Activists in Denver opened psychedelic floodgates for the United States with their successful psilocybin decriminalization initiative in 2019. Since that time, the trickle of bills and initiatives seeking to undo the criminalization of psychedelics has turned into a torrent.

Is it the year of the magic mushroom? (Creative Commons)

This year, psychedelic reform measures are popping up like mushrooms after a rain shower, with serious decriminalization or legalization efforts in several states, and either therapeutic or study efforts (or therapeutic study efforts) in many more. Many, perhaps most, of these bills will not pass this year, but then, legislating controversial topics is seldom a single-year process. Initiatives probably have a better chance of success -- provided they can make it to the ballot.

With a big tip of the hat to Ballotpedia and Marijuana Moment, here's is what we've got going in 2022:

California

There are two different paths to psychedelic legalization this year, one via the legislature and one as a potential November ballot initiative.

Senate Bill 519 would legalize the possession and unremunerated sharing of psilocybin (2 grams, or 4 grams of magic mushrooms), psilocin, DMT (2 grams), LSD (0.01 gram), MDMA (4 grams), and mescaline for people 21 and older. The bill passed the Senate last year, but sponsor Sen. Scott Weiner (D-San Francisco) put it on pause, signaling he needed more time to build support in the Assembly.

Regardless of what happens in Sacramento, activists with Decriminalize California have drafted the California Psilocybin Initiative of 2022 , which "decriminalizes under state law the cultivation, manufacture, processing, distribution, transportation, possession, storage, consumption, and retail sale of psilocybin mushrooms, the hallucinogenic chemical compounds contained in them, and edible products and extracts derived from psilocybin mushrooms."

Whether the initiative will qualify for the ballot will be known soon; campaigners have only until March 13 to come up with 623,212 valid voter signatures. As of mid-February, they had not reported gathering 25 percent of the signatures, as is required when that benchmark is reached, so that is not a good sign.

Colorado

New Approach PAC, which supported the Oregon therapeutic psilocybin initiative in 2020, as well as various marijuana legalization initiatives, is supporting a pair of psychedelic reform initiatives, both known as the Natural Medicine Healing Act. The first would legalize the possession, cultivation and an array of entheogenic substances, as well as establish a regulatory model for psychedelics therapy. The other would initially legalize psilocybin and psilocin alone for personal adult use while and allow for their sale and administration in a therapeutic setting.

Meanwhile, activists with Decriminalize Nature Boulder County have filed the Legal Possession and Use of Entheogenic Plants and Fungi initiative, which would allow people 21 and over to possess, cultivate, gift and deliver psilocybin, psilocyn, ibogaine, mescaline and DMT. The initiative would also allow psychedelic services for therapeutic, spiritual, guidance, or harm reduction purposes with or without accepting payment.

Both initiatives will need 124,632 valid voter signatures by August 8 to qualify for the November ballot.

Florida

State Senate Minority Leader Lauren Brook (D) has filed Senate Bill 348, which would require the state to research the medicinal benefits of psychedelic substances such as ketamine, MDMA, and psilocybin. The bill directs the state Health Department to "conduct a study evaluating the therapeutic efficacy of alternative therapies" such as those substances, "in treating mental health and other medical conditions," such as anxiety, depression, bipolar disorder, and PTSD. A companion version of the bill, House Bill 193 has been filed in the House. Neither has moved since last fall, though.

Hawaii

A bill to set up a state working group to study the therapeutic effects of psilocybin mushrooms, Senate Bill 3160, won approval in the Senate Health Committee this month and now awaits a Senate floor vote. Companion legislation, House Bill 2400, is awaiting action in the House.

Meanwhile, Senate Bill 738 would decriminalize psilocybin by removing from the state's schedule of controlled substances and requiring the establishment of therapeutic psilocybin treatment centers, which was filed more than a year ago, awaits action in the Senate Judiciary Committee.

Iowa

There are a trio of psilocybin bills that are all technically still alive, although they were filed a year ago and have yet to see action. House File 549 would deschedule psilocybin, but a Public Safety subcommittee recommended indefinite postponement last March, and it remains postponed indefinitely. House File 636 would set up a regime for therapeutic psilocybin, and House File 480 would decriminalize certain psychedelics for use by a patient diagnosed with a terminal illness or a life-threatening disease or condition. Neither of those bills have moved out of committee.

