Oregon Voters Legalized Psilocybin Use. But What About Micro-dosing?

Oregon’s psilocybin mushroom therapy, Last week, as some experts gathered virtually for a Zoom meeting to discuss Oregon’s psilocybin mushroom therapy, two board members had a disagreement.

The issue at hand: whether the Oregon Psilocybin Advisory Board would hear from Dr. James Fadiman, a leading figure in the field of microdosing, during the session.

The exchange occurred between two prominent academics, both appointed by Gov. Kate Brown to the psilocybin advisory board. Dr. Atheir Abbas, an assistant professor of behavioral neuroscience at Oregon Health & Science University (OHSU), and Dr. Mason Marks, an assistant professor at the University of New Hampshire and senior fellow at Harvard Law’s Project on Psychedelics Law and Regulation, were at the center of the debate.

About 15 minutes into the two-hour public meeting, which was convened by the research subcommittee, Dr. Abbas called on Dr. Marks to speak, as he had raised his hand.

Marks began, “I’d like to have Dr. James Fadiman speak at this meeting—”

Abbas quickly interrupted, “Sorry, Mason, that’s not on the agenda. You’ve been…”

Marks responded, “No, this is relevant to what we’re discussing here, and I’ve been trying to get a response from you for the past 24 hours.”

The dispute centered on Dr. Fadiman, a well-known researcher in the psychedelics field and author of The Psychedelic Explorer’s Guide, who is often credited with popularizing the practice of microdosing.

Microdosing refers to the practice of taking small doses of psilocybin to potentially treat conditions like anxiety or depression without experiencing a full-blown psychedelic trip. This was the key topic for the January 20 meeting. Oregon voters approved the therapeutic use of psilocybin in 2020, but the law does not specifically address the practice of microdosing.

The debate highlighted a division among board members about an important unresolved question: Is microdosing allowed under the state’s psilocybin policy?

Dr. Fadiman, who was attending the meeting as a public participant, weighed in after the exchange. “Microdosing will happen in Oregon whether or not this committee takes action,” he said. “The real question is: Can we help people use it more safely and effectively?”

Under Oregon’s Ballot Measure 109, which was passed in 2020, adults 21 and over will soon be allowed to consume psilocybin in a therapeutic setting, under the supervision of licensed facilitators. Oregon became the first state to legalize the production, distribution, and administration of psilocybin.

However, Measure 109 focused on “macrodosing,” where larger doses are taken to induce a full psychedelic experience. While supporters of the measure believe these trips can be therapeutic, especially for those struggling with trauma or addiction, microdosing was never explicitly addressed in the law.

Tom Eckert, chair of the Psilocybin Advisory Board and a key proponent of Measure 109, explained that the law was not designed to create a model for microdosing. “Measure 109 supports science-based services at licensed facilities,” he said, “not a dispensary-type model.”

Microdosing typically involves taking sub-perceptual doses of psilocybin over an extended period, aiming to alleviate mental health issues such as depression, anxiety, and PTSD without impairing daily activities. Dr. Fadiman, a strong advocate for the practice, argues that microdosing can improve cognitive function, emotional stability, and overall physical health.

Despite the benefits reported by users, microdosing remains unproven in large-scale clinical trials, which has raised concerns among some medical professionals. Dr. Abbas, for example, pointed to studies suggesting that psilocybin could affect serotonin receptors in heart valves, potentially increasing the risk of heart disease.

Fadiman counters that those concerns are based on research related to fen-phen, a weight loss drug, which was given at doses far greater than those used in microdosing. He argues that microdosing is far safer and is done at doses too low to trigger such risks.

While microdosing is not mentioned directly in Measure 109, the measure leaves room for discussion about how psilocybin products are dosed and packaged. Dr. Marks, who advocates for legalizing and regulating microdosing, sees this as an opportunity for harm reduction. “People will be microdosing anyway,” he said, “so it’s better to regulate it.”

Board member Dr. Rachel Knox emphasized the importance of educating facilitators about microdosing, suggesting that they should be prepared to answer questions about it, as clients are likely to ask. Oregon’s psilocybin mushroom therapy

However, some members, like Regina Moore of the Psychedelic Pharmacists Association, expressed concerns about making facilitators experts on microdosing. “This feels more like a medical system issue, and that wasn’t the intention of the measure,” she said.

The board is working toward a consensus on the rules for psilocybin therapy, with a deadline to submit recommendations to the Oregon Health Authority by June. Meanwhile, Dr. Fadiman argues that allowing microdosing could offer valuable data on a practice that remains under-researched. “We could gather important insights without any additional work,” he said.