Tag: psilocybin

Current Kratom and Psilocybin Legislative Action in Iowa

I just saw an excellent post from Dr. George Dawson, MD, DFAPA on Kratom. His emphasis that the risk for harm from this substance should be “…remembered at every policy debate.” I agree. This reminds me of what happened in the Iowa Legislature this term at the second funnel regarding substances with the potential for harms to users. Two drugs survived the second funnel: the Kratom bill House File 2133 and the Psilocybin bill House File 978, copied from the Iowa Capital Dispatch story published by Robin Opsahl, Brooklyn Draisey, and Cami Koons on March 20, 2026:

“Kratom:House File 2133 would designate kratom products – a substance currently legal for sale and possession in Iowa which produces a stimulant effect at low doses, and acts as a sedative at high doses – as a Schedule I hallucinogenic substance. People found in possession of kratom would be subject to a serious misdemeanor charge for their first offense, an aggravated misdemeanor for their second and a Class D felony charge for subsequent offenses. The bill passed the House and was placed on the unfinished business calendar in the Senate.

Psilocybin: The Senate Health and Human Services Committee amended and passed House File 978  Thursday, a bill that would allow for the legal, medical use of psilocybin in clinical environments with psychiatric support that have been approved by the state. Products with psilocybin, the psychoactive compound in “magic mushrooms,” and operators providing treatment involving psilocybin, would be regulated by the state through the Medical Cannabidiol Advisory Board, which would be expanded to include four members with expertise in psilocybin treatment. The program created through this legislation would be limited to individuals seeking treatment for post-traumatic stress disorder, but the board could seek legislative approval for using psilocybin in treatment for other mental health issues as more research becomes available.

I don’t know exactly what “unfinished business” means with respect to the Kratom bill. All I know at this stage is that it has not yet been signed into law by Governor Reynolds. I’ll have a couple of remarks about the Psilocybin bill later.

Kratom is currently legal in Iowa. A couple of years ago while we were driving on Highway 1 through Iowa City, I saw a big sign on a small store saying it was for sale. As of 12/02/2025, the FDA has issued an opinion:

“There are no prescription or over-the-counter drug products containing kratom or its known alkaloids that are legally on the market in the U.S. If a new drug application (NDA) is submitted for kratom (or one of its components) to treat a specific medical condition, FDA will review the scientific data to determine if a drug product containing kratom (or its components) is safe and effective to treat that specific medical condition. Consistent with FDA’s practice with unapproved substances, until the agency scientists can evaluate the safety and effectiveness of kratom (or its components) in the treatment of any medical conditions, FDA will continue to warn the public against the use of kratom for medical treatment. The agency will also continue to monitor emerging data trends to better understand the substance and its components.”

The web articles I found on Kratom indicate that it’s not controlled under the Controlled Substances Act, but the DEA says it’s a “drug of concern” and warns against its use according to a web article posted on March 11, 2026 by the National Institute on Drug Abuse (NIDA).

When I posted on my blog about Kratom after I saw the road sign advertising its sale at what appeared to be what we used to call a “head shop.” I tried to find more information about the substance. At that time, I found an article that saying when the DEA tried to place it on Schedule I in 2016, the American Kratom Association prevented it simply by protesting it (which may or may not be true). An historical overview of Kratom’s legal status in Iowa is here.

Kratom: Summary of State Laws

Kratom 101: What You Need to Know

As for the Iowa bill on Psilocybin, this post is getting a little long and I’ll try to keep my remarks brief. There was a news story about the bill which identified psilocybin as also being known as “magic mushrooms.” It also mentioned that it might be helpful for some people who struggle with PTSD and that last year, Governor Reynolds vetoed a bill that would have allowed distribution of the drug.

I found one of my old blog posts (“Maybe We Need a Dose of Humor) which was partly about psilocybin. I mentioned Dr. Henry Nasrallah’s article on how it might reduce the “visceral hatred” that is prominent in American politics:

In the current political zeitgeist, could psychedelics such as psilocybin reduce or even eliminate political extremism and visceral hatred on all sides? It would be remarkable research to carry out to heal a politically divided populace. The dogma of untreatable personality disorders or hopelessly entrenched political extremism is on the chopping block, and psychedelics offer hope to splinter those beliefs by concurrently remodeling brain tissue (neuroplasticity) and rectifying the mindset (psychoplasticity); September issue of Current Psychiatry, by the journal’s editor, Henry A. Nasrallah, MD (From neuroplasticity to psychoplasticity: Psilocybin may reverse personality disorders and political fanaticism. Current Psychiatry. 2022 September, 21(9): 4-6 | doi: 10.12788/cp.0283).

