BOSTON -- Supporters of psychedelic mushrooms are urging voters to approve a referendum legalizing the hallucinogenic drug for "therapeutic" use, but critics argue the move would jeopardize public health and safety and fuel a gray market.
Question 4 would, if approved, decriminalize psilocybin and other psychedelics and allow adults 21 and older to use the drugs under supervision at licensed centers. It would also allow people to grow their own mushrooms at home and give the drugs to others.
Unlike the legalization of recreation cannabis in 2016, Question 4 if approved wouldn't authorize retail sales of psychedelics. Psychedelics sold at therapeutic facilities would be subject to the state's 6.25% sales tax and a new 15% excise tax.
Adults 21 and older would be allowed to grow, possess and use psychedelics. A home-grow provision in the proposal would allow people to cultivate psychedelic mushrooms in their home in a 144-square foot area, according to the referendum's wording.
The group Massachusetts for Mental Health Options, which has cleared several hurdles to put the question before voters, frames the effort as a way to help treat mental illness, citing studies showing the promise of psilocybin as a therapeutic drug.
Backers of the referendum, which include military veterans and former police officers, argue there is growing body of evidence that psilocybin and other psychedelic substances can help in treating psychological disorders such as post-traumatic stress disorder and anxiety.
"For years, I struggled with PTSD and depression ... Psychedelic medicine was a breakthrough for me," said Emily Oneschuk, a Navy veteran and outreach director for the group, said in recent TV ad urging voters to approve the measure. "It helped me embrace life again."
But opponents, including medical experts, argue that legalizing a drug that can lead to psychosis would jeopardize public health and safety.
Chris Keohan, spokesman for the opposition group Coalition For Safe Communities, said major concern about question for Question 4 is that it wouldn't allow cities and towns to opt out of hosting "therapy" centers. He said opponents are also alarmed about the "bedroom size" grow area that would be allowed for psychedelics under the home-grow provision.
"We're not challenging the medicinal benefits for the people that genuinely need the help," he said. "But this was written to enable for-profit facilities to open up."
Another concern for opponents is the cost of psychedelic therapy, which won't be covered by insurance and will likely be beyond what most people in the state can afford to pay for out-of-pocket healthcare costs, he said. The ballot question doesn't set a cap on how much can be charged for the therapeutic treatment.
"I'd like to know how many people in the state of Massachusetts are going through the painful issues that they talk about can afford $750 to $3,500 per visit," Keohan said. "They are providing false hope to the people that need it the most."
He said another concern is that the referendum includes several different kinds of psychedelic compounds, in addition to psilocybin, which create major health risks for patients. That includes mescaline, derived from the peyote cactus, and ibogaine, a drug that comes from the roots of the African shrub iboga, which is known to cause cardiac arrests and seizures.
"Massachusetts voters aren't stupid and they know when they're being sold a bill of goods, and that's what this is," Keohan said.
The ballot question is backed by the Washington, D.C.-based New Approach political action committee, which has supported similar initiatives in Oregon and Colorado, where psilocybin is legal. The group has raised and spent millions of dollars on advertising to sway voters on the referendum.
The U.S. Food and Drug Administration has authorized "breakthrough therapy" status for the psychedelic drug for the purposes of clinical trials being conducted by private research companies.
But psilocybin is still illegal under federal law, classified as a Schedule 1 drug under the U.S. Controlled Substances Act along with LSD, heroin and other drugs, with no accepted medical uses.
A handful of Massachusetts communities, including Salem, Amherst and Cambridge, have approved plans to decriminalize small amounts of psilocybin and authorize its use for therapy.
A legislative committee that reviewed the proposal concluded that the primary goals of the referendum -- licensure and decriminalization -- would likely "undercut each other by creating two separate systems for the use of psychedelic substances." The lawmakers said that could fuel black market sales of the hallucinogenic drug.
"The petition would both create a system of state-licensed and taxed therapeutic facilities on the one hand and, on the other, decriminalize the cultivation, possession, and distribution of a variety of hallucinogenic and psychoactive substances," lawmakers wrote in a report on the proposal.
A report by Tufts University's Center for State Policy Analysis echoed those concerns.
Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group's newspapers and websites. Email him at cwade@cnhinews.com