Colorado’s opportunity to determine its own mental health rules [Reason]

It is safe to assume that psychedelic medicine will be legal within the next decade across most of the United States, given a steady flow of promising clinical trials in mental health research and growing bipartisan political support. Colorado voters now have an opportunity to decide whether they want to craft their own medical standards or cede authority to the federal government.

Under Proposition 122, the Natural Medicine Health Act, Colorado would create America’s second state-regulated framework for allowing certified mental health professionals to administer psychedelics.

Some opponents have raised concerns about creating a legal framework for currently illegal compounds, especially in the wake of a national opioid epidemic. But this line of opposition ignores the fact that the Food and Drug Administration (FDA) has taken steps in recent years to fast-track the approval of psychedelics for use in serious mental health conditions.

For the last two decades, nonprofits have poured over $100 million into rigorous medical trials around the world to prove that psychedelics can be an effective treatment for the most challenging mental health cases, including PTSD, anxiety, suicidal ideation, ADHD, and alcohol use disorder. The outcomes of these trials have repeatedly shown that psychedelics are extraordinarily effective—often two to three times more than any other known treatment.

In 2023, physicians will likely be allowed to prescribe the psychedelic compound MDMA to those experiencing PTSD, given how far that modality has advanced in the FDA regulatory approval process. Psilocybin, the active ingredient in “magic mushrooms,” shows similar promise and will likely be available for medical prescription in the next few years.

There are several reasons for Colorado to take matters into their own hands rather than cede control over its destiny to other states or the federal government.

First, leading medical researchers, including those from Johns Hopkins, have argued that psychedelics should be taken off the list of dangerous drugs because an overwhelming amount of scientific studies show them to be safe and effective. The current legal pathway to reclassify psychedelic drugs is through the FDA approval process.

Unfortunately, the traditional pharmaceutical model does not work for naturally occurring compounds. Psilocybin mushrooms grow in nature and cannot be patented in their natural form, so pharmaceutical companies have little incentive to invest hundreds of millions of dollars into clinical trials. The FDA drug approval process was never set up to evaluate the efficacy of naturally occurring botanicals, but Colorado has an opportunity to offer its citizens access to natural medicines outside of the traditional FDA process.

Second, it is reasonable to expect psychedelic-assisted treatment through a doctor’s prescription to be extremely expensive and exclusive. A likely scenario where the FDA only permits psychedelic-assisted therapy under extremely limited circumstances and requires a protocol where each patient is privately counseled by two professionals simultaneously could cost thousands of dollars per patient.

Proposition 122 would allow professional psychedelic therapy to be administered to groups of up to 30 people rather than requiring individuals to seek more costly individualized services. Allowing this form of therapy could significantly expand access by bringing the cost down for patients to a few hundred dollars.

Third, Colorado will also be the first to legalize several promising compounds, such as iboga, which could be the most effective known treatment for opioids, alcohol, and other addictions. Right now, some nonprofits fly veterans out of the country to get life-saving treatment at clinics offering iboga and other psychedelics, returning to the US to receive follow-up therapy and counseling. Colorado can lead the way and empower its own citizens with better, more effective—and local—tools to improve their mental health

Psychedelic medicine is moving into the mainstream, and its progress is not slowing down. The election this November will determine whether voters lead the way in making the most advanced mental health treatment accessible to all Coloradans.

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