The clock is ticking for legal psilocybin therapy to begin in Colorado. In 2022, voters approved Proposition 122, a measure to both decriminalize psychedelic drugs and legalize supervised psilocybin services—for which the state government must create regulations. Part of that process has now been delayed, amid concerns over proposed licensing costs. Such costs will inevitably be passed on to people seeking services—so if they’re set high, services could effectively be reserved for the wealthy.
The Colorado Department of Revenue’s Natural Medicine Division is due to set the fees for the psilocybin “healing center” licenses required for these facilities to operate legally. According to local reporting, the agency planned to make its final decision on September 16, but received public comments critical of its proposal. It therefore decided to postpone, and will now hold a final rulemaking hearing on October 21, accepting additional public comments in the meantime. The state has set a deadline of December 31 to begin accepting psilocybin business applications.
Under Colorado law, adults over 21 will be able to pay to be given the psilocybin at approved healing centers. You’ll have to consume the drug on site, supervised by a trained professional or “facilitator.” Facilitators will be separately licensed by the state.
Doctors, psychiatrists, therapists or other health care professionals will be among those eligible to be licensed. If you have a health care facility, you could expand it to offer psilocybin to your patients.
Colorado distinguishes between “standard” and “micro” healing centers. In proposed rules released in August, the Natural Medicine Division envisaged charging micro centers $3,000 in application and compliance fees in the first year, increasing to $12,000 by the third year. Standard healing centers would meanwhile pay a total of $16,000 in the third year.
“We recommended a reduced fee specifically for smaller practices … Anything below $5,000 a year would still be expensive but might be feasible for people.”
Tasia Poinsatte, director of the Healing Advocacy Fund in Colorado, explained why her organization is pushing to lower those numbers.
“Concerns were raised by many advocates, including us, that the proposed fees for a micro healing center were too high to be workable,” she told Filter. “The goal for a micro healing center is that someone who is a licensed therapist, who wants to include psilocybin as a modality at their office, can get their office licensed and do that as one more tool in the toolbox. It’s economically challenging to add this within their existing practice if the fees are too high. We’re arguing the fees should be much lower because it would otherwise be a lower quantity of [people participating].”
“Many of these places might only hold one or two psilocybin sessions a month,” she continued, “so they would be making essentially no profit and maybe coming up short relative to the licensing fees at that rate. We recommended a reduced fee specifically for smaller practices … Anything below $5,000 a year would still be expensive but might be feasible for people.”
Evidently, the more expensive it is for healing centers to operate in Colorado, the more service users will be asked to pay.
Oregon, which became the first state to regulate supervised psilocybin use, after voters there approved Measure 109 in 2020, provides an example. Legal psilocybin services there, the first of which opened in 2023, are costing anywhere from $500 to over $10,000, a major barrier to equitable access. High regulatory costs create a challenging environment for Oregon businesses, too, with at least one already reported to have shut down.
“In Colorado, someone who’s a licensed therapist, if trained as a facilitator, can work with their existing patients and incorporate their skills as a therapist.”
Colorado’s measure was inspired by Measure 109, but there are important differences. Oregon has more restrictions on healing centers, which must be dedicated facilities—there’s no mixing of psilocybin services with health care or psychotherapy. Those facilitating psilocybin can’t sell it as a medical or therapeutic service.
In contrast, Colorado allows for various kinds of businesses to become healing centers, from dedicated psilocybin venues which may include overnight accommodations, to therapists’ offices and other health care faciilties. While licensing fees remain a sticking point, the more facilities the state licenses, the more different options—and price points—are likely to be available to consumers.
“[Oregon] requires licensed mental health and medical practitioners not operate under their licenses when operating as a psilocybin facilitator,” Poinsatte said. “In Colorado, our rules allow them to wear both hats at the same time—someone who’s a licensed therapist, if trained as a facilitator, can work with their existing patients and incorporate their skills as a therapist in their natural medicine practice.”
“We anticipate a somewhat higher demand than in Oregon.”
Unlike Oregon, Colorado will also allow “in home” psilocybin services, allowing facilitators to visit less-mobile recipients.
“Colorado allows more flexibility with where sessions take place,” Poinsatte said. “Psychedelic care could be provided at a participants’ home to allow access for people with barriers like a disability, or if they’re on hospice.”
While the Department of Revenue is responsible for licensing healing centers, cultivators, manufacturers and testing labs, the Department of Regulatory Agencies will separately license facilitators. The question of how high those fees are ultimately set carries similar implications.
“Our hope is that health care providers will start to talk about this with their patients,” Pointsatte said, “and because there is an opportunity for them to more directly participate, there will be more comfort with referring it. We anticipate a somewhat higher demand than in Oregon. It’s hard to give specific numbers, but I would say [Colorado’s market] will be in the vicinity of Oregon or higher.”
Photograph by Mushroom Observer via Wikimedia Commons/Creative Commons 3.0
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