Massachusetts voters on Tuesday rejected Question 4, the ballot measure that proposed decriminalizing the use of psychedelic substances for people older than 21 and allowing people to grow the hallucinogens at home. The AP projected the result in the early morning hours of Wednesday.
The initiative proposed to decriminalize the use of five psychedelic compounds, most notably psilocybin, or so-called magic mushrooms, which can dramatically affect a person's perceptions and thinking. The other chemicals are psilocyn, which is also found in mushrooms, as well as three other substances in plants: dimethyltryptamine, mescaline, and ibogaine.
Coalition for Safe Communities, which had opposed the measure, declared victory prior to the AP call with about 57 percent of the vote on their side. Meanwhile, the Yes on 4 campaign acknowledged that the results were not trending in their favor.
"We're confident that we won and we're happy," said Caroline Alcock Cunningham, spokesperson for Coalition for Safe Communities, who added that the group knew "that we have it" when they saw that Democratic-leaning cities and towns, especially in Western Massachusetts, were voting overwhelmingly against the initiative.
The substances already have been decriminalized in eight Massachusetts communities, including Amherst, Cambridge, Medford, and Salem.
Proponents of the initiative acknowledged late Tuesday that their campaign had likely failed but vowed to continue working with "legislators in the new session" and to "keep fighting to find new pathways for all those who struggle with their mental health."
"We spoke to tens of thousands of Massachusetts voters and heard broad agreement that natural psychedelics should be more accessible to those who cannot find relief through traditional medication and therapy. We understand there were concerns about the home grow provisions, and those concerns likely led to tonight's result," supporters said in a statement.
Decriminalization of the five psychedelics would have meant a person would not be prosecuted for possessing the substances. Just as with alcohol, the legal age for use of psychedelics would be 21. But practically speaking, licensing and regulation for the new system would take much longer; under the initiative, such regulations for at least one of the five psychedelics needed to be in place no later than April 1, 2026.
The ballot initiative would have also allowed people to grow and possess limited amounts of the plants and fungi in their home.
The initiative would have likely garnered more support if there was more research backing the potential uses for psychedelics and if the language of the ballot question was "much more restricted in who would have access," Alcock Cunningham said. She added the lack of medical oversight at centers raised major concern, as well as the issues of home growth.
"We're glad with the outcome," she said.
Emily Oneschuk, the grassroots outreach director of Massachusetts for Mental Health Options, which led the campaign in support of Question 4, was emotional late Tuesday. Oneschuk, a US Navy veteran, has recounted for the past year how a psilocybin retreat to Jamaica, where she tried magic mushrooms, helped her alleviate her depression, anxiety, and post traumatic stress after losing her brother to gun violence and returning from the Navy. She had tried a range of treatments up to that point -- all to no avail.
"You're sharing your trauma journey very publicly in hopes that you're changing a piece of culture, which is tough. It's tiring, and people are definitely disappointed," she said, adding that she is encouraged by the burgeoning curiosity around the topic. "Everyone will recharge their batteries and keep trucking."
Massachusetts would have been the third state, behind Oregon and Colorado, to decriminalize the use of some psychedelics. One stark lesson learned from Oregon, the first to legalize, was that the cost of setting up its system of oversight made the opportunity out of reach for many residents, with one psychedelics session typically costing more than $1,000.
Despite the high-profile ballot initiative, the potential health benefits and risks of such mind-altering substances are hardly settled science, with researchers and mental health specialists debating the issues, even as both sides agree there are many questions that require more research.
Advocates extol psychedelics' ability to ease post traumatic stress symptoms and quell depression in some people for months after just one or two sessions, compared to traditional medications that can take weeks to kick in or do not work for some patients. The substances show promise for treating alcohol use disorder as well as tobacco and opioid addiction. Limited research suggests that use of psychedelic drugs, such as psilocybin, does not typically lead to addiction. But researchers are still trying to more fully understand how psychedelics work, and they warn of potentially significant and dangerous health problems.
Why, for instance, can the substances produce severe reactions, triggering schizophrenia or mania in what's believed to be a small percentage of people with no prior history of such problems?
"Is it releasing something that might have occurred anyway? Or is it that it triggered something that you might have passed through safely had it not been for the psychedelic?" Dr. Jerry Rosenbaum, psychiatrist-in-chief emeritus at Massachusetts General Hospital, and cocreator of the Center for the Neuroscience of Psychedelics at MGH, told the Globe in the weeks leading up to the election. Scientists at the MGH center are studying a variety of psychoactive substances.
Rosenbaum did not take a public position on the ballot question. "Mylane," he said, "is what works for people with addiction or PTSD or depression and how can these drugs be safely developed through the FDA."
Dr. Nassir Ghaemi, a psychiatrist at Tufts Medical Center and president of the Massachusetts Psychiatric Society, opposed the ballot initiative, in part because of psychedelics' unknowns.
He pointed to one recent case he consulted on, a young woman who took the psychedelic dimethyltryptamine, known as DMT, and suffered such severe delusions and hallucinations she ended up hospitalized for six months, at one point catatonic. She eventually got better with electric shock treatment, he said.
While this woman was not using the drug to treat a mental health problem, Ghaemi said many are seeking psychedelics because traditional mental health treatments have failed them.
"The solution is for the medical field to produce better drugs" to treat mental health problems, he said.
Unlike the 2016 ballot question legalizing recreational marijuana,Question 4 would not create dispensaries to sell the products. But Rosenbaum and others had worried that the initiative, which calls for licensed "facilitators" to supervise psychedelic sessions and sell the products, would produce de facto dispensaries.
"People who are frustrated waiting for treatments for depression and other mental health problems will have access to this other mechanism," Rosenbaum had said, raising the concern that some people would bypass psychiatric care and instead try to treat their mental health problems on their own with psychedelics.
Health specialists also raised concerns about training for the facilitators who would supervise customers' psychedelic sessions. The ballot initiative required them to be licensed but left it up to a not-yet-established "psychedelic substances commission" to develop education, training, and licensing requirements.