Navigating Legality
Recent ballot measures in Oregon and Colorado directed the states to develop regulated and licensed psilocybin-assisted therapy centers for legal “trips.” Oregon’s first center was opened in 2023, and Colorado is now developing its own licensing model.
According to the Oregon Health Authority, the centers are not medical facilities, and prescription or referral from a medical professional is not required.
The Oregon Academy of Family Physicians (OAFP) has yet to release guidance to clinicians on how to talk to their patients about these drugs or potential interest in visiting a licensed therapy center.
However, Betsy Boyd-Flynn, executive director of OAFP, said the organization is working on continuing medical education for what the average family physician needs to know if a patient asks about use.
“We suspect that many of our members have interest and want to learn more,” she said.
Dr. Grinspoon said clinicians should talk with patients about legality during these conversations.
“The big question I get is: ‘I really want to try microdosing, but how do I obtain the mushrooms?’ ” he said. “You can’t really as a physician tell them to do anything illegal. So you tell them to be safe, be careful, and to use their judgment.”
Patients who want to pursue microdosing who do not live in Oregon have two legal and safe options, Dr. Grinspoon said: Enroll in a clinical study or find a facility in a state or country — such as Oregon or Jamaica — that offers microdosing with psilocybin.
Clinicians also should warn their patients that the consequences of obtaining illicit psilocybin could exacerbate the mental health stresses they are seeking to alleviate.
“It’s going to get worse if they get tangled up with law enforcement or take something that’s contaminated and they get real sick,” he said.
Lisa Gillespie contributed reporting to this story. A version of this article appeared on Medscape.com.