Electronic Winter 2024 | Issue 61

State Legislative Update

By: Mark Peysakhovich, IPS Legislative Consultant

IPS Urges Caution as Illinois House Committee Explores Behavioral Health Potential of Psychedelics

Over the last few years, interest in the potential of psychedelic treatments for behavioral and mental health conditions has moved from the margins of medical conversations to the center stage. Patients, advocates and providers (including scientists, physicians and other clinicians) around the country have stepped forward with stories of healing and recovery attributed to substances like ketamine, MDMA and psilocybin, the active ingredient in “magic mushrooms.” And a growing number of people, including some of us, know someone who has found relief from such treatments. 

Currently, proposals are pending in both houses of the Illinois General Assembly to create pathways for state licensing and regulation of psilocybin clinics as an alternative to FDA authorization. While none of these bills are likely to pass this year, new versions will be reintroduced in 2025. A growing number of legislators who are moved by feedback from veteran groups, first responder organizations, behavioral health advocates and others who support various forms of psychedelic therapy, are expected to co-sponsor the bills.

On December 10, 2024, the Illinois House Mental Health & Addiction Committee held a hearing to gather information about the potential benefits and risks of using psilocybin and other hallucinogenic substances to treat a plethora of behavioral and mental health conditions. IPS appreciated the opportunity to participate in this hearing.

Speaking on behalf of the Illinois Psychiatric Society, Christopher Holden, MD, a psychiatrist certified in addiction psychiatry and addiction medicine, acknowledged the compelling testimony from psychedelic therapy patients, practitioners and advocates. At the same time, Dr. Holden cautioned against moving forward with any state regulation of psilocybin that circumvented the FDA approval process. Dr. Holden’s testimony was positively received by legislators. His comments on behalf of IPS also appeared in several news stories about the hearing.

Here is a summary of the key points Dr. Holden made in his testimony: 

  • Legalizing the medical use of psilocybin precedes evidence about its safety and efficacy. Research is underway on psilocybin for the treatment of depression and PTSD and it has sparked interest in its potential, but the results are not yet conclusive.

  • Importantly, we do not know enough about psilocybin’s: 

    • Dosing limitations and guidelines

    • Interactions with other medications

    • Efficacy within a comprehensive treatment plan that includes therapy and other supports 

    • Short and long-term side effects

  • We have strong evidence-based ways of treating depression and other mental health conditions that should be considered before hallucinogens (which include psilocybin) but they are often underutilized, or not fully utilized. These include therapy, medications, and combinations of those. 

  • Most of the research protocols require use under the supervision of a physician in part because hallucinogens can have significant immediate health and psychiatric impacts including changes in perception (like hallucinations), intense emotions (like intense anxiety or dysphoria), increased heart rate/blood pressure/respiration/temperature, and in rare cases paranoia and psychosis.

  • As headlines and industries tout treatments (without qualifying the need for use in protocolized ways with medical supervision), the general consumer may seek that substance to find relief. It is important to not get ahead of the science, research and guidelines, whether it be with psilocybin or any other similar substance that could potentially be associated with a substance use disorder.

  • The FDA has not yet approved psilocybin for any medical condition. While the FDA has granted psilocybin “breakthrough therapy status,” this merely establishes the process by which to further study this treatment in a medically supervised setting. This status does not signify safety or legality. 

  • The Illinois Psychiatric Society, American Psychiatric Association, and American Medical Association support continued research and therapeutic discovery into psychedelic agents with the same scientific integrity and regulatory standards applied to other promising therapies in medicine. Clinical treatments should be determined by scientific evidence.

  • We urge the legislature to defer any bills related to psychedelic treatment until the FDA and the broader medical community have hard evidence on efficacy and develop adequate standards of care, such as dosing, prescribing, treatment protocols, and packaging.