Will Oregon’s Psilocybin Program Solve the Racial Inequities that Cannabis Did Not?
Her doctor recommended she try a course of antidepressants. Instead, Ifetayo Harvey opted for a morning on magic mushrooms.
In October 2013, Harvey was a senior year college student at Smith College, in Massachusetts. On an autumn Saturday morning, she recalls having stood in her dorm kitchen, chopping up the fungi, and mashing them inside a peanut butter sandwich. Nearly 30 days earlier, she had been diagnosed with depression, she says. Thirty minutes later, she was on her first psychedelic trip.
While walking in the woods, Harvey recalls alternating between laughing and crying. She was overwhelmed, but also felt “alive.” Through much of her life, she has struggled with mental illness. Among many stressors, she had to cope with the incarceration of her father — who was later deported to Jamaica — and she has grappled with the challenges of racial discrimination. Harvey says this took a toll on her, manifesting in anxiety, trauma, and eventually, thoughts of suicide. But that morning offered respite. “It reminded me why you should live.”
Since then, Harvey, now 29, recalls having had nearly ten psychedelic trips. All have been in recreational settings. Many have helped her confront painful memories, such as the deaths of people closer to her, offering new perspectives. “There’s this three month warranty on how sad you can be after someone dies…” she said, “after a certain point, you’re expected to move on.” Psilocybin “magic” mushrooms have helped her acknowledge that these memories still affect her. “It was therapy for me because I got to release all those emotions I was hiding.”
Mushrooms have also helped Harvey find laughter when she needs it. “It makes you feel good about yourself… For a lot of folks, joy is not a feeling they feel often.”
In summer 2020, she began using smaller amounts of psilocybin ‒ the active ingredient in magic mushrooms ‒ in capsule form, three to four times monthly, as part of a growing trend called “microdosing.” These smaller, regular doses help her deal with daily anxiety and ruminations and “have a sense of humor about it.”
Harvey’s experience pushed her to launch the People of Color Psychedelic Collective, a New York non-profit educating the BIPOC community about psychedelic drugs.
While an estimated 30 million people have used psychedelic drugs at some point in their lives, people of color have long avoided psychedelics out of fear, due to stigmas arising from decades of discrimination. People of color have also been left out of much of the research conducted to date, even though psychedelics were first used centuries ago in the cultural traditions of the BIPOC community. The drugs can also be effective in treating forms of trauma uniquely experienced by people of color.
As many states consider bills to decriminalize ‒ and in some cases ‒ legalize the drug, they will have to address these inequities. Oregon, the first state to legalize psilocybin services in 2020, will need to consider lack of representation among decision makers, and affordability. Advocates like Harvey are watching closely to see how Oregon responds. (Harvey was employed with the Drug Policy Alliance (DPA), a primary sponsor of Measure 110 ‒ which decriminalized all drugs in Oregon ‒ at the time of its campaign and passage in November 2020.)
Early signs suggest the state is ready to take action. Still, Harvey says she isn’t holding her breath.
Psychedelic Drugs’ Decades of Discrimination
Despite early research having been led by Americans, many psychedelic drugs originated outside the United States. Indigenous healers in Mexico were some of the first to lead ceremonies with magic mushrooms. Other psychedelic drugs have origins in South America and Africa, respectively.
Still, psychedelic research in the United States through the 1950’s and 1960’s was largely led by White scientists, including R. Gordon Wasson, Timothy Leary, Albert Hofmann, and Walter Pahnke. While research was ramping up, so did the association between psychedelic drugs and counterculture, and fears of drug abuse became more widespread.
In the decades that followed President Nixon’s “War on Drugs” declaration in 1971, incarcerations soared in the United States. According to the DPA, the number of nonviolent drug offenses increased eight-fold from 1980 to 1997. Most of these prison sentences disproportionately affected people of color. In 2018, the DPA reported 80% of people in federal prisons for drug offenses were Black or Latino.
As a result, many communities of color hesitate to use psychedelics. Dr. NiCole Buchanan, a Michigan-based psychologist and racial equity advocate with the Chacruna Institute, said her clients react differently when discussing psychedelics, depending on their race. With White clients, “there’s often interest and curiosity… and a notable lack of fear,” said Buchanan. However, Black clients have “a lot of concern, a lot of questions about safety… a lot of questions around how long it stays in your system and could it be tested” if applying for a job or driving the next day.
