Psilocybin-assisted therapy: How it works in Colorado and Oregon

Before Dee Lafferty decided to add psychedelic-assisted therapy to her repertoire, she wanted to try it for herself.

A licensed clinical social worker of more than a decade, Lafferty had heard about the promise of substances such as ketamine and psilocybin to improve mental health. In June, Lafferty sat with a facilitator in a psilocybin service center she owns and operates in Albany, Oregon, called Inner Guidance Services. And she took a journey.

“It was kind of like how all psychedelic experiences go, from my observation,” she said. “You go in thinking you know what you want to work on and what you want to gain from the experience, but you actually walk out with whatever it is you need — and that may or may not be what your expectation is.”

Oregon became the first state to legalize psilocybin-assisted therapy via a ballot measure in 2020. Colorado followed suit last November, and regulators here are now developing rules to govern the new industry, from licensing workers in the space to product testing and compliance.

Dominique Mendiola, senior director at Colorado’s Natural Medicine Division, says her department is looking to Oregon and working with officials there as it develops rules and best practices.

While much is still yet to be decided, elements of this type of therapy have become recognized as standards while it’s been happening underground — and now legally in the Pacific Northwest.

Psychedelic-assisted therapy typically consists of three phases: preparation, administration and integration.

Preparation involves meeting with a facilitator once or more to discuss the recipient’s medical history, intentions and goals, and safety protocols.

Participants do not need a doctor’s note or a formal diagnosis to receive psilocybin therapy at Inner Guidance Services, Lafferty said. However, Oregon’s laws prohibit individuals who are actively taking lithium from partaking in the service, and other medications could have bad interactions. Clinical trials also typically exclude people with a family history of schizophrenia or bipolar disorder out of concern that psychedelics might induce psychosis.

Administration refers to the session during which a person ingests psilocybin; these last, on average, four to eight hours. At Inner Guidance Services, participants purchase 3.25 grams of mushrooms that they eat raw. They also can bring pre-packaged food products, such as tea, to consume with the mushrooms.

Lafferty’s team provides each person with an eye mask, a pair of headphones and a blanket and encourages them to get comfy before the psilocybin sets in.

Unlike traditional talk therapy, there’s rarely discussion during an administration session.

“If the person is up and they want to talk, of course, we’re going to talk to them,” Lafferty said. “But the hope is that they’re going to go inside (themselves), because this is an internal process where the psilocybin products help your brain and body move through the process toward wellness and less suffering.”

The final phase, integration, happens in the days and weeks after a psychedelic journey. Participants work with their facilitators to process their experiences and apply any insights to their lives.

While it’s not required by law, Lafferty believes integration is among the most important steps in this therapy. Individuals with prior experience using psychedelics for recreational purposes have told The Denver Post that the therapeutic approach — with support before, during and after taking the drugs — produced different results.

Many recipients also said they experienced challenging emotions during their trip, but ultimately, these sessions can be transformational.

“It’s not magic,” Lafferty said. “You’re not going to walk out a new person. But you may walk out better off than you were when you came in.”

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