Kansas

House Bill 2465 would decriminalize the possession of less than 100 grams of psilocybin and make possession of more than 100 grams a misdemeanor. The bill would also legalize the home cultivation of psilocybin mushrooms. Introduced last month, the bill is now before the House Committee on Corrections and Juvenile Justice.

Maine

Legislative Document 1582 would enact "the Maine Psilocybin Services Act, which establishes a regulatory framework in order to provide psilocybin products to clients in Maine." Although it is not yet officially dead, it failed to get reported out of the House Health and Human Services Committee earlier this month.

Maryland

A pair of complementary bills, House Bill 1367and Senate Bill 709, would create "the Post-Traumatic Stress Disorder Alternative Therapies Fund to support the study of the effectiveness of and improving access to alternative therapies for post-traumatic stress disorder in veterans." While there has been a Senate hearing on its bill, neither bill has moved out of committee yet.

Massachusetts

House Bill 1494would establish an interagency task force to study the public health and social justice implications of legalizing the possession, consumption, transportation, and distribution of naturally cultivated entheogenic plants and fungi. It is currently before the Judiciary Committee.

Michigan

Sen. Jeff Irwin (D) filed Senate Bill 631 last September. It would legalize the possession, cultivation, and delivery of plant- and fungi-derived psychedelics, such as mescaline and psilocybin. The bill would free people from criminal liability except for "receiving money or other valuable consideration for the entheogenic plant or fungus." In other words, no commercial sales, but people can charge a "reasonable fee for counseling, spiritual guidance, or a related service that is provided in conjunction with the use of an entheogenic plant or fungus under the guidance and supervision of an individual providing the service."

Meanwhile, activists with Decriminalize Nature, Decriminalize Nature Michigan, and Students for Sensible Drug Policy earlier this month filed the Michigan Initiative for Community Healing, which would legalize the use and possession of a broad range of natural entheogens and allow for "supervision, guidance, therapeutic, harm reduction, spiritual, counseling, and related supportive services with or without remuneration."

The measure has yet to be approved for signature gathering -- a decision on that will come next month -- and if and when it is, it will need 340,047 valid voter signatures by May 27 to qualify for the November ballot.

New Hampshire

A bipartisan group of legislators have filed House Bill 1349-FN, which would decriminalize the possession of psilocybin mushrooms. The bill would decriminalize the possession of up to 12 grams of 'shrooms, enough for several psychedelic experiences. The clock is ticking on this one; it must clear Criminal Justice and Public Safety Committee by March 10 or it dies.

New York

Assemblyman Pat Burke (D) has filed a bill, Assembly Bill 8569, that would legalize psilocybin mushrooms for therapeutic purposes and create facilities where the mushrooms could be grown and provided to patients. It is a set-up similar to what Oregon voters approved last year. The bill provides a list of qualifying medical conditions but also says psilocybin could be recommended "for any conditions" certified by a practitioner. The Department of Health would be responsible for providing a training course for practitioners and licensing the psilocybin centers.

Meanwhile, Assemblymember Linda Rosenthal (D/WF) has filed Assembly Bill 6065, which decriminalizes psilocybin. That bill has been referred to Assembly Health Committee.

Oklahoma

State Reps. Daniel Pae (R) and Logan Phillips (R) have filed a pair of bills that would promote research into psilocybin's therapeutic potential, and one of them would also decriminalize small-time possession of the drug. The bills are designed to give lawmakers different options to reach similar objectives, but Pae's bill would also decriminalize the possession of up to an ounce and half of psilocybin. Pae's bill, House Bill 3414, has been referred to House Public Health Committee, while Phillips' bill, House Bill 3174, =has been referred to House Rules Committee.

Pennsylvania

Rep. Tracy Pennicuick (R-Montgomery County) filed House Bill 1959, "Providing for research and clinical studies of psilocybin, for duties of Department of Health, for duties of institutional review boards, for duties of authorized psilocybin manufacturers, for duties of approved investigators and for reports" last October. It was referred to the House Health Committee, where it has remained ever since.

Utah

Rep. Brady Brammer (R-Highland) has filed House Bill 167, which would create a Mental Illness Psychotherapy Drug Task Force that would "study and make recommendations on drugs that may assist in treating mental illness." Although not mentioned specifically in the bill, supporters say psilocybin, the psychoactive compound in magic mushrooms, is the drug most likely to be considered by the task force. The bill passed the House last week and now heads for the Senate.

