Reclassification of Psilocybin
EXECUTIVE SUMMARY:
Currently, psilocybin is placed in the Schedule I category, which means people cannot use this substance medically or recreationally. Studies have shown that psilocybin can lead to people having happier and better lives after partaking in psychedelic-assisted therapy. There are multiple Schedules that psilocybin can be placed in, each having its limitations to the medicinal use of psilocybin. Schedule II is very restrictive in the way that it can be prescribed to patients to prevent abuse. Schedule III is a bit more relaxed, meaning that there are a few more cases that a patient can get psilocybin prescribed. Schedule IV is even more relaxed and allows doctors and psychologists to prescribe psilocybin more frequently. Each of these different Schedules has an advantage compared to the current Schedule that psilocybin has, which is Schedule I. Psilocybin should be used in the medical field because it has the potential to treat patients with depression and anger issues. These different categories also allow researchers to further research the effects of psilocybin on the mind of an individual. Additionally, the black market for psilocybin can be minimized if psilocybin is moved away from the current schedule. Psilocybin should be placed in Schedule III because it allows more people to use psilocybin medicinally, while also limiting the possibility of abuse.
RATIONALE
According to the Drug Enforcement Agency, “Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse” (DEA). Under this classification falls psilocybin, which has different chemicals that many people can benefit from. However, people cannot take advantage of these benefits when this substance is classified as a Schedule I drug. People who attempt to benefit from these chemical compositions are met with numerous consequences. Suppose a person is apprehended with magic mushrooms. In that case, they will get charged with a felony in 49 states, Oregon being the only state legalizing magic mushrooms and allowing them for therapeutic use. This can lead to the person spending multiple years in prison, which can take many years away from their life, and having a felony on their record, which can prevent these same people from being able to get a job or return to a “normal life.” It is unfair for a person to be jeopardized from their future just for wanting to use alternative medicines than what is currently viewed as the standard. Magic mushrooms have chemicals that can be used medicinally but are currently viewed as harmful and the consequences for possessing this Schedule I drug have a longer effect on people than this substance does. This substance has the potential to treat depression and moving it to a different Schedule can help regulate and minimize the black market around it.
Psilocybin Decriminalization
The first policy involving psilocybin is decriminalizing it, just as marijuana started in many states. What this means is that people will no longer be charged with felonies if they are apprehended with magic mushrooms. Aside from this, decriminalizing psilocybin is a stepping stone toward legalizing the substance. In addition to this, it can also allow more researchers to further their research on the short and long-term effects of psilocybin on the human mind. This would be very useful in determining if this substance is then legalized for medical and recreational use. Decriminalizing psilocybin does not necessarily have many benefits compared to other alternatives, but it can lead to possibly bigger consequences and downfalls than the alternatives.
If psilocybin is decriminalized, people and businesses are unable to produce these for others to buy. In addition, this also does not allow doctors or therapists to prescribe them to their clients. This would limit the possibilities for people to obtain psilocybin legally to use it medicinally. This can lead to people illegally growing and harvesting magical mushrooms since they have less to worry about if they are caught with them now. However, people can then get charged with felonies for drug trafficking if they are found producing these items. Only decriminalizing psilocybin can lead to a bigger black market for magical mushrooms than there currently is since people are not as worried about being apprehended with these products. This also limits the scope of research that can be done on psychedelic therapy. While decriminalizing psilocybin would enable psychedelic therapy, it would still be heavily regulated and could potentially slow down the development of knowledge about psilocybin. According to Gregor Hasler, “in psychotherapies, including PAP, temporary symptom amplification has been widely accepted.” This means that, although there are some downsides to using psychedelic mushrooms in therapy, they are still being used in a controlled manner and the professional conducting these therapies can alert safety officials if need be. Knowing that psilocybin can create temporary symptom amplification, moving psilocybin to a medically controlled manner makes more sense rather than just decriminalization. However, if there is no way for people to access these magic mushrooms in a controlled manner, they are more at risk of having psychotic episodes and harming themselves or others. The United States Drug Enforcement Agency also published an article titled “Drugs of Abuse, A DEA Resource Guide ” which states that “Panic reactions and a psychotic-like episode also may occur, particularly if a user ingests a high dose.” Allowing medical professionals to handle prescriptions of psychedelic mushrooms will mitigate this worry of people ingesting high doses of psilocybin. In this same article, the DEA states that people may sometimes misidentify poisonous magic mushrooms. Only decriminalizing psilocybin is a good starting point for the legalization of the substance, but it creates more concerns than if psilocybin was Scheduled as a II, III, or even IV drug.
Schedule II
Rather than decriminalizing psilocybin, it can be moved to Schedule II in the DEA Drug Schedule. This means that the drug is believed to have a high potential for abuse and psychological dependence (DEA). Placing psilocybin in the Schedule II section will give the same benefits as if it were decriminalized, but it will now be legalized for medicinal use. Allowing people to use psychedelic mushrooms can help those who are suffering from severe depression. According to Carhart-Harris, after conducting psilocybin treatment for depression, “Relative to baseline, QIDS-SR16 scores were significantly reduced at all six post-treatment time points” (Carhart-Harris).
