Election Day might see Massachusetts become the third state to decriminalize psilocybin, if enough Bay State voters mark “yes” on their ballot’s Question 4.

But some experts say that shift could be quite dangerous.

Many drug policy researchers now say the large body of research surrounding the mind-expanding compound in magic mushrooms just isn’t sufficient to allow for free and private use.

Advocates often assert that psychedelics, namely magic mushrooms, can ease the pain of mental health issues such as depression and post traumatic stress disorder (PTSD).

“The media and public hype is way beyond where the science is,” said Luke Niforatos, co-founder and executive vice president of the Foundation for Drug Policy Solutions. “If you really follow the data, where you have a lot of entrepreneurs who…with their ‘fake it till you make it’ sensibility — they claim [psilocybin] helps with everything. And then it turns out it doesn’t, and they’ve kind of screwed everyone who gets hurt along the way.”

The measure would allow adults 21 and older to legally possess, use, and even cultivate five specific psychedelics derived from plants and fungi. Governing.com reports that, if passed, the law would set up a tax system for psychedelic sales and establish a regulatory board overseeing licensed providers. 

But voters are sharply divided on the matter. A University of Massachusetts Amherst poll shows 43% in favor and 43% opposed.

In a recent phase 2 trial, the largest of its kind, a single 25 mg dose of synthetic psilocybin combined with psychotherapy led to a marked reduction in depression symptoms. According to the American Society of Microbiology, after just three weeks, participants reported significantly greater improvements compared to those given a low 1 mg dose — offering new hope for those trapped in cycles of treatment-resistant depression.

This kind of data underpinned Oregon and Colorado’s relatively recent moves to decriminalize both psychedelics and the health centers using them to treat mental health issues, such as addiction and depression.

Cities, too, like Washington D.C., Seattle and Santa Cruz, California  — among some 26 local governments — have listed psychedelic possession as a “lowest law enforcement priority.”

But Mr. Niforatos says these studies are fraudulently cited as concrete successes, while real success takes time to prove. What’s more, he said, this is precisely the order of events that took place in the case of marijuana legislation, and the national results haven’t been pretty. 

“So this all started, you know, 40 years ago, they were trying to get ballot measures. Advocates were trying to pass marijuana legalization, and the country didn’t, did not want that, so they came up with a brand new media campaign,” he said. “You know: ‘We’re going to call it medical marijuana as a red herring to get the public more likely to support marijuana.’ They called it ‘medical.’ They used cancer patients, they used veterans. They said that this is medicine.”

Mr. Niforatos said touting marijuana as a miracle cure was a lie.

“It’s hilarious because those same people now are saying we need psychedelics to cure everyone of PTSD and cancer and everything else, but those are the same people who said marijuana was going to do that,” he said.

The change in demeanor toward mushrooms has been relatively recent. Over 200 psilocybin trials are  underway or will be soon, according to the National Library of Medicine. “Five years ago, you wouldn’t have found any,” David Nichols, a professor emeritus from Purdue University School of Pharmacy, told the ASM last year. 

In 2018, the Food and Drug Administration took a significant step by granting psilocybin a special designation to accelerate research into its use as a treatment for depression. And in the past few years, study after study has seemed to indicate that psilocybin could potentially outpace the efficacy of medicines like SSRIs in treating mental health issues. 

While advocates tout the healing potential of these substances, critics warn that opening the floodgates without proper safeguards could lead to dangerous, unregulated chaos.

Charles Lehman, a fellow at the Manhattan Institute working on the Policing and Public Safety Initiative, said this increasingly galvanized push for legalization has two outcomes — one that protects users and one that doesn’t.

“On the FDA route, things are progressing in a direction that I like. You know, research is being done on the efficacy of these drugs and making judgments about the costs and benefits. And in that case, you know, we’re talking whether or not doctors should prescribe them, and you can describe what the regulatory system should look like after that,” he said. 

But, for Mr. Lehman, the pain point with psychedelic advocacy comes alongside the parallel political push. “Basically, [they’re saying] we should implement the medical marijuana model for these substances at the state level, which is where you end up with the non-FDA-approved, non-doctor-overseen availability of these substances,” he said.

That model is what currently exists in Oregon, Colorado and Washington D.C. And, if voters so choose on Tuesday, it will exist in Massachusetts. 

“I think basically what you see in those situations is these relatively low-barrier, state legal marketplaces that are still pretty undersubscribed because most of what happens is this giant gray market pops up,” he said.

The “gray market” that Mr. Lehman describes is evident in many of these cities. In essence, it’s a black market that conducts business in the light of day.

Because of their status as decriminalized substances, mushrooms are often openly sold in brick-and-mortar shops and highly advertised on the street. From a legal standpoint, the loophole that shop owners work around proves to be a small obstacle. 

Consumers will usually be charged for an expensive but negligible “gift,” and the psychedelics they’re actually buying will be thrown in for “free.” Other delivery services have robust websites instead of shops. Consumers can then have psychedelics delivered to their doors — they just have to pay in cash. 

Jacob Rich, a drug policy analyst at libertarian think tank Reason Foundation, says it make doesn’t make a difference whether people use these psychedelics sold to them, gray market notwithstanding. 

Mr. Rich says the only good argument against “shrooms” would be one that questions their effect on public health, one he doesn’t thinks exists — at least when it comes to psychedelics specifically. 

“From what I’ve seen, it’s a bunch of super high-agency people using incredibly small amounts to self-diagnose something. Or maybe they take a lot occasionally, and then they kind of have … a trip,” he said. “But you’re not going to go on a six-day binge or be addicted to mushrooms eventually. And so I don’t, I really don’t see that leading to any sort of negative mental health outcome publicly.”