Vermont

Rep. Brian Cins (D/P) filed House Bill 309, "An act relating to decriminalizing certain chemical compounds found in plants and fungi that are commonly used for medicinal, spiritual, religious, or entheogenic purposes" 51 weeks ago. It has sat in the House Judiciary Committee without moving ever since, although it did get a hearing in January.

Virginia

In January, the House Courts of Justice Subcommittee voted to delay consideration of a bill to decriminalize a wide range of psychedelics, House Bill 898, until 2023. The move came even after the bill was amended by its sponsor, Del. Dawn Adams (D), to only apply to medical practitioners and people using psychedelics with a practitioner. The object for the delay is to build support and try again next year. A similar bill in the Senate, Senate Bill 262, remains alive.

Washington

State Senators Jesse Salomon (D) and Liz Lovelett (D) have introduced a bill that would allow people to use psilocybin and psilocin, the psychoactive ingredients in magic mushrooms, with the assistance of a trained and state-licensed psilocybin services administrator. The bill, Senate Bill 5660, is titled the Psilocybin Wellness and Opportunity Act. People would have to go to a licensed service center to partake, unless they suffer certain medical conditions or are unable to travel, in which case they could receive psilocybin at home and meet remotely with a facilitator. The bill got a Senate Health and Long Term Care Committee hearing earlier this month, but remains in committee.

There is also likely to be a ballot initiative to broadly decriminalize drugs in 2022, similar to what neighboring Oregon voters passed in 2020. That effort, which was foiled in 2020 because of the pandemic, is being led by Commit to Change WA.

The South Carolina Senate approves a medica marijuana bill, a new Rand study tracks opioid prescribing declines, and more.

Opioid pain prescribing practices are in the news. (Creative Commons)

Ohio GOP Senate Leader Says He Will Not Bring Marijuana Legalization Initiative to a Vote. State Senate President Matt Huffman (R-Lima) says he will not bring the Coalition to Regulate Marijuana Like Alcohol's marijuana legalization initiative to a vote in the Senate. Under Ohio law, petitioners who collect the requisite number of valid voter signatures for a ballot initiative then place the proposal before the legislature, which has four months to act on it. If the legislature refuses to act on the proposal or rejects it, petitioners can undertake a second round of signature gathering and, if successful, present the issue to directly to the voters.

"I don't want anybody to misunderstand my position," Huffman said. "I'm not going to bring it to the Senate floor. And if that means people want to go put it on the ballot, have at it." While the Coalition has yet to comment on Huffman's remarks, it has previously indicated it will indeed proceed to that second round of signature gathering. They will need to come up with 132,887 valid voter signatures to make the November ballot.

Medical Marijuana

South Carolina Senate Approves Medical Marijuana Bill. After the debate on medical marijuana made it to the Senate floor last week, the Senate on Wednesday approved the South Carolina Compassionate Care Act (Senate Bill 150). The bill gets a final vote in the Senate Thursday, before heading to the House, where its fate is unclear. Whether House Speaker Jay Lucas (R) will let the bill move in his chamber remains uncertain. And Gov. Henry McMaster (R) remains noncommittal on whether he would sign the bill, saying "that would depend on a lot of things."

Opioids

Opioid Prescribing Declines, but Cuts Are Not Uniform Across Locations, Age Groups, or Type of Prescriber. The volume of prescription opioids dispensed from retail pharmacies declined by 21% from 2008 to 2018, but the decline was not uniform across geographic areas, among types of patients, or by type of prescriber, according to a new RAND Corporation study. The study, published by the Annals of Internal Medicine, is the first to examine the decline in opioid prescriptions filled at retail pharmacies based on both volume and potency of the drugs dispensed.

The study found that over the study period, per capita MME (morphine milligram equivalents) volume declined the most in metropolitan counties (more than 22%) and in counties with higher rates of fatal opioid overdoses (a 35% decline). Substantial variation existed both within and across states. In some states, MME volume per capita increased in multiple counties. In many other states, there were both counties with increases and others with substantial decreases. Counties that experienced substantial decreases in per capita MME often were adjacent to counties with per capita increases.

