Massachusetts Votes Down Psychedelic Therapy After Hard-Fought Legalization Campaign, What's Next?

Massachusetts voters decisively rejected Question 4, a ballot measure proposing the legalization and regulation of certain psychedelics, including psilocybin, mescaline, DMT and ibogaine, for therapeutic use.

With 90% of votes counted, Question 4 was defeated with a 56.9% "No" vote, marking a significant setback for the U.S. psychedelics reform movement. This decision keeps Massachusetts from joining Oregon and Colorado in establishing a state-regulated system for psychedelic-assisted therapy, instead upholding current restrictions on psychedelics for those seeking alternative mental health treatments.

Hard-Fought Campaign

The campaign for Question 4, led by Massachusetts for Mental Health Options (MMHO), was heavily backed by the national drug policy reform PAC New Approach, several veterans groups like Reason for Hope and the Heroic Hearts Project, and the Multidisciplinary Association for Psychedelic Studies (MAPS).

Opposition to Question 4 came from both prohibitionist organizations and dissenters within the psychedelics community itself. A majority of Massachusetts' Special Joint Committee on Ballot Initiatives recommended against it. Governor Maura Healey, who introduced a veterans-focused bill to study psilocybin’s therapeutic potential also expressed caution about full-scale legalization. Within the psychedelics community, Bay Staters for Natural Medicine, initially a supporter of the initiative, eventually opposed it, aligning with the No on 4 campaign.

Complex Voter Sentiments And Rising Challenges

The divisive nature of Question 4 appears to have resonated with voters, who faced the complexity of decriminalization as well as regulated access. In recent polls, support for the measure seemed narrow. Advocates now acknowledge that the initiative's dual objectives may have added confusion among voters.

The timing of Question 4's defeat also underscores a broader struggle for the psychedelics movement. The U.S. Food and Drug Administration recently denied MDMA-assisted therapy as an approved treatment for PTSD, a reminder of the challenges advocates face in securing acceptance and regulatory approval. 

Had it passed, Question 4 would have created a state commission to regulate licensed therapy centers, set cultivation limits and oversee compliance. Revenue from proposed excise and sales taxes would have funded the oversight structure. Opponents, however, argued that these regulated facilities might fuel an underground market, citing the steep costs of therapy sessions in other states, which range from $800 to $2,500.

What's Next?

In a statement to Boston.com, an MMHO spokesperson noted that the initiative's home cultivation provisions may have dissuaded some voters, yet they remain committed to legislative advocacy for mental health alternatives. "We look forward to working with legislators in the new session to continue advocating for access, for hope, and for healing," he said, adding that the group has “made hugely important strides on this issue of psychedelic therapy, and we will keep fighting to find new pathways for all those who struggle with their mental health"

Ismail L. Ali, MAPS' Director of Policy and Advocacy, told Benzinga that, "Whether Trump wants to admit it or not, the nationwide mental health crisis leading to substance use disorders, overdoses, and suicides is ours to solve," adding that the association expects the new Administration to "seek input and listen to stakeholders in Congress, across the aisle, and among communities of patients, providers, and caregivers." 

As Ali explained, MAPS remains cautiously optimistic about the possibility of continued funding for psychedelic research through Congress and federal agencies like the Veterans Administration and National Institutes of Health. 

In conversation with Green State, Brett Waters, executive director for Reason for Hope, also urges the federal government "to reduce regulatory barriers and increase investment in clinical trials that can support FDA approvals," pointing a way forward on "creating collaborative research partnerships with states that have legalized these therapies to ensure a more comprehensive understanding of their public health impacts."

Cover image made with AI