Mr. Lehman disagrees, and he’s not alone in his stance. The academic tides have shifted a bit after years of the medical world’s rapid-onset interest in psilocybin’s mental health uses. And most of the concern stems from the threat of unregulated private use — and private harm. 

Dr. Joshua S. Siegel, a psychiatrist at Washington University in St. Louis, told The New York Times that patients with serious mental health conditions have become increasingly interested in trying more natural remedies for their health.

But Dr. Siegel said “shrooms” are dangerous and destabilizing to those very same people, who are generally in great need of stability. 

“People can partly or completely lose touch with reality and behave in irrational and potentially dangerous ways,” he told the Times.

Gregg Mollenhauer, a Navy veteran in Florida, turned to psilocybin to cope with crippling depression and self-diagnosed PTSD, but he found a complicated path to peace. 

“Everything talks to you louder when you’re on it,” he told The Washington Times, recounting moments of intense psychosis during his trips. “For people with bipolar, psilocybin can be risky. You go from feeling completely happy to completely miserable, and that’s a dangerous place to be.” 

At times, Mr. Mollenhauer struggled to control his hallucinations, which led to irrational actions and moments of panic. During one recent shrooms trip, Mr. Mollenhauer trashed his own small apartment.

“My mom kind of put it in perspective. I always would get migraines and say, ‘Well, enjoy the times you’re not sick,’” he said. “And mushrooms, I don’t know, kind of goes to your body, like physically, mentally and, like, spiritually, and just kind of ruffles it all up — and then you’re sick. But it’s like a forced, you know, controlled pain, if that makes sense.”

Mr. Mollenhauer found that shrooms, in many ways, intensified his experiences with what he believes to be his own bipolar disorder, a condition he hoped shrooms would alleviate.

“I believe psilocybin does put me in a state where I’m high … up and sad. Which, for bipolar, that’s a very risky place to be, because that’s what causes the psychosis: you trying to make sense of being completely happy, about being completely miserable. And you can go manic,” he said.

He said on another trip, he tried to touch electricity and eat glass as a result of an hallucination that he experienced while looking at a photo of some glass. “If I was in a controlled environment, I’m pretty sure none of that would [have] happened,” he said.

But despite these darker experiences, he believes mushrooms helped him confront trauma he’d long buried. He says he’s getting to a more stable place, the more he works with himself while on them, figuring out which dosage is best for a more calm and fruitful experience. 

“I wouldn’t say I’m not suicidal,” Mr. Mollenhauer said. “I still have ideations, but I’ve been better able to cope. Psilocybin helps me re-associate feelings and emotions, and it slows down my mind.”

Between 2018 and 2022, psilocybin-related calls to poison centers skyrocketed, tripling among teens from 152 to 464, and more than doubling among adults aged 20-25, rising from 125 to 294, according to data from the National Poison Data System. 

This summer, a wave of illnesses struck nearly 160 people who consumed Diamond Shruumz gummies and chocolates from vape and smoke shops, reigniting the conversation surrounding the hidden dangers of unregulated, psychoactive substances. The Center for Disease Control and Prevention cited three deaths potentially linked to these sweets, which contained illegal psilocybin from shrooms. 

And last year, an off-duty Alaska Airlines pilot who was accused of trying to bring down a plane midflight said he had consumed magic mushrooms before boarding, according to several reports.

But according to Dan — a hotel manager in the suburbs of Knoxville, Tennessee who declined to share his last name for privacy reasons — psilocybin changed his life in the way advocate researchers seem to believe it can. 

Dan called himself “one of the lost causes.” At least, that’s before he took three grams of psychedelic mushrooms with a friend. Now, Dan’s promoted at work. He eats well and exercises six days a week. 

But for 15 years, Dan did what he describes as “every drug under the sun.” It had started out as an addiction to Oxycontin after a car wreck in New Orleans left him in dire need of surgery. The addiction spiraled — eventually, it was a debilitating dependence on both fentanyl and heroin. Overdosing, Dan said, was a regular occurrence. 

In fact, he said it happened 10 or 11 times.

Yet that was what Dan described as the “before times.” Overdosing hasn’t been in the equation since he stumbled upon psilocybin. In fact, he hasn’t touched a drug. And what’s more, he hasn’t felt the need to. 

“One day, I was trying to have a good time, and I found something that changed my life,” Dan told The Washington Times. 

Even so, when it comes to their purported health advantages, even Reason’s Mr. Rich doesn’t think the regularly-cited evidence that advocates endorse is good enough — nor has regular psilocybin use been studied long enough — to come to firm conclusions on their efficacy in treating mental health. 

Indeed, despite the intense focus it has come under, psilocybin remains classified as a Schedule One drug, meaning it holds an official designation as containing “high abuse potential with no accepted medical use; medications within this schedule may not be prescribed, dispensed, or administered,” according to the National Institutes of Health.

The state legal systems across America considering lessening of psychedelic restrictions aren’t thinking about the matter of control nearly enough, Mr. Lehman said. 

More time is needed before the kind of broad allowance that Massachusetts voters are considering, says Mr. Niforatos. 

“Look, it’s definitely not a foregone conclusion that these substances are just like the medical panacea, or even that they’re efficacious,” he said. “Because right now, the data are so inconsistent, and the studies that are found finding promise are a few and far between, as well as not always the best quality data.”

But for Dan, the question of control — or legalization — isn’t complicated at all. He believes everyone should have access to what he deems a “miracle.”