Missouri Lawmakers Push To Legalize Psilocybin For Mental Health Conditions And End-Of-Life Care

A Missouri Republican last week announced his intent to introduce a bill to legalize and regulate psilocybin therapy for people with certain mental health conditions, framing the proposal as an alternative path to addressing high suicide rates and trauma among the nation’s military veterans.

Rep. Matt Overcast (R), a lawyer and U.S. Air Force veteran, spoke about the measure alongside a handful of veterans and advocates on a video call with Marijuana Moment on Thursday. While the legislation is not yet filed, Overcast referred at times to a working draft of the forthcoming measure.

As planned, it would legalize the use of psilocybin for people 21 or older with post-traumatic stress disorder (PTSD), major depressive disorder, substance use disorders or other conditions that clinical trials registered with the U.S. Food and Drug Administration (FDA) show can be effectively treated with the psychedelic, the lawmaker said.

Overseen the by the state’s Department of Mental Health, the program would require participants to demonstrate an established relationship with a health care practitioner who can certify that they require end-of-life care or have been diagnosed with one of the qualifying medical conditions.

The administration of psilocybin would need to be supervised by a licensed healthcare professional, including doctors, psychologists, professional counselors and licensed marital or family therapists, advanced nurses and a number of others.

A pair of other bills already introduced in Missouri’s House and Senate, meanwhile, would legalize a much narrower program for only veterans enrolled in clinical studies on psilocybin, though the same list of conditions would apply.

Overcast’s forthcoming legislation differs in significant part by removing the veterans and clinical study requirements. The goal is to make more widely accessible what he sees as a promising alternative therapy to help adults manage and overcome conditions that negatively affect—or even claim— their lives.

“There’s no language saying it just has to be veterans, it has to be law enforcement,” he said. “This stands to benefit veterans, law enforcement, firefighters, potentially attorneys…It’s fantastic as far as the potential impact this could have on society as a whole.”

The freshman Republican said he had some concern about publicly supporting psychedelics reform but felt it was an urgent issue to pursue.

“It’s psilocybin,” he said, “I won’t lie. I was like, this probably isn’t the right thing for me to discuss with my constituent base…Anytime you’re talking, if you will, alternative therapies, drug reform, whatever, people have their biases, right?”

But, he continued, “I can’t count on both hands how many friends I’ve lost—and, you know, I too, if we’re being honest, could probably benefit from these therapies.”

Overcast noted that he experiences psychological non-epileptic seizures. “Essentially it’s how my PTSD manifests itself,” he explained. “As an attorney and an active father, that’s really a nightmare.”

He emphasized that the program would have “tight” medical restrictions. “This isn’t, you know, legalizing psilocybin,” he said. “This is a pro-life bill, make no mistake about it, right? That is the objective. Give people options so that way, hopefully, we reduce the number of public servants who are succumbing to, ultimately, their mental health challenges, their addictions and whatever it may be.”

The representative was joined by a number of advocates who spoke in favor of legalizing access to facilitated psilocybin. Among them were retired St. Louis Metropolitan Police Department Detective Kim Kowalski; Annie Stanfield, a vice commander at the Veterans of Foreign Wars (VFW) post in Washington, Missouri; Carl Shepard, a U.S. Army veteran who served in the Iraq War; and Will Wisner, executive director of the Grunt Style Foundation, an organization that provides veteran aid and supports psychedelics reform as part of mental health treatment. Organizing the call was lobbyist Eapen Thampy, founder of the group Psychedelic Missouri and a backer of several past reform efforts.

Kowalski said alternative therapies—in her case, cannabis—helped “reset” her brain after being exposed to trauma both in work and as a line-of-duty-death widow. After finding cannabis, she said, “I am forever grateful that I did not go the pharmaceutical route,” which she associates with suicidal ideation in veterans and fellow police.

“We have the science to say psilocybin is a viable route of treatment that can save lives,” she said. “I am tired. I am old. And it is time to move this forward, because the numbers are too high…Let’s save lives and quit talking about it.”

Carl Shepard, a Columbia resident and military combat veteran who said he’s been diagnosed with PTSD, traumatic brain injury and “all that good stuff,” said he too avoided pharmaceuticals recommended by U.S. Department of Veterans Affairs (VA) doctors.

“I was living a really chaotic life coming back out of the service,” Shepard said. “Psychedelics and microdosing on my own were part of my journey into my current form, I guess you could say. I feel healed and just like it was a really massively transformative, blessed kind of part of my journey.”

