In a former church on a rural slice of land in Clackamas County, the first ever psilocybin facilitators in the U.S. are attending their last day of classes.
These are the trained practitioners who will help people in Oregon take psychedelic mushrooms under the state鈥檚 .
While they鈥檝e learned a great deal about psilocybin over the last six months at school, there are still plenty of unanswered questions. Where will they find work? There won鈥檛 be any licensed service centers open until at least this summer. How much will psilocybin facilitators make? Some say $80,000 per year, others predict much less. And will their workplaces be raided by federal authorities? .
But for now, the group is mostly focused on ethics.
Teacher Gina Gratza sets up a scenario where a woman who has just taken psilocybin becomes agitated. She鈥檚 shouting, 鈥淕et away. Get away!鈥�
鈥淎fter 20 minutes, she begins to rock herself back and forth. She begins to calm her system. She looks up at you and asks you to put your hand on her stomach. What do you do?鈥� Gratza asks the group.
A male student says he definitely would not touch her. The Oregon Health Authority dictates facilitators are only allowed to touch a clients鈥� hands, feet or shoulder. The students have been taught that touch feels unusually significant during the heightened sense of awareness that comes with psilocybin consumption. And there have been during sessions with psychedelic substances.
Another student says she鈥檇 tell the client that they could each touch their own stomachs and then they could hold hands.
鈥淭hat鈥檚 a beautiful response,鈥� Gratza says.
These psilocybin facilitators are being trained to usher people through the process of taking the hallucinogenic drug, from an initial interview, where they say what they鈥檙e hoping to get from the facilitation, to a meeting afterward to discuss how participants change their approach to life as a result. Because this is the first class ever to graduate in Oregon, these students are setting the tone for the future.
They鈥檝e learned all kinds of things about psilocybin: from the ethics of touch to mushroom dosing.
鈥淲e had a whole class on informed consent. We had a whole class on trauma informed presence,鈥� said 79-year-old student Lusijah Marx, who is a clinical psychologist.
Marx started her career as a nurse in Iowa, then became a nurse practitioner with OHSU. For years she鈥檚 been a psychologist with the Portland nonprofit Quest Center for Integrative Health, which provides health care to low-income individuals.
She said her cohort of students contains doctors, nurses, grief counselors, family therapists, social workers and naturopaths, as well as people who haven鈥檛 been in the health care field, like a real estate agent and a software engineer.
But what they all have in common, she said, is a belief that psilocybin can be an effective treatment for maladies like depression, anxiety and post-traumatic stress disorder.
Each of the 107 students at InnerTrek school paid about $8,000 for the six-month course. InnerTrek was set up by Tom Eckert, one sponsor of the 2020 ballot measure that legalized psilocybin therapy.
鈥淲hat鈥檚 revolutionary here in Oregon is this is not just piggybacking on the medical model or a different profession,鈥� he said. 鈥淭his is a new ecosystem.鈥�
directed the Oregon Health Authority to license the manufacture, transportation, delivery, sale, and purchase of psilocybin for therapeutic purposes or personal discovery.
Most of the InnerTrek students paid an additional $3,000 to take a trip to Mexico, so they could consume psilocybin legally.
Marx said she took the trip and the drug hoping to think about the pros and cons of a new career as a psilocybin facilitator. Instead, she found herself focusing on her conservative upbringing.
鈥淚 was looking at my Scandinavian, Midwestern roots, the amount of rigidity around work, and being productive, and being quote: 鈥楢 good person,鈥欌�� she said.
Marx saw herself in a rigid cage. 鈥淲hat came to me in my psilocybin experience was 鈥榮pacious ease.鈥� You can live with spacious ease.鈥�
She said psilocybin gave her permission to stop during the workday and enjoy the moment.
鈥淭here鈥檚 a lighter way of living. I love it,鈥� she said.
Now that her classes are done, Marx has taken InnerTrek鈥檚 final exam. Next, she鈥檒l need to pass the state鈥檚 official licensing test.
鈥淚t鈥檚 like how many grams can a person receive? And what are the rules around touch? And if you were going to do a group, how many people could be in it? There鈥檚 just a lot of different rules,鈥� she said.
Marx expects to pass. The problem she sees is if she starts dosing people with psilocybin, she might get in trouble with federal authorities, the Oregon Psychology Board or her employer, the Quest Center. She can鈥檛 use psilocybin at Quest because it receives federal funding via Medicare and Medicaid.
So, Marx has come up with a work-around. She鈥檚 hoping to work with Quest to use another psychedelic, ketamine, which is legal for use by registered medical practitioners and can put a patient in an altered state of mind. It鈥檚 widely used as an anesthetic.
By using ketamine instead of psilocybin, Marx won鈥檛 have to worry about federal raids. She won鈥檛 be able to fill insurance claims for the drug because she鈥檒l be using it off-label, but she will be able to bill insurance for therapy and other aspects of the work, if Quest Center agrees to move forward.
Insurance isn鈥檛 paying for psilocybin therapy at this time.
Still, within a year, Marx hopes to be involved in a psilocybin therapy center with other InnerTrek graduates, once they have seen how the legal issues play out.
For Marx and many new facilitators, this work is not about money. They think psilocybin therapy will be a game changer for intractable medical issues like post-traumatic stress disorder, depression and anxiety. They say they especially want to make sure marginalized people can get services. But, Marx said, they have wondered about potential wages.
鈥淥ne person calculated it out, (and) said, 鈥業鈥檇 probably make the same amount of money as I might as a barista,鈥欌�� she said.
While that student estimated they鈥檇 make roughly $35,000 a year, InnerTrek is more optimistic, telling students someone could make up to $80,000 depending on how many clients they see.
Gratza, the InnerTrek teacher, said salaries are just one of many unknowns in this brand new system.
鈥淚t鈥檚 not like regular therapy,鈥� she said. 鈥淵ou鈥檙e in there for six hours and depending on someone鈥檚 experience, it may make you feel like, 鈥業 need a few days off before the next one.鈥欌��
Being a new industry, there is plenty of uncertainty surrounding psilocybin therapy. On March 1, the Netherland鈥檚-based Synthesis Institute notified its students in Oregon that the and that their education was being indefinitely paused before a single student had graduated.
Students like Lesley Clarke, who paid $9,600 for the course, are now unsure if they鈥檒l be able to find work, and what the collapse of a major education provider means for the psilocybin field.
鈥淚t鈥檚 not just about what鈥檚 happening to the students, it鈥檚 about what happens period,鈥� Clarke said.
Oregon legislators, too, are anxious to know what鈥檚 going to happen with the state鈥檚 psilocybin experiment. State Sen. Elizabeth Steiner, D-Portland, has introduced Senate Bill 303, which would create a voluntary, anonymous data collection system.
鈥淲e鈥檙e on the cusp of having more psychedelic research and evidence around outcomes, being conducted in one year, than has happened in the last 50 years,鈥� said Nathan Howard, InnerTrek鈥檚 director of operations.
Hundreds of psilocybin facilitators from around the state have now graduated or are near the end of their programs.
Meanwhile, everyone is waiting to see how many service centers the Oregon Health Authority will license and where they will be.
And answers to many of the students鈥� questions about their role in Oregon鈥檚 psilocybin therapy system won鈥檛 come until this summer, when they can begin administering their first doses to clients.
Copyright 2023