Most clinical specialties recorded declines in the MME volume per practicing clinician. The greatest decrease in MME volume per practicing clinician was among adult primary care physicians (40% decline) and pain specialists (15% decline) -- the clinicians with the highest MME volume per clinician in 2008 -- 2009. The greatest percentage decrease was among emergency physicians (71% decline) -- clinicians who are likely prescribing opioids predominantly to patients experiencing acute pain in acute care settings.

"These results suggest the effects of clinician and policymaker efforts to reduce opioid prescribing have affected populations differently," Stein said. "Future efforts to enhance clinically appropriate opioid prescribing may need to be more clinically nuanced and targeted for specific populations."

CDC Proposes New, Slightly Looser Opioid Prescribing Guidelines. The Centers for Disease Control and Prevention (CDC) on Thursday released new draft guidelines for prescribing opioids for pain relief. The new guidelines remove previously recommended ceilings on doses for chronic pain patients, leaving it instead for doctors to use their own best judgment. But they also urge doctors to first resort to "nonopioid therapies" for both chronic and acute pain.

The new guidelines are the first comprehensive revisions of the CDC's 2016 guidelines, and attempt to find the proper balance between alleviating severe pain and exposing patients to the perils of opioids. The new guidelines have now been published in the Federal Register and are open for comments. Comment here.

Thailand removes cannabis from its schedule of controlled substances (but marijuana legalization is still down the road a bit), a Washington state drug decriminalization initiative is cleared to begin signature gathering, and more.

A broken crack pipe. Bowing to noise from the right, the Biden administration won't fund harm reduction kits with them. (CC)

Colorado Bill Would Protect Workers from Being Fired for Off-Job Marijuana Use. Rep. Brianna Titone (D-Arvada) has filed a bill, House Bill 1152, that would bar employers from either refusing to hire or firing workers because of their off-duty marijuana use. The measure also includes a provision requiring employers to consumer medical marijuana at work, with some exemptions for safety-sensitive positions. "Marijuana is legal in Colorado," said state Rep. Titone. "And what people do in their spare time that doesn't impact their work shouldn't really be a problem for them. They should be able to enjoy the legal things that we have here in Colorado and not be penalized for it." The state Supreme Court has previously ruled on the side of employers on the issue, particularly in the 2015 case of Brandon Coats v. Dish Network.

Drug Policy

Washington Drug Decriminalization, Treatment Initiative Ready to Begin Signature Gathering. A drug decriminalization and treatment funding initiative that was filed last month by the group Commit to Change WA, which is backed by the state ACLU, is ready to begin signature gathering in a bid to qualify for the November ballot. The move comes after a Monday deadline for challenges to its ballot title passed without any challenges. The initiative would remove the state's existing penalties for drug use and possession, expunge past drug use and possession convictions, and appropriate more than $100 million a year for drug prevention, treatment, outreach, and recovery, including at least $10 million a year for harm reduction. The campaign now has until July 8 to come up with 324,516 valid voter signatures to make the ballot.

Harm Reduction

Cowed by Criticism from the Right, Biden Administration Drops Funding for Safer Crack Pipes. Office of National Drug Control Policy (ONDCP -- the drug czar's office) head Dr. Rahul Gupta announced that a harm reduction grant program for drug users will not fund safer pipes for crack or meth smokers. "No federal funding will be used directly or through subsequent reimbursement of grantees to put pipes in safe smoking kits," Gupta and Health and Human Services Secretary Xavier Becerra said in a statement.

There is $30 million in federal funding for harm reduction, and the Substance Abuse and Mental Health Services Administration had listed "safe smoking kits/supplies" among the items that could be purchased with taxpayer money. Other items included included overdose prevention drugs, medication lockboxes, test kits for infectious diseases, and syringe disposal containers. The tender did not actually mention pipes, but it did trigger online reports that the Biden administration was using taxpayer dollars to buy "crack pipes."

International

Thailand Officially Drops Cannabis from List of Controlled Substances. As of today, cannabis is no longer a Category 5 controlled substance. Public Health Minister Anutin Charnvirakul signed a ministerial announcement officially removing it on Tuesday. The delisting means that all parts of the plant can be legally consumed, but THC extracts above 0.2 THC will remain illegal. The change will go into effect in 120 days. This means that production of hemp and hemp-based CBD products can commence, but it will still be against the law to grow and consume marijuana until a bill is submitted to parliament in order to establish a regulatory framework for production and sales.

