Katelyn McGruder

Associate Editor

Loyola University Chicago School of Law, JD 2026

As the mental health crisis continues to challenge the United States, the need for innovative treatments is becoming increasingly evident. Psychedelic therapy, using substances like psilocybin and MDMA, is gaining attention as a promising approach to treating conditions such as post- traumatic stress disorder (PTSD), depression, and anxiety. Oregon and Colorado have pioneered the movement toward legalizing psychedelics for therapeutic use, and their progressive policies have the potential to provide a roadmap for the rest of the country. The question arises: should the entire U.S. follow in their footsteps? Oregon and Colorado’s frameworks could serve as a model for other states seeking to legalize psychedelics in therapeutic settings.

Oregon’s trailblazing approach: psilocybin services program

Oregon made headlines in 2020 by passing Measure 109, which legalized the supervised use of psilocybin for mental health treatment. This initiative created the Psilocybin Services Program, a regulatory framework overseen by the Oregon Health Authority (OHA). While the substance remains illegal for recreational use, Oregon’s law allows trained and licensed professionals to administer psilocybin in controlled environments to support therapeutic outcomes.

Oregon has established stringent training and certification processes for facilitators, ensuring that only qualified professionals guide patients through their psychedelic experiences. By prioritizing safety and oversight, the state mitigates the risks associated with unsupervised use, addressing concerns about potential psychological harm.

The decision to legalize psilocybin was driven by compelling clinical evidence suggesting its efficacy in treating severe depression and PTSD, particularly for patients resistant to traditional therapies. Oregon’s regulatory structure provides a controlled setting where patients can access these potentially life-changing treatments under medical supervision.

Colorado’s legalization: a model of flexibility

In 2022, Colorado followed Oregon’s lead with the passage of Proposition 122, which decriminalized the personal use of psychedelics, including psilocybin, DMT, ibogaine, and mescaline (excluding peyote). This law also laid the groundwork for the state to develop a regulated system for therapeutic use by 2024.

Unlike Oregon’s psilocybin-only framework, Colorado’s law takes a broader approach by allowing the therapeutic use of multiple psychedelics. This flexibility could offer greater opportunities for personalized treatment plans, catering to different mental health needs.

Colorado’s model includes provisions for “healing centers,” where individuals can access psychedelic therapy in safe and supervised environments. These centers emphasize community-based healing and cultural sensitivity, aligning with indigenous traditions that have long utilized psychedelics for spiritual and medicinal purposes.

Should the entire U.S. follow suit?

With nearly one in five U.S. adults experiencing mental illness each year, the limitations of conventional treatments have become increasingly clear. Psychedelic therapy offers a new avenue of treatment for those who have not responded to antidepressants, cognitive-behavioral therapy, or other standard approaches. Early research on psychedelics, particularly psilocybin and MDMA, has shown that these substances can induce profound, lasting improvements in mental health.

The therapeutic potential of psychedelics is not based solely on anecdotal evidence. Clinical trials conducted under FDA guidelines have demonstrated the safety and efficacy of substances like psilocybin and MDMA for treating PTSD, depression, and anxiety. The FDA’s recent decision to reject MDMA for therapeutic use in treating PTSD has generated significant disappointment within the psychedelic industry, though advocates remain undeterred in their pursuit of FDA approval. Lykos Therapeutics, the company leading clinical trials of MDMA-assisted therapy, presented data showing promising results for reducing PTSD symptoms. Nonetheless, the FDA and its advisory panel ultimately determined that current evidence did not sufficiently address long-term efficacy, potential risks, and the effectiveness of the associated psychotherapy protocol. This decision keeps MDMA classified as a Schedule I substance, recognized as having high abuse potential and no accepted medical use. Despite this setback, the psychedelic industry continues to push forward. The Department of Veterans Affairs (VA) recently signaled openness to funding further trials of MDMA-assisted therapy for PTSD, potentially giving the industry a critical boost.

Critics often raise concerns about the safety of psychedelics, citing the potential for misuse or psychological harm. However, the regulatory frameworks established in Oregon and Colorado address these concerns through strict licensing requirements, professional oversight, and structured treatment protocols. These models demonstrate that psychedelics can be integrated into healthcare systems in a way that maximizes benefits while minimizing risks.

Ethical considerations and cultural sensitivity

As the U.S. considers broader legalization, it is crucial to remain mindful of the ethical and cultural implications. Psychedelics have been used for centuries in indigenous cultures for spiritual and medicinal purposes. Any legalization framework must respect these traditions and ensure that psychedelic therapies do not exploit or appropriate indigenous practices.

In Oregon and Colorado, initiatives are underway to include cultural competency in training programs for facilitators, emphasizing respect for indigenous knowledge and practices. This culturally sensitive approach should be adopted nationwide to ensure that legalization efforts do not erase or diminish the deep cultural heritage associated with psychedelics.

Oregon and Colorado have laid the groundwork for what could become a nationwide movement to legalize psychedelics for therapeutic use. Their regulatory models demonstrate that psychedelics can be integrated safely and effectively into mental health treatment under the right conditions. By ensuring professional oversight, adhering to rigorous safety standards, and respecting cultural traditions, the rest of the U.S. could take a page out of Oregon and Colorado’s books and move toward broader legalization. This would not only offer new hope for millions of Americans struggling with mental illness but also pave the way for a more inclusive, equitable healthcare system.