About
Colorado's Natural Medicine Health Act

In a groundbreaking move toward innovative mental health treatments, Colorado has become a leader in legalizing access to psychedelic substances for therapeutic purposes. The Natural Medicine Health Act (NMHA), passed by voters as Proposition 122 in November 2022, decriminalizes certain natural psychedelics and establishes a regulated framework for their use in supervised therapy sessions. This law recognizes the potential of substances like psilocybin—found in "magic mushrooms"—to address conditions such as treatment-resistant depression, PTSD, anxiety, and addiction, where traditional therapies often fall short. As of October 2025, the program is fully operational, with healing centers offering psilocybin-assisted therapy to adults statewide. This article explores the law's key elements, implementation, and implications for those seeking alternative mental health options.

Background and Passage of the Act

Colorado's journey to psychedelic reform began amid growing evidence from clinical trials showing psilocybin's promise in mental health care. Proposition 122, approved by 53.6% of voters, aimed to create a "compassionate and effective approach" to natural medicines by decriminalizing personal use and regulating therapeutic access. The measure was implemented through Senate Bill 23-290, signed into law in May 2023 and effective July 1, 2023. Oversight falls to state agencies like the Department of Regulatory Agencies (DORA) for facilitators and healing centers, and the Department of Revenue (DOR) for the supply chain. A 15-member Natural Medicine Advisory Board, including experts in therapy, public health, and Indigenous practices, provides ongoing guidance. This makes Colorado the second state after Oregon to offer regulated psychedelic therapy, reflecting a shift toward evidence-based alternatives amid a national mental health crisis.

Substances Covered and Personal Use Provisions

The NMHA focuses on "natural medicines," including psilocybin, psilocin (its active metabolite), dimethyltryptamine (DMT), ibogaine, and mescaline (excluding peyote to respect Indigenous traditions). Synthetics are excluded from the program. For adults 21 and older, personal use is decriminalized, allowing possession, consumption, cultivation, and sharing without remuneration in non-commercial contexts like spiritual guidance or harm reduction services. Cultivation is limited to a 12x12-foot enclosed space on private property. Prohibitions remain for minors, public consumption, driving under the influence, or using hazardous methods in manufacturing. This decriminalization reduces legal risks, enabling individuals to explore these substances safely outside formal therapy, though unsupervised use is not recommended due to potential psychological effects.

Regulated Access for Therapeutic Use

The heart of the NMHA is its regulated access program, designed to provide psilocybin-assisted therapy (PAT) in controlled environments. Adults 21+ can access services at licensed healing centers or approved locations like private homes or healthcare facilities. The process includes preparation sessions (discussing goals and expectations), administration (ingesting psilocybin under supervision, lasting 4-12 hours), and integration (post-session support to apply insights). Sessions can be individual or in groups up to 64 people. Facilitators, who must complete over 100 hours of training and hold certifications like Basic Life Support, guide the experience. Health screenings assess risks, and consent forms cover aspects like supportive touch (limited to non-intimate areas). The law protects users' rights, preventing discrimination in areas like insurance, employment, or child custody based solely on participation.

Micro-healing centers offer a more accessible option, allowing existing mental health providers to integrate PAT into their practices with limited sessions and on-site storage. This addresses cost barriers and expands reach for those with ongoing therapists.

Licensing and Supply Chain Regulations

To ensure safety and quality, the NMHA requires licenses for facilitators, healing centers, cultivators, manufacturers, and testing facilities. DORA handles facilitator and center licensing, with pathways for original training, endorsements, legacy healers, or clinical professionals. DOR oversees the supply chain, enforcing standards for security, inventory tracking, waste disposal, packaging, and testing for contaminants. Businesses must meet environmental, social, and governance criteria, and advertising cannot exploit cultural traditions. A Tribal and Indigenous Working Group advises on cultural sensitivity and conservation. Local governments can regulate location and operations but cannot ban the program outright.

Implementation Status in 2025

By 2025, the NMHA is in full swing. License applications began in late 2024, with approvals starting in early 2025. Micro-healing centers and cultivators were among the first to operate, followed by standard centers by summer. Cities like Boulder have aligned local ordinances with state rules. Public education, adverse event reporting, and annual reviews ensure ongoing improvements. While ibogaine, DMT, and mescaline may be added post-2026, the focus remains on psilocybin.

Implications for Mental Health Therapy

This law opens doors for those with conditions like GAD, OCD, PTSD, or depression, where psilocybin has shown rapid, lasting benefits in studies. Advocates see it as a "revolutionary" tool for trauma, anxiety, and addiction, especially for veterans or survivors. However, it's not FDA-approved, and access requires self-payment—sessions cost $1,000-$3,000, similar to Oregon. Insurance coverage may come with more evidence.

Challenges and Federal Considerations

Despite state progress, psilocybin is federally a Schedule I substance, creating conflicts—federal enforcement could apply on federal lands or interstate matters. High costs and training requirements may limit equity, prompting calls for subsidies. Safety is prioritized, but risks like intense experiences underscore the need for supervision.

Looking Ahead

Colorado's NMHA represents a bold step in rethinking mental health care, blending science, compassion, and regulation. As more data emerges, it could inspire national reforms. If considering this therapy, consult licensed providers and stay informed through state resources like DORA or DOR websites. This evolving landscape offers hope, but always prioritize professional guidance.