KOJO NNAMDIWelcome back. There was a clear winner in last week's election: drug reform. Voters legalized recreational marijuana in four more states and approved medical marijuana in two. Recreational marijuana is already legal in the District, but voters had the opportunity to decriminalize psychedelic mushrooms, which passed with 76 percent of the vote. And voters in Oregon became the first state to decriminalize all drugs, even drugs like heroin and cocaine.

KOJO NNAMDIAnd that leads us to this question: Is the war on drugs over? Well, joining me to discuss this right now is Matt Sutton. He is the director of media relations for the Drug Policy Alliance. Matt Sutton, thank you for joining us.

MATT SUTTONThank you so much for having me.

NNAMDITalk about last week's election and what voters across the country had to say about the war on drugs.

SUTTONYeah. So, we definitely heard a resounding message from voters across the country that they support drug policy reform. They took this message with them to the ballot box. And every single drug policy reform measure that was on a ballot across the country passed, and most of them passed pretty overwhelmingly.

SUTTONIn Oregon, DPA was running the All Drug Decriminalization Campaign, and that measure passed with 58 percent of the vote, making Oregon the first state in the United States to decriminalize all drugs. And, here in D.C., you know, we saw that voters overwhelmingly approved to deprioritize mushrooms. So, I mean, we've seen pretty significant reforms all across the board. We also saw really significant marijuana reforms in states that previously we probably would have not expected to see these kind of reforms, you know, in pretty red states. So, yeah, I mean, we're really excited for what's to come.

NNAMDIWhat's the difference in D.C. between what you describe as deprioritizing mushrooms and decriminalizing them altogether?

SUTTONYeah. So, it is a little bit complicated, but basically, deprioritization just means that they've made it the lowest enforcement priority possible in D.C. So, literally, if an officer sees somebody jaywalking and somebody with mushrooms, they have to prioritize stopping the person that's jaywalking over the person with mushrooms. So, it just really shows that, you know, while they did not completely decriminalize it or legalize it so that people could purchase it, they do see that it's, you know, very harmless and, you know, that people should not be criminalized for it.

SUTTONAnd, you know, I mean, that's really like something that I want to point out is, you know, while I think maybe something like mushrooms might've been a little bit more digestible to the public, you know, we really want to point out that it's important that we do not criminalize any drugs, because people are going to use drugs, regardless. But what we've seen as the criminalization of drugs is much more harmful than the drugs themselves could ever be.

SUTTONAnd, disproportionately, the people that are criminalized are communities of color. And we've definitely seen this in D.C., because even D.C., actually, you know, voted to decriminalize and then legalize marijuana, but there's still been some holdups in actually setting up a regulatory framework in D.C. And so, there's still a lot of people that are arrested and charged for public consumption of marijuana. And, disproportionately, by far and large, these are people of color. So, anytime that we are, you know, removing criminal penalties for drugs, we are really, you know, removing a lot of the racial disparities that exist within the criminal justice system.

NNAMDIJoining us now is Dr. Matthew Johnson, a professor of psychiatry and behavioral sciences at Johns Hopkins Medicine. Dr. Johnson, thank you for joining us.

MATTHEW JOHNSONPleasure to be with you.

NNAMDIAs we just discussed, D.C. voters deprioritized psychedelic mushrooms and Oregon voters legalized psilocybin, its active ingredient. What is psilocybin, and how is it used medicinally?

JOHNSONPsilocybin is a -- it's in the pharmacological class that's called classic psychedelics. That puts it in the same class as LSD and mescaline, which is in peyote. It's a drug that's been examined for over a half a century in clinical research. And there's been a resurgence in that research over the last 20 years. I've been conducting work with it for over 16 years. And it's showing substantial medical promise under controlled conditions in the treatment of a growing number of psychiatric disorders.

NNAMDICan you talk about what those disorders are and how psilocybin works to help them, or to get rid of them?

JOHNSONSure. The most rigorous evidence to date is in the treatment of cancer-related distress. So, these are people with serious cancer, some of which are terminal, who have substantial anxiety and depression surrounding their condition. And so, there's been three randomized controlled trials that show -- we conducted the largest of those at Johns Hopkins -- showed large reductions from a -- in depression and anxiety resulting from a single high dose of psilocybin.

JOHNSONAnd the remarkable thing that really is a paradigm shift in psychiatric treatment is that those benefits, those reductions looked virtually identical six months later. Which, you know, we're not talking about taking a pill every day. We're talking about taking the pill one time, in a supervised context, where you can minimize the risk. But that's really the remarkable, paradigm-shifting thing. They have an experience -- it's a learning opportunity.

