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Voices & Opinion

POV: Join Me in Supporting Ballot Question 4, a Step Toward Safer, Regulated Psychedelic Therapy in Massachusetts

A yes vote “offers Massachusetts the chance to embrace a future where psychedelic therapy is not only legal but also regulated, safe, and accessible”

As a licensed independent clinical social worker and the director of BU’s Faculty & Staff Assistance Office, I have observed a growing demand for mental health treatment over the past few years. An increasing number of employees are seeking care for depression, anxiety, post-traumatic stress disorder, and addiction. While traditional therapies offer relief to many, they often fall short for those dealing with treatment-resistant conditions. This is where psychedelics are emerging as a potential solution. Drawing from practices rooted in Indigenous cultures, where psychoactive plants and fungi have served as healing tools for centuries, psychedelic therapy offers a bridge between ancient traditions and modern science—an approach that could provide Massachusetts with an additional tool to address its mental health challenges.

A BU faculty member recently confided in me that they were considering traveling abroad for a guided psychedelic experience. Inspired by Michael Pollan’s How to Change Your Mind—a book that traces both the history and therapeutic potential of substances like psilocybin and mescaline—they hoped to learn about and experience the benefits of psilocybin and explore its potential for their adult child, who has long struggled with trauma-related mental health issues, despite exhaustive treatments.

This faculty member’s story is not unique. Across Massachusetts and the nation, people are exploring alternative mental health treatments due to the limitations of existing therapies. And while psychedelic-assisted therapy is not currently available in Massachusetts, a measure on this November’s ballot—Question 4—could change that.

If passed, Question 4 would establish a regulated system for psychedelic-assisted therapy within the state, creating pathways for safer and controlled access. It would introduce rigorous training for facilitators, screening and safety protocols, and accountability structures—all of which would provide the kind of security that is absent for individuals currently seeking these treatments in underground or unregulated settings. For many, including this faculty member, this could be a lifeline in the pursuit of healing.

Critics of psychedelic-assisted therapy often point to the risks associated with these substances, including concerns that we lack a complete understanding of factors leading to adverse effects, such as ongoing emotional distress or hallucinogen persisting perceptual disorder (HPPD). These are valid concerns, and caution is warranted. Question 4 would require screening for an individual seeking to receive these substances at a treatment facility to root out incompatibilities. It is also important to recognize that in the real world, people are already seeking out these therapies. Without regulation, they are left to navigate these powerful substances on their own, often in unsafe or uncontrolled environments.

By voting yes on Question 4, Massachusetts can offer a safer alternative. Regulated therapy centers would provide the oversight and education necessary to minimize risks while maximizing therapeutic benefits. And this is not an entirely radical notion. Other countries, such as Canada, Australia, and the Netherlands, have already implemented systems for legal, regulated psychedelic-assisted therapy. In the United States, Oregon has led the way, with Colorado set to follow in 2025.

Opponents of Question 4 also raise concerns about the provision that would legalize the cultivation, possession, and sharing of small amounts of the naturally occurring psychedelics: psilocybin and psilocin found in magic mushrooms, ibogaine from the West African iboga plant, mescaline from cacti, and DMT from a range of tropical plants. They fear this could lead to increased use outside of controlled environments, potentially endangering public safety. However, this argument overlooks the fact that unregulated use of magic mushrooms is already widespread and that the other substances grow in specific ecosystems that limit their natural availability. Decriminalizing isn’t about unleashing a flood of psychedelics—it’s about acknowledging reality. Adopting a harm-reduction approach, which prioritizes education and the creation of safer conditions for those seeking these experiences, would do more to protect the public than continued prohibition ever could.

There’s also a historical precedent here that’s hard to ignore: the war on drugs has been an unmitigated failure. Prohibition has done little to curb use, while disproportionately penalizing Black people, Indigenous people, and people of color. By contrast, decriminalizing psychedelics—an approach already adopted by eight Massachusetts cities and towns—would reduce the risk of arrest for individuals using these substances in underground settings and safeguard the underground guides who, at significant personal risk, facilitate access to these potentially transformative therapies.

Massachusetts is well-positioned to take this step forward. A national leader in mental health treatment, McLean Hospital hosts a web page explaining the benefits of psychedelic-assisted therapy, and Massachusetts General Hospital’s Center for the Neuroscience of Psychedelics is conducting research in this area. Governor Maura Healey’s recent signing of the HERO Act further paves the way for research into psychedelic treatments through the state’s veterans services office.

We are in the midst of a mental health crisis that demands bold action. This November, a yes vote on Question 4 offers Massachusetts the chance to embrace a future where psychedelic therapy is not only legal, but also regulated, safe, and accessible. For many, this could be the hope they’ve been waiting for.

Karen Brouhard is the director of BU’s Faculty & Staff Assistance Office, which offers free and confidential consultation, counseling, and referrals to BU employees and their household family members. She can be reached at karensb@bu.edu.

“POV” is an opinion page that provides timely commentaries from students, faculty, and staff on a variety of issues: on-campus, local, state, national, or international. Anyone interested in submitting a piece, which should be about 700 words long, should contact today@bu.edu. BU Today reserves the right to reject or edit submissions. The views expressed are solely those of the author and are not intended to represent the views of Boston University.