U.S. path to legal MDMA and Psilocybin-assisted Therapy
After decades of prohibition and misinformation, the perspective on psychedelics is shifting both in public opinion and government policy. In 2018, the U.S. Food and Drug Administration (FDA) designated psilocybin as a “breakthrough therapy” for severe depression. The following year saw the establishment of research centers focused on psychedelics at leading institutions like the Imperial College London, Yale, and UC Berkeley. By 2023, states such as Oregon and Colorado have taken steps to legalize psilocybin for adult use in specific treatment settings, although not yet for full-fledged psychedelic-assisted therapy. Many other states are exploring legislative options, primarily leaning towards allowing psychedelic-assisted therapy rather than simple decriminalization. The route to federal approval for broader therapeutic use hinges on the success of clinical trials.
Clinical Trials with FDA Updates
Currently, MAPS has completed its MDMA Clinical Trial Phase 3B with promising results, and is preparing their submission to the FDA later in 2023. If approved, MDMA could become a legal designated therapy drug to treat PTSD as early as 2024. After which MAPS may ask the FDA to use their result to designate MDMA as a legal therapy drug under therapeutic administration settings. Compass has been approved to begin its Phase 3 trial of over 1000 participants for psilocybin therapy. Compass’ route to FDA approval is yet unknown, but we’ll likely hear more on it later this year. With FDA approval of MDMA and psilocybin for therapy based on the results of these phase 3 clinical trials, states will be able to pass regulations they are currently working on into laws to allow for psychedelic-assisted therapy.
Read more about our Psilocybin Clinical Trials
Psychedelic-Assisted Therapy Legalization Efforts by State
Click on each state to learn more. Oregon and Colorado's services for clients and practitioners can be found down below.
U.S. States Working Towards Psychedelic Therapy in Alphabetical Order
ARIZONA RESEARCH DEVELOPMENT
Legislation is currently being reviewed that plans to set aside $30 million from the state budget for research grants on psilocybin. This legislation is known as House Bill 2486 and includes the establishment of an advisory council focused on psilocybin research. On February 1, 2023, the bill gained full support from the Military Affairs and Public Safety Committee. In addition, $5 million is designated for psilocybin research within the healthcare budget. The primary goal of these studies is to investigate the impact of psilocybin on various conditions, including PTSD, depression, prolonged symptoms of COVID, and inflammatory diseases.
CALIFORNIA PASSES LAW TO LEGALIZE PSYCHEDELIC THERAPY UPON FDA APPROVAL
California Governor Gavin Newsom has signed a new law allowing healthcare professionals in the state to prescribe Schedule I substances like MDMA and psilocybin for medical use, if these substances are reclassified by the federal government. The law will automatically take effect when federal reclassification happens. Other bills related to the decriminalization of psychedelic substances are also waiting for Governor Newsom’s approval. Additionally, Oakland and Santa Cruz have already decriminalized psychedelics, and San Francisco has made them the “lowest priority” for law enforcement.
COLORADO’S PSILOCYBIN SERVICES AND LEGALIZATION OF MDMA THERAPY TO TREAT PTSD UPON FDA APPROVAL
In the November 2022 mid-term election, Colorado voters approved Proposition 122, also known as the Natural Medicine Health Act of 2022 (NMHA). This act will legalize various psychedelics in the state, similar to Oregon’s MB 109, but with additional broader initiatives. Furthermore, Colorado Governor Jared Polis has signed a bipartisan bill that will permit the prescription of MDMA for medical use if the U.S. Food and Drug Administration (FDA) approves it. The bill, which passed both the House and Senate, allows for the “prescribing, dispensing, transporting, possessing, and using” of MDMA, specifically for treating PTSD in combination with talk therapy. The legislation expects that the FDA may approve MDMA-assisted therapy as early as 2023.
See more about Colorado’s Natural Medicine Health Act Below.
CONNECTICUT PSYCHEDELIC-ASSISTED THERAPY
On January 9, 2023, Democratic Representatives David Michel and Gary Winfield introduced a bill, HB 5102, that aims to allow the medical and therapeutic use of psilocybin for various health conditions. The bill was sent to the Joint Committee on Public Health for more review. Another bill, HB 6146, was introduced by Democratic Representative Michelle L. Cook on January 18, 2023. This bill aims to start a pilot program for psychedelic-assisted therapy, using funds from the General Fund. It was moved to the Appropriations Committee for further review on February 8, 2023.
