Oregon’s first shrooms regulator sees promise for healing trauma through psilocybin

A mushroom in Bush’s Pasture Park on Saturday, Dec. 18, 2021. (Amanda Loman/Salem Reporter)

Angie Allbee started her career serving refugees and domestic violence survivors at nonprofit organizations.

Though she’s crafted policy in Oregon state government for years, it was her years helping clients that inspired her to take on her latest job: Oregon’s first shrooms czar.

Officially, Allbee’s title is “Psilocybin Section Services Manager,” a new role in the Oregon Health Authority’s prevention and wellness program.

Her prior nonprofit work “gave me an opportunity to see the perspectives and better understand the perspectives of many people who have struggled with trauma, anxiety, (post-traumatic stress disorder), addiction,” Allbee, 43, said. “That really taught me that healing is essential for people to experience joy and health, and also that processes for healing can look different for different people and require other approaches.”

She began work in June 2021 after Oregon voters in November 2020 approved Measure 109, making the state the first in the country to legalize psilocybin usage in therapeutic settings.

“It’s been really an amazing opportunity for me to take all of the things that I’ve learned over the past 20 years of my professional experience, and be able to work through and apply them in the implementation,” Allbee said.

Psilocybin is the active ingredient in so-called “magic mushrooms” and has been used for thousands of years by many Indigenous people in the Americas.

More recently, clinical trials in the U.S. have shown the drug is effective in reducing depression and anxiety.

The U.S. Food and Drug Administration has granted it “breakthrough” status for treatment-resistant depression, a designation intended to fast-track drug review because evidence suggests it’s a significant improvement over other available treatments.

The ballot measure has been compared to Oregon’s legalization of marijuana and has many similarities, including the challenges of establishing a state regulatory framework for a substance that remains federally illegal.

But there are some key differences too.

Psilocybin will be administered in a licensed treatment location to people 21 and older, not prescribed or sold to be taken home.

Those administering it must be at least 21 and licensed to do so, a process which includes a state-approved training program, as well as a high school diploma and proof of Oregon residency for at least two years. But those licensed facilitators don’t need a particular medical background, and people receiving psilocybin services won’t have to be diagnosed with any illness or medical condition.

“It’s not a medical or a clinical model, and it’s also one that allows for facilitators, people that want to be facilitators to go through a training program,” Allbee said.

The measure also specified that psilocybin can’t be grown outdoors, so don’t expect hallucinogenic mushroom farms cropping up around the state. Indoor production can be natural or synthetic under the text of the law.

By mid-2022, Allbee said they’ll issue rules and regulations governing how production, processing and administration will work.

Much of that work is guided by an advisory board set up in March which includes people with expertise in public health, traditional and alternative medicine, addiction treatment, psychology and mycology.

To date, Allbee said they’ve been reviewing existing research, hearing testimony from experts and seeking input from the public about how Oregon’s program might be set up. The process has been “eye-opening” for her, highlighting the range of conditions that the drug can potentially help treat.

On July 30, the group released a rapid review of existing evidence about psilocybin usage with recommendations. In addition to clinical trials showing the effectiveness of the drug in treating depression, anxiety, trauma and substance abuse, the board also noted its spiritual benefits, long observed in Indigenous cultures.

“One of the proposed mechanisms for observed improvements in depression and anxiety symptoms in clinical trials is a sense of spiritual well-being that many people report during psilocybin treatment. Spiritual phenomenology or mystical experiences in these trials include self-reported experience of meaning beyond oneself and sense of interconnectedness,” the review said.

Angela Allbee, psylocybin services section manager at the Oregon Health Authority (Courtesy photo)

That promise is what Allbee circles back to when asked about her work. Her enthusiasm about the program is clear, but you won’t catch her joking about tripping (hallucinating on psilocybin) or even referring to “shrooms,” much less calling herself the state’s shrooms czar.

For her, it’s about psilocybin’s promise to help Oregonians who have found little relief elsewhere.

“It was an honor to be able to step into this role and lead this work,” she said. “I’ve never hesitated about stepping into a role like this because of the promise it can provide to folks.”

The state is still a year out from opening applications for licenses for businesses to grow or process psilocybin, and for treatment centers to begin operating.

One of the issues Allbee wants to address as she and the board work to set up rules is equity and access. Services won’t be covered by insurance, and Allbee said the state hopes to set a licensing fee that’s sufficient to cover their costs of administering the program, but not so great that care becomes prohibitively expensive for people who need it.

Safety is another concern, ensuring that people using psilocybin are aware of potential side effects and interactions with other drugs or medical conditions.

Much of her day-to-day work is no different from government administration in less hotly anticipated areas of public health and public policy, she said.

“Public service and working in state government – every day seems different. In my experience there’s always something new. There’s always a new challenge. There’s always a new question to answer,” she said.

Contact reporter Rachel Alexander: [email protected] or 503-575-1241.

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