On November 8, Colorado voted to legalize the medicinal use of psilocybin and psilocin—the two active compounds in psychedelic mushrooms—joining Oregon to become the second state to do so. Proposition 122, known as the Natural Health Act, passed with 53% of the vote. The measure came just three years after Denver became the first city to decriminalize so-called “magic” mushrooms.

The measure creates a pathway for legal medical treatment with psychedelics under supervision and decriminalizes personal possession. Specifically, Proposition 122 does the following:

  • By 2024, residents 21 and over will have access to supervised psychedelic treatment at licensed facilities known as healing centers.
  • It allows Colorado to expand the types of substances that can be administered in the healing centers to include other plant-based substances, including ibogaine, mescaline (not peyote-derived) and DMT (the psychoactive agent in ayahuasca) starting in 2026.
  • Decriminalizes possession, sharing, growing and use—but not sale—of five psychedelic substances by residents 21 and over. Stipulates that local governments can decide how, where and when the healing centers can operate in their own jurisdictions. Creates penalties for people under 21 who transport, possess or use psychedelic substances and for people over 21 who allow underage access.

Access, however, won’t be immediate. What happens next is an implementation phase, in which a 15-member Natural Medicine Advisory Board will guide the measure’s rollout. Implementation is likely to be complex; in addition to establishing processes for the new medical milieu among law enforcement, regulators and advocates, Colorado must issue rules for drug testing standards, license requirements, and health and safety warnings by Jan. 1, 2024. From there, the state has just nine months to start accepting applications for licensed facilities to start administering psilocybin.

A big difference between the Natural Health Act and previous laws regarding medical marijuana use is that there will not be public-facing dispensaries, where residents can buy mushrooms legally, and all treatment must be under supervision.

“Psilocybin is not a commodity like cannabis,” Sean McAllister, a drug reform advocate and cannabis business attorney, told Colorado Public Radio. “It’s a service like therapy. That’s the difference here, is that you really are going to see service centers where they’re surrounding people in a healthy environment and helping them work through mental health challenges.”

Colorado’s new provision comes amid emerging research on the benefits of psilocybin for treatment of depression, anxiety and PTSD. In the past year alone, research from Johns Hopkins University and a review in the New England Journal of Medicine have found enough evidence of the potential benefits of psilocybin in treatment-resistant depression to convince researchers to continue conducting studies.

Colorado, like Oregon, may soon provide more data.

https://ballotpedia.org/Colorado_Proposition_122,_Decriminalization_and_Regulated_Access_Program_for_Certain_Psychedelic_Plants_and_Fungi_Initiative_(2022) https://denvergov.org/Government/Elections/Denver-Decides/State-Ballot-Measures/Colorado-Proposition-122
https://hub.jhu.edu/2022/02/16/psilocybin-relieves-depression-for-up-to-a-year/ https://www.nejm.org/doi/full/10.1056/NEJMe2210975

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