For veterans with severe post-traumatic stress disorder (PTSD), finding a treatment that works can be a challenge. An option which has gained acceptance in recent years is psychedelic-assisted therapy, or P-AT.
Psychedelics such as psilocybin (the chemical in some mushrooms which causes hallucinations) remain illegal in Missouri. But a bill to change that passed out of committee, only to die in the Missouri House earlier this year.
The bill was sponsored by Rep. Richard West (R-New Melle), who came to politics after a career in law enforcement.
“Being a retired police officer, I really had adverse thoughts about this when I entered into the legislature,” West said. “Being anti-drug really kind of played on me on this.”
Aside from leading him to develop a strong anti-drug stance, West’s law enforcement career also led him to a 28-month stint as a police advisor in Iraq, an experience that he says made him more aware of PTSD.
“I did see a lot of folks over there that suffered from PTSD,” West said.
That close encounter with the effects of warfare led West to look for a way to help veterans, and changed his view on psychedelics.
“I did a lot of research, a lot of studying. I met with some veterans groups. I educated myself through some reading material on exactly what this program was about, what it did, how it actually did help some of our veterans,” West said.
Research suggests that P-AT may be helpful to patients whose severe PTSD hasn’t improved with other courses of therapy. West’s bill proposes a narrow legalization of psilocybin for therapeutic use by veterans.
Changing brain function
Psilocybin has the ability to improve neuroplasticity, or how easily the brain’s neural pathways can change and adapt.
Greg Williams is a Navy veteran pursuing his master's degree in social work at the University of Missouri. Together with MU faculty member Dani Adams, he’s researched and advocated for the implementation of P-AT. He even traveled to Oregon, one of two states where P-AT is legal, to undergo the treatment in October of last year.
To understand neuroplasticity, Williams imagines a snowy mountain where people have been skiing.
“You’ve got the little ski trenches, or whatever you wanna call them," he said. "With every pass they get a little bit deeper, a little bit deeper, a little bit deeper.”
Williams said the brain’s neural pathways are like those trenches in the snow. To treat PTSD, therapists aim to help patients escape those trenches. For some patients, psilocybin may be able to help them do that.
Limiting the use of psilocybin
Although convinced of psilocybin’s potential benefits for P-AT, West is still concerned about its potential misuse. In negotiating the language of the bill with his colleagues, West made certain to ensure that psilocybin would only be available through a prescription from a doctor who has a “bona fide” relationship with the patient.
After a patient receives a prescription, Williams said a patient would proceed through a three-step process guided by a facilitator. West’s bill defines who can become a facilitator and requires that they be specially licensed.
First are the preparatory sessions, when the facilitator helps the patient prepare for the process.
Next is the dosing session. Williams said a small dose of prescribed psilocybin is typically mixed with a liquid such as lemon juice. Whereas a typical therapy session lasts about an hour, Williams says a dosing session can continue for up to six hours.
The psilocybin can dredge up old memories and emotions. By processing these things anew, the patient can create new neural pathways and reduce their PTSD symptoms.
The last step is integration. Williams said this step should continue for as long as someone feels it is beneficial and can be conducted as either individual or group therapy sessions. He wants to ensure this followup period is taken seriously because it can help the patient solidify the changes that occurred during the dosing session.
West said that he’s encountered a lot of apprehension from his colleagues. But he hopes his relationships with his fellow legislators and a research-based approach to the bill can help him overcome hurdles.
While his bill didn’t make it to the House floor during the 2025 session of the Missouri legislature, West said he’s optimistic about next year.
