The Psychedelic Safety Institute received a grant to understand the state of Colorado's Natural Medicine Health Act (NMHA) ecosystem, and to conduct a strategic analysis with recommendations to support program success.
50+
Needs Identified
Project proposals revealed what the ecosystem needs most to grow and succeed
When CO Passed its NMHA, the Real Work Began
In November 2022, Colorado voters said "Yes" to the Natural Medicine Health Act—opening the door for legal psilocybin-assisted therapy. By mid-2025, healing centers were opening across the state.
But critical questions remained:
What would prevent people from accessing these new legal services?
Many were still using psychedelics underground — why?
Could practitioners afford to go legal with training and licensing costs and requirements?
Who was tracking what was actually happening? What data do we need to know if the program is working?
What does success look like? What should CO aim to achieve?
We Analyzed
Our analysis revealed a program with strong foundations but vulnerabilities that threaten its success.
Where the NMHA is succeeding:
Positive Stakeholder Sentiment
The state has effectively engaged stakeholders through listening sessions and community dialogue, creating strong alignment around shared values of access and safety.
Healing Center Sustainability
Most healing centers are breaking even or profitable and are expecting significant growth. Practitioners reporting positive client experiences and meaningful therapeutic outcomes.
Public Demand for Licensed Services
Users are drawn to licensed services for their trust, legitimacy, and safety guarantees, viewing regulation as a pathway to higher quality care.
Field Commitment to Indigenous Engagement
Practitioners and healing centers are actively seeking education on reciprocity models and already incorporating cultural context into their work with clients.
Stakeholders Report Cautious Optimism
On a scale of 1-10, how effectively do you think Colorado is implementing the NMP and why?
Average:
6.5
out of 10
Four critical threats to program success:
Despite this progress, we identified four systemic barriers that could undermine the program:
The Affordability Crisis
There is a systemic mismatch between what services cost and what most people can afford, which drives users underground.
The Training Barrier
High costs to enter the regulated system are keeping experienced practitioners underground, limiting the workforce.
The Awareness Problem
Despite growing interest, most potential users don't know how to access services.
The Data Risk
Without immediate action, invaluable outcome data from thousands of real-world sessions could be lost — along with a chance to gather evidence about psychedelic outcomes that could inform psychedelic programs around the world.
The Price of Psilocybin Services is >2x What Consumers Say is “Too Expensive”
Affordable options are critical, however:
Cost and Flexibility Keep Practitioners Underground
Q: What do you think would make clients choose licensed over underground psychedelic services? (or vice versa)?
“Some of my clients still want underground services because of cost and accessibility...”
“Underground providers... [who use the] personal use law offer more flexibility in setting and dosage.”
Why Practitioners Choose to Stay Unlicensed:
Seven strategic priorities emerged:
To address these threats and build on early successes, coordinated action is needed across five key areas:
Make Psychedelic Services Affordable
Address the cost gap between service pricing and what most Coloradans can afford
Explore group models and cost-effective paths for treatment
Establish subsidization mechanisms and mercy funds for equitable access
Support Data Collection
Support implementation of SB 25-297 to build one of the largest policy-relevant psychedelic datasets in the world
Establish registries for workforce credentials and patient outcomes
Create standardized metrics for safety, efficacy, and public health impacts
Support Indigenous Relationships
Establish ethical sourcing practices and cultural reciprocity with Indigenous representation
Develop benefit-sharing agreements and formal consultation processes
Integrate traditional knowledge holders into the regulatory ecosystem
Continue to Improve State Policy
Continue to improve legislation and regulation through effective organization and advocacy efforts
Coordinate and align stakeholder to identify and address regulatory gaps
Maintain neutral convening spaces for evidence-based policy refinements
Develop the Psychedelic Workforce
Reduce barriers for experienced practitioners to enter the regulated system
Improve the quality of training programs, develop assessment standards for graduates, and develop credentialing systems
Establish professional registries, accreditation frameworks, and advanced training opportunities
Drive Awareness and Access
Develop public education initiatives and wayfinding systems for navigating services
Develop referral pathways and integrate with healthcare systems
Connect with first response systems to ensure appropriate care coordination
Support Public Health and Safety
Ensure safe supply chains and promote safe use practices
Support user organizations and peer support networks
Develop harm reduction protocols and emergency response systems
This is How Movements Become Sustainable Progress
Colorado's program is being watched by states, countries, and international health organizations as a potential model for psychedelic access. By deeply understanding what's happening in the field and developing a data-backed coordination strategy, PSI supports a sustainable, equitable, and thriving ecosystem in Colorado aligned with the real-world needs of Coloradans.
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