Massachusetts voters next month will have the chance to legalize five different psychedelic drugs for use in treating mental health disorders, with Question 4 on the state ballot.

If the initiative is victorious, it’ll make Massachusetts the third state to take such a policy leap, following Oregon and Colorado, which both also had versions of psychedelic legalization ballot measures that passed, Boston.com reported.

The ballot measure is somewhat limited, in that it wouldn’t authorize a brand new industry, but it would allow for personal home cultivation of psychedelics, along with the purchase and use of the drugs at a licensed facility and under the watch of trained health care professionals. The structure is similar to that of Colorado’s, which voters approved in 2022. Oregon legalized psilocybin in 2020, but no other psychedelics.

Up for legalization in Massachusetts are psilocybin, psilocin, dimethyltryptamine (DMT), mescaline and ibogaine, which would all become legal for consumers in December if Question 4 is approved. It also includes a provision for home cultivation of “magic” mushrooms in a 12 foot-by-12 foot space and the sharing of psilocybin among adults, which opponents of the measure argue could spawn a new illicit market.

But the launch of therapeutic centers where patients could partake in treatment sessions wouldn’t get going until 2026 at the earliest, Boston.com reported, with a phased-in rollout written into the law. Regulations for all five psychedelics likely wouldn’t be finished until 2028.

The initiative would create a new governing agency to oversee the psychedelics trade, a five-member Natural Psychedelic Substances Commission and a 20-member Natural Psychedelic Substances Advisory Board that would offer policy recommendations on issues such as taxation.

Psychedelic sales at treatment centers would be subject to the state sales tax as well as a 15% excise tax and up to a 2% local tax that could be added on by municipalities where centers are established. Cities and counties would not be able to ban psychedelic treatment centers, but they could add their own rules and regulations, such as restricting operating hours.

Question 4 is being championed by Massachusetts for Mental Health Options, which argues that psychedelic treatments can be “a really effective option” for patients struggling with post-traumatic stress disorder, anxiety, depression and other mental health issues.

But another pro-psychedelics group, Bay Staters for Natural Medicine, came out against the ballot measure, arguing that its structure would only lead to a thriving underground market for psychedelics due to the high cost of the proposed treatment centers.

“It’s not legal if no one can afford it,” James Davis, the founder of the coalition, told Boston.com.

“While I agree that if people are growing and sharing it, it will put downward pressure on price, if the regulatory structure to operate legally is that expensive, then it’s almost extra predatory against those who want to set up a legal facilitation center,” Davis said. “Because you’re basically saying, ‘We’re going to let an illicit market undercut all of your hard work if you do follow the law.’”

Another opposition group, the Coalition for Safe Communities, has also emerged to fight Question 4 due to its home cultivation provision, which it charges is an “astronomical” size for any private home in which to grow the mushrooms.

“That’s the equivalent, in Massachusetts, of an average bedroom,” coalition spokesman Chris Keohan told Boston.com, emphasizing that his group doesn’t dispute the potential medical benefits of psychedelic treatments.

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