I found another one of my blog posts about psychedelic-assisted therapy from a couple of years ago.

The remarks from a former colleague were politely negative about the quality of the research in question in the Lykos study mentioned in my post which cited the Psychiatric Times article about the study. Dr. Jess G. Fiedorowicz, MD, PhD formerly was formerly on staff at University of Iowa Health Care. He’s now the Chief of Mental Health at The Ottawa Hospital where he’s also Professor and Senior Research Chair in Adult Psychiatry, Department of Psychiatry, University of Ottawa, Ontario. His remarks in the transcript are typical for his erudition and expertise as a clinician scientist.

And that segues into the University of Iowa Dept. of Psychiatry study on psilocybin for alcohol use disorder. There’s a podcast that mentions it with a link to an article. The department is currently recruiting according to clinicaltrials.gov:

“Psilocybin vs Ketamine for Alcohol Use Disorder: This study will collect data that measures the effects of a psychedelic intervention on patients struggling with alcohol use disorder (AUD). The study design will be a double blind, randomized, active-comparator trial with two study arms. Subjects randomized to Arm 1 (n=40) will receive individual psychotherapy sessions plus a 30 mg dose of psilocybin. Arm 2 subjects (n=40) will receive individual psychotherapy sessions and a 0.75 mg/kg dose of ketamine.”

However, the Iowa legislature’s bill supporting psilocybin is, for now, geared toward treatment of PTSD.

I think the Kratom bill goes in the right direction and I’m not so sure about the psilocybin bill.

Thoughts About Psychedelic Assisted Psychotherapy

I read the Psychiatric Times article “FDA Issues CRL to Lykos for MDMA-Assisted Therapy.” The short story is that the FDA essentially told the drug company Lykos that their study of the efficacy of MDMA-assisted treatment of PTSD needs more work.

I tried to wade through the on-line documents of the FDA’s meeting on June 4, 2024. There are hundreds of pages and I didn’t go through every page of the transcript. The minutes were succinct and much easier to digest.

I’m going to simply admit that I’m biased against using psychedelics in psychiatry for personal and professional reasons. I’m not a research scientist. I’m a retired consultation-liaison psychiatrist. I saw many patients with a variety of psychiatric diagnoses including PTSD and substance use disorders. I’m not opposed to clinical research in this area, but I’m aware of the difficulty of conducting it.

In that regard, I want to also admit that I’m very susceptible to being influenced by a former colleague’s remarks about the quality of the research in question in the Lykos study. Dr. Jess G. Fiedorowicz, MD, PhD formerly was formerly on staff at University of Iowa Health Care. He’s now the Chief of Mental Health at The Ottawa Hospital where he’s also Professor and Senior Research Chair in Adult Psychiatry, Department of Psychiatry, University of Ottawa, Ontario. His remarks in the transcript are typical for his erudition and expertise as a clinician scientist.

It’s difficult to wade through the pages of the FDA transcript and I couldn’t digest all of it, by any means. But if you’re interested in reading both sides of this issue, it’s a good place to get the best idea of the committee members’ thinking about it. The minutes are much easier to read and provide a succinct summary.

I realize the Psychiatric Times article editor doesn’t agree with the FDA recommendations for further study of psychedelic-assisted psychotherapy for PTSD. It may or may not influence the University of Iowa’s study of psilocybin. In my opinion, the FDA did the right thing.

The University of Iowa Role in the Science Behind Psilocybin for Psychiatric Treatment

On April 9, 2024, the University of Iowa educational podcast, Rounding@Iowa presented a discussion about the study of the use of psilocybin in the treatment of psychiatric and addiction disorders. You can access the podcast below. The title is “Psilocybin Benefits and Risks.” The format involves an interview by Dr. Gerard Clancy, MD, Senior Associate Dean for External Affairs, Professor of Psychiatry and Emergency Medicine with distinguished University of Iowa faculty and clinician researchers.

In this presentation, the guest interviewees are Dr. Michael Flaum, MD, Professor Emeritus in Psychiatry, University of Iowa Carver College of Medicine, and Dr. Peggy Nopoulos, MD, Chair and Department Executive Officer for the University of Iowa Department of Psychiatry, Professor of Neurology, Pediatrics, and Psychiatry, University of Iowa Carver College of Medicine.

