Psilocybin legislation fuels psychedelic drug comeback

An operational manager finds relief from her depression using psilocybin, the primary psychoactive ingredient in “magic mushrooms”. A veteran overcomes his post-traumatic stress disorder through therapy with MDMA, a synthetic compound known on the street as “ecstasy” or “molly.” A stay-at-home mom tries LSD, also known as acid, for her anxiety.

Almost daily, stories emerge about the healing power of psychedelic drugs.

These stories reflect a so-called “psychedelic renaissance“of the moment—a new interest in the drugs most often associated with the counterculture of the 1960s, but now seen in a different light therapeutic rather than recreational purposes.

A handful of states, led by Oregon and Colorado, are leading the way in legalizing the use of various naturally occurring psychedelic compounds. In 2020, Oregonians Pass Measure 109who legalized the controlled use of psilocybin and introduced a new system for its production and consumption.

And in 2022, Colorado residents succeeded Proposition 122, The Natural Medicine Health Actwhich created a psilocybin program similar to Oregon’s. So far, Oregon and Colorado are the only states to have such programs, but many other states are considering bills that would do so.

Like a drug researcherI conducted interviews with psilocybin facilitators, service center owners, manufacturers, researchers, and policymakers in Oregon. My goal is to get their perspectives on the pros and cons of their state’s model for psilocybin legalization.

For adult use only, not for medical purposes

Oregon’s Measure 109 established a strict “adult use” program, meaning anyone 21 or older can access psilocybin treatment without any medical diagnosis.

Under this program, consumers must purchase psilocybin through a state-licensed service center, where they must also ingest it in the presence of a state-licensed facilitator. Facilitators are licensed through state-approved training institutions and do not need to have a specific medical background. Only natural, mushroom-derived psilocybin, as opposed to the synthetic psilocybin that pharmaceutical companies such as Compass Pathways are developing— is allowed. The first batch of facilitators graduated in the spring of 2023 and the first service center opened that summer.

The Licensing process for facilitators is not burdensome: You must have a high school diploma or equivalent and a relatively clean criminal record, and you must complete a 160-hour, state-approved degree program, including 40 hours of on-the-job experience. This ease of obtaining a license to practice was intentional: The architects of Measure 109 wanted to make room for people of diverse backgrounds to become facilitators. “Certain people are great at what they do, and school may not be the right path for them,” one facilitator told me.

However, many service center owners and facilitators feel that additional qualifications or training would be helpful. One of my interviewees suggested that some of the required training courses could be taught by a psychiatrist or neurologist, since many clients seeking psilocybin services have existing mental health diagnoses and may already be taking multiple psychopharmaceutical medications.

How much does psilocybin cost?

As everyone I interviewed acknowledged, the primary problem with the Oregon model is cost. It is estimated that the average trip costs about US$1,500. That includes $500-$2,000 for the facilitator, $300-$600 for the room, and $150-$200 for the psilocybin itself. For more intensive facilitation at more expensive facilities, the cost can go up to $5,000 per trip.

Part of the exorbitant cost is the start-up costs, which are significant. The architects of Measure 109 wanted the state’s psilocybin service office to be self-funding. As a result, annual licensing fees for facilitators ($2,000 per year), service centers ($10,000 per year), and manufacturers ($10,000 per year) are relatively high. Specialty manufacturing equipment and high taxes further increase the cost.

All this translates into higher prices for consumers, who have not flocked to psilocybin service centers on the expected volume. The vast majority of clients undergoing psilocybin treatment come from outside the statepossibly because most Oregon residents can obtain psilocybin easily and at a lower cost outside the legal market.

One service center owner told me, “We don’t really have a scalable or profitable model. It’s very labor-intensive on the facilitator side. Investors typically want to make five times their money, and they don’t see how that can happen with the way the industry is structured today.”

Other State Pathways to Psilocybin Legalization

The second state psilocybin program to go online will be in Colorado, where the Natural Medicine Health Act was adopted in 2022.

For now, the term “natural medicine” for legal treatment only refers to psilocybin, but the law could be expanded in the future to include DMT, ibogaine And mescalineother naturally derived psychedelic drugs.

Unlike Oregon’s program, which created a license for a single facilitator, Colorado’s program Proposal 122 poses a layered approach to facilitator licenses, with one path for those with clinical degrees and one for those without. Prop 122 also decriminalized the possession, use, cultivation, production, and even sharing of natural medicines for “personal use.”

Other states have considered similar programs, but none have yet been enacted into law. Two psychedelic bills recently failed in California. In Arizona, Democratic Gov. Katie Hobbs a bill vetoed in June 2024 that would have allowed psilocybin treatment and testing in the state. The bill was sponsored by Republican Senator TJ Shope.

For the most part, however, such bills have support on both sides of the aisle, indicating that state-level legislation on psilocybin is likely to continue in the coming years. This will happen in conjunction with developments at the Food and Drug Administration, which has already approved several psychedelic drugs “breakthrough therapy” statusa designation that accelerates the process of drug development and evaluation.

Developments at the FDA

Major pharmaceutical companies such as Johnson & Johnson investing in the development of psychedelic drugs, but the emerging industry is really being driven by smaller disruptors like Compass And MindMedboth of which are trying to get FDA approval for their own patented psychedelic formulas.

Many industry experts believe the FDA will approve certain psychedelic drugs, including synthetic psilocybinin the coming years. Since Oregon and Colorado’s programs work only with natural substances, and since all FDA-approved psychedelics can likely only be prescribed by medical professionals, synthetic psilocybin would not be used in service centers under current law.

The development of the market for potential FDA-approved psychedelics thus represents a parallel track to the psychedelic renaissance. Some of my interviewees predicted an eventual conflict between the state-level legalization track and the FDA-approved drug track, but my research suggests that this conflict will not come to a head for many years.

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