{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:03:12Z","timestamp":1791388992391,"version":"4.3.3"},"posted":{"date-parts":[[2026,8,12]]},"group-title":"Public and Global Health","reference-count":33,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,8,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Oregon (OR) and Colorado (CO) were the first states to enact regulations for provision of psilocybin with support of licensed \u2018facilitators.\u2019 As more states and countries adopt similar policies, informed public policy decisions require that client characteristics and rationale for using psilocybin, psilocybin dosing practices, mental health outcomes, and adverse events are understood. We performed a retrospective observational study of responses for 2363 individuals receiving psilocybin at OR and CO regulated service centers. Clients and facilitators entered data before and after receiving psilocybin, including the Mystical Experience Questionnaire-30 (MEQ-30), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and World Health Organization Well-Being Index-5 (WHO-5). Preexisting mental health issues were common (66%) in participants. Psilocybin doses ranged from 1-95 mg, with a mean total of 28\u00b78 mg. We observed improvements of 49% in PHQ-9 scores, 51% in GAD-7 scores, and 22% in WHO-5 scores at two-weeks after dosing. MEQ-30 scores were dose-dependent. Changes in PHQ-9 and GAD-7 scores were not different for psilocybin doses \u226430 mg and &gt;30 mg, and only weakly correlated with MEQ-30 scores. There were 94 mild adverse events during and after dosing, five more serious events not clearly related to treatment, and evidence of possible risk of increased suicidality. Study limitations include open label administration, self-reporting, loss of participants for follow-up, and a short 2-week post-dosing end-point. We conclude that psilocybin services, delivered within these regulated frameworks, is associated with improvements in mental health in real world populations, however, more robust monitoring is needed to ensure safety.<\/jats:p>","DOI":"10.64898\/2026.08.11.26360133","type":"posted-content","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T22:35:15Z","timestamp":1786574115000},"source":"Crossref","is-referenced-by-count":1,"title":["Real-world use, safety, and mental health efficacy of regulated psilocybin services in Oregon and Colorado"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9844-9049","authenticated-orcid":false,"given":"Scott M.","family":"Thompson","sequence":"first","affiliation":[{"name":"Brain and Behavior Innovation Center, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045"},{"name":"Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin P.","family":"Effinger","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Novick","sequence":"additional","affiliation":[{"name":"Brain and Behavior Innovation Center, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045"},{"name":"Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara C.","family":"Bates","sequence":"additional","affiliation":[{"name":"Althea PBC, 1941 Pearl Street, Suite 200, Boulder, CO 80302"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Scott","family":"Conley","sequence":"additional","affiliation":[{"name":"Althea PBC, 1941 Pearl Street, Suite 200, Boulder, CO 80302"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Tobin-Campbell","sequence":"additional","affiliation":[{"name":"Althea PBC, 1941 Pearl Street, Suite 200, Boulder, CO 80302"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Neill","family":"Epperson","sequence":"additional","affiliation":[{"name":"Brain and Behavior Innovation Center, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045"},{"name":"Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai Rex","family":"Skievaski","sequence":"additional","affiliation":[{"name":"Althea PBC, 1941 Pearl Street, Suite 200, Boulder, CO 80302"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026081411152323000_2026.08.11.26360133v1.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.14530"},{"key":"2026081411152323000_2026.08.11.26360133v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2025.08.001"},{"key":"2026081411152323000_2026.08.11.26360133v1.3","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1001\/jamapsychiatry.2022.2096","article-title":"Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder: a randomized clinical trial","volume":"79","year":"2022","journal-title":"JAMA Psychiatry"},{"key":"2026081411152323000_2026.08.11.26360133v1.4","doi-asserted-by":"publisher","DOI":"10.1177\/02698811211073759"},{"key":"2026081411152323000_2026.08.11.26360133v1.5","first-page":"e2612589","article-title":"Ekman CJ Henje E, Berglund A, Tiger M","volume":"9","year":"2026","journal-title":"Short-term and late-term effects of psilocybin on symptoms in major depression: a randomized clinical trial. 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