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Pharmacy Practice in Focus: Health Systems
September 2025Volume14 Issue 5
Pharmacists Can Apply Their Expertise to the Medical Psilocybin Act
Key Takeaways
- Psychedelic-assisted therapy shows promise for mental health conditions, including PTSD, depression, and substance use disorders, with increasing clinical trials and legislative support.
- States like Oregon, Colorado, and New Mexico have enacted laws permitting regulated psychedelic-assisted therapy, with New Mexico's Medical Psilocybin Act allowing medical use of naturally occurring psilocybin.
Engagement and recognition of pharmacist expertise grows as state psychedelic bills expand.
Introduction
Psychedelic compounds have been used by Indigenous peoples and ancient civilizations in spiritual, religious, and healing practices for millennia. During the 1950s and 1960s, psychedelics found their way into Western culture via psychiatry. The term psychedelics1 was coined in 1957 for their effects on thought, perception, and mood. During this time, the National Institutes of Health funded over 130 psychedelic research grants.2 However, by 1970, these substances were placed into Schedule I under the Controlled Substances Act, which halted most scientific investigation for decades.3 In the 1990s, psychedelic research began to resurface in the United States and Europe. Psychedelic research has accelerated within the past decade, with hopes of approved mental health indications in the near future. As of May 2024, 278 clinical trials had been registered for classic psychedelics, MDMA, and related compounds.4
Image Credit: Ayehab | stock.adobe.com
Nearly 1 in 4 adults 18 years or older were reported to have a mental illness in 2023, and 5.7% (14.6 million) had a serious mental illness.5 As the need to treat mental health continues to rise, there is a renewed interest in psychedelics as a promising solution. They offer hope to many patients for whom current treatments have failed or are inadequate. Psychedelic-assisted therapy (PAT) is demonstrating promise as a treatment for various mental health conditions, including posttraumatic stress disorder (PTSD), generalized anxiety disorder, major depressive disorder, treatment-resistant depression (TRD), and substance use disorder (SUD).6
Additionally, PAT is demonstrating effectiveness as a treatment for chronic pain, cluster headaches, traumatic brain injuries, and end-of-life care.7-10
While it is not federally approved, 3 states have enacted legislation permitting PAT. Oregon was the first state to regulate PAT via Oregon Psilocybin Services.11 In November 2020, Ballot Measure 109 (now ORS 475A) was passed, directing the Oregon Health Authority to license and regulate the manufacturing, transportation, delivery, sale, and purchase of psilocybin products and the provision of psilocybin services.12
Colorado followed suit in May 2023 by enacting Senate Bill 23-290, known as the Natural Medicine Regulation and Legalization Act, authorizing state-licensed “healing centers” for psilocybin-assisted therapy and permitting personal use by individuals 21 years and older.13 This initiative is designated as the Natural Medicine Program.14
New Mexico became the third state to approve PAT for specific medical uses on April 7, 2025, when the governor signed Senate Bill 219, known as the Medical Psilocybin Act, into law.15
The Psychedelic Pharmacists Association (PPA) advocates for the integration of pharmacists’ specialized expertise in the therapeutic use of PAT to guide ethical and responsible decision-making in psychedelic medicine initiatives and reform. New Mexico’s Medical Psilocybin Act offers an opportunity for pharmacists to take an active role in the implementation of PAT.
New Mexico’s Medical Psilocybin Act
New Mexico’s Medical Psilocybin Act removes naturally occurring psilocybin and psilocin from the state’s Schedule I controlled substances list for treating qualified medical conditions, allowing regulated medical use of the compound found in “magic mushrooms.” The act excludes synthetic or synthetic analogues of psilocybin from the rescheduling.16
New Mexico will now develop safe pathways for trained facilitators to provide psilocybin-assisted therapy to eligible patients, aiming to implement the program by December 31, 2027. Qualifying medical conditions include TRD, PTSD, SUD, end-of-life care, and other conditions approved by the Department of Health (DOH).
