Psychedelic Mushrooms: The Next Grassroot Drug?

Boston, MA (WorkersCompensation.com) - Voters in Denver next week will decide whether to decriminalize small amounts of the drug psilocybin. The Denver Psilocybin Mushroom Decriminalization Initiative does not seek to legalize so-called ‘magic mushrooms,’ but to make possession and use of the drug “the lowest law enforcement priority in Denver,” and prohibit “the city from spending resources on enforcing related penalties,” according to the ballot language. If passed, the legislation would make Denver the first city in the U.S. to halt prosecution of people caught with the hallucinogenic drug.

Proposals to allow the drug for medicinal use were introduced last year in California and Iowa. Neither state approved the proposals, but legislative experts in the workers’ compensation system say it is an issue to watch.

“This is how marijuana got started; they’re following the same game plan,” said Brian Allen, VP of Government Affairs for Mitchell’s ScriptAdvisor Pharmacy Benefit Management business. “I think it’s a tougher road for them because more people had experience with marijuana. So it will be a harder sell.”

While psilocybin is a Schedule I drug under federal law, Allen said there is some anecdotal evidence that it may be helpful for a limited number of medical conditions. In an interview with WorkersCompensation.com, Allen called the situation surrounding psilocybin another rare example of “public sentiment outpacing science,” something he says is also true of marijuana.

Medical Marijuana

Currently 33 states as well as Guam, Puerto Rico and the District of Columbia have legalized medical marijuana, although the statutes vary widely.

Allen is closely watching the latest developments surrounding that drug. There have been proposals in some jurisdictions, for example, that would require employers or insurance carriers to pay for it.

“We’re concerned about how those state laws interact and conflict with federal law and what that means for our customers and how we can manage it,” he said. “We’re watching it carefully.”

One of the questions increasingly being raised by insurers who may have to pay for the drug is how long should the treatment last. In an article in the April edition of Claims Magazine, Sedgwick’s Senior Medical Director Teresa Bartlett, M.D. questioned whether it might have to be a lifetime commitment. She noted that some drugs, such as muscle relaxers have a certain time frame before their effectiveness wears off. No such information exists for marijuana, however.

Among the challenges is the lack of research showing whether marijuana is effective in relieving medical conditions. Because it is illegal under federal law, the evidence so far is anecdotal. Researchers will be able to undertake more rigorous research if and when it becomes legal on the federal level.

“Everyone is anxious to see from clinical studies what marijuana can and can’t do, the potential side effects, the potential harmful long-term effects,” Allen said. “Anecdotally, there’s an emergence of [information] that some people with underlying mental health conditions have psychotic episodes when using it.

Allen also noted the increased reports of marijuana users showing up in emergency rooms with repeated and severe bouts of vomiting. The rare condition, called cannabinoid hyperemesis syndrome, occurs for unknown reasons and only among some daily users of the drug.

“So there are things like that out there but we don’t know enough to make a determination. Those would be explored in true clinical trials,” he said. “We’re hopeful we’ll see more of that science so when it does become legal, there’s a way for us to help our customers manage when it’s appropriate to be used and what safeguards are in place.”

Federal Action on Marijuana

Various proposals for marijuana have been advanced at the federal level. Several would reschedule it or remove enforcement from the Controlled Substances Act. One bill, ironically called HR 420, would unschedule the drug and have it regulated by the states, like alcohol.

“Our position is we want to see good science so when we do [take a position], we can take a position that is informed,” Allen said. “I believe Congress will do something in the next 12 to 18 months. I think it will be a campaign issue in 2020. Too many states have moved forward, creating a conundrum” with conflicting state and federal laws.

Whether psychedelic mushrooms gain the same traction marijuana has is anyone’s guess. The first clue will come with next Tuesday’s vote in Denver.

“Whether it dies in its infancy, we don’t know,” Allen said. “There are proponents out there. It will be interesting to see how it goes.”

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