We live in challenging times, which manifest in a number of our current mental health indicators. Rates of clinical depression and anxiety, drug and alcohol problems, overdose, academic failure and loss of productivity — all are at unprecedented levels. No doubt the pandemic aggravated our mental health difficulties, but our lives are indeed stressful.
As a board-certified physician in the practice of addiction medicine, I find myself on the front lines of these mental health battles each day. People’s struggles are real, yet it troubles me that the first question so often asked by patients and care providers alike is, “Is there a pill for that?” I fear that we are losing our ability to deal with reality on reality’s terms without an almost knee-jerk reliance on mind-altering pharmaceutical remedies.
I was recently asked to review a proposed piece of legislation, SB200, which codifies the decriminalized use of psilocybin, a drug derived from so-called “magic mushrooms.” Since I am well aware of extensive research and a fast-tracked approval process currently underway on this drug, SB200 struck me as premature.
In my practice, we selectively administer another nontraditional drug called ketamine under specific circumstances. We have seen some very positive results. Even so, my approach remains highly cautious. There is a great deal we do not know. Just days ago, I read a medical journal article entitled, “Ketamine Clinics are Jumping Ahead of the Science”. The subheading read, “New mental health treatments must be approached with caution.” I could not agree more, and that includes psilocybin.
As a doctor, I see a number of red flags with SB200. When we normalize the use of a commonly available street-level drug, we send a signal to young people that can be dangerously misleading. The fact that a substance can be useful in a therapeutic setting does not mean it is safe and harmless for general use. The human brain is an incredibly delicate organ; any intervention with its processes must be undertaken with great care and carefully monitored by qualified professionals.
A task force at our own University of Utah College of Pharmacy recently completed an in-depth review of the issues surrounding the safety and efficacy of psilocybin. They concluded — and I concur — that the drug does indeed show promise in very specific clinical situations. They also reported that while safety data is promising, it is not yet complete. They reiterated that psilocybin is currently under fast-track review by the FDA. More importantly, the task force recommended that “Utah NOT proceed with the creation of any psychedelic-assisted psychotherapy program ahead of FDA approval.” That is exactly my point with regard to SB200, and why I strongly oppose the bill.
Given the task force findings and the FDA’s position, SB200 strikes me as the classic “solution in search of a problem.”
Proponents should note that no one is trying to block the approval of this drug for medical use by qualified treatment professionals. It is a matter of when. The task force also indicates that in the meantime, “Pathways currently exist for patient access, including participation in a clinical trial and compassionate use status.”
Even beyond this bill, I am very concerned about this disturbing new trend of “electing” medications. Having voted to bypass normal processes and elevate marijuana to a legal pharmaceutical, we are now faced with yet another political (legislative) campaign promoting a psychoactive substance as medicine. What is next? This notion of approving pharmaceutical products by political means will not, in my estimation, end well.
In conclusion, I fail to see a valid reason for Utah to follow the lead of such states as Colorado and Oregon, which have both fecklessly legalized most common street drugs. I reside in Utah County and can scarcely imagine my friends and neighbors happily following the lead of either of the two states. Both are now reaping their rewards in the form of increased criminal activity, addiction and overdose. It is one reason that each has counties considering annexation into neighboring states.
It is indeed likely that, at some point, psilocybin could become a valuable intervention for a specific range of clinical conditions. That time is not yet. We must encourage our lawmakers to take the prudent path by rejecting SB200.
SB200 is currently in the Utah Senate Health and Human Services committee.
Dr. Terry Sellers is board certified in the practice of addiction medicine. He resides in Orem, Utah.