FLORIDA’S EFFORTS AT PSILOCYBIN ASSISTED THERAPY
Senate Minority Leader Lauren Book and Representative Michael Grieco, both Democrats, had proposed legislation urging state officials to study the potential of alternative therapies like MDMA, psilocybin, and ketamine for treating various health conditions. These proposals, known as SB348 and HB193, were inspired by a similar law passed in Texas but did not advance in committee in March 2022. In a previous legislative session, another bill, HB549, sought to legalize and regulate psilocybin for mental health care but was not approved in the Professions & Public Health Subcommittee in April 2021.
GEORGIA PSILOCYBIN THERAPY FOR PTSD
On March 3, 2022, Georgia lawmakers amended and passed HR896. This resolution aims to establish the House Study Committee on Alternative Post-Traumatic Stress Disorder Treatment Resources for Veterans. The committee is tasked with examining the needs and issues related to using psilocybin-assisted therapy for veterans with PTSD or depression, as well as for treating addiction. The resolution will next go to the House Rules Committee for more review.
HAWAII PSILOCYBIN THERAPY
On January 21, 2022, Senate Bill 2575 was introduced with the aim of removing “psilocybin and psilocyn from the list of Schedule I substances” and establishing specific treatment centers for their therapeutic use. If passed, the bill would also mandate the governor to form a psilocybin review panel to assess the impact of this legislation. More recently, on March 10, 2023, Democratic Senator Chris Lee put forth a bill, SCR69, proposing the creation of a Beneficial Treatments Advisory Council. This council would evaluate and offer guidance on new mental health treatments, especially focusing on safe and affordable access to therapeutic psilocybin and MDMA for adults 21 and older. Although a public hearing was scheduled for March 24, 2023, action on the bill was delayed by the Health and Human Services Committee on that day.
ILLINOIS PSILOCYBIN RESEARCH AND SERVICES
On February 10, 2023, Senator Rachel Ventura introduced a bill to amend the Illinois Controlled Substances Act. Known as the CURE Act or SB 2353, the bill aims to change existing rules, including the Schedule I status of psilocybin, to permit the Department of Financial and Professional Regulation to authorize its use for medical and scientific research. The focus of the research would be on treating various mental health issues such as addiction, depression, and anxiety disorders. The bill also specifies that the department would begin accepting applications for roles related to the manufacturing, distribution, facilitation, and testing of psilocybin products.
INDIANA’S EARLY EFFORTS
Indiana’s interim study committee on public health, behavioral health, and human services recently met to discuss the potential use of psychedelics for treating mental health disorders. The meeting included Dr. Ranji Varghese, a psychiatrist who uses ketamine in clinical practice, and Stefan Egan, a veteran who has found relief from treatment-resistant mental health issues through the use of psychedelic mushrooms. Rep. Vanessa Summers (D-Indianapolis) said that if scientific evidence shows that substances like psilocybin are effective for mental health treatment, lawmakers have a responsibility to consider a program like the one in Oregon. The meeting indicates a growing interest in rethinking the legal status of psychedelics for medical use.
IOWA END OF LIFE PSYCHEDELIC THERAPY
On February 11, 2021, HF480 was introduced and sent to Human Resources. The bill aims to decriminalize specific Schedule I controlled substances like DMT, LSD, peyote, psilocybin, psilocyn, and MDMA for certain patients with terminal illnesses or life-threatening conditions. Another bill, HF636, was introduced on February 23, 2021, and forwarded to the House Public Safety Committee. This bill proposes creating a regulated framework for psilocybin use by adults aged 21 and over in the state. It also suggests reducing the legal priority for actions against non-commercial activities involving various entheogenic plants and substances, including ibogaine, DMT, mescaline, peyote, psilocybin, and psilocin.
