As Colorado prepares to launch its Natural Medicine Program—which starts by allowing facilitated psilocybin practice—more and more therapists are considering training as Clinical Facilitators. This could be pivotal in providing life-changing healing and advancing the psychedelic therapy cause.
Before embarking on this exciting journey, therapists must be aware of important legal, ethical, and practical considerations associated with these regulations, many of which aren’t initially apparent. It’s important to stress that these are not insurmountable obstacles but factors that must be understood and addressed.
Understanding these nuances, such as the complexities of state v. federal law, financial and insurance challenges, and operational processes, is crucial for therapists interested in providing psilocybin therapy.
Here is a list of key considerations to bear in mind. This information is provided for your general awareness and is not legal or financial advice. Please seek expert counsel before making any decisions.
Navigating Federal and State Laws
While the Colorado natural medicine program decriminalizes psilocybin for adult use and therapeutic applications, it remains classified as a Schedule I controlled substance under the Controlled Substances Act (CSA).
This creates a legal grey area that therapists must navigate with care. Key considerations include:
- Adhering strictly to state regulations and licensing requirements.
- Recognizing the theoretical risk of federal prosecution, even if it seems unlikely—to date, the DEA and other federal regulatory bodies have taken a stance of ambiguity and non-enforcement of the CSA as it pertains to state-based psychedelic programs; however, there is no guarantee that that stance will continue.
- Those who hold a DEA license have an additional level of risk due to conflict with federal law.
Banking and Financial Challenges
Many financial institutions will not provide services to Psilocybin Clinical Facilitators because of psilocybin’s legal status under federal law.
As a result, credit card processors and payment gateways often refuse to handle transactions involving psilocybin services—both Mastercard and Visa cannot work with businesses involved in Schedule I substances.
Under Section 280E of the Internal Revenue Code, businesses ‘trafficking’ in Schedule I substances cannot deduct typical business expenses from their federal taxes. This can result in a significantly higher effective tax rate, impacting profitability.
- Businesses may need to use several entities to handle different aspects of their work, separating funds associated with psilocybin from those associated with other revenue streams.
- They may also need to rely on cash-only or cryptocurrency-based transactions, which can be less convenient and pose additional security risks than standard financial services.
Insurance Challenges
Due to the CSA, many insurance companies will not underwrite policies for Psilocybin Clinical Facilitators. As a result, businesses may find it challenging to obtain general liability, property, or professional liability insurance.
- Therapists must review their existing general and professional liability insurance coverage to determine whether it covers services they provide under a Clinical Facilitator license—it probably doesn’t.
- Many major insurance companies will not insure businesses involved with Schedule I controlled substances.
- When coverage is available, premiums may be higher than average to offset the perceived risks of insuring a federally illegal operation.
Licensing Board Scrutiny
Local licensing bodies may approach psilocybin therapy with skepticism; even for those working within states that have legalized psilocybin services, other jurisdictions may impose additional restrictions or outright bans. Therefore, staying informed about local board positions for your profession and receiving guidance is vital.
Also, state-level regulations for psilocybin services are still developing. Psilocybin Clinical Facilitators must stay informed and compliant with changing rules, which can be resource-intensive.
- Therapists must meticulously document treatment rationales and protocols and be prepared to defend their practices if questioned.
Ethical Considerations
As with all psychedelic therapy, dilemmas may arise when working with clients in altered states of consciousness or when addressing spiritual experiences within a clinical framework, and Colorado regulations require extensive coverage of ethical considerations.
Obtaining truly informed consent can be complex but is vital for ethical practice. Therapists must educate clients on the known risks associated with psilocybin use, discussing the unpredictable nature of psychedelic experiences and potential impacts on employment or legal status.
Additionally, therapists have ethical obligations that extend beyond the acute treatment phase.
- Developing protocols for post-session integration is essential for helping clients process their experiences effectively.· Establishing referral networks for ongoing support can enhance the therapeutic relationship and ensure clients receive comprehensive care.
Client Safety and Protection
Client safety must be paramount in any therapeutic setting involving psychedelics, and maintaining clear professional boundaries is vital, given the intimate nature of psychedelic experiences.
Meticulous documentation, including the informed consent processes mentioned above, is essential for record-keeping, and therapists must understand how existing privacy laws apply to psychedelic therapy.
- Implement thorough and secure documentation processes.
- Develop robust screening protocols to identify contraindications.
- Have emergency procedures in place for adverse reactions.
- Be aware of the implications if clients self-source psilocybin outside clinical settings.
Professional Licensing and Training
As mentioned in our previous blog, becoming a Psilocybin Clinical Facilitator requires completing state-approved training programs, and maintaining licensure may require ongoing education to stay abreast of best practices and regulatory changes.
- Colorado is planning to implement a 20-hour-per-year CE requirement.
Stigma and Public Perception
Despite state legalization, some communities may oppose psilocybin services due to lingering stigmas. This can lead to challenges in obtaining local permits or facing public resistance.
Professional Risks: Individuals involved in psilocybin services may face professional repercussions, such as challenges to their credentials or standing in other professional organizations.
Conclusion
While the Colorado Psilocybin Natural Medicine program offers exciting possibilities for mental health treatment, it also presents significant legal, practical and ethical challenges.
Therapists in this field must seek specialized training, stay informed about evolving regulations, and carefully consider their risk tolerance.
By proactively addressing these issues, mental health professionals can contribute to the responsible development of psychedelic-assisted therapy in Colorado.