Oregon’s landmark effort allowing adults older than 21 to access psilocybin has evolved beyond “strictly medical uses” and may be allowing more people to enroll in the program than is safe, according to a new study.
Researchers at Johns Hopkins University published their findings in mid-June in the International Journal of Drug Policy, drawing upon 2025 data from the Oregon Health Authority.
The study notes most patients in Oregon’s program come from high-income backgrounds and outside of Oregon. They found that few people had an adverse reaction to the psychedelic drug, but that a significant proportion of clients in Oregon reported using psilocybin services for general health and wellness. The other top two reasons for participation in the service last year were change in perspective and “expanded consciousness,” according to state data.
Oregon is the only state in the nation to use a “supported adult use” model for psilocybin access, meaning individuals only have to be supervised by a licensed facilitator at a service center and can access the drug for their own personal reasons. But researchers warned that the program raises “several safety concerns,” particularly when individuals are seeking psilocybin for serious medical issues.
David Yaden, an associate professor of psychedelic research at Johns Hopkins University School of Medicine, said the program’s “risk profile” was better than he expected, pointing to a low number of reported negative responses involving psilocybin. But he said that there is still a possibility that concerns are not being fully reported.
“Some people reported seeking out psychedelic services for general well-being while others reported seeking out services to treat medical or psychiatric conditions,” he wrote in an email. “There is some ambiguity about whether the services were designed to support these kinds of medical treatment related reasons, and this is an area for further discussion and consideration on the policy level.”
The findings come as Oregon is charting a four-year plan from 2025 to 2029 aiming to destigmatize the use of psilocybin “as a culturally responsive option for healing and wellness” following its decriminalization in 2020. State health officials have pointed to research showing the use of psilocybin for healing in Indigenous communities as well as addressing depression, alcohol and tobacco dependency and trauma.
Psilocybin, a drug which often comes in the form of mushrooms, creates a chemical compound similar to the chemical messenger serotonin, helping to regulate functions such as mood, appetite, cognition and perception. Research has shown that it can alter the brain’s ability to both strengthen and weaken neural pathways, but there is less information available about the effects of numerous other compounds that are a part of psilocybin mushrooms.
Erica Heartquist, a spokesperson for the Oregon Health Authority, noted in a statement that Oregon voters passed Oregon’s Psilocybin Services Act in November 2020 and that state law comes with its own “broad eligibility criteria” that is “not expanded by the agency.”
She pointed to a fact sheet on the program, which notes that “psilocybin products consumed must be cultivated or produced by a licensed psilocybin manufacturer, tested by a licensed laboratory, and may only be provided to a client by a licensed psilocybin service center during an administration session.”
The new study isn’t the only recent research conducted on Oregon’s psilocybin program. A federally-funded study announced in February by Oregon Health & Science University aims to examine the safety and effectiveness of access to psilocybin in community settings rather than highly-regulated laboratories.
Todd Korthuis, a leader of that effort and co-director of the university’s Oregon Psilocybin Evaluation Nexus, said the study provides useful insight into Oregon’s program. He said his group would also be releasing their own findings in July detailing how individuals respond to psilocybin up to 72 hours after treatment, rather than on the day of receiving it. That data will allow researchers to evaluate whether more negative reactions to psilocybin occur for individuals who turn to the drug for serious issues such as trauma or depression.
“I am cautiously optimistic that expanding services through state regulated programs will be a good thing, but we won’t know that for sure until we have long term data on people accessing these services,” Korthuis said.
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