State task force recommends decriminalization of psychedelics in new report

NINA MOINI: Minnesota's psychedelic medicine task force published their second ever report this week. It includes their recommendations on the use of psychedelic drugs, including psilocybin, MDMA, and LSD for medical purposes. The task force has tapped into a growing body of research that suggests that these psychedelic drugs could be a game changer in the field of psychotherapy to treat conditions like addiction, PTSD, depression, and bipolar disorder. Jessica Nielson is a neuroscientist and the Chair of the Psychedelic Medicine Task Force. She joins us now on the line to explain these latest recommendations. Jessica, thank you for your time today.

JESSICA NIELSON: Yeah, thank you so much for having me.

NINA MOINI: I want to take a step back, for starters, for those in our audience who may not have heard much about these drugs and how they could be effective in treating mental health. So you're a neuroscientist. You've been studying this field. Tell me more about how these drugs work therapeutically and why they're different from perhaps existing drugs on the market that treat depression, like SSRIs.

JESSICA NIELSON: Yeah, that's a good question. So the point of the task force really was to review the scientific literature about psychedelic medicines. And so in doing so, we looked at the clinical trials that were occurring for psychedelic medicines. And we found some promising evidence that MDMA, psilocybin, and LSD may help treat mental health conditions as well as or better than currently available options, like psychotherapy or certain medical conditions.

However, these trials have been small. And more research is needed if any of these are going to be approved by the Food and Drug Administration. But they do differ from other medications in really trying to open up what's called this critical period of development, which really helps the brain change when exposed to these types of substances and experiences. And so that's where we think the therapeutic potential might be.

NINA MOINI: So there's a lot of room for exploration, which is probably part of the reason that you're having this task force. And when you report to the legislature, it's to see, where do we go as a state around all of this? So in reading the report-- and correct me if I'm wrong, but the recommendations that I saw were to create a state-regulated clinical program for some psychedelic medicines, decriminalizing personal use and possession in some cases, and more funding for research into the health benefits around some of these different substances. So why do you think these were-- this was the area that you all landed on and formed a consensus around? What is it about these recommendations that make sense for the moment that we're in?

JESSICA NIELSON: Yeah, that's a good question. I think it was born out of building upon the success of other states pioneering to create state-regulated psychedelic medicine programs. So other states like ours have been following in their footsteps to try and pass new laws and enable access. Oregon was the first, with measure 109, that created a psilocybin service centers. Those have been up and running since the summer of 2023. And Colorado will be opening up psychedelic medicine clinics this year, under the Natural Medicine Program. So I think that, combined with the promising scientific research, really inspired those of us in Minnesota to really push for a psychedelic medicine access program here.

NINA MOINI: And your recommendations didn't go as far as recommending overall legalization, expunging criminal records for those who had been selling. What do you think about some of those steps? Was it just that we're not able to support that infrastructure yet as a state?

JESSICA NIELSON: I mean, there were-- yeah, there was a lot of discussions that happened around different access models and what the state would be comfortable with based on the federal legality or illegality of these substances. I mean, the report is designed to be a long-term resource for the state to roll out an access program over the coming years. And the legislature is not bound by these recommendations. So it'll be up to them to introduce and champion a bill that is hopefully built upon these recommendations.

NINA MOINI: And I think--

JESSICA NIELSON: As the state becomes ready for them.

NINA MOINI: OK, sure. I think culturally people are starting to-- their ears are starting to perk up around studying psychedelics in this way. What have you noticed in a shift in public perception?

JESSICA NIELSON: That's a good question. I mean, I think there's a lot of communities around the country that are rallying around psychedelic medicines and trying to find ways of access. And so I think we're seeing something similar as with cannabis, where first, the medical model with cannabis started to change the public perception and acceptance of that. And so I think we're seeing a similar thing with psychedelic medicines, with a lot of promising research, as well as these states trying to innovate in ways to access them.

NINA MOINI: Let's talk about the specific drugs-- so MDMA, LSD, and then psilocybin. So are these similar in the effect that they would have on people? Or are they slightly different or more severe in different ways?

JESSICA NIELSON: Yeah. So I would say all of these drugs basically act on serotonin and receptors in our brain that engage with serotonin. And so they have similarities in that way. But psilocybin and LSD are probably a lot more similar experientially than MDMA. MDMA tends to have a more euphoric feeling.

And this is why people think it might be good for post-traumatic stress disorder, to help dampen down fear that might come up with traumatic memories while engaging with that type of medicine in a therapeutic context, whereas psilocybin and LSD produce more of what you would consider a classical psychedelic experience with visual experiences. And they're much longer lasting as well. So I think they do have similar mechanisms. But the experiences of them and the pharmacology of them are a little bit different.

NINA MOINI: And obviously, these drugs can be harmful if abused. When you're working with the task force, are you also working on making sure to promote responsible use of these drugs as the state might move in a different direction?

JESSICA NIELSON: Yeah. I mean, one of the main points that we were coming up-- a plan with for the legislature was a plan around public education that really would center on making sure people understand what these substances are, what is responsible use practices. A lot of these, like psilocybin, have been used for hundreds, if not thousands, of years safely. And so we did do a lot of-- we had a lot of discussions around public safety.

And by and large, these substances are pretty safe physically. There's just some additional risks when it comes to psychological safety around how people are engaging with them and who is with them, who would be their therapist in that context. And do they know how to handle what's going on with these experiences in a therapeutic setting?

NINA MOINI: Sure. With the concept of legalization, perhaps the task force hasn't-- doesn't have a handle around this, but is legalization, like in the way that cannabis has been legalized, something that you think is on the horizon in 10 years, five years? Where does that feel like it could go?

JESSICA NIELSON: Yeah, I think-- I don't think society is necessarily ready for that on the level that we have with recreational cannabis. But from a harm reduction and public safety standpoint, legalization and regulation is really the safest option, because I think we're seeing now a lot of these weird products hitting the market.

There was this fiasco with these diamond shrooms, mushroom chocolates that had different kind of synthetic molecules in them that were unregulated. People didn't know what they were taking. And this is really companies trying to get around the Controlled Substances Act and giving people things that are technically legal. But we don't know how people react when they take them. So having a legalized, regulated market would really get ahead of that. I think we saw this with the synthetic cannabinoids and people trying to get access to THC with cannabis. So it would be in the public's best interest to legalize these things if we want to promote a safe supply.

NINA MOINI: OK. So as we wrap up here, your next meeting is going to be held January 8. Oh, that's next week. What is next for this task force after releasing your report? What happens now?

JESSICA NIELSON: Yeah. Well, actually, we've completed all of our work. And we don't have any more meetings. I think the website might just need to be updated. But we completed our work at the end of-- at the beginning of December and then obviously released the report to the public yesterday and submitted it to the legislature.

So now we're basically just on hold, hoping that some of the legislators will put in a bill to implement some of these recommendations from the task force and be available if people want to talk about this from a public education standpoint. So that's the work I see from task force members moving forward, is really just engagement with the legislature and the public around the recommendations.

NINA MOINI: That makes sense. Jessica, thanks for coming on and sharing about your work.

JESSICA NIELSON: Yeah, thanks so much for having me.

NINA MOINI: That was Jessica Nielson, the Chair of Minnesota's Psychedelic Medicine Task Force.