As psychedelic therapy arrives in the Pacific Northwest, professionals learn to lead trips

DAMASCUS, Oregon – Among tall Douglas firs and oaks, surrounded by a winding creek that empties into the Clackamas River, a new kind of therapist is being created in Oregon.

The aptly named Inner Trek is one of many companies taking local mental health professionals, healthcare workers, and alternative healers on a six-month course that will earn them certification from Oregon Health. Authority to become one of the first guides to administer psilocybin to people in the United States. On Friday, at a retreat center in Damascus, east of Portland, about 30 people gathered to learn how to counsel people through a psychedelic experience.

While psychedelic drugs remain illegal at the federal level, Oregon’s Measure 109 passed voters in 2020 and will allow licensed administration of psilocybin at licensed service centers across the state by licensed guides from next year.

The industry launch in Oregon provides a glimpse of what a potential rollout in other states, including Washington, could look like. While a legalization bill in the last Washington legislative session failed to gain traction, efforts are likely to resurface.

More recently, voters in Colorado have followed in Oregon’s footsteps, and already local municipalities across the country, including Seattle, are decriminalizing the use of psychedelics, while dozens of ketamine-assisted therapy courses and MDMA are recruiting mental health professionals to jump headfirst into a psychedelic. Renaissance.

But with certification courses costing thousands of dollars and thousands of people seeking care in a nationwide mental health crisis with worker shortages, how will this first wave of treatment unfold?

The “magic” of mushrooms

There are over 200 varieties of psychedelic mushrooms around the world. If ingested, psilocybin – the active ingredient in “magic mushrooms” – creates a mind-altering experience, often described as intense, euphoric or mystical. This sometimes includes visual hallucinations or, in rare cases, synesthesia, a neurological condition where the senses are experienced differently and a person can taste colors, for example.

Compared to drugs like alcohol, psychedelic mushrooms are generally considered safe with low abuse potential and no known lethal doses. Although not advised for people with serious mental illnesses like bipolar disorder or schizophrenia, for people with depression, PTSD or trauma, a growing body of research has found significant therapeutic benefits.

Researchers at the John Hopkins Center for Psychedelic & Consciousness Research, for example, found that two doses of psilocybin provided relief for people with major depressive disorder for up to a year in some cases. The study, though small, was published in the Journal of Psychopharmacology in early 2022. Other researchers are investigating the value of psychedelics in helping people quit smoking, people with chronic illnesses or anorexia, and even healthcare workers suffering from burnout.

To go on a trip

In Oregon, psilocybe cubensis, a common variety that grows in the Northwest, will be the species used in the treatment. Guests do not have to be Oregon residents or have a mental health diagnosis, but must be at least 21 years old. informed consent form (the medicine can cause headaches, nausea and increased blood pressure, among other side effects).

Then they will undergo a six to eight hour session with the drug, where a guide is expected to keep them physically safe and help them if their journey becomes uncomfortable or stressful. Although many people have a good experience with psychedelics, it is not uncommon for the trip to become overwhelming or frightening at times.

In the guide trainings, “we explain…how to make a really thorough selection, how to help a client refine their intention for the journey they’re embarking on,” says Jason Foster, a former civil engineer turned therapist and psychedelic. educator with Inner Trek. ” And give [clients] the tools and knowledge of what to expect as they embark on the journey.

Finally, a third optional session called integration will allow customers to give meaning to their trip with the help of their facilitator.

Ultimately, the cost of a session is still up in the air – state officials won’t regulate the cost, but sessions will likely cost upwards of $1,000 (most international experiences cost between $3,000 and $10,000 for a few days to a few weeks).

Foster thinks the first wave of “psychonet” tourism in Oregon will range “from the curious to the spiritually hungry to the suffering people” and he expects them not just to come from Oregon and from Washington, but also nationally and internationally.

Training efforts

Under current Oregon rules, those wishing to obtain a guide license must have at least a high school diploma (although training companies say they often screen potential students with higher standards, looking for people with training in mental or behavioral health). They must also be residents of Oregon for at least two years or wait until 2025 before they can begin providing services.

Facilitators must complete at least 120 hours of training and an additional 40 hours of internship or hands-on experience through an approved training program. Their training ranges from the ethics and responsibility of being a guide, to topics of consent when touching clients, to how to deal with people undergoing a difficult journey, and general facilitation skills before, during and after. a psychedelic experience, as well as self-care. for the guide.

During the Friday class at Inner Trek (owned by Tom Eckert, architect of Measure 109), future animators discussed the diversity of the psychedelic experience for each person. Educators have compared it to a flight: after ingesting psilocybin, the drug can take up to 75 minutes before takeoff. This is where people can expect “turmoil” with feelings of shortness of breath or anxiety. The peak of the drug reaches about three to four hours, with the descent at five or six hours, often in waves of clarity.

Traumatic or repressed memories can arise and cause clients to cry, scream or have answers where they struggle to speak, educators explained to students on the course. Facilitators must be able to help their client without bringing in their own feelings or personal agendas, or overstimulating the client.

Students in the course practiced staying aware during a client’s journey, acting out scenes that other animators had witnessed. Students were also taken through guided meditations, using eye masks and soft music to practice grounding techniques.

Training programs currently cost around $8,000 to $10,000; animators must then pass a state exam before being fired.

Major hurdles remain before the industry is up and running, said Victor Cabral, social worker and director of policy and regulatory affairs at Fluence, another company that provides training for mental health professionals interested in the administration of psychedelics.

“Some of the administrative rules are still in public consultation right now, so they are not finalized,” he said. “They require us to be careful and be prepared to make potential changes, depending on what those finalized administrative rules look like.”

For example, current rules state that clients can only take 5 grams of dried mushrooms (about 50 mg of pure psilocybin) during their session. Some providers are concerned that the dose is too low for some people to receive the necessary treatment, and during the last public comment period they shared it with state regulators.

The 40-hour internship requirement also poses a problem: Students currently cannot legally take people through a psychedelic journey anywhere in the United States to gain vital first-hand experience, which means that this first wave of therapists may be less prepared.

“One of the biggest potential problems is that there are only guides who aren’t ready to engage people and guide them through these experiences,” Foster explained.

Many students choose to earn these hours in Jamaica or Mexico, where retreats have sprung up allowing new guides to train.

What’s next for Washington?

While the Oregon Health Authority will begin accepting applications from facilitators, service centers, labs, and manufacturers on Jan. 2, it’s unlikely many will be ready soon. Getting this new supply chain going will take time – educators believe everything will be fully operational by summer or fall 2023.

Psychedelic aficionados also raise concerns that plague the mental health field in general — how the workforce is largely white, despite Indigenous psilocybin use and barriers to accessing care. This form of treatment is not reimbursable by insurance and the high cost means that some people who would benefit most from care are the least likely to be able to afford it.

In Washington, State Sen. Jesse Salomon, D-Shoreline, who proposed a bill to bring psychedelic-assisted therapy to Evergreen State, is taking notes on Oregon’s efforts.

Solomon said he plans to try again in the next legislative session. After becoming the face of state legalization, he hears from people who would like the opportunity to heal or have a once-in-a-lifetime experience.

“One thing we did – and I think it was genius – was let Oregon go first and then we’ll just learn, either by adopting what they did or learning from their mistakes. “, did he declare.