KANSAS DECRIMINALIZATION
On January 10, 2022, Kansas Representative Aaron Coleman, a Democrat, put forth a new bill, HB 2465, with the intent of lessening the penalties for those growing or holding small amounts of specific controlled substances. If enacted, the newly named “Legalized Homegrown Mushroom Act of 2022” would make it legal to grow or possess up to 50 grams of psilocybin or psilocin.
KENTUCKY RESEARCH ON ADDICTION TREATMENT WITH IBOGANE
On January 4, 2023, a legislative proposal known as HB 98 was put forward, focusing on “Controlled Substances.” Should it become law, the bill aims to lessen penalties related to the possession of controlled substances. The bill also calls for the creation of harm reduction centers.
On May 31, 2023, Kentucky’s Attorney General Daniel Cameron revealed plans to allocate $42 million from the state’s share of the Opioid Settlement Fund towards research on addiction treatment using ibogaine.
MAINE FOLLOWING IN OREGON’S FOOTSTEPS
On May 9, 2023, the legislation LD1914 was introduced with the goal of creating the Maine Psilocybin Health Access Act. Inspired by Oregon’s approach, the bill proposes that authorized organizations and people could provide psilocybin. It also recommends decriminalizing the personal use, growing, and holding of small amounts of psilocybin for adults aged 21 and over. As of May 22, 2023, action on the bill has been put on hold.
MARYLAND PSYCHEDELICS FOR PTSD
On April 8, 2022, Maryland lawmakers sent SB0709 to the governor for consideration. The bill seeks to create a state-funded program to provide military veterans suffering from PTSD and traumatic brain injuries with free access to psychedelics like psilocybin, MDMA, and ketamine. Although Governor Larry Hogan did not sign the bill, he allowed it to become law on May 27, 2022. Initiated by Democratic Senator Sarah Elfreth, the legislation had received unanimous support in both the House and Senate prior to arriving at the governor’s desk.
MASSACHUSETTS PSYCHEDELIC-ASSISTED THERAPY TRAINING
On March 30, 2023, HB 3574 was introduced, proposing to limit the cost of each MDMA treatment service unit to $5,000 for all registered providers. The bill was forwarded to the Committee for Public Health on April 13, 2023. On that same day, another bill, HB 3605, was introduced. This bill aims to require the Department of Public Health to establish guidelines for issuing psilocybin facilitator licenses. The training curriculum for these licenses would vary between 20 and 300 hours and include at least 21 hours of hands-on practice. This bill was also referred to the Committee for Public Health on the day it was introduced. Furthermore, on May 11, 2023, the city council of Salem voted to stop arrests for psilocybin use and possession by adults, directing that city resources should not be used to enforce criminal penalties against adult psilocybin use.
MICHIGAN PSYCHEDELIC LEGALIZATION AND PSYCHEDELIC TREATMENT
On February 1, 2022, a ballot initiative was proposed to reform Michigan’s drug laws. If approved, the initiative would decriminalize possession of Schedule 1 and 2 substances. It specifically identifies psilocybin, psilocin, ibogaine, peyote, and dimethyltryptamine as “Natural Plants and Mushrooms,” which would be legal for anyone over 18 to cultivate, possess, use, or gift. The proposal also calls for a regulated system for sale and treatment. Entities designated by a hospital and holding a “Certificate of Need” from the Michigan Department of Health and Human Services could administer and sell these substances to patients with a written recommendation from a Michigan-licensed physician. The 2022 ballot initiative has been postponed to 2024 to allow for signature collection. On June 8, 2023, the Michigan State House introduced concurrent resolution No. 5, urging Congress, the Department of Defense, and the Veterans Administration to invest in non-technology treatment options for psychological trauma in military service members and veterans. This includes the use of psychedelics in clinical settings.
MINNESOTA’S PSYCHEDELIC MEDICINE TASK FORCE
On February 16, 2023, Democratic Representative Andy Smith introduced HF 1884, aimed at establishing a “Psychedelic Medicine Task Force.” The task force is focused on examining the potential legalization of certain psychedelics like psilocybin, LSD, and MDMA. The initial version of the bill had a broader scope, including additional psychoactive substances. A related bill, SF 1954, was introduced by Democratic Senator Kelly Morrison on February 20, 2023. The task force, consisting of 23 members, is set to review existing scientific research and compare psychedelic therapies to conventional drug treatments. Preliminary findings are expected by February 1, 2024. By May 23, 2023, the provision for the task force had been incorporated into a larger health bill that narrowly passed both legislative chambers. Governor Walz then signed it into law. A comprehensive report from the task force is expected by January 1, 2025.
