{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:18:41Z","timestamp":1792707521883,"version":"4.5.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:sec id=\"ab-ysc220004-1\"><jats:title>Importance<\/jats:title><jats:p>Psychedelic drugs are becoming accessible in the US through a patchwork of state legislative reforms. This shift necessitates consensus on treatment models, education and guidance for health care professionals, and planning for implementation and regulation.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ysc220004-2\"><jats:title>Objective<\/jats:title><jats:p>To assess trends in psychedelics legislative reform and legalization in the US to provide guidance to health care professionals, policy makers, and the public.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ysc220004-3\"><jats:title>Evidence Review<\/jats:title><jats:p>Data were compiled from legislative databases (BillTrack50, LexisNexis, and Ballotpedia) from January 1, 2019, to September 28, 2022. Legislation was identified by searching for terms related to psychedelics (eg, <jats:italic>psilocybin<\/jats:italic>, <jats:italic>MDMA<\/jats:italic>, <jats:italic>peyote<\/jats:italic>, <jats:italic>mescaline<\/jats:italic>, <jats:italic>ibogaine<\/jats:italic>, <jats:italic>LSD<\/jats:italic>, <jats:italic>ayahuasca<\/jats:italic>, and <jats:italic>DMT<\/jats:italic>). Bills were coded by an attorney along 2 axes: which psychedelic drugs would be affected and in what ways (eg, decriminalization, funding for medical research, and right to try). To explore drivers and rates of legislative reform, data were compared with other state indices including 2020 presidential voting margins and marijuana legislative reform.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ysc220004-4\"><jats:title>Findings<\/jats:title><jats:p>Twenty-five states have considered 74 bills (69 legislative initiatives, 5 ballot measures); 10 bills were enacted, and 32 were still active. The number of psychedelic reform bills introduced during each calendar year increased steadily from 5 in 2019 to 6 in 2020, 27 in 2021, and 36 in 2022. Nearly all bills specified psilocybin (67 [90%]), and many also included MDMA (3,4-methylenedioxy-methamphetamine; 27 [36%]). While bills varied in their framework, most (43 [58%]) proposed decriminalization, of which few delineated medical oversight (10 of 43 [23%]) or training and\/or licensure requirements (15 of 43 [35%]). In general, bills contained less regulatory guidance than the enacted Oregon Measure 109. While early legislative efforts occurred in liberal states, the margin between liberal and conservative states has decreased over time (although the difference was not significant), suggesting that psychedelic drug reform is becoming a bipartisan issue. In addition, an analytic model based on marijuana legalization projected that a majority of states will legalize psychedelics by 2034 to 2037.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ysc220004-5\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Legislative reform for psychedelic drugs has been proceeding in a rapid, patchwork fashion in the US. Further consideration should be given to key health care issues such as establishing (1) standards for drugs procured outside the medical establishment, (2) licensure criteria for prescribers and therapists, (3) clinical and billing infrastructure, (4) potential contraindications, and (5) use in special populations like youths, older adults, and pregnant individuals.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2022.4101","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T16:01:39Z","timestamp":1670428899000},"page":"77","source":"Crossref","is-referenced-by-count":181,"title":["Psychedelic Drug Legislative Reform and Legalization in the US"],"prefix":"10.1001","volume":"80","author":[{"given":"Joshua S.","family":"Siegel","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Daily","sequence":"additional","affiliation":[{"name":"Center for Empirical Research in the Law, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetrius A.","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginger E.","family":"Nicol","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"1","key":"ysc220004r2","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1038\/s41386-021-01150-y","article-title":"The evolution of the psychedelic 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Psychiatry"},{"issue":"3","key":"ysc220004r37","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1037\/cap0000285","article-title":"Entheogens and psychedelics in Canada: proposal for a new paradigm.","volume":"63","author":"Rochester","year":"2022","journal-title":"Can Psychol"},{"key":"ysc220004r1"},{"key":"ysc220004r7","volume-title":"Denver Psilocybin Mushroom Policy Review Panel. 2021 Comprehensive Report","author":"Gael Gir\u00f3n","year":"2021"},{"key":"ysc220004r27","article-title":"Qualitative data analysis: an expanded sourcebook.","volume-title":"SAGE","author":"Miles","year":"1994"},{"key":"ysc220004r4","unstructured":"COMPASS. 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Online legal research. Accessed August 2, 2022. https:\/\/www.lexisnexis.com\/en-us\/products\/lexis.page"},{"key":"ysc220004r28","unstructured":"MJBizDaily. Where marijuana is legal in the United States. Published 2022. Accessed August 8, 2022. https:\/\/mjbizdaily.com\/map-of-us-marijuana-legalization-by-state\/"},{"key":"ysc220004r29","unstructured":"National Conference of State Legislatures. State medical cannabis laws. Accessed September 27, 2022. https:\/\/www.ncsl.org\/research\/health\/state-medical-marijuana-laws.aspx"},{"key":"ysc220004r30","unstructured":"Ballotpedia. Colorado Proposition 122, Decriminalization and Regulated Access Program for Certain Psychedelic Plants and Fungi Initiative (2022). Accessed September 26, 2022. https:\/\/ballotpedia.org\/Colorado_Proposition_122_Decriminalization_and_Regulated_Access_Program_for_Certain_Psychedelic_Plants_and_Fungi_Initiative_(2022)"},{"key":"ysc220004r32","unstructured":"US Food & Drug Administration. 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