The November 2024 Massachusetts ballot measure that would have created a supervised psychedelic therapy program — and why it narrowly failed with about 43% yes.
Massachusetts Question 4 would have created a state-regulated supervised-use program for four natural psychedelics for adults 21 and older. The four covered substances were psilocybin, DMT, mescaline, and ibogaine.
A new state body — the Natural Psychedelic Substances Commission — would have licensed "psychedelic therapy centers" and trained facilitators. Adults could attend a center for a preparation session, a supervised dosing session, and an integration session afterward. No medical diagnosis or doctor's referral was required.
Beyond the supervised program, the measure would have decriminalized personal possession, home growing, and sharing (without payment) for adults 21 and older. The home-grow allowance — up to 100 square feet of plant material — went further than Colorado's law and became the sharpest point of attack for opponents.
The commission's rules would have covered preparation, administration, and integration sessions; health and safety warnings before dosing; safety screening by a facilitator; substance testing standards; advertising limits; and age verification. Centers could have offered group sessions, not just individual ones.
Psilocybin and psilocin were listed as the primary launch substances. The commission would have had authority to phase in DMT, ibogaine, and mescaline as research and regulatory frameworks matured — a detail few news reports covered at the time.
The No campaign's core argument was that the measure "goes way too far, way too quickly" — not that supervised therapeutic use was wrong, but that the specific design was flawed. This distinction mattered and shaped how the "no" vote was framed in the media.
Coalition for Safe Communities spokesperson Caroline Alcock Cunningham stated the initiative might have passed with more research behind it and "much more restricted" access. The group's opposition focused on three specific provisions.
Massachusetts for Mental Health Options ran the Yes campaign and raised more than $8 million — a fundraising advantage of roughly 80 to 1 over the No side. Money alone did not move enough voters.
New Approach PAC, the Washington, D.C.-based group that also funded the Oregon and Colorado campaigns, provided a large share of the funding. Out-of-state individual donors — including Blake Mycoskie, founder of TOMS Shoes — wrote major checks. The Harvard Crimson reported the campaign drew national attention precisely because of this funding pattern.
The heavy reliance on out-of-state money gave the No side an effective counter-narrative: that a well-funded outside coalition was trying to override local judgment. This framing stuck in suburban swing communities where the measure lost badly.
Supporters included veterans' groups who pointed to ibogaine's promise for PTSD and traumatic brain injury, several mental health advocacy organizations, and individual clinicians. The Boston Globe covered an October 2024 press conference featuring endorsers including actress Eliza Dushku, a Boston native who spoke about personal experience with trauma and mental health treatment.
Boston, Cambridge, Somerville, and college towns like Amherst, Northampton, and Provincetown all posted majority yes votes. These communities share high concentrations of young adults and residents who had already voted for local psychedelic decriminalization.
Inner suburbs told a different story. Wellesley and Lexington — both affluent communities with older median ages — voted strongly against the measure. This suburban opposition proved decisive: Massachusetts's population is concentrated in the suburban ring around Boston, so even strong urban support could not offset suburban rejection.
Several communities that had already decriminalized psychedelics at the local level — including Medford, Somerville, Salem, and Easthampton — voted yes at the town level. That pre-existing local policy created a floor of support but not a statewide majority.
Colorado Proposition 122 and Oregon Measure 109 both passed; Massachusetts Question 4 failed. The three measures covered similar ground but differed on three design choices that shaped voter reaction.