MISSOURI PSYCHEDELIC THERAPY
On March 1, 2022, HB 2850 was introduced, proposing the legalization of certain “natural medicines” like ibogaine, psilocybin, psilocin, DMT, and mescaline, excluding peyote, for various medical conditions. The bill also aims to offer legal protection to healthcare providers who recommend these natural medicines to patients. Additionally, it would lessen the penalties for possession of these substances outside of approved medicinal use. On March 7, 2023, the House Veterans Committee unanimously passed HB 1154, first introduced by Republican Rep. Dan Houx on February 14, 2023. This bill calls for a joint study between the Department of Health and Senior Services and a U.S. Department of Veterans Affairs medical center. The study aims to explore the effectiveness of MDMA, psilocybin, and ketamine for treating PTSD, treatment-resistant depression, substance abuse disorders, and end-of-life care. The study will also feature a clinical trial focused on psilocybin and a thorough review of existing scientific literature. The findings are to be reported to the Governor.
MONTANA’S MEDICINAL USE OF PSILOCYBIN
On December 3, 2022, Republican Montana Representative George Nicolakakos introduced LC 2311, a proposal for a temporary study on the use of psilocybin in mental health treatments. The proposal was put on hold on December 12, 2022. On March 27, 2023, a draft of HB 1208 was sent for final review to the Executive Director. This proposed bill seeks to allow the medical use of psilocybin for treating specific mental health conditions such as PTSD. The bill also sets guidelines for the cultivation, processing, and distribution of the substance.
NEW HAMPSHIRE DECRIMINALIZE PSYCHEDELICS
In a State Supreme Court case, the use of specific psychedelics in New Hampshire may be constitutionally protected if deemed a valid religious practice. Additionally, on January 5, 2022, HB1349-FN was introduced in the House and sent to the Criminal Justice and Public Safety Committee. The bill aimed to decriminalize the possession or use of a certain quantity of psilocybin mushrooms for individuals 18 years or older.
NEW JERSEY PSILOCYBIN THERAPY
On June 23, 2022, Bill S2934 was introduced in the Senate and sent to the Senate Health, Human Services and Senior Citizens Committees. The “Psilocybin Behavioral Health Access and Services Act” aims to authorize the production and use of psilocybin for health and wellness. It also proposes to decriminalize and eliminate past offenses related to the production, possession, use, and distribution of psilocybin.
NEW MEXICO INVESTIGATES THERAPEUTIC USE OF PSILOCYBIN
On March 1, 2023, New Mexico introduced HB393, which seeks to establish a Psilocybin Advisory Group. The group’s purpose is to explore the possibility of creating a clinical program that uses psilocybin-based treatments for specific mental health and substance use disorders. The advisory group would also be responsible for developing rules for the cultivation, production, and distribution of psilocybin for medical purposes. In addition, the group would create treatment standards, criteria for patient selection, and training and certification guidelines. The advisory group will also monitor similar initiatives in other states, including any legal and regulatory challenges they may face. Managed by the Department of Health, the group is expected to complete a report by December 1, 2025.
NEW YORK PSYCHEDELIC THERAPY
In early January 2023, New York Assembly members Rosenthal, Simon, and Reyes introduced Bill A00114 to decriminalize the adult use of certain plant-based hallucinogens like psilocybin and DMT. The legislation aims to provide legal protection against discrimination in employment and mental health services for those who use these substances lawfully. The bill also prohibits local law enforcement from assisting federal agencies in enforcing federal laws that conflict with this state legislation. Later in January, Senator Fernandez introduced Bill S 3520, which focuses on the medical use of psilocybin. The bill seeks to create a grant program for psilocybin-assisted therapy and has been referred to the Finance Committee for review.
