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2020’s psychedelic drug ballot measures, explained

Oregon and Washington, DC, voters may relax their laws for psychedelic drugs.

Zac Freeland/Vox

This November, voters in two states could take significant steps toward ending the US’s near-total criminal prohibition of psychedelic drugs.

In Oregon, voters will decide on a ballot measure that would allow psilocybin mushrooms, also known as magic mushrooms, to be used for medical purposes. In Washington, DC, voters could, in effect, decriminalize a range of psychedelic plants and fungi.

The measures are seen by many activists as the next stage in scaling back America’s war on drugs, now that marijuana legalization has already reached 11 states and could be legalized in four more in the November election.

Polls show strong support for marijuana legalization, but it’s unclear how much public backing there is for measures decriminalizing psychedelics or legalizing them for medicinal purposes. Denver became the first US city to vote to decriminalize psychedelic mushrooms in 2019, but no state has decriminalized or legalized psychedelic substances for medical use.

But activists may have an advantage in Oregon and Washington, DC — both of which are very liberal, and were among the first jurisdictions to legalize cannabis for recreational uses (although DC, due to a bill passed by Congress, still prohibits sales).

The Oregon and DC, measures, then, stand to set the stage for future drug policy reform efforts. If two progressive places move forward with their measures, that may signal a wider public appetite for expanding access to psychedelic drugs. If the measures fail — especially in an election year that currently seems very favorable to more progressive causes — drug policy reformers almost certainly have their work cut out for them.

Measure 109 in Oregon would allow magic mushrooms for medical purposes

Oregon’s Measure 109 would create a program for administering psilocybin products, such as magic mushrooms, to patients for medical purposes. Unlike medical marijuana laws, this wouldn’t mean that patients could just get a doctor’s recommendation and then buy psilocybin at a dispensary. Instead, they’d be able to buy, possess, and consume the psychedelic drug at a “psilocybin service center” in which they’d be supervised and guided through their trips by trained facilitators. There aren’t set limits on which conditions would let patients qualify, but they’d have to be 21 or older, and the Oregon Health Authority would set up regulations.

There’s a growing body of research for this type of approach. The idea is that a person taking psychedelics on their own can have a bad or even traumatic experience. But under proper supervision, a trained facilitator can guide someone to make the most of the experience. The studies done so far tended to be small, but they’re promising — with potential benefits for a range of mental health conditions, including depression, anxiety, PTSD, and addiction. Unlike other medications for such conditions, the research indicates that just one or two doses can have effects for years or even decades.

The research is so promising, in fact, that the Food and Drug Administration has allowed psychedelic treatments with psilocybin and MDMA (also known as ecstasy or molly) to go forward in clinical trials. There’s a chance that, regardless of what voters decide in Oregon this year, these drugs could be legal for medical use in some capacity in the coming years.

Why does this seem to work? In short, psychedelic treatments appear to offer a greater sense of perspective — a decoupling of the mind and ego, described as “ego dissolution” — that helps people work through serious mental health conditions. Some of the early studies looked at the effects on cancer patients, who dealt with serious, understandable dread over their potentially imminent deaths. In 2015, Michael Pollan wrote in the New Yorker on early participants’ experiences:

A woman I’ll call Deborah Ames, a breast-cancer survivor in her sixties (she asked not to be identified), described zipping through space as if in a video game until she arrived at the wall of a crematorium and realized, with a fright, “I’ve died and now I’m going to be cremated. The next thing I know, I’m below the ground in this gorgeous forest, deep woods, loamy and brown. There are roots all around me and I’m seeing the trees growing, and I’m part of them. It didn’t feel sad or happy, just natural, contented, peaceful. I wasn’t gone. I was part of the earth.” Several patients described edging up to the precipice of death and looking over to the other side. Tammy Burgess, given a diagnosis of ovarian cancer at fifty-five, found herself gazing across “the great plain of consciousness. It was very serene and beautiful. I felt alone but I could reach out and touch anyone I’d ever known. When my time came, that’s where my life would go once it left me and that was O.K.”

For the skeptical, this can sound a bit strange. But advocates and experts point out that what matters here is whether these experiences that might seem fishy to skeptics are real for the patients. If someone genuinely believes they saw God or the face of death, and that helped them get through a mental health issue, then that’s a good therapy even if it doesn’t meet a rigid understanding of secular and scientific principles.

“What it represents in the brain, we’re not really sure,” James Rucker, a clinical lecturer at King’s College London who worked on a psychedelic-depression study, previously told me. “The way they describe it is often symbolic of what’s going on in their head. Take the goddess leading you through. Maybe it’s the goddess leading you through your depression and out the other side — if you take the metaphor like that.”

