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The safety of supported psilocybin use in Oregon

Nature Medicine volume 30, pages 17–18 (2024)Cite this article

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Legalized psilocybin services have recently begun in the US state of Oregon after a rule-making process initiated by the state’s Ballot Measure 109 in 2020. These services are governed by the Oregon Health Authority, but regulations allow for personal use and rely on facilitators as guides during use. No clinical indication is needed, and guides need not be trained therapists.

We support the decriminalization of psychedelic use and the protection of Indigenous practices, but we believe that policies such as Oregon’s outpace evidence on psilocybin’s safety1. Experts generally agree that psychedelics can be used safely under medical supervision2. However, most trials have excluded people at risk for bipolar disorder, psychosis, suicidality and many physical conditions (including diabetes, arrhythmias, seizure disorders and cardiovascular conditions)3,4. Questions remain about how safety data from these trials may generalize outside carefully controlled research contexts; no data exist yet to support regulatory frameworks to ensure safety for psychedelic use.

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Acknowledgements

W.R.S. is supported by the US National Institute of Mental Health (grant T32MH019112).

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Authors and Affiliations

  1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    William R. Smith

  2. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

    William R. Smith

  3. Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Dominic A. Sisti

  4. Department of Psychiatry, Columbia University, Vagelos College of Physicians & Surgeons, New York, NY, USA

    Paul S. Appelbaum

  5. Center for Law, Ethics & Psychiatry, New York State Psychiatric Institute, New York, NY, USA

    Paul S. Appelbaum

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  1. William R. Smith
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  2. Dominic A. Sisti
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  3. Paul S. Appelbaum
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Corresponding author

Correspondence to William R. Smith.

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Competing interests

D.A.S. serves as an ethics advisor to Tactogen.

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Smith, W.R., Sisti, D.A. & Appelbaum, P.S. The safety of supported psilocybin use in Oregon. Nat Med 30, 17–18 (2024). https://doi.org/10.1038/s41591-023-02727-4

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