The Natural Medicine Health Act

Background and Passage

In November 2022, Colorado voters approved Proposition 122 with 53.6% of the vote, establishing the Natural Medicine Health Act (NMHA). The measure was implemented through Senate Bill 23-290, signed into law in May 2023 and effective July 1, 2023. Colorado became the second state after Oregon to create a regulated framework for psychedelic-assisted therapy.

What the Law Covers

The NMHA focuses on naturally occurring "natural medicines" including psilocybin, psilocin (its active metabolite), dimethyltryptamine (DMT), ibogaine, and mescaline (excluding peyote, to respect Indigenous traditions). Synthetic versions are excluded. The current focus is on psilocybin, with other substances potentially being added to the regulated program after 2026.

Personal Use Provisions

For adults 21 and older, personal use of these substances is decriminalized. This includes possession, consumption, cultivation (limited to a 12x12-foot enclosed space on private property), and sharing without payment in contexts like spiritual guidance or harm reduction. Public consumption, driving under the influence, and access by minors remain prohibited.

Regulated Therapeutic Access

The heart of the NMHA is its regulated access program for psilocybin-assisted therapy (PAT). Adults 21 and older can receive services at licensed healing centers or approved locations including private homes and healthcare facilities. Sessions can be individual or in groups of up to 64 people and follow a structured process of preparation, administration (lasting 4-12 hours under supervision), and integration.

Licensing and Oversight

The Department of Regulatory Agencies (DORA) oversees facilitator and healing center licensing. Facilitators must complete over 100 hours of training and hold certifications like Basic Life Support. The Department of Revenue (DOR) regulates the supply chain, including cultivators, manufacturers, and testing facilities. A 15-member Natural Medicine Advisory Board provides ongoing guidance.

Implementation Status

License applications began in late 2024, with approvals starting in early 2025. Micro-healing centers — which allow existing mental health providers to integrate PAT into their practices — were among the first to operate, followed by standard healing centers. As of late 2025, the program is fully operational statewide.

Protections for Participants

The law includes important protections: participants cannot face discrimination in employment, insurance, education, or child custody based solely on their involvement with natural medicine programs. Health screenings and consent forms are required, and facilitators must follow strict ethical guidelines.

Cost and Insurance

Sessions currently cost between $1,000 and $3,000 depending on the scope of treatment. Insurance coverage is not yet available but may develop as more evidence accumulates and the regulatory landscape evolves.

Looking Ahead

Colorado's NMHA represents a significant shift in how we approach mental health care — blending science, compassion, and careful regulation. As data emerges from the state's program, it may inspire similar reforms nationwide. Psilocybin remains a Schedule I substance federally, creating some tension, but state-level progress continues to accelerate.