Hawaii House Committees Approve Bill To Create A Limited Therapeutic Psilocybin Program To Treat Certain Mental Health Conditions

Members of a two Hawaii House committees have approved a bill to create explicit legal protections around the therapeutic use of psilocybin, with eligible patients able to possess and consume the psychedelic under a trained facilitator’s care.

The House Judiciary & Hawaiian Affairs Committee and Health & Homelessness Committee passed the legislation from Rep. Della Au Belatti (D), with amendments, in separate 7-1 and 10-0 votes on Tuesday.

The measure is the product of a task force on breakthrough therapies that was formed last year to explore the issue, Sen. Chris Lee (D), sponsor of the Senate’s companion version, told Marijuana Moment last month.

HB 2630 would not legalize psilocybin itself. Instead, it would create an affirmative defense for qualified patients and their caregivers, effectively exempting them from state laws against psilocybin.

Prior to passage, committee members adopted an amendment to add a defective date, which is a procedural method of ensuring that the legislation receives additional discussion before being enacted. The joint panel also accepted technical amendments to define licensed mental health professional, for example.

The bill has also been referred to the Consumer Protection & Commerce Committee and the Finance Committee.

The Hawaii Department of Law Enforcement (DLE) offered testimony recognizing that psilocybin has shown to be “useful in mental health treatment,” but opposing the measure because they say it is “premature and lacks appropriate safeguards for diversion.”

While the department said Hawaii should not create a therapeutic psilocybin program until federal laws around the psychedelic change, it did recommend legislative language that it said lawmakers should adopt to strengthen the proposal, including sections on creating registration requirements for patients and maintaining records and inventories.

The Office of Wellness and Resilience (OWR) in the governor’s office, which hosted the psychedelics task force that informed the bill, testified in support of the proposal.

“The OWR is honored to play a role in the bill and for the opportunity to support this program. We anticipate participating in future discussions as more dialog is warranted for implementation to be effective and efficient,” the office said. “This bill provides access to another option for healing.”

A representative of the state Department of Health (DOH) was invited to weigh in on the measure, but they said the department does not currently have a position on the reform proposal.

Under the legislation, mental health professionals would need to identify a person as having at least one of several listed eligible medical conditions, then write a recommendation for therapeutic psilocybin. Patients would be allowed no more than five grams of psilocybin per session and would need to complete a preparation session prior to the drug being administered.

Eligible conditions for treatment with psilocybin would include post-traumatic stress disorder (PTSD); treatment-resistant depression or major depressive disorder; end-of-life anxiety, existential stress and demoralization; eating disorders such as anorexia and bulimia, substance use disorders and obsessive compulsive disorder (OCD). Additional qualifying conditions could be added by the state Department of Health in response to requests from patients or mental health professionals.

“Psilocybin has shown promising potential for treating mental health conditions,” the bill says in its findings section, pointing to research showing the substance can effectively help treat a range of medical and mental health conditions. Voters in Oregon and Colorado, it adds, have already adopted laws licensing and regulating psilocybin, while other states have seen similar legislative efforts, task forces and proposals to expand research.

“The purpose of this Act,” the measure continues, “is to ensure that people who struggle with trauma and treatment-resistant mental health ailments are not penalized by the State for the use of psilocybin for therapeutic purposes when the patient’s licensed mental health professional provides a professional recommendation that the benefits of therapeutic use of psilocybin would likely outweigh the health risks.”

Facilitators would need to meet certain criteria, including being 21 or older, holding a high-school diploma or equivalent degree and being a Hawaii state resident. They would also need to complete a “psychedelic integration training program” whose curriculum has been approved by the OWR.

All facilitators would need to support patients during three stages of psilocybin treatment: a preparation session, an administration session and a follow-up integration session. Patients would not be compelled under the proposal to return for an integration session, however.

As drafted, the Hawaii legislation would not create regulated psilocybin industry along the lines of systems in Oregon and Colorado. The legislation doesn’t directly address where patients or facilitators would obtain psilocybin, though it broadly defines “therapeutic use” as including “the acquisition, possession, cultivation, use, distribution, or transportation of psilocybin,” as well as psilocybin derivatives and paraphernalia.

If police seize therapeutic psilocybin products, they would be required to return the property after defendants demonstrate in court that the products comply with the therapeutic psilocybin system. Falsely claiming protection under the law, if passed, would be a petty misdemeanor, subject to a fine of $500.

Hawaii legislators have advanced bills and resolutions to encourage investigations into psychedelic therapy in recent sessions, but the legislation has not been ultimately enacted.

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The psilocybin proposal is just one noteworthy drug reform issue facing lawmakers this session. The legislature is also set to consider a 300-plus page marijuana legalization bill drafted by the state attorney general’s office.

Democrats in control of Hawaii’s Senate said last month that cannabis legalization is one of their top priorities this legislative session, framing the reform as a means to boost the state’s economy.

Last year the Senate passed a separate legalization bill that has stalled the House. But legislators have signaled that 2024 may be the year that legalization becomes law.

In November, the AG’s office defended an earlier version of the legislation it put forward earlier that month after Honolulu Prosecuting Attorney Steve Alm said law enforcement are firmly against legalizing marijuana. David Day, a special assistant with the attorney general’s office, said at the time that Alm’s concerns were overblown and the legalization measure that’s been put forward deliberately took into account law enforcement perspectives.

A separate legalization bill that advanced through the Senate in March is also still in play in the state’s two-year legislative session.

Advocates struggled under former Democratic Gov. Dave Ige, who resisted legalization in part because he said he was reluctant to pass something that conflicts with federal law. But since Gov. Josh Green (D) took office, activists have felt more emboldened. Green said in 2022 that he’d sign a bill to legalize cannabis for adults and already had ideas about how tax revenue could be utilized.

Last April, the Hawaii legislature also approved a resolution calling on the governor to create a clemency program for people with prior marijuana convictions on their records.

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Image courtesy of Kristie Gianopulos.