German Ascani
German Ascani
In 2022 Coloradans voted yes on Proposition 122, allowing regulated access for adults 21 and older to natural psychedelic medicines, including psilocybin, that show promise in treating a variety of mental health conditions. For nearly a year, regulators and an expert advisory board have been carefully crafting requirements for Colorado’s new psilocybin therapy program, and in 2025, Colorado will officially become the second state to offer this groundbreaking modality for those who can safely benefit.
As a psychiatrist with 17 years of experience in the public and private sector, I am hopeful about the access to care this program can offer Coloradans with mental health conditions. So many in our state have long been suffering with depression, PTSD, end-of-life anxiety associated with cancer and other serious conditions that are simply not responding to currently available treatment models. These conditions are labeled “treatment-resistant conditions.” Research from leading medical institutions demonstrates psilocybin can be an incredibly powerful tool for recovering from mental illness, leading the Food and Drug Administration to award psilocybin a breakthrough therapy designation for treatment-resistant depression, which allows expedited development and review of psilocybin therapy.
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A commentary published April 29 in The Gazette, however, frames psilocybin as a dangerous substance with no accepted medical benefits and suggests psychedelics will be available for purchase just like marijuana edibles found in retail dispensaries across Colorado (“Exposing Colorado’s psychedelic conflicts of interest”). This is simply wrong.
First and foremost, Colorado’s therapeutic psilocybin program does not allow for dispensaries or retail sale of psychedelic medicines. Adults seeking healing through a psychedelic medicine process must undergo a screening and intake assessment with a licensed facilitator to identify heightened risk in the context of their medical and psychological health and determine if this treatment is appropriate for them. Individuals will only access psilocybin therapy with close supervision and support from trained and licensed facilitators. Pregnant women, children and those with certain physical and mental conditions will be excluded from participation.
Furthermore, the April 29 commentary blatantly mischaracterized a survey on challenging experiences with psychedelics to argue psilocybin is by and large a dangerous substance. In reality, when researchers compared harms associated with 20 substances, including readily available substances like alcohol, cannabis, pharmaceuticals and tobacco, psilocybin was determined to be the least harmful, both in terms of harm to oneself and harm to others. The survey describes the challenging experiences as mostly beneficial, not harmful.
Psilocybin carries no significant risk of addiction or overdose and has been well tolerated in clinical studies. It is true, however, psilocybin is a powerful substance and should be treated with care. Facilitators trained in psychedelic-assisted modalities are familiar with the challenges that may arise during a session and are skilled in helping clients integrate them into the healing process.
As a clinical psychiatrist treating the spectrum of mental health disorders, I regularly prescribe medications that are potentially more toxic, and deadly in overdose, than psilocybin. Some of these FDA-approved treatments include psychostimulants, antipsychotics, benzodiazepines and mood stabilizers. For some patients, they are life-saving and life-changing, and yet for many others they simply don’t work and lead to many adverse side effects. Meanwhile, the mental health crisis claims countless lives, tears families apart and creates devastating ripple effects through our communities. Colorado ranks 45th in the nation for adult mental health. More than 6% of Coloradans experience suicidal ideation each year, much higher than the national average. We are in the midst of a dangerous public health crisis.
Rigorous scientific research shows psilocybin has the potential to help those with mental health challenges. A groundbreaking 2020 study from Johns Hopkins of patients with Major Depressive Disorder showed psilocybin led to full remission for more than half of participants, and had no significant adverse side effects. Additionally, psilocybin therapy does not involve daily medication intake like most other treatments for depression — these results came after just two doses of psilocybin with supportive therapy, and the relief in symptoms lasted for more than a year.
For decades, public and scientific understanding of psychedelics has been clouded by politics, fear mongering and misinformation, and research and public education efforts have lagged due to criminalization. In mental health, we have been stuck for decades without innovation and lacking new approaches and tools to offer our patients as rates of mental illness keep rising. Many Coloradans are experiencing immense suffering, and psychedelic medicine can be a tool to help them heal. It won’t heal everyone and it won’t heal everything, yet to anyone with preconceived notions about psychedelics and their value, I humbly ask you to look at the medical literature and the wisdom of traditional and indigenous cultures for the ways in which powerful plant medicines, delivered in a safe and responsible manner, can help us heal.
German Ascani is a board-certified psychiatrist, psychedelic mental health consultant, educator and researcher working in private practice in Denver with Evolve Mind Wellness, a mental health clinic he founded in 2018.
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