At some points, Harvey has had similar fears affect her own decision to use psychedelics. She says she refrained from using the drug through all of 2016, when she moved to New York, because of the state’s history with stop-and-frisk policing, which disproportionately affected Black and Latinx communities.
People of color can also face discrimination online when discussing psychedelics. Carolyn Fine, co-founder of the Portland-based Psychedelic Equity Project (PEP), said local Facebook groups are “not a safe space for anyone living along margins of society.” In many of these groups, posts discussing race have long comment threads debating whether the topic should be discussed at all. In 2018, Fine founded the PEP, an online forum for people to openly discuss psychedelics, race, and equity. To enforce safety, PEP requires prospective members to describe their perspective on racism and oppression before allowing them into the group. In the future, Fine is seeking to make the PEP a physical space.
Dr. Diana Quinn, a Michigan-based naturopathic doctor who hosts discussions for BIPOC groups to debrief experiences with the drug, said discussing race in psychedelic communities can be especially difficult. Because the drugs can offer users feelings of enlightenment, discussing racial inequity can be seen as divisive. People “tend to be even more resistant to the conversation because it doesn’t seem like it’s in keeping with the themes of unity, and love, and togetherness.” In the psychedelic community, this trend is called “spiritual bypassing.”
Harvey said racial stigmas compound with the stigma that psychedelics make people “crazy,” given the drugs’ mood-altering effects. Black people “know we don’t have a space to act ‘crazy’ in this world. There’s so much pressure on us to keep it together… It’s sad because you should be able to lose control… that’s how you heal.”
A Potential Treatment for Racial Trauma
Last year, researchers across the United States and Canada sought to understand how psychedelics affect people who have suffered racial trauma, or mental and emotional distress caused by race-based discrimination. Their survey of 313 BIPOC individuals found that, on average, depression, anxiety, and stress related to racial trauma decreased in the 30 days following just one psychedelic experience.
Buchanan says that she has worked with multiple Black clients who have described their ancestors “coming to them” during their psychedelic experiences. They have offered important messages about “their legacy of pain and suffering and triumph.” Buchanan has heard about this trend from enough clients that she feels it “represents a distinct aspect of the psychedelic journey for Black people.”
Harvey, too, says she has thought about her ancestors on recent psychedelic trips. She has reflected on how much her parents and grandparents had to struggle with racism in America. “It not only reminds me of what my elders went through, but it reminds me that I can survive anything because of them. It reminds me of the strength I have behind me.”
Barriers to access can prevent people of color from accessing psychedelics, even in research settings. A 2018 review of 18 studies with psychedelics from 1992–2017 found that 82% of participants were non-Hispanic White, and only 2.5% were African-American.
Dr. Rachel Knox, chair of the Oregon Cannabis Commission, said that the illegality of these drugs has diminished access for people of color. “We need to treat [BIPOC individuals’] trauma with the very thing that was weaponized against them,” she said.
Buchanan also noted the lack of diversity among clinicians and psychologists. A 2020 study found that 84% of psychologists identified as non-Hispanic White, and 4% identified as Black. “This creates a disconnect when…[therapists] don’t have that kind of familiarity,” said Buchanan. “You don’t understand the words and idioms that are used… you don’t understand the cultural history.”
This lack of diversity also risks further hurting patients that do seek help. Black individuals treated with psychedelics have reported confusion and frustration when trying to explain their thoughts to White facilitators. In one documented exchange, a therapist suggested “maybe there is a part of you that doesn’t want to be understood,” while the patient replies, “there is nothing more than I want in life to be understood, especially as a Black woman.”
Buchanan said that microaggressions are especially dangerous in the context of psychedelic experiences because the drug can make patients vulnerable. Patients also cannot leave during the hours-long treatment. “Imagine you’re there, you’re trapped, you’re at the beginning of this multi-hour ride, and now you have something that makes you afraid and ruins your trust with the clinician.”
Oregon’s Push Towards Social Equity
Race and equity are top of mind for key stakeholders of Oregon’s Psilocybin Services Act. Many point to Oregon’s racial breakdown as a risk. Because 85% of the state’s population is White — compared to 78% nationally — Harvey said it may be difficult to assess how these measures and new policies affect people of color.
Natalie Ginsberg, director of Policy & Advocacy at MAPS, said the 2020 approval of Oregon Measure 110 — which decriminalized all drugs — is “a much bigger deal” than the Psilocybin Services Act. Without decriminalization, people who want to engage with psilocybin but cannot afford state-sanctioned services would still be vulnerable to arrest.
