Massachusetts voters will soon consider Question 4, also known as The Natural Psychedelic Substances Act, a ballot initiative that would legalize the possession and personal cultivation of certain naturally occurring psychedelics for people over the age of 21. This includes psilocybin, psilocyn, DMT, mescaline (excluding peyote), and ibogaine. Polls show a near even split among voters, with around 13% of voters undecided. 

The bill would create a new 5-person Natural Psychedelic Substances Commission as well as an advisory board to work towards developing regulations for the licensing of therapeutic centers where these substances could be administered by licensed professionals. While the legislation would decriminalize possession and use at the state level, these substances would still be federally classified as Schedule I with no currently accepted medical use. 

If Question 4 passes, Massachusetts would join Oregon and Colorado in regulating psychedelic compounds. Like current cannabis regulations, the psychedelic substances decriminalized at the state level by this bill would remain illegal under federal law.

Personal Use

The Massachusetts bill would allow individuals over the age of 21 to grow, possess, and use naturally occurring psychedelic substances. Specifically, adults would be allowed to possess:

• 1 gram of DMT
• 18 grams of mescaline
• 30 grams of ibogaine
• 1 gram of psilocybin
• 1 gram of psilocyn

These weights exclude the weight of any material other than the active ingredient. Cultivation would be permitted in a space no greater than 12’ x 12’, inaccessible to anyone under 21. Under the proposed law, individuals would be permitted to give away up to the personal use amount to another person above the age of 21. 

Public Sentiment and Debate

Question 4 is supported by Massachusetts for Mental Health Options, a group that has been funded through contributions from Dr. Bronners, MAPS, New Approach PAC and others. These same groups were behind successful psychedelic legislation in Colorado and Oregon, as well as attempts to pass a similar law in California. 

The proposed bill has been endorsed by 45 state elected officials including Senator Elizabeth Warren, five Massachusetts city councils, and more than 240 healthcare professionals, including Boston University professor and trauma expert Dr. Bessel van der Kolk,,author of The Body Keeps The Score. Law Enforcement Action Partnership, veterans groups including Disabled American Veterans of Massachusetts and Heroic Hearts Project, and advocacy groups including Massachusetts Sierra Club and Students for Sensible Drug Policy also support the bill.

Opposition to Question 4 has been led by Coalition for Safe Communities, a group whose largest contributor is Smart Approaches to Marijuana, which has advocated for a largely probationary approach to drug policy related to cannabis and psychedelics. Coalition for Safe Communities claims that Question 4 creates a loophole for an unregulated black-market, will exacerbate DUIs, and presents increased danger of accidental intoxication to children and pets. In their election endorsements, The Boston Globe and Berkshire Eagle advised their readers to vote no on the bill. 

Implementation Timeline

If passed, ‘The Natural Psychedelic Substances Act would take effect on December 15, 2024, with decriminalization starting immediately. The Natural Psychedelics Commission must develop regulations for at least one substance by April 1, 2026, and for all substances by April 1, 2028. Applications for licensure would open by September 1, 2026.

Administering Psychedelic Services

Question 4 anticipates the creation of licensed psychedelic therapy centers that would be entitled to cultivate and distribute one or more allowed psychedelic substances. These centers would also administer the substance and provide natural psychedelics from a licensed facilitator. 

While offering these services, the bill calls for a standard of care that includes at least three sessions – one each for preparation, administration, and integration. The law also has language which would allow for therapeutic group sessions and permits licensed facilitators to offer these services in alternate locations such as homes or healthcare facilities. It emphasizes equitable and inclusive access to services for those from low-income backgrounds.

Under the proposed law, Massachusetts psychedelic therapy centers must meet strict licensing and operational requirements. These include oversight and secure recordkeeping policies that ensure participant privacy, with facilities protected by operational security alarms. Centers may charge for services and must be accessible statewide. These organizations can share premises with other licensees or healthcare facilities. An individual may not have a financial interest in more than five psychedelic therapy centers. 

Licensed facilitators are required to be 21 years of age and meet specific licensing requirements to be defined by the new state commission. These providers are permitted to administer psychedelic services in various settings, including healthcare facilities, private residences, and other approved locations. While facilitators may be compensated, they aren’t required to supply the substances themselves.

Requirements for facilitators include a defined scope of practice, tiered education and training based on participant needs. Training will cover participant safety, mental and physical health, ethics, and cultural considerations, with waivers available for applicants with relevant experience. Licensing will be structured to avoid undue financial or logistical burdens, especially for low-income individuals, and will not require professional degrees beyond the facilitator license. Facilitators must adhere to supervision and recordkeeping standards, and there will be disciplinary processes for misconduct.

Establishing A Psychedelic Bureaucracy

The bill sets forth guidelines to establish new regulatory bodies that would oversee the cultivation and administration of natural psychedelics. A newly formed Natural Psychedelic Substances Commission would develop rules for administering distinct licenses for psychedelic therapy centers, facilitators, and testing facilities in Massachusetts. These centers would handle the cultivation, processing, and administration of natural psychedelic substances during licensed sessions. While the bill would not allow retail sales, it sets up a 15% excise tax for sales within these centers. 

The bill also anticipates creating a cultivation, processing, or sales-only license. This would allow people to provide and sell allowed psychedelic substances to therapeutic users on the premises of a separately licensed psychedelic therapy center or approved location. Psychedelics sold under these provisions would also be subject to state sales tax and local jurisdictions could impose an additional tax of up to 2%.

The Natural Psychedelic Substances Commission would consist of five members appointed by the state’s governor, attorney general, and treasurer, who could serve up to two, five-year terms. The law sets forth that the governor’s appointee will have a background in psychedelic research and science, the attorney general’s appointee will have a public safety background, and the treasurer’s appointee will have experience in corporate management, finance or securities. 

The remaining two seats in the proposed commision will be appointed by majority vote of those three offices, and will include one commissioner with professional experience in oversight or industry management in a regulated industry. A second commissioner would be appointed who had experience related to Indigenous or traditional uses of natural psychedelic substances. The law provides for commissioners to be full-time, with the chair’s salary aligned to match the state’s secretary of administration and finance and the other commissioners receiving 75% of that amount. The commissioners are also expected to appoint a full-time executive director. 

The proposed measure also calls for the governor, attorney general, and treasurer to create a 20-member Natural Psychedelic Substances Advisory Board that would make recommendations on the regulation and taxation of allowed psychedelic substances. The board is to consist of the commission’s executive director as chair, the state’s health and human services secretary, the revenue commissioner, public health commissioner, and the state police colonel, each with a designee – along with appointees by the governor, attorney general, and treasurer. 

Under this plan, the governor will select five members with expertise in areas such as mental health, psychedelic therapy, and Indigenous practices. The attorney general’s five appointees will cover health care, mycology, and emergency services, while the treasurer’s appointees will include experts in harm reduction, research, and peer support. Members will serve two-year terms without compensation, aside from necessary expenses.

The board will advise the commission on public health guidelines, research, and regulatory recommendations concerning the use of natural psychedelic substances, addressing issues of safety, cultural responsibility, and equitable access. Additionally, it will create subcommittees to focus on areas like public health, law enforcement training, licensing facilitators, and supporting traditional practices. These subcommittees will help formulate recommendations to measure and report on the program’s outcomes, protect Indigenous practices, and explore sustainable practices and reciprocity efforts.