A plain-English reference for where each state stands on therapeutic access, decriminalization, and active legislation. Federal law sits on top of everything below — read that section first.
Schedule III. Legal with a valid prescription. Spravato (esketamine nasal spray) is FDA-approved for treatment-resistant depression under a REMS program that requires in-office administration. Off-label IV and IM ketamine for depression, PTSD, and other conditions is prescribed widely but is not FDA-approved for those indications.
Schedule I. No FDA approval. Compass Pathways (COMP360) Phase 3 program is reading out through 2025-2026; Usona IPR001 Phase 3 is ongoing. State-level therapeutic programs are live in Oregon (Measure 109, 2023) and Colorado (Prop 122, 2024-2025).
Schedule I. FDA declined Lykos Therapeutics' first NDA in August 2024 and requested an additional Phase 3 trial. No approved clinical use; access is primarily via trials.
Schedule I. MindMed's MM120 (LSD-D-tartrate) received FDA Breakthrough Therapy Designation for generalized anxiety disorder and is in a Phase 3 program.
Schedule I. No FDA approval; significant cardiac safety profile. State appropriations for research exist in Texas (SB 2308, ~$50M, 2025) and were proposed in Kentucky and Arizona.
Schedule I. Beckley Psytech / atai's BPL-003 (synthetic 5-MeO-DMT) is in Phase 2b for treatment-resistant depression.
Schedule I. Federally exempt under 42 U.S.C. § 1996a and 21 CFR 1307.31 for bona fide ceremonial use by Indians practicing traditional Indian religions (Native American Church).
Schedule I (as DMT). Four US religious organizations hold confirmed federal DEA exemptions under RFRA: União do Vegetal (SCOTUS 2006), Santo Daime (9th Cir. 2009), Iowaska Church of Healing (DEA settlement 2024), and the Church of Gaia (first-ever non-litigation DEA approval, May 2025). All other US ayahuasca ceremonies operate without federal legal protection.
Measure 109 psilocybin services (2023). Licensed facilitators administer psilocybin at licensed service centers; no physician referral required; clients must be 21+. As of 2026, over 100 service centers are licensed and operating statewide.
Measure 110 (2020) decriminalized all drug possession; partially rolled back by HB 4002 (2024) which restored misdemeanor personal-use possession.
Natural Medicine Health Act (Prop 122, 2022). Psilocybin healing centers began licensing in 2024–2025; Division of Professions and Occupations supervises facilitators. DMT, mescaline, and ibogaine scheduled for 2026 advisory-board review for inclusion in the therapeutic program.
Personal use, possession, and gifting of psilocybin, psilocin, DMT, ibogaine, and mescaline (non-peyote) is decriminalized for adults 21+. MDMA and LSD are NOT included — those remain Schedule I under state law.
Denver.
Peyote explicitly excluded from the decriminalization statute in deference to NAC concerns. Psilocybin-containing edibles and gummies are not a separately licensed retail product category — the Prop 122 program covers psilocybin in a facilitator-supervised healing-center setting. Personal possession and home use of psilocybin mushrooms by adults 21+ is decriminalized under state law, meaning it is not a criminal offense — but federal Schedule I status still applies.
SB 2308 (2025) appropriated substantial funding for ibogaine research at Texas A&M in partnership with former Kentucky official W. Bryan Hubbard. Texas IMPACT ibogaine trial is one of the larger active US ibogaine research programs.
Texas remains the only US state where wild peyote harvest is permitted under federal distributor licensing. Psilocybin and psilocybin-containing products (including gummies and edibles) are Schedule I in Texas; no decriminalization has passed. Amanita muscaria (which contains muscimol, not psilocybin) occupies a regulatory grey area and is sold in some Texas stores — it is not the same as psilocybin mushrooms and does not produce the same effects.
HB 54 (2024) authorized a pilot program studying psilocybin and MDMA for mental health indications in partnership with designated healthcare systems.
