How psilocybin legalization could look
“The best way to predict your future is to create it”
— Abe Lincoln
Big changes need small ones first.
Legalization of psychedelics is a massive undertaking, and yet we see progress in Denver, Oakland, Santa Cruz, Oregon, and DC.
Ken Burns’ excellent documentary “Prohibition” provides a great case study.
Two lessons stood out
- Adversity helps: the Great Depression exacerbated the demand to re-legalize alcohol
- Single issue politics: sticking to one point was what got the ban on alcohol repealed
Two lessons, apropos now:
- Adversity: COVID triggered a mental health crisis that accelerated demand for solutions
- Single issue: legalize psilocybin.
All due respect to other psychedelics, there’s only one Mona Lisa.
Psilocybin is safe, sustainable, and the most well-documented psychedelic compound.
So let’s wave a magic wand, imagine psilocybin achieves full legalization, and play this out.
What might this world look like?
Like most compounds, one-size-fits-all ain’t gonna cut it.
So, let’s approach this like an ER doctor that triages patients, or a tech entrepreneur that segments users into different cohorts.
- High risk e.g. treatment resistant mental illness
- Medium risk e.g. healthy, but struggling
- Low risk e.g. stable
This user/patient, let’s call him Tough-Time-Tommy, is quite unwell. Tommy (42 years old) is suffering from treatment resistant depression and bipolar disorder.
Tommy requires significant care and supervision. Provide him with all the tools at our disposal for psychedelic use within the medical system.
This may apply to before, during, and after his entire multi-session psychedelic therapy.
There are many fantastic guide protocols (e.g. CIIS or Synthesis) that detail the nitty-gritty. A few high-level for Tommy:
- 5–10 hours of prep work with a trained professional
- 1–2 guides present during every session
- 5–10 hours of post journey integration
Let’s call this user Training-Wheels-Tiffany (29). She’s generally healthy, but not great, and she runs the risk of descending into more pathological mental illness.
As they say, better to teach a man to fish.
The first couple psychedelic sessions are very different from subsequent journeys. Give Tiffany hands-on guide support for her first few experiences, then remove the training wheels.
A healthy individual that’s gone through a couple guided sessions will be more likely to safely conduct journeys on her own.
In addition, like with wave function collapse, observation changes the outcome. Some psychedelic experiences are better when you are completely alone.
Once Tiffany has gone through a couple sessions and gotten accustomed to the experience, provide the tools for her to continue work on her own.
- 2–3 hours of prep work with a guide or trained professional
- 1 guide present for only the first 2–3 sessions
- 2–5 hours of integration work per session
- Tools for solo journeys
This will reduce costs for Tiffany and the burden on the medical community… and enable deep solo journeys.
Let’s call this user DIY-Dave. Dave (37) either has previous experience or feels confident in his ability to handle the journey.
Dave feels healthy, strong, and doesn’t like being told what to do.
He wants to optimize cognitive abilities and find purpose.
Don’t make Dave jump through hoops, because he won’t.
This is the cohort that breaks the regulated model. For the determined, it’s fairly easy to obtain or grow psilocybin mushrooms so DIY Dave is unlikely to ask or wait for a prescription.
Give him tools that make the experience safe, satisfying, and meaningful, without being onerous.
It’s similar to the debate around providing young adults with free condoms. We know they’re going to engage in sexual activity whether we provide condoms or not, so better to encourage safety.
We know Dave will engage in psychedelics with or without us, so let’s help him do it right.
Give him a tool that encourages robust prep, follow up, and integration… and gives him power over the process.
Dave likes things simple and efficient. Provide an elegant-UX tool that enables a few things:
- Suggestions for set-and-setting
- Post-journey integration
- Connection with others
- A feedback loop
Let’s call this user Socialite-Stephanie. Steph (22) wants to explore psychedelics with her best friends.
She’s losing interest in alcohol and wants to explore a different state of mind.
“Life, uh… finds a way,” and much like the sentiment from Jeff Goldblum’s Jurassic Park quip, Steph will find a way to use psychedelics recreationally.
People like Steph will often turn into future intentional users, so, rather than demonize her, better to help her engage safely.
Provide her with the same tools we offered DIY-Dave. In addition, emphasize that during her psychedelic experience:
- She’ll be very suggestible
- Her resilience to adversity will be severely impaired
- Her ability to handle complex situations will be similar to a 10-year-old’s
This mental health crisis beckons for a solution, and single issue politics can sharpen the focus.
Psilocybin legalization plus precision medicine can salve our wounds.
Like Honest Abe remarked, this future is possible… so let’s create it.