The law mandates creating a 9-person Medical Psilocybin Advisory Board that meets the following requirements: at least 1 member shall be an enrolled member of an Indian nation, tribe, or pueblo in New Mexico; 1 member must be licensed to provide behavioral health care in New Mexico; 1 member shall be a mental or behavioral health equity advocate; 1 member shall be a representative of the health care authority; and at least 1 member must be a United States armed forces veteran. The board will review, recommend, and accept additional qualifying medical conditions; recommend patient qualifications; recommend formulation, preparation rules, and dosage standards for psilocybin; assist in establishing, monitoring, and evaluating best practices for producers and clinicians; and conduct a public hearing twice per year to evaluate petitions.
When developing guidelines, the DOH shall consult with tribes as provided in the State Tribal Collaboration Act, which outlines collaboration between the state and tribes to benefit New Mexico’s Native American citizens.17
Additionally, the act will create 2 funds. The medical psilocybin treatment equity fund will help cover therapy costs for qualifying low-income patients, while the research fund will provide grants to state universities and health care providers studying medical psilocybin.
Why Pharmacists Should Be Involved in PAT Implementation
Pharmacists are among the most accessible and trusted health care professionals. They possess extensive drug expertise and strong patient counseling skills, allowing them to translate complex pharmacology into understandable terms that help patients understand therapeutic benefits, potential risks, management of adverse effects, and coping strategies.18,19
Additionally, pharmacists’ expertise in medication management is crucial for polypharmacy scenarios common in mental health and other populations. Pharmacists’ comprehensive medication reviews identify and mitigate potential interactions, contraindications, and dosing issues. Furthermore, pharmacist-led interventions reduce adverse drug events in health care settings. Pharmacist involvement in multidisciplinary teams reduces medication errors by up to 78%, shortens hospital stays, and lowers mortality rates in critical care settings.20
Moreover, as psychedelics move from Schedule I to other schedules allowing for medical use, strict tracking and monitoring will require pharmacists’ specialized knowledge. Their experience with risk evaluation and mitigation strategies, specialty pharmacy, prescription drug monitoring programs, and quality assurance provides proven frameworks for ensuring compliant implementation.
Pharmacists Can Collaborate and Leverage Their Clinical, Regulatory, and Economic Expertise
Policy makers should recognize pharmacists as vital to psychedelic medicine care, not just in a supporting role but also when creating legislation. Pharmacists must advocate for inclusion to apply their expertise and guide responsible and ethical PAT implementation.
In New Mexico, where PAT is approved but still in early development, pharmacists can engage by exploring the medical psilocybin program’s official website.21 At the time of writing, the program had not been implemented, as the site noted that online listening sessions were planned for late August and early September, offering an early opportunity for public—including pharmacist—input. Over time, the site and infrastructure will expand to include rulemaking notifications, public hearing updates, advisory board details, meeting schedules, draft rules, and application processes.
Engaging pharmacists to contribute to the program’s design from the ground up and to advocate for their role in promoting safety, access, and high-quality care is crucial. Pharmacists residing in New Mexico also have an opportunity to apply for a position on the Medical Psilocybin Advisory Board.22 Serving in this role would place pharmacists at the forefront of policy development and provide a platform to highlight their expertise across multiple areas, such as medication safety, drug interaction screening, patient education, training, and supply chain oversight. It’s a chance to ensure pharmacists are embedded in the state’s approach and are meaningfully involved in each stage of rulemaking and implementation of the program.
Of note, pharmacists of native and indigenous heritage in New Mexico have a unique opportunity, as at least 1 advisory board member must be an enrolled member of a state Indian nation, tribe, or pueblo.16 Such pharmacists are equipped to ensure therapy programs are culturally sensitive while concurrently offering clinical and other expertise.