All three of these highly respected and accomplished faculty taught me when I was a trainee in the psychiatry department and afterward were esteemed colleagues.

The link icon adjacent to the title of the podcast takes you to the podcast website. The link to the article in Iowa Magazine about the psilocybin research at University of Iowa Health Care tells you more about Dr. Peggy Nopoulos and her role as principal investigator in the study.

There is also a link to the National Library of Medicine Clinical Trials web site where you can find out more details about the study design. You’ll notice a banner message which says: “The U.S. government does not review or approve the safety and science of all studies listed on the website” along with another link to a disclaimer with more details.

Maybe We Need a Dose of Humor

Sena and I were listening to the Mike Waters morning radio show (KOKZ 105.7) this morning and his invitation to listeners was to call in and quote their favorite dumb question. One of the callers recited something which was actually a George Carlin joke. Neither one of us thought we heard it right, but it’s the same framework as the joke I found on the web (only the numbers were changed):

“If you’ve got 24 odds and ends on the table and 23 of them fall off, what’ve you got? An odd or an end?”

This is an example of his wordplay humor.

Carlin’s humor was also marked by satire on American culture and politics, the latter of which has gotten pretty rough. You’ll also find references on the web to Carlin’s past history of substance use, which reportedly included psychedelics.

That reminds me of an opinion piece published in the September issue of Current Psychiatry, by the journal’s editor, Henry A. Nasrallah, MD (From neuroplasticity to psychoplasticity: Psilocybin may reverse personality disorders and political fanaticism. Current Psychiatry. 2022 September, 21(9): 4-6 | doi: 10.12788/cp.0283).

I was a little surprised at Dr. Nasrallah’s enthusiastic endorsement of psilocybin for treatment of personality disorders and political extremism. He acknowledges the lack of any studies on the issue. In the last paragraph of his essay is a sweeping endorsement:

In the current political zeitgeist, could psychedelics such as psilocybin reduce or even eliminate political extremism and visceral hatred on all sides? It would be remarkable research to carry out to heal a politically divided populace. The dogma of untreatable personality disorders or hopelessly entrenched political extremism is on the chopping block, and psychedelics offer hope to splinter those beliefs by concurrently remodeling brain tissue (neuroplasticity) and rectifying the mindset (psychoplasticity).

While I’m not so sure about how effective psilocybin would be for this, I’m all for trying something to reduce the “visceral hatred on all sides.”

Maybe humor could be part of the solution. It doesn’t have to be exactly like that of George Carlin. Both parody and satire have been used by many writers for this.

I like the distinction between parody and satire in one article I found on the web. One recent example of satire (or parody; the distinction is sometimes hard to make since the story was listed as “Iowa Parodies”) was in the news and it apparently fooled at least a few people. It was about the Iowa football coaching staff. The title was “Brian Ferentz Promoted to University President To Avoid Having to Fire Him (Satire): The move was deemed ‘a way easier conversation than having him fired’ by the athletic director. It was written by Creighton M, posted September 5, 2022.

I think the story was originally printed without the word “Satire” in the title. I can’t recall seeing the heading “Iowa Parodies” either. A later version of the story added the word “Satire.”

The story might have been about nepotism in the hiring of Brian Ferentz (he’s the son of head coach Kirk Ferentz) as offensive coach. On the other hand, under Iowa law, it was not illegal to hire Brian Ferentz, who in any case reports to athletic director Gary Barta, not Kirk Ferentz.

I suspect the joke had more to do with negative public attitudes about the performance of the Iowa football offense early in the season.

Is it funny? I guess it depends on your perspective. The Iowa football coaching staff probably didn’t chuckle over it. But it more or less fits the definition of satire. It uses humor to expose flaws in the way we behave. And it avoids direct and nasty confrontation, which usually triggers antagonism rather than collaboration. Will it change the Iowa football program? I doubt it. They’re actually doing pretty good so far.

But satire as a strategy to inform and maybe change the public opinion will endure. The Hitchhiker’s Guide to the Galaxy by Douglas Adams is one of my favorite books and it satirizes governments and the foolishness of people. I first learned about The Onion newspaper while we were in the process of relocating to Wisconsin (a short adventure). It satirizes the Associated Press news style.

One of the most uproarious examples of parody is a TV show which is no longer available on cable television but still offered on a streaming service (I think), Mountain Monsters. It’s a hilarious sendup of all the Bigfoot hunter shows.

The added benefit of parody and satire and other such forms of humor is that they are safer than psychedelics—unless your target was born without a funny bone.