A federally funded study published by the American Medical Association shows that Oregon’s Psilocybin Program helps people improve mental health.

Oregon’s psilocybin state-regulated program has had a good safety record, while also delivering tangible mental health improvements. An impending financial crises threatens to destroy the nation’s only legal psilocybin industry.

A study published in JAMA Network Open on Wednesday found that supervised psilocybin treatments at licensed community wellness centres are clinically effective and safe. These findings come as state regulators are considering steep fee increases, which industry insiders say could shut down the entire system.

The Open Psychedelic Assessment Nexus (OPEN), a cohort study, received federal funding through the Substance Abuse and Mental Health Services Administration. (SAMHSA), National Institutes of Health(NIH), and National Institute on Drug Abuse(NIDA). Led by Dr. Todd Korthuis of Oregon Health & Science University, the research provides the first rigorous real-world evaluation of Oregon’s psilocybin framework.

Researchers tracked 346 clients between November 2024 to March 2026 across 24 of the 26 licensed service centers in the state, which represents 92 percent. The study kept 90.2 percent at the three month mark. This gave researchers data that was representative of operational facilities, rather than being a sterile clinical trial.

The study authors reported that “people receiving state-regulated services for psilocybin in Oregon experienced very few safety incidents, high satisfaction with the services, and improvements in mental health and wellbeing as well as life satisfaction within 3 months of a psilocybin encounter.”

Participants reported a sharp decrease in their moderate-to severe psychiatric symptoms at the three-month check-up. The depression rate dropped from 42.2% at baseline to 16.5%. Anxiety rates dropped from 45.1 to 13.2 percent, and symptoms of posttraumatic stress disorder went from 48 to 16.8.

Data showed that socioeconomic barriers were also present. Clientele who access Oregon’s centers are largely white, affluent and well-educated: 86.7 percent of respondents identified themselves as white; 76.6 percent had at least a Bachelor’s degree, including 41.2 percent with either a Master’s or Doctorate, and 29 percent reported a household income exceeding $200,000.

In the survey of 346 participants, 97.5% praised the high quality of the service, while 81.5% thought the session was worth the money spent, although 32.1% said that the costs were too expensive. If the regulators double license fees, operators are likely to pass these costs on to clients and further restrict access to wealthy participants.

The study recorded another important safety benchmark. Zero participants reported unwanted physical or sexual touch from facilitators. This indicates that state-mandated codes of conduct and training have successfully protected client boundaries.

Most participants enter service centers more for personal growth, spiritual development or recreation than for a formal mental diagnosis.

The researchers reported that, “While most participants did not seek mental health services, they reported decreased symptoms of depression, anxiety, posttraumatic stress disorder, and life satisfaction. They also reported improved mental well-being, which met the thresholds for statistical significance.”

The data showed that serious adverse events are rare but also revealed a unique risk profile. Only four participants or 1.2 per cent of the cohort had serious behavioral reactions which required hospital care or emergency department treatment. All four participants shared similar characteristics: They were psychedelic naive and had vulnerabilities such as high baseline PTSD and depression.

In spite of the difficulty in defining harm, three out of four participants said that their session was highly meaningful. Two of them also stated that they had achieved their personal goals.

The study revealed a significant regulatory reporting gap. Only one of these four serious reactions was reported by the facilitators to the state at the end of the session. Facilitators recorded no adverse reactions for two of the severe cases on the day of the session. Oregon requires that only safety incidents within three business days of the session be reported. This means that adverse reactions like persistent anxiety and severe insomnia can go unreported.

The program is under severe financial strain despite these positive clinical outcomes. In order to address funding shortages, Oregon Health Authority announced on June 26 a proposal that would double the licensing fees for service providers, facilitators and manufacturers. To reduce overhead costs, the agency plans to merge Oregon Psilocybin Services into the Oregon Medical Marijuana Program on September 1.

The fee hikes, say industry advocates, will only decimate the marketplace and not solve the agency’s deficit. Sam Chapman said the plan of the state will drive licensees away.

Chapman argued that the opposite was true in an exclusive interview with Psychedelic State (s) of America. He claimed that Oregon’s financial difficulties stemmed from treating psilocybin facilitators like commercial cannabis, rather than a specialized services.

Chapman explained that “the fee-based license model is not sustainable.” The fact that we were the first to market meant that regulators had no custom playbook and relied on cannabis structures. These frameworks are based on the sale of physical retail products which is fundamentally different from psilocybin. “The product is the service, which makes the existing infrastructure ineffective.”

The impact of this flawed regulatory framework goes beyond the policy. It directly affects the client’s access and affordability.

Amy Charlesworth is a licensed psilocybin independent facilitator from Oregon. She spoke in an article for Psychedelic State of America. “You are probably looking at an average price of around $2,000 to $3000 for a single session, which seems unrealistic and uneconomical.” This will likely lead to many more closures. People may turn to underground operations in order to access psilocybin treatments.

In addition to the imminent regulatory fee increases, and the existing socioeconomic barriers that the OHA faces, it is also embroiled in a ongoing civil suit regarding physical access. Facilitators filed a lawsuit against the state in 2024 alleging that the requirement of administering psilocybin only at licensed centers is in violation of the federal Americans with Disabilities Act.

Kathryn Tucker, a plaintiffs’ lawyer, responded to industry claims that the litigation has exacerbated the financial deficits of the OHA. She said that OHA was responsible for these expenses.

“[T]The state is required to comply with the federal law on disability rights, ADA. Tucker stated that it could have avoided the lawsuit, and served their citizens, if they had complied. It fought back and tried to make the cost of defence as high as possible by repeatedly filing motions for dismissal, trying to avoid its obligations under ADA. These efforts were rejected.

Tucker, who is awaiting the oral arguments in the case, said that the plaintiff’s victory will ultimately benefit, not hinder, the pioneering system of the state.

“[I]If our case is successful it will increase the market for psilocybin products, which will benefit manufacturers and facilitators, thus enhancing the financial viability. “Most important, those who are homebound and disabled will have the opportunity to receive care and potentially resolve crippling anxiety and depression.”

Public rulemaking hearings begin in September. Licensed operators and advocates will have a short window of time to fix the funding issues before 2027’s fee increases are fully implemented.

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