In Colorado and Oregon, where PAT is already operational, pharmacists can proactively engage by familiarizing themselves with the established state program websites. Both Colorado’s Natural Medicine Program and Oregon Psilocybin Services provide access to advisory board meeting minutes, schedules for upcoming meetings, and opportunities for public engagement.11,14 Pharmacists can register to attend these meetings, in person or virtually, to stay informed about evolving rules, program priorities, and funding decisions. Written public comments are often accepted for those unable to attend. Signing up for email updates can help pharmacists stay current on announcements, regulatory developments, and advisory board vacancies.
Beyond regulatory involvement, pharmacists can play a more direct role in supporting safety and preparation at the point of care once a state program goes live. For example, pharmacists can serve as an initial point of contact for individuals seeking psychedelic therapy or even consult for healing centers and facilitators to screen individuals for eligibility, identify potential contraindications, suggest ways to reduce interaction risks, and provide education. In addition to consulting and risk assessments, pharmacists can play a key role in developing screening tools to support safe access. For example, author Kristin Speer, PharmD, BCPS, has provided both regulatory input in the creation of screening tools for Colorado’s program and expert consultation services for its licensed healing centers.
Furthermore, pharmacists can optimize dosing protocols and safety plans. They can seamlessly integrate into psychedelic therapy teams through collaborative practice agreements to prescribe medications or modify drug therapy. Pharmacists may also become licensed facilitators by completing state-approved training programs and meeting other requirements established by the state’s program, none of which, so far, require holding a professional or health care license to qualify for facilitator licensure. More broadly, pharmacists’ accessibility in community settings enables them to provide continuity of care and ongoing therapeutic support.
Uniquely, pharmacists are equipped to address financial barriers to access. For FDA-approved products in particular, pharmacists hold expertise in medication assistance programs, navigating insurance, prior authorization processes, and manufacturer assistance programs, enabling them to effectively advocate for comprehensive coverage.
Pharmacists uncertain about state legislation surrounding psychedelics can use Psychedelic Alpha’s Psychedelic Legalization and Decriminalization Tracker.23 If legislation is actively underway, a pharmacist can visit the bill website to learn about its sponsors, history, and language. For example, North Carolina Senate Bill 568, the Innovative Treatments for Mental Health Act— which was introduced in March by Sens Sophia Chitlik, Bobby Hanig, Natalie Murdock, and Joyce Waddell—would create a task force to develop guidelines for PAT and is currently under Senate review.24 As this bill progresses, updates will be posted on the website, including the opportunity to attend hearings and provide commentary.
Pharmacists in states without legislation can engage with local psychedelic or decriminalization groups to explore future initiatives that could benefit from their expertise. For example, the PPA has recently connected with 2 emerging organizations in Idaho: the Idaho Psychedelic Society (IPS) and Guiding Legislation on Wellness (GLOW) Idaho.25,26 IPS is focused on fostering education, awareness, and community engagement around psychedelic wellness. GLOW is exploring legislative pathways to protect access to evidence-based psychedelic therapies, including efforts to oppose HJR4—a proposed Idaho 2026 amendment that would restrict citizen-led initiatives on psychoactive substances, even those approved by the FDA—and to advance new legislation that prioritizes public health, compassionate care, and scientific inquiry.27
Regardless of the status of PAT legislation in their state, pharmacists should begin engaging to ensure their voices are heard.
Conclusion
Scalability of PAT depends on workforce availability and cost. Pharmacists offer a skilled workforce with existing infrastructure and experience directly relevant to psychedelic medicine. As the field evolves, pharmacists can connect scientific knowledge, patient education, and harm reduction, promoting responsible implementation of PAT.
Policy makers must include pharmacists in psychedelic medicine discussions to ensure safe, effective, and equitable PAT delivery for all patients who may benefit. Additionally, pharmacists should proactively advocate for their role to utilize their expertise and provide guidance for the responsible and ethical implementation of PAT.
