Could psychedelic therapy be the next frontier for mental health care in California?

Psychdelics such as LSD, ketamine and psilocybin, used by therapists to assist in the treatment of certain mental illnesses, could receive billions for state-funded research under a newly proposed bond initiative.

Dr. Jeannie Fontana, a Los Angeles internal medicine physician, filed paperwork last month to place a $5 billion measure on the November 2024 ballot to create a new state agency for studying the effects of psychedelic-assisted therapy for people diagnosed with PTSD, substance abuse and other mental health issues.

The Treat California Initiative — an acronym for Treatments, Research, Education, Access and Therapies — has a long way to go before it qualifies for a ballot, including the collection of approximately 1 million signatures from California voters. Yet, Fontana feels optimistic about gathering the necessary support.

“Our mental health programs are falling far, far short of what needs to be done for the citizens of California, she said. “It makes sense that we try something new and make sure we do it thoughtfully and carefully.”

Research into psychedelic medicine began in earnest in the 1950s following the discovery of LSD. But that came to a screeching halt in the 1960s due to growing political concern over the recreational use of psychedelics.

Over the past 20 years, there has been a renewed and growing interest in the therapeutic potential of drugs like MDMA, LSD, ketamine and psilocybin, a naturally occurring psychedelic compound found in ‘magic mushrooms.’ Studies over the last decade have found that psilocybin has the potential to treat substance abuse disorders and depression. MDMA, also known as ecstasy or molly, has shown promise for treating post-traumatic stress disorder.

The Food and Drug Administration in 2019 approved limited use of Esketamine, a form of ketamine, for depression in patients who did not experience relief from other antidepressant medicines.

Paul Hutson, a professor at the University of Wisconsin-Madison who studies psilocybin and leads the school’s center for psychedelics research, said he anticipates within the next five years there will be enough evidence for the FDA to approve MDMA and psilocybin to treat PTSD and depression.

What makes psychedelic-assisted therapy unique is that studies are showing that the drugs appear to have long-lasting effects after just one or a few doses, as compared to daily antidepressant consumption.

“These types of medicines really represent a paradigm shift in the way we approach mental health,” said Dr. David Olson, director of the UC Davis Institute for Psychedelics and Neurotherapeutics.

The barriers around psychedelics and mental health treatment

The federal government does not recognize a medical use for most psychedelics. Yet, universities across the globe, including almost every prominent one in California, are studying their use to treat certain psychiatric diagnoses.

Most of the research is funded by private pharmaceutical companies and nonprofits such as the Santa Cruz-based Multidisciplinary Association for Psychedelic Studies, which has raised over $130 million for research and education since it was founded in 1986, according to its website.

The state agency and funding model proposed under Fontana’s bond measure would be the first of its kind for psychedelic-assisted therapy.

Fontana envisions an agency similar to the California Institute for Regenerative Medicine, which was established through a $3 billion bond measure approved by voters in 2004 to accelerate research into stem cell treatments. With those funds drying up, California voters in 2020 agreed to an additional $5.5 billion in bonds to further the Institute’s work.

The research conducted on psychedelic-assisted therapy is strong but not yet conclusive, according to Charles Grob, a professor of psychiatry and pediatrics at the UCLA School of Medicine.

Grob, who first conducted his first research on patients in the early 90s, said a new state agency could help strengthen the science around the topic and guard against dangerous outcomes.

More than 1 in 5 adults in the U.S. are living with a mental illness, according to the Centers for Disease Control and Prevention. Fontana sees her initiative as complementary to a $4.7 billion bond measure proposed by Gov. Gavin Newsom to build up to 10,000 new behavioral health beds across California. Newsom’s measure is expected to go before voters in March.

While some hope that psychedelics could soon be part of the state’s official medicine cabinet, they won’t be the answer for all of those afflicted. For people diagnosed with schizophrenia or bipolar disorders, psychedelics may actually worsen their condition.

Some studies have also found adverse outcomes from the use of certain psychedelics. Ibogaine, a natural psychedelic drug that comes from a plant, has shown promising results for treating substance abuse but it caused heart damage and deaths to several patients.

“There’s certainly ample promise to move forward with research, but one really needs to be careful with safety parameters,” Grob said.

Psychedelic treatment is time-consuming and costly. It typically consists of an initial exam, a supervised dosing session of about eight hours — sometimes with an overnight stay — and then a debrief session. All told, a single dose requires 32 to 40 hours from trained mental health practitioners and is estimated to cost $3,000-$8,000, according to Hutson.

In addition to cost, two major barriers to broad access are a lack of trained health care professionals and uncertainty around whether insurance will pay for the expensive treatments.

Will California voters fund psychedelic treatment research?

Fontana is hoping to gather support from veteran groups and unions representing first responders — populations especially vulnerable to addiction and post-traumatic stress disorder.

The initiative comes as a bill authored by Senator Scott Wiener, D- San Francisco, makes its way through the legislature with hopes of decriminalizing psychedelics across the Golden State.

More than six out of ten registered U.S. voters support legalizing regulated therapeutic access to psychedelics and more than three-quarters favor making it easier for researchers to study the substances, according to a recently released survey by the UC Berkeley Center for the Science of Psychedelics.

If successful, Fontana’s measure will join a crowded 2024 general election ballot in California.

Lawmakers have proposed nearly a dozen bond measures to address statewide issues ranging from affordable housing and schools to climate change and fentanyl use. Other citizen-led initiatives proposed for ballots next year seek to expand rent control, limit the ability of lawmakers in California to increase taxes and authorize city and county leaders to spur more housing production by overriding state land use statutes that conflict with local regulations.

Two referendums — one to reverse a recent voter-approved ban on oil and gas wells near schools and homes and another to prevent a hike in minimum wages for fast food workers — have already qualified for the November ballot.