New JAMA Study Examines Oregon’s Regulated Psilocybin Services

A new study published August 19 in JAMA Network Open provides one of the most significant real-world evaluations yet of Oregon’s regulated psilocybin program.

The study followed 346 clients at 24 of Oregon’s 26 active service centers, supported by 83 licensed facilitators. Participants were surveyed for three months following their administration sessions.

The Good

The overall results were strongly positive.

At one month:

• 97.5% reported receiving high-quality services.
• 96.0% would recommend their facilitator.
• 95.6% would recommend their service center.
• 92.2% reported benefiting from the experience.
• 81.0% said the experience was worth the money.
• 58.6% ranked it among the 10 most meaningful experiences of their lives.

Participants also reported substantial improvements in mental health.

At three months, moderate-to-severe depression declined from 42.2% to 16.5%, anxiety from 45.1% to 13.2%, and PTSD symptoms from 48.0% to 16.8%.

Life satisfaction increased as well, from 63.0% at baseline to 82.3% at three months.

For a program that has now operated for only a few years, these are encouraging real-world results.

The Bad

The study also identified risks that shouldn’t be overlooked.

Four participants—1.2% of the study population—experienced serious behavioral adverse reactions requiring medical attention. All four were psychedelic-naive and had sought services for mental health symptoms.

This does not surprise us at Satya, as we previously estimated an emergency contact percentage in our July 31 blog post of about 0.67%. The difference in the numbers could easily be explained by the fact that many service centers conduct lower-dose or microdose sessions. Lower doses likely have a decreased risk of emergency services calls. The other thing to note is Satya, too, has had our share of emergency services calls, but our record would appear to be lower than the study demonstrated.

At three months, 4.5% reported persistent or worsening depression, 2.3% persistent or worsening anxiety, and 1.9% thoughts of dying or suicide.

This is an important fact that we point out to prospective clients: psilocybin services can “make things worse.” Our experience is this is less frequent than the study, and “things usually settle down” within a month. It is very important that clients understand the risks and make an informed decision to pursue psilocybin services. We believe Satya makes the risks VERY clear up front: clients could end up in the ER, and clients might be worse off after a journey.

The study also raises an important concern about Oregon’s safety-reporting system. Facilitators reported only one of the four serious adverse reactions identified through the study’s longer-term follow-up. The researchers concluded that Oregon’s current reporting requirements may underestimate adverse reactions because they do not adequately capture problems emerging after clients leave the service center.

Cost remains another issue. Although 81% said their experience was worth the money, 32.1% said paying for services created financial strain.

We are not surprised by this result. Satya has always sought to provide a means to make services more accessible. Clients spend a tremendous amount of money (airfare, hotels, cost of psilocybin services) to pursue a journey. Satya believes we need to make the cost as low as possible. Since we produce mushrooms under a separate OHA manufacturing license, we can ensure lower costs and quality at the same time. We also have a group of facilitators committed to lower prices. Clients can easily find a journey for $900 all-inclusive at Satya. And when clients need additional help, we often lower prices more.

What the Study Does—and Doesn’t—Tell Us

This was an observational study without a control group. It therefore cannot establish that psilocybin caused the improvements.

The 346 participants also represented only about 5% of Oregon psilocybin clients during the study period, and the sample skewed affluent and highly educated. The authors specifically caution about applying the findings to populations that were less represented.

Nevertheless, this is important research because it examines psilocybin outside a traditional clinical trial.

Oregon clients don’t need a psychiatric diagnosis and receive mushroom-derived psilocybin in licensed service centers rather than pharmaceutical psilocybin in clinical research settings.

The Bottom Line

The first substantial prospective evidence from Oregon’s regulated system is encouraging: clients overwhelmingly reported high-quality services, substantial benefits and improvements in mental health and well-being, while serious adverse reactions were uncommon.

The study also shows why Oregon should continue improving long-term safety monitoring, particularly for clients experiencing psychological difficulties after their administration session.

For Oregon’s young psilocybin program, this study gives regulators, service centers, facilitators and prospective clients something that has been missing until now: real-world evidence about how the regulated model is actually performing.

 

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2853028?utm_source=chatgpt.com