The International journal on drug policyJun 13, 2026

Balancing safety and availability in Oregon's psilocybin programs

Psychedelic Science Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 16, 2026

Abstract

In 2025, reported adverse reactions to psilocybin in Oregon were relatively uncommon under the state's Psilocybin Services Act.

Oregon's psilocybin program allows adults over 21 to access the substance without a medical referral or clinical supervision.
Most clients accessing psilocybin services are high-income individuals from outside Oregon.
The program has expanded use beyond medical applications, with clients seeking psilocybin for general health and wellness.
Some clients report using psilocybin services for specific medical reasons, such as depression and anxiety.
Concerns exist regarding the safety of clients with clinical symptoms due to broad eligibility criteria and supervision requirements.

Simplified

As jurisdictions across the U.S. consider enacting policies that facilitate access to psychedelics, they must determine how the desire to expand access to these substances should be weighed against the need to adequately protect safety. Oregon's psilocybin services program offers an important early case study of this balance in practice. Under the Psilocybin Services Act, adults over 21 are permitted to access psilocybin in Oregon at licensed service centers under facilitator supervision, with no referral from a medical practitioner, or clinical supervision, needed. Drawing on the first full year of data published by the Oregon Health Authority, this commentary examines how safety and access are being balanced through Oregon's policy. Reported adverse reactions in 2025 were relatively uncommon: however, Oregon's reporting framework sets a high threshold for reportable events. Access also remains limited, with most clients being of high-income and from outside Oregon. At the same time, the program has expanded supervised psilocybin use beyond strictly medical uses, with a proportion of clients reporting using psilocybin services for general health and wellness. Others report using psilocybin services for more medical-type motivations, such as for depression and anxiety. Overall, we argue that Oregon's broad eligibility criteria and supervision requirements may raise several safety concerns, particularly when clients with clinical symptoms seek services.

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Competing interests

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: David B. Yaden reports a relationship with Soneira that includes: consulting or advisory. David B. Yaden reports a relationship with Integrative Psychiatry Institute that includes: speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Balancing safety and availability in Oregon's psilocybin programs

Abstract

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Funding

Competing interests

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