The Psychedelic Safety Institute received a grant to understand the state of Colorado's 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 expecting significant growth, with 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
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:
Five 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.
Support Data Collection
Support implementation of SB 25-297 to build what could become the world's largest policy-relevant psychedelic dataset.
Support Indigenous Relationships
Establish ethical sourcing practices and cultural reciprocity with indigenous representation
Continue to Improve State Policy
Continue to advance legislative and regulatory improvements through effective organization and advocacy
Develop the Psychedelic Workforce
Reduce barriers for experienced practitioners to enter the regulated system.
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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