Using psychedelics helped people with depression for six months. To test for depression, the QIDS-SR16 test is taken and if someone scores 16 or greater, they are diagnosed with depression. Following these clinical trials, the test subjects’ scores were significantly reduced by a range of -11.8 to -6.6 with 95% confidence in the first 5 weeks (Carhart-Harris). People greatly benefitted intellectually from using psilocybin in a controlled environment. Without the ability to use psilocybin in a controlled manner, these people could potentially still be suffering from severe depression. According to Chris Letheby, the reason for this is that “Perhaps by dismantling pathological patterns of hub connectivity, psychedelics provide an opportunity to reset these networks into a healthier state” (Letheby). Psychedelics can be used to help “reformat” the brain which can lead to changes in people’s lives afterward. Knowing that psychedelics help people be more prone to change can explain why psychedelic therapy led to people having lower scores on the QIDS-SR16 test.
Moving psilocybin to Schedule II also has its downsides, however. While it is placed in the Schedule II category, it will be highly restricted for use in a medical setting. Drugs like Vicodin, Cocaine, and Adderall all fall under this category. However, these drugs do not have the same use and are still heavily regulated across the United States. Vicodin is used for severe pain relief and Adderall is used for controlling ADHD in people who have it, but both of these drugs require extreme circumstances to be prescribed. Just like these drugs, psilocybin will be highly controlled in this category and might limit the scope of research that can be done on the substance. One main concern with the psilocybin research that has been done so far is that these studies “do not argue against the use of placebo with support” (Barnby). The lack of a placebo group does not discredit the study but makes it difficult to interpret the effect of the independent variable, psilocybin, on the dependent variable, therapeutic effect. Keeping psilocybin in Schedule II would allow researchers to delve into the effects of psilocybin, but these studies may be prolonged due to the high restrictions that Schedule II drugs have.
Schedule III
The next possibility for psilocybin placement in the DEA Drug Schedule Chart is Schedule III. Schedule III drugs are defined as drugs that have moderate to low potential for addiction and moderate potential for abuse (DEA). Placing psilocybin in the Schedule III category would still control the production, distribution, and prescribing of psilocybin in the United States like other medically prescribed drugs. Having secure producers and harvesters of psilocybin and magic mushrooms is beneficial for the people because it guarantees that these substances are not contaminated with pesticides or other, more harmful, drugs. People will feel more comfortable consuming magic mushrooms with this category since they will know that the government is enforcing safe manufacturing laws for medical consumption. This category does not make psilocybin or magic mushrooms completely legal as if it was a bagel or regular mushroom, which is ideal since it is still a drug. It would also allow researchers to continue their research at a possibly faster rate than in the previous two examples since there will be fewer restrictions in medical trials. Following a study conducted to test the effects of psychedelics and meditation on behavior changes in life, Griffiths concluded that a high dosage of psychedelics leads to positive mood changes, altruistic/positive social effects, and positive behavior changes, all of which were statistically significant at the 99% confidence level (Griffiths). Of the maximum score, an average of 65.42% experienced positive mood changes, 67.02% experienced positive social effects, and 78.40% experienced positive behavioral changes in the “high dosage, high support” group. Very similar results were seen with the “high dosage, standard support” group, with averages in the previous examples only being about 10% lower. With the group that was given “low dosage, standard support,” the results in the previous examples were not statistically significant at any level. We can then conclude that these life changes were not due to mixing psychedelics with meditation but instead that these positive effects were due to a high dosage of psychedelics. Allowing people to take this substance can significantly improve their outlook if they consume it responsibly.
Placing psilocybin in Schedule III also comes with its disadvantages. Just like other drugs, psilocybin is prone to be abused. Anabolic steroids, Codeine, and Testosterone are all Schedule III drugs that have medicinal use but are all prone to being abused. There is no denying that psilocybin is a substance that many people would like to abuse due to its psychedelic characteristics, but that is why this substance needs to be controlled and only prescribed in a controlled environment. Another downside to making psilocybin a Schedule III drug is that the long-term effects of psilocybin and magic mushrooms are still not fully known. Psilocybin and magic mushrooms have only been researched for a few years and the subjects in these tests may show severe side effects as they age. These side effects may be minimal, or they may be severe, they are just unknown yet and can only be learned about throughout time.