With the signature of Gov. Tate Reeves (R) on a compromise medical marijuana bill on Wednesday, Mississippi becomes the 37th state to legalize the use of marijuana for medicinal purposes.

Mississippians should see dispensaries operating before year's end. (Sondra Yruel/Drug Policy Alliance)

Heedful of the will of the people, both the legislature and the governor vowed to get a medical marijuana bill passed. The Supreme Court ruling was in May 2021; it took until now for the executive branch and the legislative branch to come to agreement on how to replace what the judicial branch threw out. Meanwhile, patients waited increasingly impatiently.

They got medical marijuana, but in a more restrictive form that what the voted for back in 2020. The Mississippi Medical Cannabis Act (Senate Bill 2095) allows patients to purchase smokeable marijuana, but only ¾ of an ounce per week, and there is no provision for home cultivation. Marijuana flower must be no more than 30 percent THC, while concentrates must be no more than 60 percent.

People with a specified list of conditions -- cancer, Parkinson's, Huntington's, muscular dystrophy, glaucoma, spastic quadriplegia, HIV, AIDS, hepatitis, amyotrophic lateral sclerosis (ALS), Crohn's, ulcerative colitis, sickle cell anemia, Alzheimer's, agitation of dementia, PTSD, autism, pain refractory to opioid management, diabetic/peripheral neuropathy, spinal cord disease, or severe injury -- qualify for medical marijuana.

People with chronic medical conditions that produce wasting, severe nausea, seizures, severe muscle spasms, and chronic pain also qualify, but chronic pain is narrowly defined as "a pain state in which the cause of the pain cannot be removed or otherwise treated, and which in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts by a practitioner."

Doctors, certified nurse practitioners, physician assistants, and optometrists can all sign recommendations for patients if they believe the patient "would likely receive medical or palliative benefit" from medical marijuana. But before they can do that, they have to have completed eight hours of continuing medical education courses on medical marijuana (and five hours each year after that) and have performed an in-person examination of the patient.

People who want to get in the medical marijuana business can obtain licenses if they pay nonrefundable application fees ranging from $1,500 for a 1,000-square foot canopy micro-cultivator license to $100,000 for the largest operators. There is no cap on the number of medical marijuana businesses. There will be a wholesale tax of 5 percent in addition to the state sales tax of 7 percent.

Marijuana reform advocates generally praised the passage of the bill, though with some reservations.

"With this victory, tens of thousands of Mississippians with debilitating health conditions will finally be able to safely and legally access something that can alleviate their pain and improve their quality of life. Mississippi now serves as the latest example that medical cannabis legalization is possible in any state in the country. We are hopeful that this move will add to the growing momentum towards cannabis policy reform in the South," said Toi Hutchinson, president and CEO of the Marijuana Policy Project (MPP) in a press release.

"Marijuana access is long overdue for Mississippi's patients," NORML's State Policies Manager Jax James said in a blog post. "The overwhelming majority of voters decided in favor of this policy change over a year ago, and for the past 14 months the will of the people has been denied."

But James also expressed disappointment in some of both what the bill does contain and what it does not.

"We remain concerned that lawmakers saw fit to add unnecessary taxes on cannabis products, that patients are prohibited from home-cultivating limited amounts of cannabis for their own personal use, and that those with chronic pain are restricted from accessing cannabis products until first using more dangerous and addictive substances like opioids," she said.

For MPP, though, the bottom line was that another state now allows patients access to medical marijuana.

"Despite tremendous support, Mississipians faced an uphill battle for a medical cannabis program. With this new law, justice has finally prevailed. Patients in Mississippi who are seriously ill will no longer be subject to arrest and criminal penalties for using medical cannabis and instead will be met with compassion. We applaud the legislature for working to restore the will of the voters in one of the most conservative states in the nation and Gov. Reeves for signing it into law," said Kevin Caldwell, MPP Southeast legislative manager.

The state Department of Health will begin issuing patient registry cards in 60 days, begin accepting applications from practitioners and begin licensing marijuana businesses other than dispensaries within 120 days, and licensing dispensaries within 150 days. The clock is ticking.