New Mexico becomes the third U.S. state to legalize psilocybin therapy

Story: 2025 C.E.  |  Last updated: April 14, 2025

In April 2025 C.E., New Mexico Governor Michelle Lujan Grisham signed Senate Bill 219 — the Medical Psilocybin Act — into law, making the state the third in the U.S. to open a legal pathway for psilocybin therapy. Oregon and Colorado moved first, both through ballot measures. New Mexico did it differently: through the state legislature, with a Senate vote of 33 to 4 and a House vote of 56 to 8. For a Schedule I controlled substance, that bipartisan margin is not a routine political event.

At a glance

• Psilocybin therapy: New Mexico’s Medical Psilocybin Act creates a regulated clinical framework for treating major treatment-resistant depression, PTSD, substance use disorders, and end-of-life distress in approved facilities under trained clinicians.
• Equity fund: The law allocates $630,000 specifically to subsidize treatment for low-income patients — believed to be the first government funding anywhere in the world dedicated to psychedelic therapy access for people without disposable income.
• Implementation timeline: The program is mandated to be operational by December 31, 2027 C.E., but state health officials announced in December 2025 C.E. they were targeting first patient access by end of 2026 C.E. — a full year ahead of schedule.

Why the legislative path changes things

Oregon’s Measure 109 passed in 2020 C.E. Colorado’s Proposition 122 passed in 2022 C.E. Both were citizen ballot initiatives — which means both require another public vote to amend, even for technical corrections. Implementation delays and legal challenges have followed in both states.

Because New Mexico’s program was passed through the legislature, lawmakers can revise Senate Bill 219 directly as clinical evidence develops and real-world experience accumulates. No referendum required. That flexibility could matter enormously as the science moves and the program scales.

Affordability has been the most visible failure of Oregon’s rollout. A single psilocybin therapy session in Oregon currently costs between $1,500 and $3,500. Most patients with treatment-resistant depression or PTSD cannot cover that out of pocket, and no state mandates insurance coverage. New Mexico’s equity fund acknowledges that problem from day one. A therapy accessible only to people who can afford it is not a public health program.

What the program actually looks like

The framework is deliberately clinical. Every session must take place in a New Mexico Department of Health-approved facility. Clinicians must complete a DOH-established training program. Patients must carry a qualifying diagnosis: treatment-resistant depression, PTSD, a substance use disorder, or a terminal illness requiring end-of-life support.

Sessions follow a three-part structure — preparation, guided psilocybin therapy, and integration. Only natural psilocybin mushrooms are permitted; synthetic psilocybin is not authorized under the Act.

A nine-member Medical Psilocybin Advisory Board will set guidelines, training standards, and future policy. Its required composition is worth noting: at least one member enrolled in a New Mexico Indian nation, tribe, or pueblo; at least one behavioral health equity advocate; and at least one U.S. armed forces veteran. The University of New Mexico — historically a leading institution in psychedelics research — stands to benefit directly from a separate research fund established under the same law.

The gap the law doesn’t hide

The Medical Psilocybin Act is explicit about what it does not do. Possession, use, cultivation, or sale of psilocybin mushrooms outside the medical program remains illegal under both New Mexico state law and federal law. The bill’s text states directly that it “does not propose broad decriminalization of psilocybin” and that legal protections are “narrowly tailored.”

That gap is real. Someone who uses psilocybin outside the approved clinical system — even for personal therapeutic purposes — still faces criminal exposure. The law creates a medical program, not a general civil liberty, and that distinction matters for the many people who will never qualify or never gain access to an approved facility.

Part of a faster-moving picture

New Mexico is a state with significant rural populations, Indigenous communities, and veterans — groups that carry disproportionate burdens of PTSD and treatment-resistant depression and have historically been underserved by conventional mental health systems. Whether the equity fund and the board’s composition translate into real access for those communities remains to be seen.

The evidence base for psilocybin in treatment-resistant depression and PTSD is still developing. Clinical trials published in the New England Journal of Medicine have shown meaningful results, and researchers at institutions including Johns Hopkins and NYU continue building the dataset. But clinical infrastructure takes time, and the science is not finished.

What is notable is the signal. A legislature voting 56 to 8 to fund psychedelic-assisted therapy — and explicitly allocating money so low-income patients can use it — is a different kind of milestone than a ballot measure scraping past 51 percent. It suggests the political center of gravity has moved, and it moved through elected representatives, not around them.

Senator Jeff Steinborn, the bill’s co-sponsor, called the first Advisory Board meeting in December 2025 C.E. “a historic day not just for the state, but really even for the whole country and the whole world.” For once, that may be measured language.

The mental health treatment gap in the U.S. is large and well-documented. New Mexico’s approach — clinical rigor, legislative flexibility, and a built-in equity mechanism — won’t close it alone. But it offers a model that other states can study, adjust, and build on. That’s something.

Read more

For more on this story, see: Foley & Lardner LLP

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