What to know about Massachusetts' psychedelics ballot question

Massachusetts voters will decide in November whether they should have access to psychedelic substances as a form of mental health treatment.

Why it matters: Studies out of Johns Hopkins University and other research institutions have found certain psychedelics that are federally illegal can help relieve depression, reduce anxiety in cancer patients and treat alcoholism and cigarette addiction.

State of play: A yes on Question 4 would legalize five psychedelic substances for people ages 21 and up by 2028, starting with one by 2026, says Jennifer Manley, spokesperson for the "Massachusetts for Mental Health Options" campaign.

• The DEA currently classifies these substances — psilocybin, psilocin, dimethyltryptamine, ibogaine and mescaline — as Schedule I drugs , meaning they have "no accepted medical use."
• Proponents said they would be used as medicines to help people treat Post Traumatic Stress Disorder, clinical depression or other mental health conditions.

Yes, but: Retailers couldn't sell them like they do alcohol or cannabis.

• Instead, a licensed "facilitator" would provide the psychedelics as part of a behavioral health or substance use disorder treatment, per the ballot measure petition .
• Residents could also grow them in a 12-foot-by-12-foot space, as long as it's secured from anyone under 21.

In the weeds: The ballot question would regulate the use of natural psychedelics, not synthetic ones.

• Psilocybin and psilocin are found in mushrooms.
• Dimethyltryptamine (DMT) and ibogaine are found in plants. (DMT is the psychoactive ingredient in ayahuasca, a hallucinogenic tea used by indigenous cultures in South America.)
• Mescaline is found in cacti, including peyote, though the ballot question excludes peyote from legalization.

The other side: A campaign led by a Massachusetts General Hospital surgeon opposes the ballot question, primarily because it allows people to grow psychedelics at home.

• "We're not arguing against the therapeutic value," spokesperson Chris Keohan, a partner at Shawmut Strategies Group, told the State House News Service in May.
• "We see real danger in the ability to grow at home, especially the square footage it allows," which he said equates to an average bedroom.

How it works: The ballot measure would create a five-person commission to regulate the industry, as well as a 20-member advisory board.

• The legislature would need to pass a law creating the commission and implementing others provisions.
• The law would impose a 15% excise tax, along with sales tax. A city or town could impose a local tax of up to 2%.
• Local officials could restrict where, when and how licensed wellness centers operate, but they can't ban them or their psychedelic services altogether.
• MassHealth wouldn't be allowed to deny someone's behavioral health treatment if it includes legal psychedelic treatment.
• No insurance provider would have to cover the cost of the psychedelic itself.

Zoom out: Oregon voters in 2020 passed a ballot measure decriminalizing psychedelics.

• The first psychedelic treatment centers opened in 2023.
• Colorado voters approved a measure decriminalizing the same five psychedelics before Massachusetts voters this year.

By the numbers: Here's how much a person could use per substance:

• One gram of DMT
• One gram of psilocybin
• One gram of psilocin
• 18 grams of mescaline
• 30 grams of ibogaine.