Magic mushroom advocates following cannabis playbook
Say psychedelic drugs are therapeutic, should be decriminalized
ALEXANDER KARASIK, a 31-year-old engineer living in Somerville, first tried using “magic mushrooms” while traveling in Thailand. He said his experience with the illicit hallucinogenic drug opened him up to seeing more beauty in the world. “I see the life and aliveness in nature and living creatures more,” Karasik said.
After he was nearly killed in a robbery in Chicago and diagnosed with post-traumatic stress disorder, Karasik again turned to mushrooms, this time as medicine in combination with traditional therapy. “It really helped me move forward and significantly changed my perspective on what happened in a positive way,” he said.
Karasik today is part of a group, Baystaters for Natural Medicine, seeking to decriminalize psychedelic drugs like mushrooms. While the drugs are illegal under federal and state law, resolutions to make enforcing the laws a low priority for law enforcement have passed in Cambridge and Somerville. State Rep. Mike Connolly, a progressive Democrat from Cambridge, has introduced a bill that would establish a task force to study the potential legalization of entheogenic plants, another term for hallucinogenic or psychedelic drugs.
The debate over magic mushrooms in many ways mirrors early discussions around cannabis. Advocates seem to be following the same playbook as they did with marijuana in Massachusetts and other states. They are pushing for decriminalization in a growing number of cities. Then they try to legalize it for medical use, as was done in Oregon. Longer term, the goal is to fully legalize the drug.
James Davis, lead organizer for Baystaters for Natural Medicine and another advocacy group Decriminalize Nature Massachusetts, argued that the public health risk of not legalizing psychedelics “is far, far higher” than legalizing them.
Davis said it is clear that incarceration does not help drug addiction. He said legalization would destigmatize the use of these plants and make them more accessible for research to determine their medical benefits – such as ending opioid addiction, which can be fatal. “We have a moral obligation to others to destigmatize plant medicine so people can access it equitably,” Davis said.
Entheogenic plants are natural plants that contain psychoactive compounds that can cause psychedelic experiences. The most well-known are “magic mushrooms” – mushrooms that contain the mind-altering compound psilocybin. Another plant, peyote, a cactus containing the compound mescaline, is legal in the US only for religious use by the Native American church. There are other entheogenic plants, like iboga and ayahuasca, which are less common in the US.
Historically, these plants have been used for ritual purposes in various parts of the world, including the Americas and Africa.
Mushrooms are eaten raw. Because they do not taste good, they are often brewed into tea, baked into chocolate, or spread on peanut butter and jelly sandwiches.
The drugs have been illegal and classified as Schedule I – which means they have “no currently accepted medical use and a high potential for abuse” – since the Nixon administration.
Users describe seeing hallucinations, experiencing out-of-body sensations, and perceiving music differently. Some describe having mystical and spiritual experiences.
From a medical perspective, there are potential uses for entheogenic plants. The US Food and Drug Administration gave psilocybin “breakthrough therapy” status for treating depression, a designation indicating that it has shown promise and will be tracked for a faster approval process. Medications using psilocybin to treat depression are in clinical trials, though none are approved.
Massachusetts General Hospital recently announced that it was launching a new Center for the Neuroscience of Psychedelics, which will study the potential mental health benefits of treatment with psychedelic drugs.
The Johns Hopkins Center for Psychedelic and Consciousness Research in Maryland has conducted studies that found that psychedelic drugs can potentially treat nicotine and opioid addiction and reduce anxiety in patients with life-threatening cancer. Johns Hopkins psychiatry professor Matthew Johnson, associate director of the center, called the results “promising,” and said the science “is extremely strong in showing large efficacy.”
Dr. Ari Kriegsman, an addiction medicine specialist at Mercy Medical Center in Springfield, said the science is preliminary because of the challenges in running trials with an illegal drug and because there is no way to perform a placebo-controlled test, since the impact of psychedelics is so strong. But he said early results show psychedelics work with significant effectiveness in addressing behavioral health problems such as addiction, depression, anxiety, and obsessive-compulsive disorder. Psychedelic drugs work quickly, and one experience can impact someone’s brain for months.
For a person with depression, for example, who keeps ruminating on one intrusive thought, like guilt or a lack of self-esteem, the use of a psychedelic drug can disrupt that pattern of thought.
“They seem to work incredibly well in the small sample size we have, and they seem to work in a lot of ways more effectively than the standard therapies we have,” Kriegsman said.
Jennifer Stell, a 43-year-old nurse living in Leominster, has spent most of her life suffering from migraines and cluster headaches, which left her in constant pain and led her to become addicted to opioid pain medication, then heroin.
Several years ago, she tried using psilocybin mushrooms. She describes her first experiences as “heavy,” and said she became introspective, having an internal dialogue with her subconscious. Yet after getting headaches nearly daily for years, she didn’t get a headache for six months. “It was a life changer for me,” Stell said. She has used mushrooms three or four times and each time the effect lasts longer.