NORTH CAROLINA RESEARCH GRANTS
On April 18, 2023, HB 727 was introduced with the goal of establishing the Breakthrough Therapies Research Grant Fund, allocated a total of $2.5 million. These grants would be designated for research within the state on the therapeutic uses of MDMA and psilocybin. Specifically, research on MDMA would aim to treat PTSD in veterans, first responders, and survivors of domestic or sexual violence. Psilocybin research would concentrate on treating anxiety or depression and would also evaluate its effectiveness in pain management.
OHIO LEGISLATION
SB 3 would have reformed drug sentencing laws by reducing penalties from felonies to misdemeanors for certain drug possession convictions and by diverting certain offenders to treatment instead of prison. The bill was never brought up for a final floor vote.
OKLAHOMA PSILOCYBIN THERAPY
In January 2022, two bills, HB 3174 and HB 3414, were introduced to encourage scientific research on psilocybin-assisted therapy and to facilitate new clinical trials. In February 2023, HB 2107 was introduced by Republican Daniel Pae. This bill aims to protect researchers from legal repercussions when using psilocybin to study various medical conditions, such as PTSD, depression, and opioid addiction. After its second reading, the bill was referred to the Health and Human Services Committee and was subsequently sent to the Appropriations Committee in late March 2023.
OREGON LEADS THE WAY
In November 2020, Oregon became the first state to legalize psilocybin-assisted therapy and to decriminalize small amounts of all psychedelics for personal use. In January 2023, the Oregon Health Authority started issuing licenses to businesses for providing psilocybin services to individuals 21 years and older. These services must occur in a licensed facilitation center and be overseen by a licensed facilitator.
See more about Oregon’s Psilocybin Services Below.
PENNSYLVANIA PSILOCYBIN RESEARCH
On March 16, 2022, HB 2421 was introduced and sent to the health committee. The Psilocybin Data Act aims to support research and clinical studies on psilocybin and psilocybin-assisted therapy. The act outlines a structure for research to explore new ways to maximize the public health benefits of psilocybin.
RHODE ISLAND PSILOCYBIN THERAPY
On March 2, 2022, HB7715 was introduced with the aim of decriminalizing possession of psilocybin. Additionally, the bill would permit “a practitioner in good faith and in the course of his or her professional practice” to “prescribe and dispense psilocybin as a therapeutic.” The Director of Health would also be authorized to create rules and regulations to enable practitioners to prescribe psilocybin for therapeutic use in line with this bill.
TEXAS PSYCHEDELIC THERAPY RESEARCH
On March 9, 2023, Rep. Richard Peña Raymond introduced HB4288, which aims to explore alternative treatments for PTSD such as MDMA, psilocybin, and ketamine for veterans. The bill was referred to the Public Health Committee on March 21. On the same day, Rep. Josey Garcia introduced HB4423 with the goal of establishing a council for research on psilocybin related to mental and neurological conditions. The next day, Rep. Julie Johnson put forth HB4561, which focuses on creating a research consortium for alternative mental health therapies. This includes authorizing ketamine clinics and examining treatments like ibogaine and 5-MeO-DMT for veterans. A report is anticipated by December 1, 2024.
UTAH PSYCHEDELIC THERAPY
On March 22, 2022, the Utah Governor signed 64 bills into law, including HB167. This bill established the Mental Illness Psychotherapy Drug Task Force. While the bill does not legalize or decriminalize any psychedelic compounds for medical or recreational use, it does set the stage for state lawmakers to reevaluate the role of certain scheduled compounds in mental health treatment. The task force is required to submit a written report of their findings to the Utah State Legislature’s Health and Human Services Interim Committee by October 31, 2022.
VERMONT RECOGNISE PSYCHEDELICS THERAPEUTIC VALUE
On February 24, 2023, H.371 was submitted to the House Judiciary Committee. The bill aims to decriminalize psilocybin and establish a work group to study its therapeutic benefits. This proposal complements other existing bills, S.119 and H.423, which focus on setting up safe supply services through the Vermont Department of Health. On March 1, another bill, S.114, was introduced. It seeks to recognize the therapeutic value of psilocybin, remove criminal penalties for its possession, and form a Psychedelic Therapy Advisory Working Group. This group would explore the possibility of a state program similar to those in Connecticut, Colorado, or Oregon, where healthcare providers are allowed to administer psychedelics in therapeutic settings.