Schedule 4
Schedule IV drugs consist of Darvon, Soma, and Valium, which can be used to treat mild pain and sleeplessness (DEA). A Schedule IV drug is a drug that has a low potential for abuse and a low potential for psychological dependence. Placing psilocybin in this category would have lighter restrictions on the prescription of magical mushrooms than in the previous categories. According to Lowe, using psilocybin in therapies can “provide new and significant opportunities to current issues in the conventional treatment of psychiatric disorders” (Lowe). Moving psilocybin to Schedule IV will not only allow researchers to conduct larger clinical trials, but it will also allow people who need to use psychedelics for treating depression, anxiety, or psychiatric disorders to have more access to psilocybin. Johns Hopkins researchers believe that psilocybin should be treated like “a schedule IV drug such as prescription sleep aids, but with tighter control” (Johns Hopkins). People will be able to go to a therapist and have psychedelic-assisted therapy much easier than in the previous Schedule categories. This will be beneficial as there will be fewer requirements for using psychedelics, but these psychedelics will be used in a controlled environment. Allowing further research also allows scientists to learn how to create similar substances that can heal people the same way psilocybin does, without the hallucinogenic effects. Researchers at Gilgamesh Pharmaceuticals have found a way so that “the trip should last only about one hour, not the 6–12 hours typical with psilocybin” after replicating compounds that have the same effects as psilocybin (Dolgin). Allowing further research on psilocybin can then lead to the creation of “safer” versions of psilocybin and eventually remove the need for psilocybin in the medical industry.
The downside to this Schedule is that there is a possibility for psilocybin and magic mushrooms to be used in a recreational manner, rather than for their intended medicinal purpose. Recreationally using psilocybin can be very dangerous since people may not be fully informed of the proper way to use the substance. Incorrect usage of psilocybin can lead to people having severe psychotic episodes and can lead to the authorities getting involved. In addition, people prescribed psilocybin can mishandle the magic mushrooms and resell them to people who are not prescribed this substance. This is very common with other drugs like Xanax, Adderall, and Codeine, however.
Policy Recommendation
Each Schedule that psilocybin can potentially be placed in has its positive and negative contributions. Moving psilocybin to Schedule II decreases the total restrictions on the substance, but it will still be very difficult for patients to be prescribed psilocybin. It will also limit the amount of research that can be done on the substance and it might not decrease the size of the black market overall. Although this Schedule still allows the medicinal use of psilocybin, it is very restrictive for its users. Schedule IV, on the other hand, has few restrictions. Johns Hopkins researchers believe that placing psilocybin in this Schedule will treat psilocybin as “almost a sleeping pill” (Johns Hopkins). This can lead to potential abuse of psilocybin and magic mushrooms since they will be very accessible and can be given to those who do not need them. Schedule III is the perfect mix of both since it will be less restrictive so that people can have good access to this substance but, at the same time, there will be some restrictions so that people cannot abuse the substance. This Scheduling will also reduce the size of the psilocybin black market.
Works Cited
Barnby, Joseph M, and Mitul A Mehta. “Psilocybin and Mental Health-Don’t Lose Control.” Frontiers in psychiatry vol. 9 293. 3 Jul. 2018, doi:10.3389/fpsyt.2018.00293
Carhart-Harris, R., et al. “Psilocybin with Psychological Support for Treatment-Resistant Depression: Six-Month Follow-Up.” Psychopharmacology, vol. 235, no. 2, 2018, pp. 399–408. ProQuest, http://libproxy.usc.edu/login?url=https://www.proquest.com/scholarly-journals/psilocybin-with-psychological-supporttreatment/docview/2002038543/se-2, doi:https://doi.org/10.1007/s00213-017-4771-x.
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DEA. “Drug Scheduling.” Drug Enforcement Agency, 10 July 2018, https://www.dea.gov/drug-information/drug-scheduling.
DEA. “Drugs of Abuse, a DEA Resource Guide (2020 Edition).” DEA, 2020, https://www.dea.gov/sites/default/files/2020-04/Drugs%20of%20Abuse%202020-Web%20Version-508%20compliant-4-24-20_0.pdf.
Dolgin, Elie. “Taking the Tripping out of Psychedelic Medicine.” Nature News, Nature Publishing Group, 28 Sept. 2022, https://www.nature.com/articles/d41586-022-02869-4.
Griffiths, Roland R, et al. “Psilocybin-Occasioned Mystical-Type Experience in Combination with Meditation and Other Spiritual Practices Produces Enduring Positive Changes in Psychological Functioning and in Trait Measures of Prosocial Attitudes and Behaviors.” Journal of Psychopharmacology, vol. 32, no. 1, 2017, pp. 49–69., https://doi.org/10.1177/0269881117731279.
Hasler, Gregor. “Toward the ‘Helioscope’ Hypothesis of Psychedelic Therapy.” European Neuropsychopharmacology, vol. 57, 1 Apr. 2022, pp. 118–119., https://doi.org/10.1016/j.euroneuro.2022.02.006.
Johns Hopkins. “Reclassification Recommendations for Drug in ‘Magic Mushrooms’.” Johns Hopkins Medicine Newsroom, 26 Sept. 2018, https://www.hopkinsmedicine.org/news/newsroom/news-releases/reclassification-recommendations-for-drug-in-magic-mushrooms.
Letheby, Chris. Philosophy of Psychedelics. Oxford University Press, 2021, Oxford Academic, https://doi.org/10.1093/med/9780198843122.001.0001, Accessed 25 Sept. 2022.
Lowe, Henry et al. “The Therapeutic Potential of Psilocybin.” Molecules (Basel, Switzerland) vol. 26,10 2948. 15 May. 2021, doi:10.3390/molecules26102948