Utah's psilocybin pilot program (HB 54) authorizes clinical research, not consumer access. Psilocybin mushrooms remain Schedule I under Utah law and federal law. No general-public decriminalization has passed.
HB 2759 (2024) appropriated $5M for psilocybin research at Arizona universities; separate ibogaine interest via veterans-focused legislation.
Arizona funded $5M in psilocybin research at state universities through HB 2759 (2024), but this is a research appropriation, not a consumer access program. Psilocybin mushrooms are Schedule I under Arizona Revised Statutes §13-3401 and federal law. No decriminalization has passed; the research-to-access pipeline is expected to evolve as the university research matures.
Florida has no state-level decriminalization and no licensed psilocybin program as of 2026. Several legislative efforts have been introduced — HB 1113 (2024) would have created a state-run pilot, and SB 504 (2025) proposed a therapeutic access model — but none have passed into law. No Florida city has passed a formal entheogen deprioritization resolution. Psilocybin mushrooms are Schedule I under Florida Statutes §893.03 and federal law.
Ohio passed Issue 2 in November 2023 legalizing adult-use cannabis, but that law does not affect psilocybin. Psilocybin mushrooms remain Schedule I under Ohio Revised Code §3719.41 and federal law. No psychedelic decriminalization has passed at the state level. Columbus, Cleveland, and Cincinnati have not passed city-level decriminalization resolutions. HB 249 (2025) proposes a therapeutic pilot but has not advanced.
No state-level decriminalization. SB 58 (2023) passed the legislature but was vetoed by Governor Newsom. SB 1012 (2024) failed. SB 751 (2025) advancing through the senate as of 2026 and could create a regulated therapeutic access framework.
Oakland, Santa Cruz, San Francisco, Berkeley, Arcata, Eureka.
California's six city-level deprioritization resolutions (Oakland, Santa Cruz, San Francisco, Berkeley, Arcata, Eureka) direct local police to make entheogen enforcement the lowest priority — but these are not legal protections. State and federal prosecutors are not bound by city resolutions. Psilocybin mushrooms are Schedule I under California Health & Safety Code §11054(d)(13) and federal law. There is no legal pathway to purchase, possess, or consume them in California as of 2026.
Seattle, Port Townsend, Olympia.
Washington's Psilocybin Services Task Force released its final report in 2024 recommending a licensed facilitator model similar to Oregon's, but the state legislature has not passed a therapeutic access bill as of 2026. Psilocybin mushrooms are Schedule I under state and federal law. The three cities with deprioritization resolutions (Seattle, Port Townsend, Olympia) do not make possession legal.
New York has no decriminalization and no licensed program. Multiple bills have been introduced in successive sessions, reflecting significant legislative interest, but none have passed as of 2026. Psilocybin mushrooms are Schedule I under New York Public Health Law §3306 and federal law.
Question 4 (Massachusetts Natural Psychedelic Substances Initiative) failed at the November 2024 ballot (57-43).
Somerville, Cambridge, Northampton, Easthampton, Salem, Amherst, Provincetown.
Ann Arbor, Detroit, Hazel Park, Ferndale, Ypsilanti.
Maryland's Psychedelic Substances Task Force released its report in January 2024 recommending a regulated psilocybin services program modeled on Oregon's. HB 0160 (2025) would create such a program. No law has passed as of 2026; psilocybin mushrooms remain Schedule I under state and federal law.
Nevada's AB 242 (2023) created a working group that recommended a licensed psilocybin services program for Nevada. SB 242 (2025) would establish a formal advisory board. Las Vegas and Reno have no city-level decriminalization. Psilocybin mushrooms are Schedule I under Nevada and federal law; no decriminalization has passed as of 2026.
Illinois has introduced multiple bills addressing psilocybin, including a CURE Act modeled on similar legislation elsewhere. None have passed as of 2026. Psilocybin mushrooms are Schedule I under the Illinois Controlled Substances Act and federal law. No city in Illinois has passed a deprioritization resolution specifically for psilocybin.