| Feature | MA Question 4 (2024, Failed) | CO Prop 122 (2022, Passed) | OR Measure 109 (2020, Passed) |
|---|---|---|---|
| Home cultivation allowed | Yes — up to 100 sq ft | Yes — personal use amounts | No |
| Ibogaine in launch scope | Yes — in initial program | Decriminalized; added later via advisory board | No — psilocybin only |
| Personal possession decriminalized | Yes — adults 21+ | Yes — adults 21+ | No — supervised on-site only |
| Medical oversight at centers | Licensed facilitators only | Licensed facilitators only | Licensed facilitators only |
| Year passed / failed | Failed 2024 (~43% yes) | Passed 2022 (~53% yes) | Passed 2020 (~56% yes) |
| Out-of-state funding (Yes side) | Majority out-of-state (~$8M raised) | Significant out-of-state | Significant out-of-state |
The operational detail that stands out: Massachusetts included ibogaine in the initial program scope at a moment when ibogaine's cardiac risks were receiving more coverage than in 2020 or 2022. Arizona (2025) and Texas (SB 2308) chose narrow ibogaine research bills over broad legalization. That narrower framing may be a lesson the Massachusetts legislature takes into its 2025–2026 session. See the Colorado Proposition 122 guide and the Oregon Measure 109 guide for how those programs work today.
Massachusetts voters cannot bring another psychedelic ballot measure until at least 2028 under state law. The legislature can move faster and is already doing so.
By February 2025 — just three months after the ballot loss — a wave of bills had been filed at the Massachusetts State House. More than a dozen proposals range from limited therapeutic pilot programs to full adult-use legalization.
Two bills cleared the Joint Committee on Mental Health, Substance Use and Recovery in March 2026 with "do pass" recommendations:
A third bill, H.4050, proposes full regulated adult use of psilocybin — the longest shot this session, but its Joint Committee on Revenue hearing in September 2025 established a formal legislative record.
Massachusetts researchers have also pushed for an ibogaine-specific opioid treatment bill, separate from the broader psychedelic legislation. With Massachusetts carrying one of the highest opioid overdose rates in New England, the ibogaine-for-addiction angle has bipartisan support that the broader ballot measure could not build.
All four substances in Question 4 — psilocybin, DMT, mescaline, and ibogaine — remain Schedule I under federal law. State action does not change that.
Federal Schedule I status blocks insurance reimbursement, restricts clinical research, and means any Massachusetts program would operate without federal legal cover — the same constraint Oregon and Colorado face. The FDA's breakthrough therapy designations for psilocybin (PTSD, depression) and MDMA (PTSD) are research tools, not approvals, and do not affect state scheduling.
For where Massachusetts stands relative to other states today, see the legal status by state tool and our guide to what psychedelics are legal in the US. For the federal picture specifically, the Controlled Substances Act guide covers how Schedule I works and what would need to change federally.
No. Massachusetts Question 4 failed on November 5, 2024, with approximately 43% yes and 57% no. It was the first major psychedelic therapy ballot measure to fail in the United States.
Question 4 would have created a state-regulated supervised-use program for four natural psychedelics — psilocybin, DMT, mescaline, and ibogaine — for adults 21 and older. A new Natural Psychedelic Substances Commission would have licensed therapy centers and trained facilitators. It also would have allowed adults to grow and possess these substances at home for personal use.
The main reasons Question 4 failed were concerns about home cultivation (the measure allowed growing up to 100 square feet of psychedelic plants at home), the inclusion of ibogaine (which carries cardiac risks), and opposition from the Massachusetts Psychiatric Society and a surgeon-led coalition. Many voters saw the measure as too broad too quickly, even if they supported supervised therapeutic use in principle.
The Coalition for Safe Communities led the No campaign, chaired by Anahita Dua, a surgeon at Massachusetts General Hospital. The Massachusetts Psychiatric Society — with over 1,500 member psychiatrists — issued a formal position paper against the measure. The opposition raised about $100,000 in campaign funding, far less than the Yes side.
The Yes campaign, Massachusetts for Mental Health Options, raised more than $8 million. Most of that came from New Approach PAC — a Washington, D.C. group that also funded the Oregon and Colorado campaigns — and from out-of-state philanthropists including TOMS Shoes founder Blake Mycoskie.
Yes, but not by ballot measure until at least 2028 under Massachusetts law. The legislature can act sooner. By early 2026, lawmakers had introduced more than a dozen bills, and two psychedelic therapy pilot program bills (H.2203 and H.4200) advanced out of committee in March 2026.
Massachusetts law has not changed since Question 4 failed. Our state-by-state tool shows current legal status for psilocybin, ibogaine, DMT, and other substances — updated as bills move through state legislatures.
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