Where to find (legal) psilocybin therapy in the US?

Psilocybin, the psychoactive compound found in "magic mushrooms," is gaining increasing attention for its potential therapeutic benefits in treating conditions like depression, anxiety, and PTSD. While still largely illegal at the federal level, some states are paving the way for legal, supervised psilocybin therapy. It's a landscape of cautious optimism, and understanding where to find legal access is crucial for those considering this novel approach to healing.

States leading the way

Currently, only a handful of states have established legal pathways for psilocybin therapy, marking a significant shift in drug policy. These pioneering states recognize the potential of psilocybin when administered in a regulated, therapeutic environment. This approach prioritizes safety and professional guidance, aiming to maximize therapeutic outcomes while minimizing risks.

• Oregon: In 2020, Oregon became the first state to legalize psilocybin for supervised, non-medical use under Measure 109. This allows adults 21 and older to access psilocybin services at licensed facilities with trained facilitators.

• Colorado: Following Oregon's lead, Colorado voters approved Proposition 122 in 2022, legalizing psilocybin and other natural medicines for supervised use at designated "healing centers."

• New Mexico: As of April 2025, New Mexico has become the third state to establish a legal pathway for medical psilocybin access, notably through legislation rather than a voter initiative. This program focuses on qualifying medical conditions, including treatment-resistant depression, PTSD, substance use disorders, and end-of-life care.

While these states offer legal avenues, it's important to remember that regulations and accessibility can vary within each state, with some counties or cities opting out of statewide programs.

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Navigating clinical trials and compassionate access

Beyond state-level legalization, another significant avenue for accessing psilocybin therapy is through clinical trials. These research studies are crucial for gathering more evidence on the efficacy and safety of psilocybin for various conditions. Many reputable institutions across the US are conducting trials for:

• Major depressive disorder

• Post-Traumatic Stress Disorder (PTSD)

• Anxiety and existential distress in cancer patients

• Substance use disorders

Participation in a clinical trial offers access to cutting-edge treatments under strict medical supervision. Information about ongoing trials can often be found through university research centers or organizations dedicated to psychedelic medicine research.

You might be interested in: Is psilocybin therapy addictive?

For individuals with life-threatening conditions who may not qualify for clinical trials or for whom other treatments have failed, a pathway known as "expanded access" or "compassionate use" may be available through the FDA. 

This allows access to investigational drugs outside of clinical trials in specific, limited circumstances. While this pathway is not widely available for psilocybin, it represents a potential, albeit rare, avenue for those in dire need. The landscape of psilocybin therapy is evolving rapidly, and staying informed about legislative changes and research developments is key.

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