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Regional Interests

Amid Ongoing Debate, State Senate Approves Bill to Decriminalize Psychedelic Drugs in California

The California Senate on Tuesday approved legislation to decriminalize the possession or sharing of psychedelic drugs.

Senate Bill 519, introduced by state Sen. Scott Wiener, D-San Francisco, now heads to the state Assembly.

“This is a big step for this legislation and for our movement to end the war on drugs and to take a more health and science-based approach and to move away from criminalization of drugs,” Wiener said in a Twitter video posted on Tuesday.

 

The legislation would allow doctors to prescribe psychedelics for treating mental health disorders such as depression and PTSD. It would also allow psychedelics for personal use, and expunge criminal records for people with prior convictions for possession.

In May, the medical journal Nature Medicine published results of a study using the psychedelic drug MDMA, also known as ecstasy, to treat post-traumatic stress disorder among research participants who received the drug, along with counseling. Sixty-seven percent felt their condition had improved to the extent that they no longer qualified for a diagnosis of PTSD.

This study adds to a small but growing body of scientific literature exploring the use of psychedelics like MDMA, LSD and psilocybin as therapy for a range of mental health conditions, including depression, eating disorders and end-of-life anxiety. The bill now working its way through the state Legislature aims to build on this momentum.

While many veterans and drug advocacy groups support the bill, opponents say the legislation would lead to an increased rate of  psychedelic drugs sold and recreationally used. On May 14, KQED Forum host April Dembosky talked to the following people involved in this debate:

Juliana Mercer, a Marine Corps veteran who used psychedelic therapy to overcome her trauma from her time serving in Iraq and Afghanistan Sen. Scott Wiener, represents San Francisco in the state Senate Dr. Jeffrey Lieberman, former president of the American Psychiatric Association and chairman of the Department of Psychiatry, Columbia University College of Physicians and Surgeons Larry Morse, legislative director, California District Attorneys Association Dr. Robert Grant, professor of medicine at UCSF and prominent academic voice around decriminalization and psychedelic therapy

The following interview has been edited for length and clarity.

A Veteran’s Personal Experience

Juliana Mercer graduated military boot camp one week before Sept. 11, 2001, and served in the United States Marines for 16 years. She served two tours of duty, one in Iraq and one in Afghanistan.

Juliana Mercer: Between Iraq and Afghanistan, where I saw the traumas of war in between those two deployments, I spent five years working with our wounded in San Diego at the naval hospital, and I did everything that was non-medical for helping them in a holistic way to get back into their lives with their injuries.

During those five years I saw the direct result of war; not just the physical trauma, but the mental trauma. And I did my job every day and did it happily because I was helping my brothers and sisters. But losing quite a few fellow Marines and other veterans to suicide between two war deployments really took a toll on me.

I didn’t realize that they had taken a toll on me because I was doing my job every day. A few years after exiting the service and continuing to work with nonprofits that help veterans, I felt just this loss of purpose. Even though I was doing purposeful work, I had a loss of who my authentic self was. My first interaction with these medicines really opened up the acknowledgment that I had suffered a lot of loss, and there was a lot of grief in there. It started to help me unpack all of the grief that I had, and hadn’t revisited because I was so busy doing my job and taking care of my Marines.

Mercer eventually connected with the Heroic Hearts Project, which specializes in ayahuasca therapy with military veterans, and traveled to a retreat center in Costa Rica for treatment.

We were there for 10 days and we had four sessions with ayahuasca. And these sessions where you drink the medicine, which is the root that’s found in the Amazon, administered by a shaman.

You go into these sessions with intentions of what you want to accomplish and what you want to bring up. I think a session lasts anywhere from six to 12 hours. The ayahuasca and psychedelic medicines really opens you up. They open up your heart and they let you start looking inside of yourself, figuring out what the blockages are.

These sessions are [like] 10 years of therapy.

The Proposed Legislation Around Psychedelics

State Sen. Scott Wiener: The legislation is sponsored by [the Heroic Hearts Project], as well as another group of vets that also works with veterans experiencing PTSD, addiction, other mental health challenges, and combat veterans.

And right now, these groups are having to send these combat veterans to other countries, to Costa Rica, to Peru, to Mexico to get treatment. We think to ourselves how outrageous it is that these are people who have gone to war for our country, who have sustained terrible injuries — physical and mental — serving our country, and we’re making it illegal for them to get effective treatment in the U.S. and forcing them to travel to another country.

I watched what was happening in Oregon and in various cities around the country as part of the movement towards drug decriminalization. The war on drugs has failed. Incarcerating people for using drugs doesn’t work. We need to take a health-based approach. And for psychedelics in particular, the mounting evidence of the health benefits of all of these substances is just extraordinary. People whose lives are being saved.

