By Kate Ruder for KFF Health News.
Broadcast version by Eric Galatas for Colorado News Connection reporting for the KFF Health News-Public News Service Collaboration

Colorado regulators are issuing licenses for providing psychedelic mushrooms and are planning to authorize the state’s first “healing centers,” where the mushrooms can be ingested under supervision, in late spring or early summer.

The dawn of state-regulated psychedelic mushrooms has arrived in Colorado, nearly two years since Oregon began offering them. The mushrooms are a Schedule I drug and illegal under federal law except for clinical research. But more than a dozen cities nationwide have deprioritized or decriminalized them in the past five years, and many eyes are turned toward Oregon’s and Colorado’s state-regulated programs.

“In Oregon and Colorado, we’re going to learn a lot about administration of psychedelics outside of clinical, religious, and underground settings because they’re the first to try this in the U.S.,” said William R. Smith, an assistant professor of psychiatry at the University of North Carolina School of Medicine.

Psychedelic mushrooms and their psychoactive compound psilocybin have the potential to treat people with depression and anxiety, including those unresponsive to other medications or therapy. The National Institute on Drug Abuse, part of the National Institutes of Health, says the risk of mental health problems caused by ingesting mushrooms in a supervised clinical setting is low, but may be higher outside of a clinical setting. Robert F. Kennedy Jr. said in a social media post last year, before his nomination as U.S. health secretary, that his “mind is open to the idea of psychedelics for treatment.”

Medical experts say more research is needed, particularly in people with a diagnosis or family history of psychotic or bipolar disorder. Adverse effects of psilocybin, including headache and nausea, typically resolve within one to two days. However, extended difficulties from using psychedelics can last weeks, months, or years; anxiety and fear, existential struggle, social disconnection, and feeling detached from oneself and one’s surroundings are most common. After the decriminalization and legalization in Oregon and Colorado, psychedelic mushroom exposures reported to poison control centers ticked up in these states and nationally.

In February, about 40 people organized by the psychedelic advocacy group the Nowak Society gathered in Boulder to talk about the coming changes in Colorado. They included Mandy Grace, who received her state license to administer psychedelic mushrooms, and Amanda Clark, a licensed mental health counselor from Denver, who both praised the therapeutic power of mushrooms.

“You get discouraged in your practice because the current therapies are not enough for people,” Clark said.

Colorado voters approved Proposition 122 in 2022 to legalize natural psychedelics, after Oregon voters in 2020 approved legalizing psilocybin for therapeutic use. Colorado’s program is modeled after, but not the same as, Oregon’s, under which 21,246 psilocybin products have been sold as of March, a total that could include secondary doses, according to the Oregon Health Authority.

As of mid-March, Colorado has received applications for at least 15 healing center licenses, nine cultivation licenses, four manufacturer licenses, and one testing facility license for growing and preparing the mushrooms, under rules developed over two years by the governor-appointed Natural Medicine Advisory Board.

Psychedelic treatments in Oregon are expensive, and are likely to be so in Colorado, too, said Tasia Poinsatte, Colorado director of the nonprofit Healing Advocacy Fund, which supports state-regulated programs for psychedelic therapy. In Oregon, psychedelic mushroom sessions are typically $1,000 to $3,000, are not covered by insurance, and must be paid for up front.

The mushrooms themselves are not expensive, Poinsatte said, but a facilitator’s time and support services are costly, and there are state fees. In Colorado, for doses over 2 milligrams, facilitators will screen participants at least 24 hours in advance, then supervise the session in which the participant consumes and experiences mushrooms, lasting several hours, plus a later meeting to integrate the experience.

Facilitators, who may not have experience with mental health emergencies, need training in screening, informed consent, and postsession monitoring, Smith said. “Because these models are new, we need to gather data from Colorado and Oregon to ensure safety.”

Facilitators generally pay a $420 training fee, which allows them to pursue the necessary consultation hours, and roughly $900 a year for a license, and healing centers pay $3,000 to $6,000 for initial licenses in Colorado. But the up-front cost for facilitators is significant: The required 150 hours in a state-accredited program and 80 hours of hands-on training can cost $10,000 or more, and Clark said she wouldn’t pursue a facilitator license due to the prohibitive time and cost.

To increase affordability for patients in Colorado, Poinsatte said, healing centers plan to offer sliding-scale pay options, and discounts for veterans, Medicaid enrollees, and those with low incomes. Group sessions are another option to lower costs.

Colorado law does not allow retail sales of psilocybin, unlike cannabis, which can be sold both recreationally and medically in the state. But it allows adults 21 and older to grow, use, and share psychedelic mushrooms for personal use.

Despite the retail ban, adjacent businesses have mushroomed. Inside the warehouse and laboratory of Activated Brands in Arvada, brown bags of sterilized grains such as corn, millet, and sorghum and plastic bags of soil substrate are for sale, along with genetic materials and ready-to-grow kits.

Co-founder Sean Winfield sells these supplies for growing psychedelic or functional mushrooms such as lion’s mane to people hoping to grow their own at home. Soon, Activated Brands will host cultivation and education classes for the public, Winfield said.

Winfield and co-founder Shawn Cox recently hosted a psychedelic potluck at which experts studying and cultivating psychedelic mushrooms discussed genetics, extraction, and specialized equipment.

Psychedelic mushrooms have a long history in Indigenous cultures, and provisions for their use in spiritual, cultural, or religious ceremonies are included in Colorado law, along with recognition of the cultural harm that could occur to federally recognized tribes and Indigenous people if natural medicine is overly commercialized or exploited.

