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Oregon Ballot Measure 109 was a 2020 measure that authorized the use of psilocybin mushrooms in therapeutic settings. It was approved by a 56-44% vote in the 2020 general election. It was one of two ballot measures that Oregon voted on that year that showed a major rejection of the "War on Drugs", the other being the decriminalization of personal possession of all drugs.

The actual text of Measure 109 is much more complicated than "psilocybin is legal". In my voter's pamphlet, the text came to 23 pages. It explains the process of becoming authorized as a provider of psilocybin therapy. Psilocybin still remains illegal under federal law, and the measure also allows individual jurisdictions within Oregon to prohibit psilocybin-dispensing facilities. There is a good chance that it will take a long time and much legal wrangling before any treatment center opens, if ever.

What is interesting to me is how a specific substance was brought up to the voters. I am unsure about the reason behind this choice: why was it psilocybin and not LSD or Mescaline, drugs with similar profiles, or perhaps slightly less classical psychedelics like MDMA or Ketamine, both with their advocates for therapeutic use, that were put before the voters? I have to admit I have had some cautions about this approach. While the idea of psychedelic use in therapy makes sense, there are a lot of medical questions: the safety and efficacy is supposed to be the result of scientific and medical evidence, not the opinion of the voters. While it is true that psilocybin, like most classical psychedelics, has a very wide therapeutic margin and few physical side effects, that is not true of something like ketamine, which is more dangerous and pharmaceutically complicated. Is putting questions like this up to popular vote the wisest decision?

My own answer to that is that the medical profession, on the whole, has already been negligent for decades, because they have been happy to go along with unscientific social and political prejudices against certain substances. Psilocybin, like cannabis, was listed as a Schedule I substance in 1970 with the idea that it had a "high potential for abuse", which is simply not true. There are many drugs with psychedelic quality that are already legal, and sometimes even not treated very seriously... tramadol, bupropion are quite widely prescribed, and dextromethorphan is an ubiquitous over-the-counter medication. So while I have some reservations about the salad bar approach to permitting substances, it is not that different from the arbitrary, unscientific process we already have.

In any case, Oregon voters decided to take a step against the War on Drugs, and whatever ramifications it may have in the future, it signals some sort of change.