But Fine noted that, in the context of psilocybin, Measure 110 removes criminal offenses only from possessing small amounts of psilocybin, but does not decriminalize the act of anyone buying, selling, growing, or harvesting the drug. “You can have them, but you can’t have gotten’ them,” she said.
A 2020 report issued by the Oregon Criminal Justice Commission estimated that drug decriminalization in Oregon would result in 1,800 fewer people in Oregon being convicted of felonies for drug possession annually, and 1,900 fewer Oregonians being convicted of misdemeanors for drug possession annually. Notably, these estimates include convictions not only for psilocybin, but also for cocaine, heroin, and other controlled substances. With respect to racial equity, the report estimated that the drug decriminalization would “likely lead to significant reductions in racial/ethnic disparities in both convictions and arrests.”
Oregon has already once before been down the path of passing drug reform while considering social equity, though with cannabis. While Oregon’s cannabis legalization of 2014 improved certain inequities, others were left unsolved. According to a 2020 ACLU report, total marijuana possession arrests in the state declined 67% from 2010 to 2018. Black people were nearly twice as likely as White people to be arrested for marijuana possession in the state, a trend which changed negligibly from 2010 to 2018. Oregon has one of the lowest racial disparities for marijuana possession arrest rates, as compared to other states.
Only 2.7% of cannabis businesses are Black-owned nationally, and a state legislative report said that ownership in Oregon is likely lower than that because national measures are inflated by California’s cannabis industry. “Lack of capital in Black and Brown communities…has denied equitable access to the cannabis marketplace,” says the report.
For years, the state has run programs to address ownership disparities. However, only in February did state lawmakers propose the Cannabis Social Equity Act, which would integrate cannabis equity into law. The bill proposes creating specialized “equity licenses” with lower fees and modified requirements for BIPOC-owned cannabis companies. It also expunges past cannabis convictions. A press release states that previous legislation has expunged the records of only 200 of 28,000 Oregonians.
“When we decide that social equity just means creating a program that sits peripheral to the regulations of that industry, we’re sort of letting ourselves off the hook.” said Knox, who advised the team behind the Oregon Psilocybin Services Act on social equity, during their campaign.
Knox suggested that the psilocybin services program include priority licensing for BIPOC individuals, similar to the proposed Cannabis Social Equity Act. She also recommends that the Psilocybin Advisory Board — who will advise the Oregon Health Authority on crafting regulations for the program — include people of color. According to the Oregon Health Authority, interviews with board candidates began last week, and the board is expected to be finalized by the week of March 15th.
The first month of Oregon’s two-year development period shows signs of promise. Candidates interested in applying for the Psilocybin Advisory Board needed to fill out an application with three questions, two of which asked them to explain their expertise and ideas for addressing racial equity.
In an e-mail statement to West Dose, Andre Ourso, a Public Health Administrator at the Oregon Health Authority (OHA), said the agency has “started thinking about equity” with respect to licensure, access for disadvantaged communities, and affordability. “OHA will rely on the advice and recommendations of the advisory board to address these equity issues and identify other areas where racial equity will need to be considered.”
Social equity is also broader than just racial equity. Fine says that many people in the underground psychedelic community who have paved the way for much of the academic research that has happened will not be protected under the Psilocybin Services Act. While they can apply for licenses, there is uncertainty around how the Oregon Health Authorities regulations will compare to the ways in which the drug has been used underground. “It takes a lot of the magic out of it… [the program] is not extending protections to any of the people who are responsible for having legitimized the work.”
Many also want affordability addressed in the program’s regulations. Psilocybin retreats abroad and comparable ketamine therapies in Oregon can cost thousands of dollars. According to Natalie Ginsberg, Director of Policy & Advocacy at MAPS, it is unlikely that psilocybin services in Oregon will be covered by health insurance, unless the drug is approved through FDA clinical trials. “The only way to ever have equity is for the way we do business to dramatically shift… [the reason] we have inequity is because we operate in a capitalist system…”
“It feels like a gatekeeping process,” Fine said, “opening up a sacred medicine…to corporate interests.”
Reflecting on social equity and the potential for psilocybin services in Oregon, Harvey is cautiously optimistic. She insists, “to change policy is one thing… but to change culture is another.”