Colorado voters this week passed the broadest reform of psychedelic drug policy ever approved in the United States. With 88 percent of ballots counted as of Wednesday night, 51 percent of voters had said yes to Proposition 122, which decriminalizes noncommercial activities related to the use of "natural medicine" by adults 21 or older. That term covers five psychedelics found in plants or fungi, some or all of which will eventually be available at state-licensed "healing centers."
"This is a truly historic moment," said the leaders of the Yes on 122 campaign. "Colorado voters saw the benefit of regulated access to natural medicines, including psilocybin, so people with PTSD, terminal illness, depression, anxiety and other mental health issues can heal. We look forward to working with the regulatory and medical experts and other stakeholders to implement this new law."
The initiative defines "natural medicine" to include psilocybin, psilocyn (another psychoactive component of "magic mushrooms"), dimethyltryptamine (DMT, the active ingredient in ayahuasca), ibogaine (a psychedelic derived from the root bark of the iboga tree), and mescaline (the active ingredient in peyote). The covered activities include "growing, cultivating, or processing plants or fungi capable of producing natural medicine for personal use." The initiative also eliminates civil and criminal penalties for possessing, storing, using, transporting, or obtaining the listed psychedelics or distributing them to adults 21 or older "without remuneration."
All of the psychedelics covered by Proposition 122 are currently classified as Schedule I controlled substances under state law. Possession of four grams or less for personal use is a misdemeanor punishable by up to a year in jail, while possession of larger amounts is a felony, as is manufacture or distribution. Manufacturing or distributing 14 grams or less, for example, is a Level 3 drug felony, punishable by a fine of $2,000 to $500,000 and two to four years in prison.
In addition to eliminating penalties for conduct related to personal use of "natural medicine," Proposition 122 aims to establish a system of supervised administration at state-licensed "healing centers." That plan is similar to what Oregonians approved in 2020, when they passed a ballot initiative that will allow adults 21 or older to use psilocybin in state-licensed "service centers" under the supervision of "facilitators."
Proposition 122 requires the Colorado Department of Regulatory Agencies to start accepting applications for healing center licenses by September 30, 2024. But the decriminalization provisions take effect after the governor recognizes the election results by proclamation or 30 days after the official canvass. Those provisions apply to a wider range of substances than Oregon's law, and they go much further than a groundbreaking initiative that Denver voters approved in 2019, which made adult possession of psilocybin the city's lowest law enforcement priority and prohibited the use of public money to pursue such cases.
The healing centers' services initially will be limited to psilocybin and psilocyn. But after June 1, 2026, regulators are authorized to add DMT, ibogaine, and/or mescaline (but not peyote itself) based on an advisory board's recommendation.
The initiative notes that "natural medicines have been used safely for millennia by cultures for healing." It adds that "an extensive and growing body of research" supports "the efficacy of natural medicines combined with psychotherapy as treatment for depression, anxiety, substance use disorders, end-of-life distress, and other conditions." But like Oregon's initiative, Proposition 122 does not require that clients of psychedelic centers have any particular medical or psychiatric diagnosis.
Natural Medicine Colorado, the main group supporting the measure, argued that it would allow "regulated access to natural psychedelic medicines, giving Coloradans who are struggling with challenging mental health issues the opportunity to heal." It added that the measure would remove "criminal penalties for the personal use of natural medicines" and create "a path for Coloradans to seal criminal records related to natural medicines," because "no person should be criminalized for trying to heal."
Protect Colorado's Kids, the main group opposing Proposition 122, argued that it was a step too far. "Colorado is high enough," it said. "We don't need more drugs sold in our communities, with easier access for our children. The psychedelics industry is backed by Big Pharma and the usual cast of addiction-for-profit characters harming our communities. Psychedelics have a strong connection to mental health harms, further victimizing users in a time of a national mental health crisis. Leading scientific authorities like the American Psychiatric Association think this is not the time to experiment so openly with these drugs."
Other opponents of the measure recognized the potential of psychedelic-assisted psychotherapy but criticized Proposition 122's commercialization of such services. "While this may sound like a good thing to people who want to see increased access to psychedelics," said Matthew Duffy, co-founder of Denver-based Society for Psychedelic Outreach Reform and Education, "this initiative is designed for corporate control, largely restricting access to corporate-owned healing centers."
The Denver Post acknowledged evidence that psychedelic drugs "can help treat debilitating post-traumatic stress disorders, treatment-resistant depression, severe anxiety, and other mental illness." But the paper's editorial board warned that Proposition 122 "goes too far, too fast for Colorado," objecting in particular to the broad decriminalization provisions. "While the intent of legalizing possession and cultivation is for medical treatment," the Post said, "we fear a robust market for recreational use would thrive. Increased legal tolerance will increase demand, which will increase the temptation for profiteering."
According to a Ballotpedia tally, the campaign for Proposition 122 had received $4.6 million in contributions as of late October. Protect Colorado's Kids had raised about $51,000.
An FM3 survey of likely Colorado voters commissioned by the Proposition 122 campaign and conducted in July, before the initiative qualified for the ballot, found that 60 percent of respondents were inclined to support it based on quoted ballot language. When the survey participants were given a "plain language" explanation of the measure, support rose to 70 percent, including 51 percent who said they would "definitely" vote yes, 15 percent who said they probably would, and 4 percent who said they were undecided but leaning toward yes.
By contrast, an Emerson College poll of "very likely voters" conducted in September put support for Proposition 122 at 36 percent, with 41 percent opposed and 23 percent undecided. The survey described the initiative as a measure that would "decriminalize and regulate distribution for psychedelic plants and fungi."
Proposition 122 establishes "the nation's second state-regulated framework for psilocybin therapy," notes Geoffrey Lawrence, director of drug policy at Reason Foundation (which publishes Reason). "Psilocybin has recently shown an extraordinary ability to treat certain mental health conditions like depression, anxiety, PTSD, ADHD, and alcoholism and has been fast-tracked for pharmaceutical use by the FDA. Proposition 122 would allow Colorado to get ahead of the curve by establishing the parameters of regulated psilocybin therapy administered under the supervision of a mental health professional. Oregon is in the final stages of rulemaking for its program, and Colorado will be able to lean on the experience gained there while continuing to innovate and improve regulatory structures."
Update, November 11: Proposition 122's margin of victory has grown since this article was published. With 93 percent of ballots counted as of Friday afternoon, the initiative was favored by 52.4 percent of voters.