What to know about Question 4 on the Mass. ballot

Following years of rising interest, promising research, and growing support on Beacon Hill, psychedelics are back in the spotlight as Massachusetts voters consider legalizing and regulating “magic mushrooms” and other substances for adults 21 and up.

The proposed law — Question 4 on the Nov. 5 ballot — offers limited legalization and regulation, allowing adults to grow, possess, and use certain natural psychedelics under certain circumstances. There are a number of important caveats written into the ballot question, and the initiative has met pushback from some Massachusetts psychedelic advocates who say the proposed regulatory framework isn’t the way to go.

Massachusetts would be the third state, behind Oregon and Colorado, to implement limited psychedelic legalization. Already, several communities statewide have opted to decriminalize the drugs, and proponents of the ballot question point to research indicating psychedelics’ benefits for those struggling with mental health. 

“I think we can feel and see that we’re in a mental health crisis,” said Emily Oneschuk, grassroots campaign director for Massachusetts for Mental Health Options, the “yes” campaign.

“Everyone knows someone on SSRIs [selective serotonin reuptake inhibitors, a class of common antidepressants] and someone looking to improve their life and someone who has exhausted the options available,” she continued. “And this is an option; it can be an option, and it can be a really effective option.”

What would Question 4 do?

The proposed law offers something of a two-pronged approach. 

If the question passes, adults would be able to purchase five psychedelic substances — psilocybin, psilocyn, dimethyltryptamine, mescaline, and ibogaine — at approved locations for use under the supervision of licensed facilitators, per a summary from the state Attorney General’s Office.

The proposal would create a five-member Natural Psychedelic Substances Commission to administer the law around use and distribution, plus a 20-member Natural Psychedelic Substances Advisory Board to study and offer recommendations on regulation and taxation. Psychedelic sales proceeds would be subject to the state sales tax and an additional 15% excise tax, and cities or towns could charge a separate local tax of up to 2%. 

While that framework may sound similar to Massachusetts’s adult-use marijuana model, there are some notable differences. For one, there would be no psychedelic dispensaries, as the proposed law otherwise prohibits retail sales. And unlike adult-use marijuana, individual cities and towns would not be able to ban psychedelic facilities, though they could “reasonably restrict the time, place, and manner of the operation,” the AG’s summary notes. 

The ballot question would also decriminalize the possession and growing of small amounts for personal use, allowing adults over the age of 21 to grow psychedelic substances in a 12-foot-by-12-foot area at home and give away limited quantities to other adults. 

The case for legalizing psychedelics

For Oneschuk, psychedelics were a crucial, albeit unconventional, tool that helped her reach an emotional breakthrough during a prolonged mental health struggle. The Wakefield native said she was in a “never-ending existential crisis,” diagnosed with depression, anxiety, and PTSD after her brother was shot and killed just as Oneschuk was going through rigorous training for the U.S. Navy. 

She traveled the world after leaving the Navy several years later, searching for something to make her feel better — hiking trips, yoga, therapy. 

“I remember being at that point, just hating waking up every day, just angry at being alive,” Oneschuk recalled. 

She ended up traveling to Jamaica and had what she described as a “very beautiful and very profound experience” on a psychedelic healing retreat. Turning her mental health around “took a village,” Oneschuk acknowledged, but she believes psychedelics gave her the opportunity to make progress that may have otherwise taken years in therapy. 

“It’s not for everyone,” she said. “Not everyone is excited or curious to go into these places, or necessarily should, or feels it necessary.” 

However, she believes legalization will particularly help people struggling with mental health conditions, including veterans and patients with terminal illnesses. She pointed to Oregon, where some users turned to psychedelics after more conventional mental health treatments failed.

A report from Tufts University’s Center for State Policy Analysis acknowledged promising research suggesting psilocybin and possibly other psychedelics can offer relief for mental health conditions. As the report noted, however, some psychedelics have also been associated with health risks — ibogaine and cardiac arrhythmias, for example. 

Yet the Tufts researchers pointed to decades and sometimes even centuries of psychedelic use around the world. They further noted the lack of severe impacts in Colorado, where the drugs have been legal for a year. Moreover, the proposed law would require participants to undergo a safety screening before consuming psychedelics.

As for the ballot question’s personal use provisions, “The decriminalization portion is important for folks that may not be able to get to a healing center,” Oneschuk explained. “So that they can do this in the comfort of their own homes without fear of penalty, just because we recognize that for some people, getting out to those — especially toward the end of life — would be impractical.”

The arguments against Question 4

Still, the home-grow element has some opponents up in arms. 

“We are not arguing against the medicinal benefits that some of the products that are listed in this ballot question could have,” said Chris Keohan, a spokesperson for the Coalition for Safe Communities, the “no” campaign. “Where we drew the line is the safety issue here, and to allow 144 square feet of grow in someone’s house is an astronomical amount of mushrooms to be growing in someone’s house.”

He added: “That’s the equivalent, in Massachusetts, of an average bedroom.”

