States’ Push to Legalize Psychedelics Gaining Momentum

The push to legalize psychedelic drugs is gaining momentum in states across the country, with a sevenfold increase in the number of decriminalization bills since 2019, new research shows.  

Researchers identified 74 bills and referendums in 25 states introduced during the study period that either sought to reform existing laws and expand access to psychedelic drugs such as psilocybin (psychedelic mushrooms) and 4-methylenedioxymethamphetamine (MDMA) or proposed further research into decriminalization.

Ten of those measures in seven states became law. Last month, voters in Colorado increased that number to 11 with the passage of a referendum legalizing psychedelics.

Support for the measures has come from across the political spectrum and investigators say if the trend follows a similar trajectory as the marijuana decriminalization effort, psychedelic drugs could be legal in most states within 12-15 years.

“The fact that this has started to come from the two polar ends of the political spectrum is a big part of the reason this is snowballing so quickly,” Joshua Siegel, MD, PhD, lead investigator and an instructor of psychiatry at Washington University in St. Louis, Missouri, told Medscape Medical News.

The findings were published online today in JAMA Psychiatry.

Legislative Activism

Psychedelic drugs such as psilocybin and MDMA are category 1 controlled substances and are illegal in the United States. But studies of their therapeutic value for psychiatric illness and the possibility of FDA approval have prompted a wave of legislative activism to legalize the drugs.

For the study, researchers reviewed legislative databases for bills and referendums introduced between January 2019 through September 2022 that focused on legalization or decriminalization of psychedelic drugs.

In that period, 74 relevant pieces of legislation in 25 states were introduced and 10 (14%) became law in seven states: Colorado, Connecticut, Hawaii, New Jersey, Oregon, Texas, and Washington. The recent passage of the legalization measure in Colorado brings the total count to 11 laws, two of which (Oregon and Colorado) were citizen-initiated referendums.

As of August 1, 46% of the bills were dead and 52% remained active. The number of new psychedelic reform bills introduced each calendar year increased from 5 in 2019 to 36 by September 28 of this year.

Only about one third of the bills called for training or licensure requirements to provide psychedelic-assisted therapy and a little less than one quarter mandated the drugs be administered in a medically controlled setting. Just 12% would require physician involvement in prescribing of psychedelics.

About 90% of the bills specifically referred to psilocybin; 36% also included MDMA. More than half of the bills proposed reducing or removing existing penalties for possessing or distributing psychedelic drugs and just under half called for policy research to explore paths to decriminalization.

“Something that struck me initially was the real breadth of states and sponsors and range of legislative proposals and that this is not cookie-cutter legislation being proposed around the country,” study investigator James Daily, JD, with the Center for Empirical Research in the Law at the Washington University in St. Louis School of Law, told Medscape Medical News. “This seems to be coming from a lot of different interest groups at once.”

The study was funded by the Taylor Family Institute Fund for Innovative Psychiatric Research, the National Institute of Mental Health, the National Center for Advancing Translational Sciences, the National Institute on Drug Abuse, and the Washington University Center for Empirical Research in the Law. Siegel serves on the scientific advisory board of Silo Wellness. Daily reports no relevant financial relationships. Full disclosures for the other authors are included in the original paper.

JAMA Psych. Published online December 7, 2022. Full text

Kelli Whitlock Burton is a reporter for Medscape Medical News covering psychiatry and neurology.

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