Kevin Saunders, a mayoral candidate in Marina, a town near Monterrey, recently filed a state ballot initiative to decriminalize mushrooms containing the psychedelic compound psilocybin.  Sensing a shift in public sentiment in the wake of California’s historic legalization of marijuana, scheduled to go into effect in early 2018,  Saunders was evidently also inspired because of his own personal experience using psilocybin mushrooms to overcome a heroin addiction.

While carefully controlled clinical trials have found benefits from laboratory synthesized psilocybin, the open use of psychedelic mushrooms poses far more potential complications than the legalization of marijuana. The knowledge of how to adequately control for safe outcomes with individuals who have consumed psilocybin remains limited to a handful of clinical investigators and an underground cohort of cultural aficionados of psychedelic mushrooms who have developed their own networks and systems of use.

Individuals who trivialize the ingestion of psilocybin mushrooms and fail to take proper safeguards are at significantly higher risk for encountering serious psychological side effects.

For the vast majority of potential users, open access would require an intensive effort to educate a large populace, which remains relatively ignorant of the range of effects of these powerful psychoactive compounds and unaware of critical safety factors, including screening out potential users with serious underlying psychological vulnerabilities, avoiding the concomitant use of other drugs and alcohol, and paying rigorous attention to optimizing the set and setting of the experience.

Over the past 15 years, several FDA-approved psychiatric research studies have explored the therapeutic potential of laboratory synthesized psilocybin and observed an impressive range of therapeutic effects, particularly in patient populations often unresponsive to conventional treatments.  Our research group at the LA BioMed conducted the first approved treatment study in several decades using a psychedelic treatment model with patients with advanced-cancer anxiety and observed a sustained reduction in anxiety and improved mood over time.  Two subsequent studies conducted on the east coast, and approved to use a higher dose of psilocybin with a larger cohort of subjects, observed even a stronger treatment effect.

Other notable research investigations in the early 21st Century have found that psilocybin helps treat alcohol abuse, cocaine and crack addiction and severe, treatment resistant obsessive-compulsive disorders. Other promising studies are in the planning stages.  But each of these was a highly structured study with very careful monitoring of subject health and safety.

Promising research with psychedelic drugs, particularly with LSD, was  more common in the 1950s and 1960s, but the studies were halted because of the drugs’ association with a politically controversial counter-culture and concerns that uncontrolled use of these compounds outside of research settings posed potentially serious mental health risks to users.  Currently, psychedelics like psilocybin are classified by the federal government as Schedule 1 drugs, defined as unsafe and without medical use, a description clearly out of synch with observations from clinical research, as well as underground use.

While a strong case can be made to decriminalize psilocybin mushrooms by transferring its oversight from the justice system to public and mental health, a corrective that is long overdue, the level of open access we will observe in the near future with marijuana will  not likely be replicated with psychedelics, at least in the short term. Approved clinical research to date has been very encouraging and points the way to entirely new and novel (and potentially more effective) treatments for serious mental health disorders. Yet, we are just scratching the surface in regards to accruing essential information regarding the relative risks and benefits of psilocybin mushrooms.

To date, federal funding has not been forthcoming and support for psilocybin research has been limited to a handful of wealthy private donors, some of whom have their own financial interests in psilocybin.  The lack of federal support for such potentially important investigations with psilocybin limits the scope and integrity of such endeavors.

If legalization of psilocybin mushrooms is ever to become a reality, a process of credentialing facilitators and the settings in which the treatment is delivered will have to be established, ensuring that the strongest safety standards and principles of ethical conduct will be adhered to.  While the open, wild use of such powerful psychoactive compounds is wrought with potential risk, their careful and meticulous exploration by qualified investigators as treatment modalities for psychologically disabling disorders that often fail to respond to our current state of the art therapies will enhance the likelihood that over time psilocybin mushrooms will have a far more salutary than harmful impact on our society.

Charles S. Grob, MD, is an LA BioMed lead researcher and chief of the Division of Child and Adolescent Psychiatry at Harbor-UCLA Medical Center.