Psilocybin mushrooms are Schedule I in New Jersey under NJSA 24:21-5. No decriminalization has passed at the state level. Multiple pending bills would create a licensed therapeutic-access program similar to Oregon's Measure 109. Until legislation passes, possession or distribution of psilocybin — including edibles and gummies — is a criminal offense under New Jersey law.
Minneapolis.
Burlington.
Initiative 81 (2020) made enforcement of entheogenic-plant-and-fungi laws among the lowest law-enforcement priorities.
The 2024 proposal to direct $42M of opioid-settlement funds toward ibogaine research at the Kentucky Opioid Abatement Advisory Commission was ultimately not funded; advocacy continues.
Georgia has passed no psychedelic reform as of 2026. Psilocybin mushrooms are Schedule I under Georgia Code §16-13-25 and under federal law. No decriminalization, therapeutic program, or research bill has advanced in the legislature.
Initiative 81 (2020) — entheogenic plants and fungi deprioritized for enforcement.
D.C. passed Initiative 81 in November 2020 with 76% of the vote, making enforcement of laws against entheogenic plants and fungi (including psilocybin mushrooms) the lowest police priority. This is not legalization — federal law still applies, and D.C.'s unique jurisdictional status means Congress can override local legislation.
Montana has passed no psychedelic reform as of 2026. Psilocybin mushrooms are illegal under both state and federal law. No decriminalization bills have advanced through the legislature. Foraging for edible wild mushrooms (morels, chanterelles, etc.) is legal and popular in Montana — but those are distinct from psilocybin-containing species, which remain Schedule I.
North Carolina has passed no psychedelic reform as of 2026. Psilocybin mushrooms are Schedule I under state and federal law. No decriminalization bills have passed; limited legislative discussion of psychedelic research has not advanced to a vote.
Idaho has some of the strictest drug laws in the United States regarding psychedelics. Psilocybin and psilocin are Schedule I under Idaho Code § 37-2705. No decriminalization has passed, and no reform legislation has advanced through the legislature. Personal possession, cultivation, and distribution of psilocybin mushrooms carry felony penalties. Federal Schedule I status also applies statewide.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Federal law applies and no state-level reform has passed or is actively progressing as of the last-reviewed date. Ketamine is legal with a prescription; psilocybin, MDMA, DMT, ibogaine, and LSD remain Schedule I under both federal and state law. No regulated therapeutic program, statewide decriminalization, or city deprioritization resolution is in effect.
Ketamine is legal nationwide (Schedule III, FDA-approved). Psilocybin is legal in licensed programs in Oregon (Measure 109, 2023) and Colorado (Prop 122, 2022). Ayahuasca is legal only for members of 4 DEA-exempted religious organizations. MDMA, LSD, DMT, ibogaine, and 5-MeO-DMT remain Schedule I with no approved US use outside clinical trials.
Yes — Oregon and Colorado. Oregon's Measure 109 service centers have been operating since 2023 for adults 21+. Colorado's Prop 122 decriminalized personal possession and licensed healing centers starting in 2025. About 30 US cities have passed deprioritization resolutions, but these are not legal protections.
Colorado is the only state with broad decriminalization of natural psychedelics (psilocybin, DMT, ibogaine, mescaline) under Prop 122. Oregon has licensed psilocybin services. Over 30 cities across 15+ states have passed local deprioritization resolutions, including Oakland, San Francisco, Seattle, Detroit, Ann Arbor, and Somerville — but city resolutions do not change state or federal law.
Australia is the only country where MDMA can be legally prescribed (for PTSD, since July 2023). In the US, MDMA is Schedule I. The FDA rejected Lykos Therapeutics' NDA in August 2024 and requested an additional Phase 3 trial. US access is limited to clinical trials and FDA Expanded Access.
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