Psychedelic mushrooms grow in a back garden in this 2008 file photo.
Can we find a middle lane as we consider legalizing psychedelics?
A bill to decriminalize five psychedelics is progressing through the California Legislature. The substances are considered a lifeline by some. But what about the risks?
A Bay Area 21-year-old died recently after taking psilocybin. It was purchased in Oakland where psychedelics are decriminalized. No instructions given. They had an adverse reaction and fell to their death. A Marin County mom lost her 16-year-old when he took psilocybin after reading he could talk to God. Shayne became ecstatic then “flew” off their deck.
I lost my own 21-year-old son Will in an accident caused by psychedelic-induced hallucinations. Two months from college graduation, Will had just started a growing business with a friend. He was in his home with close friends — like many, they perceived psychedelics as fun and “safe enough.” He took two-grams of mushrooms. Things were casual, relaxed. Until they weren’t. Will had a severe adverse reaction. He felt sick, tried to throw up and went into a psychosis. His friends called for help. Yet, with campus responders on the scene untrained in handling a psychedelic crisis, our beautiful son, detached from reality, mistook one ordinary object for another, and suddenly was gone.
Despite these tragedies, I don’t believe in drug-war policies or zero-tolerance approaches. Programs such as D.A.R.E. have had meager impact, and they have left generations without real drug education. But I do worry that we are fast-tracking into psychedelic liberalization without understanding the dangers and developing guardrails.
A new study finds that the use of certain psychedelics among young adults has nearly doubled in three years. While we don’t track prevalence of psychedelic-related harm, we know that, in California, ER visits related to psychedelic use increased by 84% since 2016.
Worst-case scenarios, along with other potential harms, have been obscured by talking points, such as “can’t overdose” and “nonaddictive.” But that’s not the whole story, and it’s misleading. Psychedelics can produce hallucinations and delusions. Emotional responses can range from euphoria to paranoia, terror and fight-or-flight panic, which can result in psychological trauma, erratic behavior, accidental injuries, even violence or death.
Most often, we are speaking about psychedelics as medicine for mental health. Research on psilocybin-assisted therapy for anxiety, depression and alcohol use disorder is encouraging but early-stage. We need large clinical trials to determine safety and efficacy. And clinical improvement is not based solely on the drug — a trained professional prepares, facilitates and processes the experience with a client; the practitioner is integral to the outcome.
Though let’s be honest, whether legal or not, psychedelic use is happening. Whatever we decide as a society, we need reality-based education and proven safeguards. Like psychedelics themselves, decriminalization can both help and harm. Depending on how it’s done, decriminalization has the potential to make use safer, such as reducing barriers to help-seeking. But in this moment of immense cultural enthusiasm for psychedelics, decriminalization also, predictably, will drive increased use, and adverse events along with it. With history as a guide, most of that use will be by young adults and other vulnerable people.
None of these kids I’ve mentioned understood the risks. Will perceived mushrooms as among the “least harmful drugs.” The young person in Oakland thought they could safely heal emotional distress. Shayne thought a “God’s dose” would deliver transcendence.
When we downplay possible adverse outcomes, we fail in our imperative to reduce harm and our ethical duty of informed consent.
Psychedelic legislation needs common-sense safeguards — a framework for setting and support, harm-reduction education, public-health tracking and first-responder training — not “later” but baked into any drug-reform policy. I don’t believe we can we rely on an industry poised to make billions to worry about safety. Public policy is the mechanism to ensure protections are in place.
Kristin Nash is the Bay-Area based executive director of the William G. Nash Foundation, which works in part on harm reduction and psychedelic safety.
Originally published at Kristin Nash