A federal district court in Oregon has allowed a lawsuit to proceed related to home-based psilocybin therapies for terminally ill, homebound individuals.
Psilocybin facilitators sued the Oregon Health Authority to allow for “reasonable accommodations” for individuals who cannot travel to a service center due to an illness or disability. Plaintiffs have alleged that existing policies violate the Americans with Disabilities Act (ADA). Current state laws permit psychedelic treatment utilization only in licensed facility settings overseen by experts.
The case could have reverberating impacts on how other states address psychedelic treatments for dying and disabled populations, said Kathryn Tucker, special advocacy advisor at the National Psychedelics Association and attorney for the plaintiffs.
“It’s respecting the rights of homebound, disabled and dying people,” Tucker told Hospice News. “Current [state] law restricts services to a service center, which bakes in discrimination when people with advanced illness may be homebound. It’s barring access with refusal for accomodation. Treatments provided in the home [can] be really important for people to feel calm, tranquil and safe and really receive the benefits.”
Plaintiffs in the lawsuit include licensed facilitators with experience in providing psychedelic treatments to people with advanced illness. They sought to expand access for homebound individuals seeking to ease psychological distress and relieve suffering related to their terminal conditions. These individuals are often denied access because they are unable to travel to psilocybin service centers.
Providing home-based psychedelic services could violate treatment facilitators’ licenses of operation, according to the Oregon Health Authority (OHA). The Oregon Psilocybin Services Act (PSA) permits licensed personnel to manufacture and provide psilocybin services to adults 21 and older at a service center. The PSA does not provide a legal pathway to make accommodations for psilocybin that can be consumed outside of a licensed service center, the OHA stated in a court document.
The OHA contends that plaintiffs lack standing because their allegations of future harm are too speculative. The agency stated that no intent to engage in unlawful conduct was evident because plaintiffs failed to identify any specific patients who would not receive psilocybin services in the future. The case brought forth a “only a mere desire, not a concrete plan,” to provide psilocybin services in violation of the PSA, according to the court document.
An amicus curiae brief was filed in support of the plaintiffs by Disability Rights Oregon and the Disability Rights Education and Defense Fund, along with 16 other groups. The Oregon Hospice & Palliative Care Association was included in the amici, along with the Autistic People of Color Fund, the Patients Rights Action Fund, end-of-life doulas and several psychedelic therapy researchers and advocates.
The case centers around questions related to federal disability rights law and the state enforcement authority to exclude access from a public health program without providing reasonable modifications for disabled individuals, as required under ADA laws. If state statutes are immune from making such modifications, this could limit access across a range of other public programs, the amici proposed.
“It’s big news and pretty significant to see the amicus participation,” Tucker said. “The parties see this case as implicating really serious issues that intersect. It’s a violation of federal law for a state to operate a program that discriminates against people with disabilities. Some of the people who could benefit the most from psilocybin services are discriminatorily barred from access.”
Psilocybin is among the psychedelic-assisted therapies that recent research has linked to improved quality and reduced costs at the end of life. For some patients with terminal or serious illnesses these treatments have been associated with relieved anxiety, depression or existential distress.
Psychedelic drugs remain a federally controlled substance, however some state-regulated programs exist in Oregon, Colorado and New Mexico. Right-to-try laws have expanded in the last few years around certain “investigational drugs,” including psilocybin and ibogaine, among others. These laws allow patients diagnosed with life-threatening conditions to participate in clinical psychedelic trials, as well as other certain types of drugs approved by the U.S. Food & Drug Administration (FDA).
The White House recently signed an executive order that expanded access to psychedelic treatments for individuals with serious mental illnesses, particularly those who have not responded to traditional therapies. The executive order included pathways to develop safe, effective use and advance innovative research models.
Despite the progress, more forward movement is needed to drive change toward improved access and better outcomes among patients, Tucker indicated.
“People with advanced and terminal illnesses don’t have time to wait for a new drug approval to wind its way to completion,” Tucker said. “For that population, they are entitled by law to have access to certain investigational drugs, and those drugs are deemed eligible investigational drugs if they meet certain criteria, which psilocybin does.”
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