Psychedelic Progress: How Massachusetts' Proposed Legislation Stacks Up Against Oregon and Colorado

Massachusetts voters are on the cusp of a pivotal decision that could position the state as a leader in alternative mental health treatment. This November, Question 4 on the ballot will ask voters whether to decriminalize and regulate psilocybin and other psychedelic substances for therapeutic use. If approved, Massachusetts would become the third state to legalize certain psychedelics, joining Oregon and Colorado. But how does the Bay State’s proposed framework compare to its pioneering counterparts?

Under the proposed Massachusetts legislation, psilocybin, psilocin, DMT, ibogaine, and mescaline—all currently classified as Schedule I substances—would be legalized for adults aged 21 and older, but only within a structured, therapeutic context. Rather than opening retail sales, the plan would authorize licensed professionals to administer these substances in designated therapy centers. An oversight commission and advisory board would also be established to guide the rollout and ensure safety protocols.

Oregon was the first state to take the leap into legalized psychedelics. In 2020, Measure 109 was passed, allowing regulated psilocybin services. Unlike Massachusetts’ proposed model, Oregon's plan specifically focuses on psilocybin alone and permits its administration in supervised, licensed settings. Notably, Oregon’s initiative set a precedent for a state-supervised training program to certify facilitators, a feature Massachusetts is looking to adopt but with broader substance coverage.

Colorado's Natural Medicine Health Act, which voters approved in 2022, took a more expansive route. Similar to Massachusetts' proposed framework, Colorado legalized not only psilocybin but also DMT, mescaline (excluding peyote), and ibogaine for regulated use. One major difference lies in Colorado’s phased approach: while psilocybin services were initially prioritized, additional substances were earmarked for potential inclusion after review. The state also allows for personal cultivation and use under specific conditions, an option not currently on the table for Massachusetts.

All three states share a common goal: to offer new treatment pathways for mental health conditions such as depression, PTSD, and anxiety. Proponents argue that regulated psychedelic therapy can unlock transformative results for patients unresponsive to conventional treatments. “Question 4 will establish infrastructure to promote safety and foster a better public understanding of psychedelics,” noted supportive healthcare professionals in Massachusetts.

However, each state faces unique challenges. Massachusetts would need to navigate potential safety concerns flagged by medical associations such as the American Psychiatric Association (APA), which argues that policy changes should be rooted in scientific evidence rather than public voting. Additionally, Tufts University’s Center for State Policy Analysis points out that while psilocybin and mescaline present more manageable risks, ibogaine and DMT carry significant health concerns, such as cardiac and neurological effects.

Early data from Oregon’s pilot program have shown promising feedback, with many participants reporting reduced symptoms of depression and anxiety. Colorado, still in the initial phases of implementation, is watching closely, tweaking its policies as lessons unfold. Massachusetts could leverage these findings to create a more refined framework, potentially minimizing public safety concerns and enhancing therapeutic effectiveness.

If Question 4 passes, Massachusetts will need to strike a delicate balance between regulation, safety, and accessibility. Drawing from the successes and shortcomings of Oregon and Colorado, the state could shape a model that combines comprehensive oversight with flexible application, offering hope to those in search of new mental health treatments.

Should Massachusetts follow Oregon and Colorado in legalizing psychedelics for mental health treatment?