Is Massachusetts the Next Beachhead for Psychedelic Drugs?

Next week, Massachusetts could become the third state in the country to decriminalize the psychedelic mushroom psilocybin. Oregon was first, in November 2020, followed by Colorado in November 2022. To date, 26 local governments have also done this, or acted to deprioritize policing and punishment of those who use the so-called "magic mushrooms."

If it passes, Massachusetts Question 4 would allow persons 21 or older to possess or use a personal amount of five specified psychedelic substances derived from fungi or plants, and to grow plants and fungi that contain them. It would also create a commission and advisory board to regulate the licensing of services that administer them and establish a regimen for taxing sales.

A recent poll by University of Massachusetts Amherst found that 43 percent of voters support the measure. Exactly the same share oppose it. This dead heat is in dramatic contrast to the disproportionate funding the “for” and “against” campaigns have received. Massachusetts for Mental Health Options, the leader of the campaign in support of Question 4, has received more than $7 million in donations. Contributions to the Coalition for Safe Communities, which opposes it, are just over $100,000.

Caroline Cunningham, general consultant for the campaign against Question 4, believes that many donations in support of it are from people with direct investments in psychedelic industries. There are profits to be made from making plant-based psychedelic products (Question 4 doesn't allow retail sales) and providing therapy that uses them, she says.

The top individual donor, at $1.25 million, is All One God Faith Inc., best known as the manufacturer of Dr. Bronner’s soap. The CEO (cosmic engagement officer) of the company, David Bronner, is the grandson of its founder. He’s a member of the board of the Multidisciplinary Association of Psychedelic Studies (MAPS), a nonprofit established in 1986 to foster "evidence-based” approaches to psychedelics.

Opponents of Question 4 don’t have a problem with scientists and physicians exploring the potential benefits of psychedelics, they say. Boston is hub for this kind of research, Cunningham says. What they don’t like are its provisions around personal use.

Lieutenant Sarko Gergerian of the Winthrop, Mass., Police Department is a vocal proponent of Question 4, not as a spokesperson for his department, but as a citizen. A mental health counselor as well as a police officer, he's had training in the therapeutic use of psychedelics and seen their benefits. Personal use is already happening, he says. "What Question 4 allows us to do is carefully and intentionally bring these practices above board into the light, where we can have a bit more of a view and a bit more control over what's going on."

Not a Local Issue

The issues in play around Question 4 are not strictly local. Massachusetts for Mental Health Options is funded by the same PAC that supported psychedelic legalization campaigns in Colorado and Oregon. In a recent post on his company’s website, Bronner recounts progress toward state programs allowing psychedelic substances in therapy. “It’s absolutely crucial that we win big in Massachusetts, which will set up a ballot measure run in California in 2026,” he writes.

The movement toward including psychedelic drugs in behavioral health programs isn’t coming from the fringes. The FDA has recognized the potential for MDMA (a synthetic psychedelic and stimulant also known as ecstasy), LSD and psilocybin to improve outcomes from treatment. Cunningham isn’t wrong about profit potential; the U.S. market for psychedelics could approach $7 billion as soon as 2027.
 
The legislative and regulatory frameworks necessary to a national commercial market for these kinds of drugs and therapies are being developed in a “rapid, patchwork fashion,” according to a survey of state legalization efforts published in JAMA Psychiatry. It predicts that psychedelic drugs will be legalized in the majority of states by 2037, if not sooner.

For some critics of these measures, research and therapy are one thing; “recreational” use is another. Question 4 doesn’t allow people to buy psychedelics at retail outlets, but it does allow them to use them, to grow psychedelic plants and mushrooms, and to share what they grow. Proponents and opponents have different views of what might result from this.

Homegrown

Question 4 allows home growers to have a cultivation area up to 12 feet by 12 feet. “That’s the size of an average bedroom here in Massachusetts,” Cunningham says. Allowing growers to share the harvest from a plot of this size, she says, would create an unregulated and unsafe “gray market” for psychedelics.

A fact sheet from the Coalition for Safe Communities lays out other concerns regarding personal use, including risks to children and pets from homegrown psychedelics and drivers under the influence of hallucinogens. Cunningham points to to a study showing that calls to poison control centers related to psilocybin increased in cities where it was decriminalized.

Gergerian is less concerned about such impacts. It’s legal for residents to make wine at home in Massachusetts, he says, and to serve it to their children at the dinner table. He doesn’t deny that people might make mistakes with psychedelics they consume or grow. “But we’re talking individual situations,” he says. More than 100,000 people die each year after properly taking prescribed medication. Nearly 180,000 die each year from excessive alcohol use. Yet, Gergerian says, "Every street corner has a liquor store.”

Research and Practice

With permission from his department, Gergerian participated in an MDMA-assisted therapy training provided by MAPS. The federal government had approved a research protocol in which 120 “healthy normals” receiving this training would take MDMA themselves to gain an understanding of what patients would undergo. Gergerian describes his experience with the psychedelic as magical and profound.

Research to date has yielded evidence that psychedelics can help with problems including depression, end-of-life distress, PTSD, suicidal tendencies and alcohol use disorder. Opponents of Question 4 agree that these findings should be pursued — within the confines of studies overseen by physicians.

Gergerian thinks citizens should have the opportunity to gain such relief on their own. His undergraduate studies included religion, and he observes that plant-based psychedelics have a long history of ceremonial use in native cultures.

According to the National Institute on Drug Abuse (NIDA), limited research suggests that psychedelics do not typically lead to addition. It would like to see more work to settle this question. NIDA also acknowledges that there are safety issues related to use outside of research settings that warrant further research. In 2023, Australia became the first country to allow MDMA and psilocybin to be prescribed to treat mental health disorders.

At present, the Drug Enforcement Agency considers psilocybin to be a Schedule 1 drug, i.e., one with “no currently accepted medical use and a high potential for abuse.” (Fentanyl is not on this list, despite being the most dangerous in a group of synthetic opioids that have played a major role in lowering life expectancy in the U.S.)

Cannabis is also a Schedule 1 drug. State-level legalization of psychedelics sets up the same conflict between state and federal law that has come with marijuana legalization. Last year, states that legalized personal marijuana consumption collected more than $4 billion in cannabis-related tax revenue.

Massachusetts isn’t considering retail sales of psychedelics yet, but scientific and commercial interest in their therapeutic uses has hit the mainstream. Question 4 arrives as scientists, regulators and investors are attempting to sort out what comes next. On Election Day, the next step forward for Massachusetts will be in the hands of voters.

The Oregon bill that allowed personal use of psychedelics came in the context of a broader effort to decriminalize possession of small amounts of all drugs. Public drug use became enough of a problem that the state stepped back from this experiment, enacting a bill that recriminalized possession, making it a misdemeanor. Gergerian recently shared the stage at a psychedelic medicine conference with a Denver chief. The chief was asked by an audience member if psilocybin legalization was causing problems. He replied that Colorado and Denver do have a lot of problems, but psilocybin is not one of them, says Gergerian.