On 8 November, over one million people in Colorado voted in favour of the Natural Medicine Health Act, Proposition 122, to decriminalise entheogens and lay the groundwork for the regulation of psychedelic compounds.
Natural Medicine Health Act
The Natural Medicine Health Act requires rules to be written for a psilocybin programme by 2024, with service centres expected to open in 2025. This will create the second state-wide industry in the US, after Oregon, and one that could quickly become the biggest.
Similar to Oregon’s programme, adults over 21 in Colorado could access psilocybin services without a diagnosis, prescription or referral. This presents an addressable market of over 3 million, 24% larger than that in Oregon.
In Colorado, state officials will be tasked with creating a process to license psilocybin manufacturers, testing laboratories and service locations – where adults can consume psilocybin with a facilitator. Regulators will also define the qualifications, education and training requirements for service providers.
Counties and municipalities in Colorado can only restrict locations through zoning restrictions, whereas in Oregon they will be able to opt out completely. In conversation with PSYCH for The Psychedelics as Medicine Report: Fourth Edition, Angela Allbee, Oregon Psilocybin Services Section Manager, recognised this as a limitation in Oregon’s statute.
‘Many local governments have adopted ordinances to prohibit psilocybin services, through either permanent bans or temporary opt-outs,’ explained Allbee. ‘These ordinances must be referred to voters at the next general state-wide election. If voters at the next state-wide election pass those ordinances, we won’t be able to issue licences in those jurisdictions.’
As adult-use psilocybin frameworks emerge, the ability of regulators to issue licences and establish efficient distribution networks will be essential. Psilocybin remains a Schedule One substance in the US, which means access to funding, insurance and banking services may be difficult.
Accessing Psilocybin in Colorado
Services are expected to cost US$3,000 and will be split into three sessions – preparation, administration and integration. There are goals to incentivise low-cost treatments for low-income adults, and also a fund to financially support marginalised communities to access facilitator training.
In a boost for accessibility, and in contrast to Oregon’s statute, the Act makes allowances for at-home psilocybin services. ‘Psilocybin administration sessions [in Oregon] can only take place at licensed service centres,’ said Allbee. ‘This presents a problem for those that want to access psilocybin services, but cannot be transported, such as those in palliative care.’
The campaign in Colorado collected over 222,000 signatures and received US$2.7m from New Approach, an organisation that funds decriminalisation initiatives across the country and supported Oregon’s successful Psilocybin Services Act.
Regulatory reform to provide psilocybin services has been bolstered by successful clinical trials, which demonstrate the compound’s therapeutic efficacy. With the potential to open up new markets, drug developers from the medical framework are exploring opportunities in adult-use programmes.
Filament Health’s CEO, Benjamin Lightburn, told PSYCH: ‘I think we can provide the most promising natural alternative to synthetic psilocybin, and that we will be able to compete and win because we can show that our product is more efficacious…We can bridge the gap between the pharmaceutical and natural markets and I think we’re the only ones that can.’
As the Natural Medicine Health Act decriminalises the personal cultivation, possession and gifting of psychoactive plants and fungi, it may present the opportunity for an unregulated market to emerge – particularly as the legislature has no language defining personal possession limits. This could create challenges for the short-term profitability of licensed service providers.
However, in 2026 Colorado’s regulators can expand the psilocybin framework to include ibogaine, ayahuasca and mescaline services.
