A patchwork of state law changes has made psychedelic substances more widely available in the US. Consensus on treatment models, training and direction for healthcare professionals, and preparation for implementation and regulation are necessary in this change’s context. This study’s objective is to evaluate psychedelics legalization and reform developments in the US in order to advise the public, policymakers, and medical experts.

Legislative databases (BillTrack50, LexisNexis, and Ballotpedia) were used to collect data from January 1 through September 28, 2022. By looking up terms associated with psychedelics, legislation was found (e.g., psilocybin, MDMA, peyote, mescaline, ibogaine, LSD, ayahuasca, and DMT). To determine which psychedelic substances would be impacted and how, bills were coded along two axes (e.g., decriminalization, funding for medical research, and right to try). Data were contrasted with other state indices, like 2020 presidential voting margins and marijuana legislative reform, to examine the causes and rates of legislative reform.

A minimum of 74 bills (69 legislative initiatives and 5 ballot measures) have been considered by 25 states; 32 are currently in work, and 10 were enacted. From 5 in 2019 to 6 in 2020, 27 in 2021, and 36 in 2022, the number of psychoactive reform bills presented each year continued to rise. Psilocybin was mentioned in nearly every bill (67 [90%]), and several also included MDMA (3,4-methylenedioxy-methamphetamine; 27 [36%]). Although the structures of the proposals differed, the majority (43 [58%]) called for decriminalization, yet, only a small number (10 of the 43 [23%]) or a majority (15 of the 43 [35%]) specified requirements for training and/or licensure. Moreover, compared to Oregon Measure 109, which was ultimately enacted, bills generally provided less regulatory direction. Early legislative initiatives were made in liberal states, but as time has passed, the gap between liberal and conservative states has decreased (although the difference was not considerable), indicating that psychedelic drug reform is turning into a bipartisan issue. A majority of states will legalize psychedelics by 2034 to 2037, according to an analytical model based on the legalization of marijuana.

In the US, psychedelic drug legislative reform has been rapidly shifting. Important healthcare issues include establishing standards for drugs obtained outside the medical establishment, licensure standards for prescribers and therapists, clinical and billing infrastructure, potential contraindications, and use in special populations like young kids, older adults, and pregnant women should be further taken into account.

Source: jamanetwork.com/journals/jamapsychiatry/article-abstract/2799268