Several studies over the past five years have shown the long-term benefits of psilocybin for treatment-resistant major depressive disorder, and the Food and Drug Administration designated it a breakthrough therapy. Late-stage trials, often a precursor to application for FDA approval, are underway.

Smith said psilocybin is a promising tool for treating mental health disorders but has not yet been shown to be better than other advanced treatments. Joshua Woolley, an associate professor of psychiatry and behavioral sciences at the University of California-San Francisco, said he has seen the benefits of psilocybin as an investigator in clinical trials.

“People can change hard-set habits. They can become unstuck. They can see things in new ways,” he said of treating patients with a combination of psilocybin and psychotherapy.

Colorado, unlike Oregon, allows integration of psilocybin into existing mental health and medical practices with a clinical facilitator license, and through micro-healing centers that are more limited in the amounts of mushrooms they can store.

Still, Woolley said, between the federal ban and new state laws for psychedelics, this is uncharted territory. Most drugs used to treat mental health disorders are regulated by the FDA, something that Colorado is “taking into its own hands” by setting up its own program to regulate manufacturing and administration of psilocybin.

The U.S. Attorney’s Office for the District of Colorado declined to comment on its policy toward state-regulated psychedelic programs or personal use provisions, but Poinsatte hopes the same federal hands-off approach to marijuana will be taken for psilocybin in Oregon and Colorado.

Winfield said he looks forward to the upcoming rollout and potential addition of other plant psychedelics, such as mescaline. “We’re talking about clandestine industries coming into the light,” he said.


Kate Ruder wrote this story for KFF Health News.


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Mental health counselors focused on Nebraska's high rate of binge drinking during Alcohol Awareness Month, which just wrapped up.

Alcohol abuse is often associated with other addictions. Nebraska's binge drinking rate is among the highest in the nation and the number of alcohol-related deaths is on the rise. Alcohol was blamed for at least 720 fatalities in 2020, the latest year data were available.

Aileen Brady, CEO of the Community Alliance in Omaha, said alcohol abuse and addiction affects families and friendships but can also lead to safety issues among employees who may be alcohol dependent.

"If their reactions are not as sharp, if they're not sleeping well and if they're distracted with the sense of needing to have that drink, it's going to affect our workplaces, as well," Brady explained.

Brady adds alcohol and other substance abuse disorders affect at least 65% of Nebraskans seeking mental health treatment at Community Alliance. Nationwide, the National Survey on Drug Use and Health said more than 224-million people 12 and older report having consumed alcohol during their lifetime.

Brady added it is common among alcohol addicted people or those who abuse it to assume drinking will improve their mood, which she said can happen temporarily, but long-term, has the opposite effect.

"That might last for a period of hours, and then once they stop the drinking and they are coming down off of that use of alcohol, then the depressant sets in," Brady observed.

Brady added Community Alliance continues to dispel myths about the effects of alcohol and raise awareness about the negative physical and mental health outcomes of drinking too much.


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Budding flowers, warmer temperatures and longer days are welcome signs to many in Maryland after the long, dark months of winter. Some people might believe warmer weather improves mental health after seasonal depression in the winter months, but that's not always the case. Many people experience increased mental-health struggles as spring rolls around.

When people's feeling in the springtime doesn't meet their expectations, said Cynthia Cubbage, director of family and post-adopt service for the Barker Adoption Foundation, it can make mental-health issues worse.

"When people are looking forward to spring because it's a time of renewal, and those expectations don't happen, and then nothing gets better for them because it's deeper than that," she said, "then they get really stressed and depression can really set in. And it's because of the expectations."

Suicide rates rise in the spring and not winter, according to Johns Hopkins Medicine. Researchers find that seasonal allergies play a role. A person with rhinitis, which causes allergy symptoms, is more than 40% more likely to be depressed.

Cubbage said there are many ways people can combat those feelings: Get outdoors as much as possible and get out socially as well. But she reminded folks that sleep is vital.

"Definitely prioritize sleep, even though we're having more daylight," she said. "It makes people want to stay up longer - that they should be doing things - and to remember that's a big transition for your body. They should still prioritize their sleep. If they were still going to sleep at eight or they were putting their kids down at eight, that should continue."

Cubbage added that, if you continue to feel depressed or down even after trying those suggestions, it's best to seek out professional mental-health help.

A bill headed to the Montana governor's desk would qualify post-traumatic stress disorder under workers' compensation for the state's first responders.

PTSD is a mental-health condition that someone may develop after a traumatic event. It can result in a range of symptoms from a negative mood and reactivity to flashbacks and difficulty sleeping. First responders report experiencing PTSD at about five times the rate of the general population, according to Relief Mental Health.

George Richards, who serves as president of both the Montana State Firefighters' Association and the Montana State Council of Professional Firefighters, said suicide is one of the top two leading causes of death among firefighters.

"Firefighters, police officers, paramedics, EMTs, experience - working on a gunshot victim or a fatality wreck or a kid death - major trauma-critical calls that really affect the brain," he said.

Richards said the bill had bipartisan support, although some opponents were concerned with the costs. The bill passed a House vote Friday, just before today's observance of Workers Memorial Day.

Until now, Montana was one of roughly a dozen states without a PTSD-related workers comp policy for first responders. Richards said treatment for PTSD will also help with worker retention.

"We want it recognized so they can get the treatment and return to work as a healthy individual with a clear mind," he said.

Treatment can take different forms, Richards noted, from peer-to-peer support to residential treatment programs.


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