Massachusetts voters ditch psychedelics ballot measure

Massachusetts voters on Tuesday rejected a ballot measure that would have legalized a selection of naturally-derived psychedelic substances to treat mental health disorders.

The measure failed Tuesday with 56.9% opposed and 43.1% in favor, with more than 90% of votes counted, according to latest state election data.

Question 4 would have created a regulated therapeutic framework overseen by a five-member commission and 20-member advisory board. Treatment centers would have faced state sales tax plus a 15% excise tax, with municipalities allowed to add up to 2% more. While local governments couldn’t ban centers outright, they could regulate operating hours.

“For nearly two years, our campaign has been dedicated to finding solutions and new options for those struggling with depression, PTSD, anxiety, and more,” Massachusetts for Mental Health Options said in a statement following the defeat.

The group said that despite the loss, they had “made hugely important strides” in educating millions of voters about psychedelic therapy access, adding they would continue working with lawmakers “for hope, and for healing.”

Thank you, Massachusetts. We will continue to advocate for access, for hope, and for healing. #mapoli pic.twitter.com/70HqWlP1Gc

— Yes on Question 4 | Hope & Healing (@Yes4MA) November 6, 2024

Kevin Sabet, president of Smart Approaches to Marijuana and the Foundation for Drug Policy Solutions, called the defeat a “tremendous victory for public health and safety in Massachusetts that will hopefully have national implications.”

“Despite being outspent by an order of magnitude, our coalition worked hard to educate voters on the harms of psychedelics and the dangers of an unregulated drug marketplace and unfettered home grow program,” Sabet said in a statement. He argued the measure relied on “flawed, biased, and incomplete research.”

BIG—WE DEFEATED PSYCHEDELIC LEGALIZATION IN MASSACHUSETTS!

Three for three so far! https://t.co/tGPDS0Zf32 pic.twitter.com/5UIOe0BqPp

— Kevin Sabet (@KevinSabet) November 6, 2024

The proposal happened to draw criticism from unexpected quarters leading up to the vote. Bay Staters for Natural Medicine, a pro-psychedelics group, opposed the measure’s regulatory structure as too costly.

The measure also would have allowed home cultivation in a 12-foot-by-12-foot space, which another oppo group criticized as “astronomical,” noting it was equivalent to an average Massachusetts bedroom.

Still, a key focus during the campaign was accessibility. In Oregon, which launched its program in May 2024, high treatment costs have remained a barrier despite legalization. The Massachusetts proposal included provisions directing regulators to examine affordable access options and potential fee waivers for lower-income participants, campaign staff said.

“One in 20 adults experience severe mental illness,” Emily Onaschuk, a U.S. Navy veteran and grassroots outreach director for the campaign, said during a September press briefing. “The circles I’ve flown in the military, outside of the military, everyone is either dealing with something or knows someone close to them that is.”

Implementation would have been gradual, with treatment centers not opening until 2026 and full regulations for all substances not complete until 2028. Legal possession limits would have included one gram each of DMT, psilocybin and psilocin, 18 grams of non-peyote mescaline, and 30 grams of ibogaine.

Jesse Gould, an Army Ranger veteran and founder of Heroic Hearts Project who worked with Oregon’s program, had noted during an earlier campaign call that treatment costs there decreased by about 15% in the first year of operation as providers gained efficient footing.

Gov. Maura Healey has also previously showed openness to exploring medical applications, signing legislation in January to create a working group studying therapeutic uses, particularly for veterans.

The state legislature is separately considering a more limited bill focused specifically on psilocybin therapy, Marijuana Moment reported in February.

While interest in nature-derived psychedelics will continue to grow, major medical organizations including the American Psychiatric Association still have not endorsed psychedelics’ use outside of clinical trials, citing inadequate scientific evidence.

“Although we are disappointed in the decision… we remain confident in a legal pathway to implement life-changing treatments in the state and across the country,” said Cody Shandraw, president of Healing Realty Trust, a healthcare real estate investment company that focuses on psychedelic therapies.

“As delays were always expected, this decision only reinforces our belief that medically-regulated psychedelics will always need to be facilitated in an exclusively licensed therapeutic  setting, and the current lack of required clinical infrastructure required for this must be addressed.”