JOHNSONWe're figuring out a lot about what's going on in the brain. And sort of the uncharted territory is learning what long term biological changes might go along with the behavioral changes we're seeing. But psychologically, it's best characterized as more like psychotherapy than a traditional psychiatric medication. People actually learn something from the experiences they have, and they change the way that they're living their lives, which has long-term sustaining ability to improve these disorders.

NNAMDIOther disorders treat -- that are very promising are the treatment of tobacco addiction, people looking to quit smoking cigarettes. I lead that research. It's been going on for over a decade in the treatment of alcoholism. And we just published a paper a few days ago on the first randomized controlled trial looking at psilocybin for the treatment of major depressive disorders. So, this is depression outside of cancer, very large effects. And all of these disorders, it's really remarkable that the effects are much larger than what you see with traditional psychiatric medications.

NNAMDIDr. Johnson, however, there are risks in everything we do and with any drug we put in our bodies. What are the possible risks with using psychedelic mushrooms?

JOHNSONThere are a number of risks, and we know a lot about what they are. So, in clinical research it's about -- and in clinical practices, it's about mitigating those risks. The biggies are the so-called bad trip. You know, strong anxiety, which in an unsupervised environment, sometimes leads to panic and dangerous behavior. It's certainly not typical. Most people that use these things recreationally don't have harmful outcomes, but it does absolutely happen.

JOHNSONSometimes it's -- you know, there are cases -- again, rare -- where people have died, because they've had a panic reaction or they've been extremely intoxicated. And so, any intoxicating drug, including a high dose of alcohol, you know, you're going to have some uncontrolled behavior in the wrong environment that could have, you know, some damaging effects.

JOHNSONThe other biggie really is a clear case that people with active psychotic disorders or predisposition towards them. So, I'm talking here about schizophrenia and similar disorders, that people with that background, that they can be destabilized and have longstanding psychiatric complications. These are sort of the urban legends of people that have tripped and never come back. That's an over -- you know, that's a mischaracterization. But the kernel of truth there is that, yes, just like a traumatic life event, a strong psychedelic experience can destabilize and harm people with that susceptibility. There are other risks, but those are the two biggies.

NNAMDIHere now is Edward, in Virginia. Edward, you're on the air. Go ahead, please.

EDWARDHi. I have a question. In 1986, I been busted with marijuana. I bought some in D.C. when my brother was coming down. I got stopped for (unintelligible) driveway to a shopping center. And I had, like, 20 -- 120 grams in my pockets (unintelligible) transferred it. I'm 68 years old now. It happened in 1986. I'd like to know if I ever be able to get my citizenship.

NNAMDIIf you'll ever be able to get your citizenship?

EDWARDYes.

NNAMDIWhat was the penalty that you had to have after you were -- after marijuana...

EDWARDI had a lawyer -- you know, some funky lawyer. I went out and got locked up (unintelligible) my father got this funky lawyer, he can get you everything. (unintelligible) went to jail and he asked me to bring $4,000, which my mother gave me. I didn't have no money. And he come at 6:00 in the morning and he had pictures of Kennedy Center (unintelligible) no problem, I'll get you...

NNAMDIOkay.

EDWARD...get your car back and everything else. And he kept postponing the case. And the sixth or seventh time we went there, right before the judge comes out, he says, you have to plead guilty to possession with intent. Otherwise, you'll go to jail. And I was so scared and, you know, so I had to do it. I was not selling it, you know. It was between my brother. So (unintelligible)...

NNAMDIOkay. But what was the penalty? Did you have to serve jail time?

EDWARDNothing. No, no, no.

NNAMDIOh, okay. Okay.

EDWARDYou know, I didn't -- I just had a -- I didn't have a probation or -- I mean, yeah, I (unintelligible) but, you know, I didn't go for tests or anything like that, you know.

NNAMDIOkay. Well, in response to the question of whether or not you can still get your citizenship or still become a citizen, that's something you would have to consult a lawyer about. But thank you for sharing your story with us. Matt Sutton, given the fact that our caller, Edward, talked about being arrested in 1986 for possession of marijuana, Matt, can you walk us through what the laws now are in this region -- in Maryland, D.C. and Virginia -- regarding marijuana?

SUTTONYeah, definitely. And, you know, I'm glad that Edward called, because I think that really points out, you know, the humongous risks of criminalization for drugs is, you know, people can, in his case, you know, either be denied citizenship, or in some cases even be deported.

