While the map might look very ‘red’, it’s important to remember a few things:

1. City land is subject to city regulation. It is only unincorporated land outside of city limits that is subject to county control. As such, cities within opt-out counties could choose to remain opted in, and become ‘safe haven’ cities. These are represented as green blobs amidst red counties on the map below.
   
   
2. Factor in population density when thinking about these results. As we explained in Bulletin 116, the seven most eastern counties represent around a third of the landmass of Oregon, but a combined population of less than 200,000 people. In fact, the combined population of this ‘eastern bloc’ is just over a fifth of Multnomah county. As such, our map is visually quite misleading in showing such large swathes of red, or counties and cities that have opted-out of psilocybin services for now. If we adjusted the size of counties on the map by their population, the picture would be much different.
   
   This point was picked up by The Oregonian’s coverage, which noted: “A map from Psychedelic Alpha shows where opt-outs passed. While it shows nearly two-thirds of the state will not allow psilocybin centers and manufacturing, the places where the majority of Oregon’s population live, the Portland metro area and the majority of the Willamette Valley, are all opted-in.”
   
   
3. Not all of these opt-outs are permanent; some are temporary moratoriums.

Amidst the spectre of state-regulated trips, some counties see voters flip

The cities of Sandy, Astacada and Molalla, for example, all voted to opt-out of psilocybin services by over 60%, according to initial results. The county within which these cities sit, Clackamas, saw 57.7% of early votes supporting an opt-out, too. Proponents of psilocybin services will be especially disappointed with this outcome: Clackamas voters endorsed Measure 109 back in 2020, but have now changed their minds.

Early results from Clatsop County, which also endorsed psilocybin services just two years ago, will also disappoint this crowd. Voters endorsed a temporary ban on psilocybin businesses. Both Clackamas and Clatsop have plenty of ‘safe haven’ cities, though.

Voters in the City of Philomath, in Benton County, supported Measure 109 at a whopping rate of 60% just two years ago. On Tuesday, however, voters changed their tune with over 50% of early votes supporting a moratorium on psilocybin services. Benton county itself, however, did not opt out.

The importance of public education and engagement

On the positive side: in Deschutes County, voters convincingly rejected the opt-out. Indeed, some residents in the county formed a campaign group to oppose the opt-out measure, which appears to have been a success.

Similarly, Jackson County—where a second opt-out rejection campaign was active—denied the opt-out measure.

On this point Sam Chapman, Executive Director of the Healing Advocacy Fund, told Psychedelic Alpha that this shows that “when people hear about the potential of psilocybin therapy from their own community members, they understand why it’s important”.

The geography of opt-outs has equity and access implications

Despite safe haven cities, some Oregoniains will need to travel quite a distance to visit a psilocybin service centre (or, a manufacturing facility or lab). Victor Cabral, Director of Policy at psychedelic therapist training company Fluence, told Psychedelic Alpha that these opt-outs will impact cost and access for everyone involved, “from clinicians and manufacturers to community members seeking treatment.” 

It’s not only travel that could act as a barrier to psilocybin services practitioners and clients, however. Earlier this week, Oregon-based psilocybin training program Earth Medicine Center scrapped its plans to move forward with a facilitator training program. The group cited “several logistical reasons” as well as personal considerations. Chief among the logistical issues cited was the fact that Oregon’s Higher Education Coordinating Commission (HECC) would oversee the training and licensing of psilocybin facilitators in the state, which came as a surprise to many. “Our business model, when coupled with the HECC requirements, is simply not sustainable from a financial perspective,” the group wrote in an email update.

Lead by example…

On a more positive note, Cabral explained that, “the hope is that over time, successful implementation and improvement of the Measure 109 program in counties that opt-in will lead to wider adoption across the state.”

Chapman agreed, predicting that “as the therapy gets implemented in Oregon communities in 2023 and beyond, voters will continue to learn about how it can help address our state’s mental health crisis, and over time access will only continue to expand.”