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Khan SM, Carter GT, Aggarwal SK, Holland J. Psychedelics for brain injury: a mini-review. Front Neurol. 2021;12:685085. doi:10.3389/fneur.2021.685085
Ross S, Bossis A, Guss J, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol. 2016;30(12):1165-1180. doi:10.1177/0269881116675512
Oregon psilocybin services. Oregon Health Authority. Accessed July 10, 2025. https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/Pages/Oregon-Psilocybin-Services.aspx
Oregon Psilocybin Services Act. Oregon State Legislature. 2023. Accessed July 25, 2025. https://www.oregonlegislature.gov/bills_laws/ors/ors475a.html
Natural Medicine Regulation and Legalization Act. Colorado General Assembly. July 1, 2023. Accessed July 20, 2025. https://leg.colorado.gov/bills/sb23-290
Natural Medicine Health Act. Colorado Department of Regulatory Agencies. Accessed July 10, 2025. https://dpo.colorado.gov/NaturalMedicine
Governor Lujan Grisham signs 60 bills into law. News release. Office of the Governor Michelle Lujan Grisham. April 7, 2025. Accessed July 5, 2025. https://www.governor.state.nm.us/2025/04/07/governor-lujangrisham-signs-60-bills-into-law/
Medical Psilocybin Act, S. 219, 119th Cong (2025). Accessed July 25, 2025. https://www.nmlegis.gov/Sessions/25%20Regular/final/SB0219.pdf
State-Tribal Collaboration Act, S 196, 111th Cong (2009). Accessed July 25, 2025. https://www.rld.nm.gov/wp-content/uploads/2021/06/State-Tribal-Collaboration-Act-SB196.pdf
Qato DM, Zenk S, Wilder J, Harrington R, Gaskin D, Alexander GC. The availability of pharmacies in the United States: 2007-2015. PLoS One. 2017;12(8):e0183172. doi:10.1371/journal.pone.0183172
Brenan M, Jones J. Ethics ratings of nearly all professions down in U.S. Gallup. January 22, 2024. Accessed July 13, 2025. https://news.gallup.com/poll/608903/ethics-ratings-nearly-professions-down.aspx
Zaïj S, Pereira Maia K, Leguelinel-Blache G, Roux-Marson C, Kinowski JM, Richard H. Intervention of pharmacist included in multidisciplinary team to reduce adverse drug event: a qualitative systematic review. BMC Health Serv Res. 2023;23(1):512. doi:10.1186/s12913-023-09512-6
Medical psilocybin program. New Mexico Department of Health. 2025. Accessed August 3, 2025. https://www.nmhealth.org/about/mcpp/mpp/
Psilocybin Advisory Board. New Mexico Department of Health. 2025. Accessed August 3, 2025. https://www.nmhealth.org/about/mcpp/mpp/mpab/
Psychedelic Alpha. Psychedelics Legalization & Decriminalization Tracker. Published November 29, 2023. Accessed July 25, 2025. https://psychedelicalpha.com/data/psychedelic-laws
Chitlik S, Hanig B. Innovative Treatments for Mental Health Act. North Carolina General Assembly. Updated March 26, 2025. Accessed August 1, 2025. https://www.ncleg.gov/BillLookUp/2025/S568
Idaho Psychedelic Society. Accessed August 1, 2025. https://www.idahopsychedelicsociety.org
GLOW Idaho. 2025. Accessed August 1, 2025. https://www.glowidaho.org
House Joint Resolution 4. Idaho Legislature. Accessed August 1, 2025. https://legislature.idaho.gov/sessioninfo/2025/legislation/HJR004/
Articles in this issue
Pharmacists Can Apply Their Expertise to the Medical Psilocybin Act
From Curiosity to Clinical Impact: Shremo Msdi’s Path in Pharmacy Research
Recent Updates in Vaccine Regulations Reveal Discrepancies Between Evidence, Policies
Pharmacists at the Forefront: Expanding Roles in Innovative and Equitable Care
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