SUTTONYou know, we've also seen people, of course, you know, have a hard time gaining employment, housing, financial aid to go to college, and even their children, in some cases. So, I mean, you know, the harms of criminalization for drugs are -- you know, they're very drastic. And, you know, so having some of these commonsense measures put into place really does give people a lot of hope.

SUTTONIt sounded like Edward was arrested in Fairfax County, so in Virginia. So, right now, Virginia still has not implemented any kind of plan for expungement. But that is something that they're currently working on. A lot of states across the country, as they have either decriminalized marijuana or legalized marijuana, they have gone ahead and, when they've done so, they've gone ahead and added things through the legislature which would expunge records and resentence people, and also just drop, you know, any pending charges regarding possession or, you know, things of that nature.

SUTTONSo, I think, you know, there is a lot of hope that, you know, when something does get passed like that in Virginia, that he could potentially get his record expunged. It's not always automatic, but we do try to push for that when we're working with legislators to really take that burden off of the people that have been harmed under these laws.

NNAMDIWhat are the laws in Maryland and D.C.?

SUTTONSo, in D.C., D.C. actually legalized marijuana in 2015. So, in D.C., you know, the laws are pretty relaxed. You can grow it, you can possess it. I think, you know, where a lot of the arrests are currently happening is for low-level sales or also public consumption. So, that's the case in D.C. The problem, too, in D.C. is in order to actually regulate marijuana where it can be sold in stores, they have to set up a regulatory framework. And the Congress is in charge of D.C.'s budget, and it's been putting in an appropriation rider that's basically been holding it hostage for the past five years. (laugh) So, that's unfortunate.

NNAMDIExactly. How about Maryland?

SUTTONYeah, in Maryland, they have decriminalized marijuana. So, if it's your first offense under, I think, it is 10 grams, you just have to pay up to $100. And then the penalty goes a little bit higher for each subsequent time that you're caught. But there's no criminal penalties for it.

SUTTONAnd then, in Virginia, they actually just implemented decriminalization a few months ago, too. And there, if you're caught with, I think it's up to 1 or 2 grams, you only have to pay -- the penalty is only $25. So, they've been trying to, you know, make it less severe across the board. And, definitely, Virginia has been working to try to pass legalization. So, I think that we'll definitely be seeing even -- you know, we'll be seeing even more reforms there where those laws will lighten up.

SUTTONIn Maryland, too, I know that that's been a priority. And I do want to just point out that in Baltimore, for instance, Marilyn Mosby, actually -- you know, once the pandemic started and, you know, it was clear that we shouldn't be arresting people for drug possession and putting them in jail, she actually has declined to prosecute any drug possession charges in Baltimore County.

SUTTONSo, I think, you know, things like that are really positive. We're seeing a lot more of that across the country, not just because of the pandemic, but because, you know, prosecutors are seeing, like, the harm that's been caused on people for just possessing drugs. And, you know, they see that a public health approach is much better.

NNAMDIHere's Michael, in eastern Maryland. Michael, you're on the air. Your turn.

MICHAELHi. Yes. I have a question for you. (unintelligible) with psilocybin being legalized in D.C., which is a hallucinogenic drug, there's also another hallucinogenic drug called ibogaine, which it's used in clinics in Mexico to fix heroin addiction. I was just wondering, is there any way Johns Hopkins will come about picking studies up on that? I haven't seen any personally and, you know, this is something I've been following for the past, like, four to five years. I'm very interested in the area.

NNAMDIDr. Matthew Johnson?

JOHNSONYeah, there aren't any plans right now. Something that people should know about ibogaine, or iboga -- which is the plant that it comes from. Ibogaine is really in a different category, in terms of the way it works. It's not near – so, psilocybin or magic mushrooms and LSD are -- they have dangers, but they don't fall in the category of physiological toxicity. You know, sort of it it's -- for most people, there's no known lethal overdose. It's not going to cause organ damage or make you stop breathing, anything like that.

JOHNSONSo, that makes them freakishly safe at the physiological level, compared to virtually any drug you compare, you know, even caffeine or most over-the-counter medicines. Ibogaine is not the same. One of the reasons that research was halted into ibogaine's medical development is that there are some serious cardiac issues, the prolongation of the so-called QT interval.

JOHNSONIt's something pharmaceutical companies stay away from with a 10-foot -- they won't touch it with a 10-foot pole in developing a drug, because this is something that, you know, you put it on the population and you could get, you know, increased number of cardiovascular events, heart attacks and strokes stemming from it. In fact, people have died in the administration of iboga and ibogaine. You know, like many drug side effects, it's like most people won't get this. Yet most people that do ibogaine are not going to have this problem, but it's a serious concern for its medical development.

