On the Medicalization of Psychedelics
I was struck by the 12/4 opinion letter criticizing Mary Sheridan’s 11/24 “The Psychedelic Frontier” column on how people can use psilocybin safely at home. Most psilocybin experiences in our planet’s history have been both safe and unsupervised.
As a clinical psychiatric pharmacist who is an expert in psychedelic substances, I am fully supportive of the careful guidance Ms. Sheridan offered for the safe use of psilocybin at home. At stake is how to safely make sacred medicines more widely available, without medicalizing the rules around their use in ways that marginalize their healing power. The opinion letter argues that medical supervision of a client’s journey is critical for safety, while ignoring the fact that everyday humans and lineage guides deeply trained in healing practices attuned to these sacred medicines have used them safely without a medical system profiting from them for thousands of years. Psilocybin is a remarkably safe medicine with no known harms to any human body systems or organs. With exceptions for those with a history of psychotic disorders, it can be used safely without medical supervision.
As background, Oregon made the first attempt in the world at bringing psilocybin into the medical system, with an advisory board of medical and Indigenous leaders who released rules governing its use. I admire the bravery of the state of Oregon; they got many things right in this process. But the Oregon system prevents medicine workers from using their other tools, or going beyond the prescribed doses or species, because we are still trying to medicalize the process of healing. It’s critical for us to fully acknowledge that true healers are going to heal. So, some are choosing not to be a part of the system and continue their work underground.
I see the interest in the medical community around the resurgence of sacred medicines. But there are serious negative consequences when the commercialized medical community pursues these opportunities. I’ve followed closely the path of ketamine, an anesthetic shown to have potent effects on suicidality and depression. Once PHARMA took interest, ketamine, previously available at around $50 a vial, was separated into its enantiomer esketamine, patented and released as a product that costs around $4,000 per dose. Now, groups like Compass Pathways are trying to do the same with psilocybin, patenting mushrooms found in nature, bringing then into medical system for mass markets and profits and dismissing the work of the lineage guides, just as the above-mentioned opinion letter did.
Healing what ails us can come from a great number of modalities: tea, herbs, medicine, sobriety, therapy and psychedelics. There is no one path that is “correct.” I question the motives of anyone who tells you there is only one way — they are frequently driven by their own profit interests. Centers like Drop Thesis only exist because of the brave scientists and guides who came before them, and these heroes of mine did so unsupervised, figuring it out as they went and sharing that knowledge with those who came after them. Sounds a lot like… science.
—Melissa Brewster, PharmD
The Immorality of Bend’s Traffic Engineers and Political Leaders
Every day, crossing Third Street at NE Hawthorne feels like a gamble. Most drivers stop, but one lane often fails — either the driver doesn’t see me, doesn’t care or calculates they can speed through before I cross. This dangerous situation, known as the “double threat,” occurs when multi-lane roads obstruct a driver’s view of pedestrians. It’s a well-documented design flaw that Bend’s traffic engineers understand but refuse to address. This negligence tragically led to a 13-year-old boy being struck and dragged by a speeding vehicle at 12th and Greenwood last year.
Instead of addressing the root causes, the City relies on Rectangular Rapid Flashing Beacons (RRFBs) — “beg buttons” that flash yellow lights when activated by pedestrians. While RRFBs improve safety at unsignalized crossings, the City restricts their use, citing concerns about overuse desensitizing drivers. Worse, they refuse to install them at single-lane crossings, normalizing the expectation that pedestrians must navigate unsafe multi-lane roads without adequate protections. The problem lies in the design of our streets. Multi-lane “stroads” encourage speeding and driver entitlement while neglecting pedestrian safety. Until we acknowledge that crossing these roadways without proper safeguards is unacceptable, we will continue to see preventable tragedies.
A moral solution requires grade-separated crossings — such as tunnels or pedestrian bridges — for multi-lane roadways. If those are too costly, then we must prioritize single-lane roads with pedestrian refuge islands. Continuing to prioritize vehicle speed over human safety is a choice that endangers lives daily. It’s time for Bend’s leaders and engineers to take a stand: Prioritize people over cars, safety over convenience. Anything less is inexcusable.
—James Teeter
Love a River
I confess. I absolutely love the Deschutes River. There is not another river like it, anywhere. It flows from springs and, in a few areas, whole tributary rivers bubble right out of the ground. It is so fantastic that the Deschutes has been deemed a Wild and Scenic River by our federal government. It is truly special to me. I’ve hiked it, biked it, swam it, fished it and guided whitewater trips through the Big Eddy rapids for eight glorious summers. Flat water kayaking is a favorite and has allowed me to witness elk, otter, mink, osprey fledglings and, on some of the sunset floats, the glorious splash of a beaver’s tail. Many of these paddles were with my wife and provide us with memories we will cherish forever.
I now fear the Deschutes River is dying. It is a slow death, and almost imperceptible to someone new to its many treasures. It is evidenced in higher summer water temperatures and associated lower levels of oxygen. Eroding and degraded riverbanks reveal challenges of dramatic changes in flow from dam control and an overabundance of enthusiastic recreationists along certain sections.
All of this may be reversible, and there is always time for action. Even the smallest steps can help the Deschutes recover. Picking up litter, avoiding destruction of riparian (stream side) vegetation and conserving water use can all contribute. A few bigger steps may even be necessary, perhaps starting with creative and sustainable solutions to river impoundments such as Mirror Pond (yes, I have an idea). As a certified old guy, I implore all you youngins to get after it. Save this river. It is so worth it, and I’ll be right there with you as long as I am able. Godspeed!
—Kevin P. Tanski
Letter of
the Week:
Kevin, thanks for your ode to our beloved Deschutes. Its presence is why many of us choose to live and play here, and its preservation should be a priority for all who live in and visit this community.
—Chris Young
This article appears in The Source Weekly January 2, 2025.
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I entirely agree with James Teeter’s observations on the inherent risk of the flashing yellow lights at multi-lane pedestrian crossings. The dangerous 12th and Greenwood crossing (cited by James) is heavily used by students on their way to Juniper Elementary School. It was there on a recent night that my dog and I came within millimeters of being smacked by a driver speeding past a vehicle that had already stopped for us. I would suggest installing speed bumps on both sides of the RRFB crossings (as well as school zones). The historic animosity of the City of Bend to neighborhood traffic calming devices is beginning to taper off, but we still need them extensively–not just on greenways.