Critics worry that a program like the one Oregon activists have proposed could end up going very wrong. If facilitators aren’t properly trained, if patients aren’t properly vetted for conditions like schizophrenia, or if psychedelic drugs end up outside of these facilities, that could lead to a lot of bad trips and scary anecdotes — the kind that shut down research into psychedelics in the 1960s and ’70s, leading to their total prohibition.

Advocates and experts in the field actually share these concerns, which is why many argue that it’s important to set up a solid structure for how the drugs are administered to people. They don’t want a medical marijuana model for psychedelics.

“Above and beyond anything else, it’s essential to preserve strong safety parameters,” Charles Grob, who’s led much of the recent psychedelic research, previously told me. “Without that, the work really cannot proceed.”

For Oregon, the question is whether all of that will be convincing to voters. It’s at least convincing enough for the Oregon Democratic Party, which endorsed the measure. But with no polls so far this year investigating the public’s opinion of the measure, whether it will succeed is an open question.

Initiative 81 in Washington, DC, would decriminalize several psychedelics

In the nation’s capital, activists are taking a different approach: With Initiative 81, they’re hoping to effectively decriminalize several psychedelic substances.

Technically, the measure would force local police to deprioritize the enforcement of laws against the non-commercial cultivation, distribution, possession, and use of “entheogenic plants and fungi,” and ask prosecutors to also drop cases related to these same substances.

In practice, advocates say DC would no longer enforce laws against these psychedelic drugs. But the measure wouldn’t allow commercial sales of the drugs — so don’t expect psychedelic dispensaries to pop up.

Advocates argue that these plant- and fungi-based drugs aren’t very dangerous, and that they would even benefit some people. (Both claims are backed by some evidence.) So, advocates say, law enforcement shouldn’t prioritize action against psychedelic substances. And any problems the drugs do cause, like a bad trip, can be handled on a case-by-case basis — by public health agencies or other social services rather than by law enforcement.

Opponents worry that decriminalization could lead to more drug use and, perhaps, an increase in bad or even violent psychedelic experiences. Indeed, these concerns are why some advocates of medical psychedelics say that these substances should only be allowed in supervised, controlled settings.

It’s possible drug use will rise if the initiative is successful: In Portugal, the decriminalization of all drugs — which was coupled with boosts to drug addiction treatment and harm reduction services — seemed to lead to more lifetime drug use overall but less problematic use. (Like DC’s initiative, Portugal does not allow commercial sales.)

It’s also possible this change has almost no effect at all. In the three years before Denver decriminalized psilocybin mushrooms, the city’s police arrested about 50 people a year for the possession or sale of shrooms, and prosecutors acted on only 11 of those cases, out of thousands of arrests overall in the city each year. (DC’s police department didn’t respond to a public records request for similar data for the District.)

Washington, DC, wouldn’t be the first city to enact such a measure, following the lead of Denver and some other cities. But it would be the closest thing to a state approving such an effort.

It’s unclear if DC’s measure will pass. The one poll on the issue found up to 60 percent support, but it was commissioned by the campaign.

If it does pass, the measure could face two extra hurdles: the DC Council and Congress, either of which could move to overturn the measure even if voters approve it. Again, it’s unclear if either would actually make such a move.

This is part of a broader effort to scale back the war on drugs

Over the past decade, progressives have increasingly called to “end the war on drugs” — citing, in particular, the vast racial disparities in anti-drug law enforcement. While some lawmakers have taken up that call, legislation has often lagged behind what progressive activists — and voters — support. So activists and voters have begun to take matters into their own hands with ballot measures.

Marijuana legalization is one such example. There’s a lot of support for marijuana legalization, with even a majority of Republicans, who are typically more skeptical of drug policy reform, backing the change in public polls. Yet progressive politicians have lagged behind voters on this issue — for instance, former Vice President Joe Biden, the Democratic nominee for president, opposes marijuana legalization (though he backs decriminalization).

Rather than wait for politicians to catch up, activists have gone through the state ballot initiative process to get the change they want. In 2012, that approach made Colorado and Washington the first two states to legalize marijuana. Nine more states, and DC, have since followed (although two states, Illinois and Vermont, did so through their legislatures). Four other states have legalization measures on the ballot this year.

Given their successes with marijuana, drug policy reformers are now looking for other ways to scale back the war on drugs through ballot measures. That includes the psychedelic drug ballot measures, as well as another measure in Oregon that would decriminalize all drugs. The question now is if the voters will be as receptive of these ideas as drug policy reformers hope they are.

If voters do prove receptive, that could make Oregon’s Measure 109 and DC’s Initiative 81 the beginning of a broader push for both decriminalization and legalization in the next few years. But it all begins with Oregon and DC this November.