New study establishes best practices for safe psilocybin use

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Last year, Oregon became the first state to offer state-regulated access to supervised services involving magic mushrooms, specifically psilocybin.

This change means many Oregonians, who have never tried psychedelics before, might now have the chance to experience them.

However, there were no established best practices for these services because the field is so new. “There are no measures of best practices because the field is so new,” said Dr. Todd Korthuis, a professor of medicine at Oregon Health & Science University (OHSU).

A new publication from OHSU and other institutions has now established best practices to ensure the safety and effectiveness of psilocybin services.

This study, published in the Journal of Psychopharmacology, recruited 36 experienced psilocybin facilitators who have worked in clinical trials, ceremonial settings, and traditional indigenous practices.

The experts identified what they believe are the best practices using the Delphi approach, which involves gathering information from experts through several rounds to reach a consensus.

The study resulted in 22 key measures of high-quality services, including important service delivery processes, safety indicators, and client outcomes.

As other states and localities follow Oregon and Colorado in legalizing psychedelics, this new publication provides the first set of core measures to monitor safety, quality, and effectiveness. Since Oregon’s program is the first of its kind, there were no established standards for measuring the safety or effectiveness of these services.

“This gives policymakers and program managers a harmonized set of measures they can use to assess how safe and effective these services are in the community,” said Dr. Korthuis, the study’s senior author.

In Oregon and Colorado, voters have approved the use of psilocybin in supervised settings for people 21 and older. Other states may also authorize the use of psilocybin and other psychedelics for medical therapy. Psychedelics have been tested in clinical trials for treating mental health conditions like depression, alcohol use disorder, and post-traumatic stress disorder (PTSD). However, it’s unclear how the safety and benefits seen in controlled experiments will translate to widespread state-approved community access.

The study identified core measures that range from the obvious to the unexpected. For example, facilitators should ask about clients’ boundaries and preferences around touch before a session, as some clients may want human touch, like holding hands, to help them navigate the experience. Clients should also rate the overall benefits and harms of their experience, and facilitators should complete a safety checklist to document items such as whether the client left before the session was complete or needed medical attention.

These measures provide important tools for the new psychedelic services industry. The results of this study will help researchers, policymakers, and service providers decide what data to collect to monitor their programs. By using the same set of measures, state-level programs can be easily compared and combined to get an overall picture of safety and success.

The researchers included members of the Open Psilocybin Evaluation Nexus (OPEN), a group of therapists and scientists focused on researching the safe and equitable implementation of psychedelic services, including those approved by Oregon voters in 2020.

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