Stell also had a treatment with the illicit entheogenic plant ibogaine. She described that experience as seeing a picture show in her head, and said it helped end her addictive cravings.
Stell said she worries that waiting for Food and Drug Administration approval for medications will take too long. Decriminalization would let people who want the drugs access them without fear of arrest.
But while psychedelic drugs are not addictive, there are risks to altering someone’s mental state.
Kriegsman said there are concerns that someone could have a psychotic break and be unable to differentiate between reality and hallucinations, either temporarily or longer term. Someone could have a traumatic experience, which could lead to post-traumatic stress disorder. Johnson said psychedelics can exacerbate someone’s existing mental health condition. Someone who panics while under the influence might engage in dangerous behavior.
Kriegsman said these risks are very, very low in the controlled setting of drug studies. But those studies have been performed on a select group of people in a safe setting, with preparation and a trained guide talking them through the experience. “That’s a different scenario than buying mushrooms off your neighbor and taking them alone or with someone else or mixing them with other drugs or alcohol, or being someone who might be prone to mental illness,” Kriegsman said.
Walpole Police Chief John Carmichael, who has advised the state on marijuana policy, said the police have been called on people who had a “bad trip” using psychedelics and are acting out with paranoia or hallucinations. He noted that edible mushrooms can be accidentally mixed with poisonous mushrooms.
Scientific studies have shown that ibogaine can reduce cravings for opioid drugs – but it has also been associated with a risk of cardiac arrest.
The Somerville City Council passed a resolution in January, in a unanimous 9-0 vote, saying no city resources should be used to enforce laws against the use and possession of entheogenic plants. It says enforcing laws against distributing and growing these plants should be “amongst the lowest law enforcement priority for the City of Somerville.” (Laws prohibiting commercial sale of the plants, sales near a school, and impaired driving could still be prioritized.) It also says the police should make it a low priority to make arrests for drug possession of any substance. The Cambridge City Council adopted a similar resolution February 3 in an 8-1 vote.
According to Davis, Northampton is expected to become the next city to consider a similar resolution, and two other communities may follow suit.
Cambridge City Councilor Jivan Sobrinho-Wheeler, who introduced Cambridge’s resolution, said the resolution fits with the city’s approach “to treat substance use as a public health issue rather than through the lens of criminalization.” He also cited the research suggesting entheogenic substances and mushrooms offer health benefits in terms of cognitive awareness.
According to national law enforcement data, psychedelics are available around Boston, but are less prevalent than in other parts of the country. They are most common among college age kids and in concert crowds. Carmichael said fentanyl, cocaine, and pharmaceutical drugs are abused far more frequently than psychedelic drugs.
The Cambridge and Somerville resolutions are unlikely to have a huge impact on police practice.
While possession of hallucinogens in Massachusetts is a misdemeanor offense, punishable by a fine or jail time, Carmichael said typically, officers will use the state’s protective custody statute to bring the person to a medical facility, rather than arresting them.
In Cambridge, Police Department spokesman Jeremy Warnick said the drug enforcement unit was already focused on crimes that cause the most social harm, including those involving more dangerous drugs like fentanyl, heroin, crack cocaine, and manufactured drugs. If someone is under the influence of a psychedelic drug, the police will most likely seek medical attention for them. In 2019, there were only two cases in which the Cambridge police made an arrest or filed a complaint for distribution or possession of hallucinogens. There were four cases in 2018 and one in 2017.
Somerville Councilor Jesse Clingan, who sponsored the Somerville resolution, said the resolution still leaves it to police discretion when to apply drug laws. “What we were doing with this is…bringing it to the forefront that this is a low priority for us as a community, so treat it as such. To give them that leeway and that judgment call to be able to not gum up the criminal justice system and not potentially put people into the legal system for something so minor,” Clingan said.
Clingan said he thinks the message around mushroom use should be the same as around cannabis or alcohol: children should not use, and adults should use responsibly.
The resolutions follow a growing national trend. Denver became the first city to decriminalize psilocybin mushrooms in 2019. Oakland and Santa Cruz in California, Ann Arbor, Michigan, and Washington, DC, have since followed suit.In November, voters in Oregon made that state the first to legalize psilocybin to be administered in licensed, therapeutic settings. Oregon adopted a lengthy process for researching and writing regulations with the first license applications to be accepted in January 2023.
Advocates pushing for “psilocybin therapy” in Oregon argued that it provides new options for mental health care. Sam Chapman, executive director of the Healing Advocacy Fund, which advocated for the Oregon ballot question, said in an email that decades of research at Johns Hopkins, NYU, UCLA and elsewhere has shown that psilocybin therapy “shows real promise in helping those who are suffering from depression, anxiety, or substance abuse.” “Currently available options work for some, but not for everyone,” Chapman said. “It’s time to add psilocybin therapy to the toolbox in a way that keeps patient safety and facilitator training top of mind, while also ensuring that these services are affordable, accessible, and equitable for all who stand to benefit.”