 for an individual session.
According to Willamette Week, EPIC will open by June 1 and serve 30 clients a month. It will be offering several levels of psilocybin service, for both individuals and groups. These options include two tiers of “microdose” (with immediate effects anticipated to last 1-3 hours), and low, medium or high doses of psilocybin (4-6 hours).
A Level 1 microdose (0.1-0.4 grams), will cost you $500 for an individual session. A high dose (2.5-4 grams) is $3,500. Group sessions are discounted—for example, a medium dose session that costs $2,800 individually would cost $2,300 per person for a group. OHA has itself acknowledged that such prices will be too high for many people.
All costs include a one-hour preparation session and a one-hour “integration” session, where the client and facilitator meet afterwards to discuss the experience. The drug itself has a separate price, about $15 per gram, plus a 15 percent state tax.
According to EPIC’s website, it will offer limited spots to people in financial need, who may qualify for a scholarship and reduced costs. The company is currently accepting applications from clients interested in the services, who have to join a waitlist.
Health insurance plans will not cover the cost of the drug or the session, because psilocybin is a federal Schedule I controlled substance, and not approved by the FDA—although research indicates the drug may provide benefit to people with depression, substance use disorder, migraines and end-of-life distress. However, some insurance plans may cover the preparatory and integration sessions, during which no drug is consumed.
One question that’s raised by this news is, are psilocybin services being defined as therapy, medicine or something else?
State rules don’t make this totally clear. On EPIC’s website, it describes psilocybin services as “therapy” and the drug as “medicine.”
But facilitators are not medical professionals—besides training, the only requirement is a high school education. And service centers are not medical clinics—OHA rules actually state that licensed facilities may not share the same building with a health care facility.
“We just recommend that people don’t use the word therapy. It confuses people in the public and they think about diagnosing and treating mental health conditions.”
Before taking the drug, clients will be asked to fill out a consent form stating, “I understand that psilocybin services do not require medical diagnosis or referral and that psilocybin services are not a medical or clinical treatment.” The “scope of practice” for licensed facilitators prohibits them from diagnosing or treating mental health conditions. And psilocybin companies are prohibited from making certain statements, such as saying that the drug has “curative or therapeutic effects.”
Some of this may seem like linguistic hairsplitting, and the federal and FDA stance on psilocybin could well change as continuing scientific investigations filter through to politics and policy. Still, precision might matter to an individual with certain medical conditions who’s spending a large amount of money.
“This is a difficult issue because when people hear the word ‘therapy,’ they think of the clinical modal of therapy,” Allbee told Filter. “Although some people refer to Measure 109 as psilocybin therapy, there’s nothing in statute or rule that refers to or defines the provision of psilocybin services as therapy.”
“Clients can receive services for any reason,” she continued, “and it’s important to note that services must be provided in a nondirective approach—licensed facilitators support clients in their journey but do not direct or guide those clients.”
Allbee wouldn’t comment on whether the language on EPIC’s website follows the rules, but said that anyone who believed it doesn’t could file a complaint through OHA’s website. OHA is responsible for making sure all licensed businesses and workers comply with state rules.
Asked if using the word ‘therapy’ is prohibited, Allbee said, “It depends on the situation and how it’s being used, ensuring they’re not claiming to have curative or any medical benefit… We just recommend that people don’t use the word therapy. It confuses people in the public and they think about diagnosing and treating mental health conditions.”
It’s likely that many of those who are finally able to access legal psilocybin this year will be happy to go ahead regardless. Many others won’t be able to afford it in the first place.
Photograph of a psilocybin therapy experiment at Johns Hopkins University by Matthew W. Johnson via WikiMedia Commons/Creative Commons 3.0