VIRGINIA PSILOCYBIN TREATMENT FOR END OF LIFE
On January 11, 2023, HB 1513 was introduced. The bill would permit possession of psilocybin with a valid prescription from a healthcare practitioner for the treatment of refractory depression, PTSD, or to reduce end-of-life anxiety.
WASHINGTON PSILOCYBIN THERAPY
Introduced on January 11, 2023, SB 5263 passed the Washington Senate and was sent to the House. The bill assigns the Department of Health to create a regulatory framework for adult use of psilocybin, effective January 1, 2024. It outlines rules for manufacturing, testing, and packaging psilocybin products and calls for the formation of a Psilocybin Advisory Board. Adults 21 and older could purchase psilocybin at approved service centers and participate in supervised sessions for preparation, administration, and integration. On May 9, 2023, a modified version of SB 5263 received the Governor’s signature, allocating $1.4 million for a two-year pilot project starting on July 7, 2023. This program will focus solely on treating veterans and first responders with psilocybin. Governor Inslee vetoed parts of the bill, notably an interagency workgroup involving the Department of Health. Additionally, voters passed Initiative 81, which makes the enforcement of laws against psychedelic plants and fungi a low priority for law enforcement.
WEST VIRGINIA DECRIMINALIZATION
On January 24, 2023, HB 2951 was introduced to the House by Delegate Kayla Young. The bill aims to remove the Schedule I status of several drugs in the Code of West Virginia, including THC and psilocybin.
WISCONSIN PSILOCYBIN THERAPY
In November 2023, proposed legislation (LRB-4215/1) aims to establish a trust fund for researching psilocybin’s medicinal uses, particularly focusing on its effectiveness in treating PTSD in military veterans. This initiative, targeting individuals 21 and older with treatment-resistant PTSD, excludes law enforcement officers from participation and mandates the use of FDA-approved psilocybin. Introduced by Sen. Dianne Hesselbein and co-authored by Sen. Jesse James and Reps. Nate Gustafson and Clinton Anderson, the bill emphasizes a bipartisan approach to veteran healthcare. It reflects a growing interest in alternative treatments for mental health, particularly for conditions like PTSD and substance addiction, amidst increasing awareness of psychedelics’ therapeutic potential. Wisconsin’s move, aligning with broader national trends, opens doors to more effective, inclusive treatments in mental health care.
Psychedelic-Assisted Therapy Legalization Efforts by State
As Oregon and Colorado begin delivering psilocybin assisted services in 2023 and 2024 respectively, there will be very few qualified psychedelic therapists and trained physicians to serve the tens of thousands of annual clients who are interested in or ideal candidates for treatment. Therapists and physicians who have taken psychedelic therapy and prescriber training will be best able to meet this new demand. You do not need to live in Oregon or Colorado to take this training or to offer psychedelic therapy services. With so few therapists and physicians who have had training and understand psychedelics, wherever you live, your expertise may be of value to those patients who will go to Colorado or Oregon for the treatment.
Introduction to Psychedelic-assisted Therapy Course
Explore psychedelic-assisted therapy in this engaging intro course, ideal for healthcare professionals seeking to broaden their practice. This course, a prerequisite for the Advanced PaT Certification Program, also offers CE credits.
Advanced Psychedelic-assisted Therapy Course
Advanced training for licensed medical practitioners, equipping them to confidently address patient queries on psychedelic-assisted therapy. Eligible for CME credits.
Physicians and Prescribers Psychedelic-assisted Therapy Program
Empower licensed medical practitioners to confidently respond to patient inquiries about psychedelic-assisted therapy with our advanced training. Eligible for CME credits.
Oregon and Colorado's Psilocybin-assisted Therapy Services Information for Clients and Practitioners
Holoyda, B. (2023). The perilous policy of Oregon’s psilocybin services. PubMed, 51(2), 160–166.
https://doi.org/10.29158/jaapl.230023-23
Natural Medicine Health Act | Division of Professions and Occupations. (n.d.).