Cost concerns

While Keohan noted the proposed law bars people from selling home-grown psychedelics, he expressed concern about a black market forming due to the expense of licensed therapeutic centers.

Pointing to the precedent set in Oregon, the Tufts report found that treatment at psychedelic therapy centers would likely be expensive due to the costs of training, licensing, and running hours-long sessions. Moreover, the regulations for growing psychedelics at home and sharing them with others would take effect quickly, compared to a lengthy rulemaking process for licensed centers, the researchers noted. 

“That will tend to push people — and particularly lower-income folks — toward personal and home use with fewer protections,” the Tufts report found. “And if the market for personal use and sharing does grow beyond expectation, it will be hard to rein in.” 

Keohan noted supervised psychedelic sessions in Oregon tend to cost anywhere from hundreds to thousands of dollars.

“We’re not arguing against the medicinal value of this, but this isn’t written for medicine,” he said. “This is written for profit, and to give false hope to the people that so desperately need the help that they’re talking about is, frankly, offensive to me.”

Cost was also a top concern for Bay Staters for Natural Medicine, a grassroots psychedelics advocacy group that opposes the ballot question but is not affiliated with the Coalition for Safe Communities.

“It’s not legal if no one can afford it,” argued James Davis, the organization’s co-founder. 

“‘Psychedelic therapy’ as a buzzword reminds me a lot of the dot-com bubble of the ’90s,” he said. “Silicon Valley bros thought that this was the next big thing they could make money on, and I just don’t think that’s going to be the case.”

However, he described some of the benefits he’s seen among people who use psychedelics to ease conditions ranging from depression to PTSD, Lyme disease, Parkinson’s, and opioid or alcohol withdrawal. 

“I don’t think that psychedelics are going to be a multi-billion-dollar industry, but I do think they’ll have billions of dollars in social benefit for our society if we introduce them in a way that’s with education, that’s integrated with conventional mental health care,” Davis said.

He explained that the average person who uses psychedelics may only do so a few times in their life, with a standard dose of psilocybin easily fitting in the palm of a hand. In other words, a 12-foot-by-12-foot growing area allowed under the proposed law could “grow enough mushrooms for everyone in New England to enjoy for years,” according to Davis. 

“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,” he argued. “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.’” 

Addressing concerns about expense, Oneschuk pointed out that facilitated sessions are an hours-long process that come at a cost, just like other mental health treatments. 

“This is going to cost money to take part in,” she acknowledged. “Prices have come down considerably in Oregon, and something that I like to point to is the group model. Being in a group — for me personally and for many others — is a large part of the healing process which one, lowers costs, and two, I think can amplify the experience.” 

The right model? 

But the Coalition for Safe Communities’ unease goes beyond cost. Although the proposed law stipulates that any home-grown psychedelics must be kept out of reach of people under the age of 21, Keohan expressed concern about accidental consumption among children and pets. 

Bay Staters, meanwhile, has taken aim at the proposed regulatory framework, with Davis specifically raising concerns about the potential for corruption among the Natural Psychedelic Substances Commission. He noted the former head of Oregon’s Psilocybin Advisory Board resigned in 2022 amid concerns about his personal relationship with the CEO of a psychedelic retreat company that had interests in the state. 

Pointing to the embattled Cannabis Control Commission here in Massachusetts, he added: “I think that creating another unelected body is just a recipe for corruption.” 

Davis suggested Massachusetts should instead implement a “light touch regulatory model” with licensed facilitators who have completed a background check and some amount of training. He pointed to several bills from the state Legislature’s most recent session as more favorable alternatives to Question 4. 

“It was always going to take a few years to pass a quality bill through Beacon Hill; it’s that way on every issue,” he said. “So I think that taking our time and getting the policy right so the scaffolding of the house we build is more sustainable, it’s better [in the] long run.” 

What happens if Question 4 passes?

While the law would take effect this coming December, there would be a staggered rollout. Per the proposal, the regulations allowing centers to offer at least one natural psychedelic would be in place by April 2026, with rules for the remaining drugs following by April 2028. 

“So it’s not like people vote yes on this and then they pop up, like, two months later,” Oneschuk said. “It builds an advisory committee and a board to do this really thoughtfully.”

The drugs would remain illegal at the federal level, and the Tufts report highlighted the possibility that Massachusetts could put itself at risk of federal backlash by passing Question 4. As Election Day nears, Keohan urged voters to read up on the proposed law and do their due diligence before heading to the polls.

“It really does come down to the safety and, frankly, affordability of this,” he said. “What is being promised to the voters is not what was written into this ballot question. And we urge them to take a deep dive and read it to understand what exactly this does.”

For her part, Oneschuk clarified that psychedelics — while potentially beneficial — are not some sort of panacea.

“I’m not promoting this as a magic cure-all. It is a tool, and then it still takes a lot of work,” she said. “It helped me tremendously, and I am still working on being a better person every day.”