NNAMDIThank you very much for your call, Michael. Here is Myra, in Maryland. Myra, your turn.

MYRAHi. Thank you for holding this show, Kojo. This is wonderful, given the current events of what happened in Oregon. The question I have is, I'm currently a student working towards a degree in therapy, so I can work and treat people. Actually, one of my projects that I'm working on is called War on Drugs, so this is perfect timing.

MYRAThe question I have is, in regards to what will it take for D.C. or Maryland specifically, to be able to get to a point where we can legalize it from a point of where we can create clinics for psilocybin? I understand the effects of psilocybin on depression. And the reason I ask is because I know a lot of people who have a lot of depression, including my own mother. And she's currently on pharmaceutical drugs. They’ve given her sleeping pills that's caused her to hallucinate and just have a lot of negative effects.

MYRABut there's a lot of people out there who'd be willing to try an alternative method, but I'm not open to just going and buying something without having professionals around to be able to treat her. So, what does it take for Maryland to be able to get to that point? And what can we, as individuals, do now to push the issue forward? Because I'm sure it may take a couple of years.

MYRAI don't know what the process is, but I feel like this is something that's very much needed. And Oregon being the first state doing that, you know, I think it's going to have a lot of positive results. But it'll be really nice to bring it to this side, as well, you know, with New Jersey legalizing for recreational. And so, what do you think?

NNAMDIFirst, I'll start with you, Dr. Johnson. The relationship, if you will, between the research process and ultimate legalization.

JOHNSONSo, there's a nuance here and psilocybin differs drastically than what you see in the history of cannabis with the state legalization process. You know, here, we're on an FDA pathway, so it's really more analogous to the development and approval of marinol or THC back in the 80s, which has essentially zero controversy associated with it. It's really whole-plant cannabis is where this controversy is at.

JOHNSONSo, you know, we are on a very solid pathway. Both phase III and phase II-B trials are underway right now. Those are the final stages of trials that can lead to approval. It depends on the data, but I think there's a very strong possibility that within the next few years, psilocybin will be medically approved -- and this will be across the United States -- medically approved by the FDA for the treatment of major depressive disorder.

JOHNSONRight now, the only legal way to access it would be in a research trial. We happen to have ongoing research using psilocybin to treat depression right here in Baltimore, Maryland. So, if someone feels inclined, they can inquire about that study at Hopkinspsychadelic.org, which brings you to the list of our various studies.

NNAMDIKathryn in Bethesda called, but couldn't stay on the phone, asking: Can this substance help in the treatment of eating disorders, Dr. Johnson?

JOHNSONThat's an extremely interesting area that I have -- well, let's see. There are many eating disorders. We have an active study right now using psilocybin to treat anorexia. So, that's one of the eating disorders. We don't have -- you know, we've only run a few participants so far. We think, theoretically, there's a lot of promise, but we're waiting on more data. If anyone is interested in that study, they can check out -- you know, look into being a participant in our research.

JOHNSONBut, of course, eating disorders also include obesity and people with food compulsions. I think that's an extremely interesting area, something I've written about, but there is no clinical research on that to date. It taps into -- one of the most exciting things about psilocybin is that it seems to -- and other psychedelics, it seems to have broad implications for behavior change. So, it's not like, you know, quelling the withdrawal or the symptoms of this particular psychiatric disorder or that one. It is a psychological process that can be brought to bear on any number of psychiatric disorders requiring behavior change.

NNAMDIWell, last week's election confirmed how divided this country is, but, Matt Sutton, in the 30 seconds or so we have left, could legalizing marijuana be the bipartisan issue that brings this country together?

SUTTONI mean, what voters across American showed us is that that is something that we can agree on. And, you know, one great thing is, actually, we have a bill sitting in Congress right now. We just got confirmation from the Steny Hoyer yesterday that the vote will take place in December. So, we hope legislators have heard the call and will pass that bill.

NNAMDIMatt Sutton and Dr. Matthew Johnson, thank you both for joining us. This segment about drug law reform was produced by Kurt Gardinier. And our conversation with filmmaker Merawi Gerima about gentrification in the District was produced by Ines Renique.

NNAMDIComing up tomorrow, it's Veterans Day. How will we honor those who served, in the midst of a pandemic? We speak with U.S. Army Veteran and WAMU reporter Victoria Chamberlin. Plus, D.C. recently introduced a slate of new Vision Zero initiatives aimed at making streets safer. You'll see more red light cameras and lower speed limits, but will it be enough to end traffic deaths by 2024? That all starts tomorrow, at noon. Until then, thank you for listening and stay safe. I'm Kojo Nnamdi.