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As Arizona considers psilocybin trials, the pros and cons of psychedelics for treating mental health

A bipartisan Arizona bill that would create a $30 million fund to study the effects of natural psilocybin — also known as magic mushrooms — on people with mental health disorders, passed in the House and is awaiting Senate approval.

If signed, it would make Arizona the first state to sponsor controlled substance trials of natural mushrooms, according to Dr. Sue Sisley, president of Scottsdale Research Institute.

“Even though psilocybin mushrooms are federally illegal, we know that there's millions of people around the globe that are actively utilizing psilocybin mushrooms to treat a variety of their own ailments. So we just want to understand how these mushrooms are working or not working,” Sisley said.

In 2021, Texas began funding psychedelic-assisted therapy research.

The Food and Drug Administration has not approved magic mushrooms for medicinal use. However, doctors can prescribe other types of medications to those with mental disorders.  Ketamine, an authorized psychedelic, is an example.

Psychedelic treatments don't just involve taking ketamine or mushrooms and calling it a day. According to Quinn Snyder, chief medical officer at DayTryp Health Ketamine Clinic in Phoenix, medical professionals must closely follow patients in a monitored setting. 

“Psychedelics allow the brain to rewire itself in a certain way, and after it's settled down for a brief period of time, people can then engage in integration and try to develop those new neural pathways within their brain which will allow them to lead a more functional life," said Snyder.

Psychedelics are essentially a tool to help those with post-traumatic stress disorder, for example, become more open to working through their disorder in therapy sessions.

Although the practice has strong support from both legislative and medical experts, some think that using psychedelics for mental disorders isn’t a black-and-white issue.

“There are a lot of risks associated with using psychedelics, a lot of them have to do with the psychological risks associated with having a challenging or difficult experience,” said Dr. Brian Pilecki, a psychologist based in Portland, Oregon. 

“Especially when one uses psychedelics in a setting that's either unsafe or uncontrolled, maybe somewhere in public, where things can happen that can lead to or contribute to a lot of distress, either during the experience and/or afterwards.”  

Pilecki believes the process should include more than just prescribing psychedelics — he says doctors should include harm reduction.

“When clients come to me and bring up the topic of psychedelics, I see my role as helping them, learn about it, develop a set of realistic expectations, and make a decision that's right for them,” said Pilecki.

In January, Oregon became the first state to legalize the use of magic mushrooms. Although not available for retail purchase like cannabis, the legislation allows anyone over 21 to consume the mushrooms in a supervised setting. 

"There are a lot of risks associated with using psychedelics, a lot of them have to do with the psychological risks associated with having a challenging or difficult experience." — Dr. Brian Pilecki, psychologist

According to Pilecki, the measure exists outside of the space of healthcare and to make psilocybin treatments more accessible. He says to be a facilitator, all you need is a high school diploma and 160 hours of training from a state-approved program.

Sisley says FDA approval is the only thing stopping mushrooms from changing the health care industry across the country.

“If there's a potential that whole natural mushrooms, that really only costs pennies to grow, could also have either equal therapeutic benefit or even go beyond what a synthetic molecule can produce, then that is really encouraging,” she said. “That could really revolutionize health care.”

“If nature can produce things so inexpensively that can help heal people, then it's important for the public to know that and to figure out how we can harness that legally and safely," Sisley said.

Ajona Olsen, medical director at DayTryp, says psychedelics including ketamine aren’t a one-size-fits-all treatment for every mental disorder.

“All of the psychedelics have quite a bit of promise in all mental health conditions,” she said. “I think schizophrenia, psychosis, maybe bipolar and mania being ones that they aren't very effective with," said Olsen.

Olsen says psychedelics show more promise for treating depression, anxiety, PTSD, addiction and eating disorders.

Oregon and Colorado are already developing training programs for this new type of integration therapy, according to Sisley.

“There's potential that these two states will be able to ramp up the training to a degree where we have tons of new trained therapists and facilitators available to create the possibility that integrated therapy could be accessible to everyone eventually,” Sisley said.

Sisley estimates at least 20,000 new therapists will be needed to accommodate the new psychedelics.

Although groundbreaking, accessibility to psilocybin treatment, once FDA approved, is another factor to consider. Currently, both magic mushrooms and  MDMA, another psychedelic commonly referred to as ecstasy or molly, are classified as Schedule 1 drugs by the federal government, making them unable to receive federal funding for research.

“It is a concern that MDMA-assisted therapy and psilocybin assisted therapy, via the route of FDA approval, will initially be very expensive, and likely not initially covered by insurance,” said Pilecki. “So, who will have access to it? Those who have the means and the resources. And so this is kind of replicating the current systemic inequities that exist in our health care system.”

In 2020, Valley resident Dave Romanelli sought ketamine treatment from Daytryp after dealing with the trauma of his daughter being diagnosed with leukemia. He says the experience helped him work through his mental health.

"You see and you feel a version of yourself that's optimal, and it's up to you to keep that bridge open to that version of yourself," said Romanelli. "I mean, I still have many days where I get triggered or worried but I’m aware of what’s possible because of the experience with ketamine, and it’s my daily practice to reconnect with that place.”

With its fair share of opponents and supporters, society will have to wait to see whether both state and federal lawmakers are willing to support natural psilocybin.

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Rithwik Kalale is an intern for KJZZ. He graduated from Arizona State University with a bachelor’s degree in journalism, and is currently in his last semester of graduate school.Kalale has worked as a community and culture reporter for the State Press, as a health reporter for Arizona PBS and as an editorial assistant for Zócalo Public Square. He also produced and hosted his own show called "POP48" for Blaze Radio, ASU’s student station. His goal is to cover both digital and audio stories that spotlight underrepresented groups.Kalale is a Bay Area native, but splits his time between the U.S. and India, where his family lives. In his free time, Kalale likes to play video games, binge TV shows and attend concerts.