On January 2, Oregon health officials began accepting license applications from businesses and individuals that want to provide psilocybin therapy services. We won’t see the nation’s first psilocybin service centers open until later in 2023. But this is an important next step after two years of debate and rule-making.
Oregon Psilocybin Services, part of the Oregon Health Authority, will be reviewing license applications from would-be psilocybin manufacturers, testing labs, service centers and individual practitioners known as “facilitators.”
Strict regulations govern every stage of getting the drug to consumers. Psilocybin must be grown by manufacturers using approved facilities and equipment, then sent to labs to be tested for heavy metals and contaminants. Then it will be sold to service centers—clinics where people will go to take psilocybin, and the only places where it will be legally available and sold. And finally, licensed facilitators working at the centers will help prepare and supervise customers through the experience, tasked with keeping them safe.
“To date we have 19 approved [facilitator] training programs; some of those have already been started.”
According to Oregon Psilocybin Services Manager Angela Allbee, the facilitator licenses will be processed the fastest. Facilitators must complete a training program from an independent provider, meeting curriculum requirements set by the state. No medical or psychology degree is required—besides completing the training, facilitators just need a high school education.
“We started the process of approving training curricula in June 2022,” Allbee told Filter. “To date we have 19 approved training programs; some of those have already been started … Ultimately someone will have to complete that training program before applying for a facilitator license.”
The other three license types—manufacturer, testing lab and service center—are more complicated and time-consuming to obtain, because they require additional steps like local zoning approval and compliance with municipal law, property owner consent, and an on-site inspection from state health officials.
Asked when she expects the first service center licenses to be issued and the centers to open, Allbee said, “I don’t have that information. A lot of that depends on the readiness of the applicant. It’s tremendous work to set up a small business that is associated with a federally illegal Schedule I substance.” Still, she predicted that the first licenses may be issued as soon as the second quarter of 2023. Applications can be completed online or by mail, and will remain open for businesses to begin the process throughout the year.
In addition to these requirements, anyone working with or handling psilocybin must also get a worker permit, which costs $25 and is valid for five years.
In November 2020, Oregon voters approved ballot Measure 109, which legalized these psilocybin services. During a two-year implementation phase from 2021-2022, a state-appointed advisory board discussed and recommended rules to the health department for how the program should work. In May 2022, the state approved rules for which psilocybin products would be allowed, testing requirements, and how facilitators must be trained. Then on December 27, the state approved a final set of regulations.
Oregon is limiting psilocybin products to one mushroom species, Psilocybe cubensis, stating that evidence on whether the many other psilocybin species are safe and reliable to consume is unclear. Mushrooms must be grown in “food grade” material—manufacturers cannot use raw manure or wood chips as a growing medium, although finished compost is allowed.
The sticker price of psilocybin services will remain an issue as we approach the opening of the first centers.
Service centers will be able to sell one serving of psilocybin at a time to clients, up to a maximum dose of 25 milligrams. Microdosing—involving amounts too small to trigger effects like hallucinations, but potentially enough to affect your mood, energy or emotional state—will also be possible. State health officials have acknowledged that this could represent a more affordable and accessible option, because people would be required to spend only 30 minutes under supervision.
The sticker price of psilocybin services will remain an issue as we approach the opening of the first centers. Oregon health officials have admitted that the program will be less accessible to lower-income people, as businesses pass on the high costs of complying with the rules. The state previously rejected a proposal to make psilocybin cheaper by creating a parallel, spiritual-ceremony model for people to use the drug in group settings.
Oregon will, however, require all license applicants to submit a “social equity plan” that explains how they will practice “diversity, equity, justice and inclusion principles.” License holders must explain how they will measure these things, and put it all in writing any time they apply for or renew a license.
The state also took some steps to make license application fees cheaper for certain populations. If you are a veteran, or on Social Security, food stamps or Medicaid, you’ll pay a lower license fee on your application for any license type.
No medical diagnosis will be required for a person to receive psilocybin therapy. But psilocybin providers will be prohibited from giving the drug to clients who have been on prescription lithium within the past 30 days, those who disclose thoughts of causing harm to themselves or others, or those who have been diagnosed with active psychosis. Clients who are pregnant or breastfeeding may participate, but must be informed that the risks of psilocybin are unknown. People with histories of physical or mental illness, who are on medication, who may have allergies to mushrooms or who may require medical assistance are allowed to take the drug—but facilitators will be expected to discuss safety options with them or encourage them to speak with a doctor first.
After some uncertain early steps and controversies, Oregon is poised to get its unprecedented program off the ground. Its progress will be closely watched, in Colorado—whose voters approved a similar program in November—and across the United States.
Photograph by Rohan523 via Wikimedia Commons/Creative Commons 3.0