‘A new hope:’ Colorado prepares for launch of psychedelic therapy at end of year

Colorado is on track to becoming the second state to offer regulated psychedelic therapy with psilocybin, or magic mushrooms, in 2025. 

Starting on Dec. 31, Colorado’s Department of Regulatory Agencies and Department of Revenue will begin accepting applications for facilitators and businesses wanting to enter into the emerging natural medicine industry. 

The first healing centers — which is what the state is calling businesses that will offer psilocybin therapy — are expected to be accepting patients by next summer. 

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Colorado has been working toward this launch since voters passed Proposition 122 in 2022. 

“In Colorado, we know that we’re dealing with a mental health crisis, much like we are in the rest of the country, and that’s part of the reason that psychedelic therapy has been supported by voters and by many in the mental health care field,” said Taylor West, the executive director of the Healing Advocacy Fund, a nonprofit leading the charge on the state-regulated programs for psilocybin in Colorado and Oregon, at a media briefing on Thursday, Dec. 5. 

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The use of psilocybin as a treatment for mental health is supported by a growing body of academic and medical research from institutions like Johns Hopkins, the University of California Los Angeles and New York University. The Federal Drug Administration designated psilocybin as a breakthrough therapy for treatment-resistant depression and major depressive disorder. 

“The legalization of psychedelic therapy in Colorado is a game changer for therapists like myself who are constantly searching for more ways to help our clients heal from debilitating conditions like depression, anxiety, addiction and PTSD,” said Mikki Vogt, a licensed professional counselor and addiction counselor in Littleton.

On Thursday, both Vogt and Erica Messinger, a doctoral and psychiatric nurse practitioner candidate at Johns Hopkins University based in southwest Colorado, spoke about how psilocybin will add another tool to tackle the mental health crisis. 

“Psychedelic therapy, to me, presents a new hope for Coloradans who continue to suffer from debilitating conditions, treatable conditions, despite our best efforts to help them find relief,” Messinger said. 

What psychedelic therapy will look like in Colorado 

There are two state departments overseeing the launch of Colorado’s natural medicine program. The Department of Regulatory Agencies will oversee the training and licensure of facilitators as the Department of Revenue administers business licenses for healing centers as well as facilities for cultivation, manufacturing and testing. 

While there is no idea to know exactly how many providers Colorado will have, a Department of Revenue survey in September demonstrated significant interest in license applications for all business types.

Colorado has approved 10 facilitator training programs with more expected soon, according to Tasia Poinsatte, who leads the Colorado office of the Healing Advocacy Fund. 

In the nearly two years since Oregon launched its program, over 8,000 patients have been seen by around 380 licensed and trained facilitators in more than 30 licensed service centers. 

Nearly all of the rules and regulations for the program launch are set and have been approved by the agencies. The rulemaking process involved input from psychology, psychiatry, pharmacology, indigenous wisdom keepers, social workers and other experts, according to Poinsatte. This includes business license fees, requirements for training and a regulatory infrastructure for the treatment. 

“Psilocybin therapy is not just taking mushrooms,” West said. “It is a model that includes multiple steps.”

The law also does not create mechanisms to allow for retail sales of mushrooms.  

In a lot of ways, Colorado’s model will mirror what the state of Oregon has done since starting to offer state-regulated psilocybin therapy in 2022. In some ways, however, it seeks to make improvements based on what providers and practitioners have learned in Oregon.  

Like Oregon, Colorado’s model has four basic steps: screening, preparation, administration and integration. 

Patients will complete a screening process to match with a psilocybin facilitator best suited to their needs. That facilitator then creates a safety plan for the patient and sets expectations for the treatment. During the administration of psilocybin, where the drug is administered and the patient is guided and overseen by a licensed facilitator. Then, the facilitator will continue to work with the patient to integrate what was learned into daily life and additional support. 

Within these four steps, the state has added several “guardrails” meant to ensure patient safety, Poinsatte said. For administration, this includes requirements around how long the facilitator must stay with the patient, how patients will get home after sessions, an individualized safety plan for during and after treatment as well as age restrictions and storage requirements. 

While psilocybin is physiologically a “very safe compound for most people” — meaning you can’t overdose or build a physical dependence — there are still certain conditions, such as schizophrenia, and situations that can increase risk, Poinsatte said. The state’s required safety screening will help address these concerns. 

What’s still to come 

With only a few weeks until the state opens the gates for applications, Colorado is well on its way to offering legal psychedelic therapy. However, a few things remain up in the air. 

While both of the state departments adopted their final rules this summer, the Department of Regulatory Agencies reopened some rules in November to “clean up” changes around confidentiality requirements, training and at-home administration, Poinsatte said. 

Critically, while fees for businesses have been set, the fees for facilitators have not been set by the Department of Regulatory Agencies. This will need to be set by Dec. 31 for the agency to begin accepting applications.

Like Oregon, Colorado’s program will continue to be refined over time. This will include finding ways to ensure affordability and accessibility. West said that the Healing Advocacy Center is working toward insurance and Medicaid coverage but expects a longer process. 

While most of the rules and regulations are being handed down from the state, local municipalities can control where and when these natural medicine businesses operate within their jurisdictions. 

Already the state ruled that natural medicine businesses cannot be within 1,000 feet of child care centers, including residential facilities, and schools. State law allows for psychedelic therapy to be located within any existing health care centers. Some local governments have started taking additional steps as well, including in Colorado Springs and Summit County.  

In September, the town of Breckenridge passed land use regulations to keep psychedelic healing centers and other facilities outside of its downtown. The towns of Silverthorne and Frisco also discussed passing tighter regulations but have not made any further moves toward doing so since discussing the matter in July and August. 

On the flip side, some municipalities — including the city of Boulder and Arapahoe County — are looking to take action to support these natural medicine businesses.  

“While local governments rightly have the ability to determine when and where healing centers can operate in their communities, it is critical to ensure that all Coloradans have access to the healing potential of natural medicines, regardless of their zip code,” said Jessica Campbell, an Arapahoe County commissioner, on Thursday. 

“Regulations forcing Coloradans to travel outside of their communities can create accessibility issues, particularly for veterans or people with disabilities, Coloradans living in rural regions of the state, and low-income Coloradans who already face health care barriers,” Campbell added.