An Evaluation of Therapeutic Harm Reduction and Psilocybin-Assisted Therapy Within Oregon's Measure 109
OpenAlex – October 02, 2025
Source: OpenAlex
Summary
A significant finding highlights that 15 facilitators working in Oregon's psilocybin clinics offer diverse perceptions of "therapeutic harm reduction." Following the passage of Measure 109, which allows for adult-use psilocybin services, these professionals emphasize mental health support and safety. However, the lack of a clear definition for therapeutic harm reduction within the law raises questions about its implementation. Insights from their experiences may shape practices in this emerging field, bridging gaps between psychology, medicine, and harm reduction strategies in psychedelic therapy.
Abstract
Despite psilocybin still being a Schedule I substance in the Federal Controlled Substance Act (OHA, 2022), Oregon voters passed Measure 109 in 2020, now codified into law as ORS457A, which allowed for the opening of psilocybin clinics for eligible clients. The passing of Measure 109 allowed for an adult-use model to be created, which is different from a therapeutic-use model. Advocates and Measure 109 framers employed the terms "harm reduction" and "mental health support" in order to secure the passing of Measure 109, but there is no specific definition of therapeutic harm reduction within M109 and ORS475A. To receive psilocybin services in Oregon, clients must be treated by a facilitator within an Oregon Psilocybin Services’-licensed clinic. This study uses semi-structured interviews and a short survey with 15 individuals who currently work in a legal psilocybin services setting to understand the perceptions and personal definitions of therapeutic harm reduction, and how those perceptions and definitions influence the specific therapeutic harm reduction techniques in their practice. The aim of this research is to provide understanding and a general definition of what therapeutic harm reduction is and what it entails from those who work as facilitators.