Stanfield, at VFW, said her main goal is to ensure health care providers have access to quality information around psilocybin. She also works for a hemp company and said she feels people in the industry often know more about cannabinoids than doctors or nurses.

When she talks to veterans, she said, “I can sit there and tell them, ‘Hey, talk to your doctor about this,’ and their doctor is completely ignorant about anything cannabis because it’s been taboo for so long.”

“My thing is having the education out there,” Stanfield continued. “Doctors and all these therapists and people who are going to be the facilitators—how do we get that information into their hands so that they’re comfortable and knowledgable of this?”

Will Wisner, of Grunt Style Foundation, is also a combat veteran and spent 17 years in military service with colleagues who developed rare cancers, severe neurological disorders and other maladies. Afterward, around 2009, he said, “the VA at that point was under pretty tremendous pressure to get people through and get a diagnosis.”

“It seemed to me the default was a psychological diagnosis, which then led down the road of a polypharma cocktail of various different SSRIs, benzodiazepines, antidepressants,” he added. “A lot of these things have bad side effects, primary amongst them being suicidal ideation.”

Wisner had to navigate his own path to healing, he said, noting that psychedelics “have played a tremendous role in that.”

Compared to the other psilocybin bills in play in Missouri this year, Wisner said Overcast’s bill is preferable because doesn’t require participants be enrolled in a clinical study.

“This research is just another way to kick the can down the road,” he said. “It’s killing people.”

He and other veterans on the panel also said they oppose provisions in psychedelics bills that require patients to try all other traditional treatments before being allowed access to psychedelics.

“I don’t know if it’s involved in this bill or not. There’s generally something about [how] you have to have exhausted all other avenues before you can access this one,” Wisner said. A requirement like that can push people into pharmaceuticals, he added, describing that path as “the status quo that’s killing us.”

Overcast initially said on the video call that under his own bill, “you’re gonna have to have tried other things first, exhausted those remedies.” But he later clarified that the draft text of the bill says only that veterans must have “considered all other treatment options” with their healthcare provider.

Thampy, the lobbyist who organized Thursday’s video event, noted that because Overcast’s forthcoming bill wouldn’t require psilocybin patients be enrolled in a federally registered clinical trial, far more Missourians could participate.

The two other psychedelics bills, HB 829 from Rep. Richard West (R) and SB 90 from Sen. Stephen Webber (D), would require all veterans who participate in program also be enrolled in FDA-registered clinical trials.

“The legislation that they’ve filed is incredibly restrictive,” Thampy said on the call, calling the clinical trial requirement “bizarre” and “unworkable.”

“Because of that one provision in that legislation,” he said, “it means the potential access in Missouri is probably less than 50 people.”

While it’s unclear exactly how many veterans under might be able to enroll in trials and access psilocybin through the other two bills, it’s a safe assumption that Overlook’s bill would open the door to more patients in the state.

Last year, Missouri lawmakers approved a separate $5 million allocation of state opioid settlement money to study whether psilocybin can help treat opioid use disorders and curb overdose deaths.

Initially the provision was for twice that amount—$10 million—and was was briefly earmarked to study ibogaine as a potential treatment rather than psilocybin. The line was later amended to focus on psilocybin, but before its final passage, all references to the specific substances were removed.

As passed by lawmakers, the line is ambiguous. The section once said the money was “to study ibogaine and its ability to treat opioid addiction,” which was later changed to say it was “to study psilocybin and its ability to treat opioid addiction.” In its final form, the measure says the money is “for opioid research and its ability to treat opioid addiction.”

Regardless, the Department of Mental Health sought to disburse the money with a focus on psilocybin.

“The purpose of this Request for Information (RFI) is to obtain written feedback from the vendor community for use in preparation of a Request for Proposal (RFP) for procurement of Opioid Related Research of Psilocybin for the State of Missouri,” an agency document from last year said.

HB 2010 was sponsored by Rep. Cody Smith (R), The short-lived addition of ibogaine, meanwhile, was the doing of Rep. Chad Perkins (R), a longtime police officer.

Also last year, two committees in the state House of Representatives advanced separate legislation that would have legalized psilocybin by military veterans, but lawmakers ultimately ran out of time in the session to consider the measure further.

That bill, HB 1830, would have allowed military veterans who were at least 21 and diagnosed with a qualifying condition such as PTSD or substance use disorders to legally access laboratory-tested psilocybin. The legislation was modeled off a separate House bill that advanced to the floor of that chamber a year earlier but was not ultimately enacted.

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Photo courtesy of Wikimedia/Mushroom Observer.