And yet we have stuck with this terrible criminalization approach and say, no, you can’t have your medicine, it’s illegal. And if you possess your medicine, you might get arrested and go to jail. And so the bill simply decriminalizes the possession of psychedelics. It actually does not authorize doctors to prescribe. That would require a change in federal law so that the doctors wouldn’t lose their prescribing privileges. But that, we hope, will happen at some point. But for now, we want to make sure that California stops arresting and prosecuting people for possessing psychedelics.

We want to effectively decriminalize it and move towards legalization, and then create pathways for people to expunge their records. It’s hard to describe how destructive the war on drugs has been. It has cost this country untold billions. A lot of people have criminal records because they were low-level drug offenses, and we want to make sure that they can clear their records and not have those convictions hanging over them, which can have implications for housing and for employment. So it’s about saying, “Listen, we made a mistake by criminalizing these substances. We’re moving away from that now.”

What Could the Drawbacks of Decriminalizing Psychedelics Be?

Dr. Jeffrey Lieberman, Columbia University: Hopefully we won’t commit the same mistake that we did in the ’60s where things got out of control, and they were used recreationally.

First, let me just say that I completely agree with the legislation. These drugs should not be criminalized. There should be decriminalization. Secondly, I enthusiastically endorse their study for therapeutic uses for various types of conditions.

But at the same time, I’m very concerned that we’re rushing headlong to a point where practice is leaping ahead of knowledge. And the first way in which this is evident is the fact that “psychedelics” is the term that’s being used to define a certain group of psychoactive drugs. But it’s being used in a way that’s not precise.

Psychedelics really refer to compounds that have been used by Indigenous peoples ritualistically for centuries, and then synthetically replicated. Ecstasy, MDMA, ketamine, ibogaine are not classical psychedelics. They have different clinical effects and they have different potential uses.

All of these drugs do have some potential uses. The problem is they have not been studied sufficiently to know what they are. So if we let the genie out of the bottle too soon, and base it on the enthusiasm of true believers who have had positive experiences, we’re potentially risking trouble.

If this is such a big thing socially for our population and people are benefiting from it and want to have access to it, why isn’t it being studied in the way that rigorously and systematically it should be?

Larry Morse, California District Attorneys Association: I endorse completely what Dr. Lieberman said about the lack of adequate studies that we are talking about: powerful, powerful drugs, LSD.

I’m of the generation where I literally remember being with people having an extraordinarily bad experience with LSD all through the evening. And it is a flight of naivete to believe that if we make this more readily accessible, legalize this, that it is not going to be used by kids. They are going to get access to it.

We are talking about making a drug more readily available. And it is just denial to suggest that it will not fall into the hands of 15-, 16-, 17-year-olds who will have terrible, terrible, terrifying experiences that have significant likelihood or possibility of long-term effects.

Psychosis, paranoia, schizophrenia. This is not like some really strong weed. These are powerful drugs that have dramatic effects on people’s moods and can lead to just horrific consequences.

The Prevalence and Equity of Psychedelic Medicines

Dr. Robert Grant, UCSF: Psychedelics are already in widespread use in the United States. Surveys have shown that something like 30 million Americans have used psychedelic medicines in their lives and something like 1 million use them on any given year.

So these medicines are being used. They’re being used largely in a criminalized context where people have to be very shy about talking about how they’ve used psychedelics, and under what circumstances, and who provided them, and whether that was a good setting for their work.

The huge advantage of this particular legislation is that it allows for all of that underground use, which is already happening, to come out and be more public — so that people can talk about when their use of psychedelics went well, and when it went badly. These kinds of open discussions are not possible now because of criminalization, and decriminalization will change that.

Three-quarters of the participants in the trial cited in Nature Medicine’s study of MDMA and PTSD were white. What do we know about the effectiveness of this drug, and access to it, for people of color?

Clinical trials in general tend to recruit predominantly white populations, and we think that that’s an issue of trust — that researchers need to do more to establish trust with communities of color.

We do know that communities of color are using these therapies. And we also know that communities of color and queer communities are at much higher risk of having PTSD. So the unmet medical need for those communities of color is enormous, and larger than in other populations.

Medicalization pathways left there on their own without decriminalization will be difficult and delayed, and will have even more difficulty recruiting people of color while we have criminalization laws on the books. So this decriminalization law, I believe, will make it easier for the National Institutes of Health to fund these studies, and that will make it easier for people of color to participate in those studies. And it’ll make it easier for people who are using these medicines therapeutically to talk about their experiences.

Listen to KQED Forum to hear the full episode.

The original version of this story was published on May 16.

Copyright 2021 KQED