Toward an Optimal Framework for Psilocybin Regulation: A Comparison of State Regulatory Approaches Across Key Dimensions.

Over the past decade, psilocybin has shifted from being viewed as a recreational drug to one that has demonstrated therapeutic potential in the treatment of several mental health conditions. Although it remains classified as a Schedule I substance under the Controlled Substances Act, renewed scientific inquiry and the Food and Drug Administration's designation of psilocybin as a breakthrough therapy have intensified public and political interest in regulated access. In response, several states have begun to experiment with distinct regulatory frameworks governing psilocybin administration. Oregon, Colorado, and New Mexico have regulated psilocybin use, but there remains little consensus regarding which regulatory framework provides the most appropriate foundation for future psilocybin policymaking. This article evaluates the emerging regulatory landscape through a comparative analysis of the statutory frameworks adopted in Oregon, Colorado, and New Mexico, examining how each model addresses accessibility and affordability, safety, adherence to evidence-based research standards, the risk of federal interference, and protections for Indigenous community practices. The analysis shows that Oregon prioritizes broad access outside the healthcare system, Colorado blends regulated services with decriminalization, and New Mexico limits psilocybin to a clinician-directed medical model for qualifying patients. This article argues that at this early stage of psilocybin policy development, a regulatory framework centered on New Mexico's clinician-directed model, while incorporating key protections for Indigenous practices reflected in Colorado's statute, offers the strongest foundation for future psilocybin regulation.