Utah is the latest state, and a notably conservative one, to authorize some form of psychedelic therapy. On March 21, Utah Governor Spencer Cox (R) announced that while he’s not signing a psychedelic bill, he’s not vetoing it either. He’s letting it take effect without a signature, on May 1.
Senate Bill 266, introduced by Senator Kirk Cullimore (R), will permit two large health care providers— Intermountain Health and the University of Utah Health, as the Salt Lake Tribune reported—to develop a behavioral health treatment program using psilocybin and MDMA. All patients must be at least 18 years old, with psychedelic treatment supervised by licensed hospital staff.
Providers must report to the legislature before July 2026, detailing the drugs used, patient outcomes including any side effects or harms, and other relevant information. The bill includes a “sunset” clause, meaning its provisions only last until July 2027.
“The issue itself of access to care in regulated settings does transcend the political binary.”
“This is one of the clearer examples of bipartisan or ‘multi-partisan’ [support] of this work,” Ismail Ali, policy and advocacy director at the Multidisciplinary Association of Psychedelic Studies (MAPS), told Filter. “The fact a bill like this could pass through a majority-Republican legislature, especially with the ease that it did and a tremendous amount of support, demonstrates that the issue itself of access to care in regulated settings does transcend the political binary.”
The bill’s text prevents smaller hospitals or health care facilities from participating, limiting the program to either “a privately-owned, non-profit, vertically-integrated healthcare system that operates at least 15 licensed hospitals in the state,” or one “closely affiliated with an institution of higher education.”
The scope of treatment with psilocybin or MDMA is also likely to be limited. The bill specifies that hospitals can only use the drugs in forms that have reached at least Phase 3 clinical trials, the final step before potential FDA approval. Only MDMA for post-traumatic stress disorder, and psilocybin for treatment-resistant depression and major depressive disorder, currently meet that standard.
It’s unclear if Utah’s law, which says treatment must be must be “supported by a broad collection of scientific and medical research,” would allow doctors any flexibility in prescribing the drugs for other conditions, like substance use disorder, end-of-life stress and more. In the absence of FDA approval of MDMA or psilocybin for a particular condition, a possible legal mechanism for providers is to offer medicine through “compassionate use” or “expanded access” pathway under FDA rules.
One psychedelic expert is highly skeptical of Utah’s bill.
“It seems like any licensed health care facility will be hesitant … unless it’s through existing federal regulatory channels.”
“It’s a bit of an oddball, I’m not sure what it achieves, if anything at all,” Mason Marks told Filter. Marks is a law professor at Florida State University, specializing in psychedelic law, and the creator of Psychedelic Week.
Dr. Marks has doubts that the hospital systems eligible to offer psychedelic treatment under the law will actually do it, for fear of running afoul of federal drug laws.
“Either of these settings will be very hesitant to get involved in this in any way other than through research or just waiting for FDA approval,” he said. “Unless there’s some actors in Utah that are excited and ready to jump into this, it seems like any licensed health care facility will be hesitant … unless it’s through existing federal regulatory channels.”
Still, it’s noteworthy how Utah’s bill was sponsored by a Republican Senator, passed overwhelmingly by a Republican-dominated House and Senate, and allowed to take effect by a Republican Governor. It indicates a pathway for psychedelic reform in more conservative states—even if the bill is far more limited than the legalization embraced by voters in Oregon and Colorado, for example.
In those states, the law allows any adult to use psilocybin or another psychedelic under the supervision of a trained professional at a licensed facility. There is no requirement for a recipient to have a medical diagnosis, and the facilitators are not medical professionals—even though many people are choosing to pay for these (expensive) services to address mental health needs.
“The trend overall is that psychedelic policy approaches are casting a fairly wide net … They tend to align with what’s politically possible in that jurisdiction.”
Colorado also took it a step further by broadly decriminalizing use, sharing and growing of naturally occurring psychedelics, guaranteeing at least some basic protections for people who use these drugs outside of the regulated system.
“I think the trend overall is that psychedelic policy approaches are casting a fairly wide net,” Ali said. “We’re seeing in some states something limited to a task force or just research for a university … They tend to align with what’s politically possible in that jurisdiction. A bill like Colorado’s may not be able to get passed in most other jurisdictions … In [Utah’s] case, it’s utilizing existing medical infrastructure, which differentiates it from Colorado or Oregon, which are standing up new infrastructure.”
Instead, Utah’s bill more closely resembles those in states including Texas, Washington and Connecticut. They have also authorized some health care providers to give people psychedelic treatment, but as part of conducting clinical research.
“Those [states] are providing funding for clinical trials, and it’s pretty straightforward,” Marks said. “Texas is funding clinical research in Houston, Washington at University of Washington, in Connecticut at Yale.” Washington’s program, for example, will be limited to adults over 21 who are military veterans and first responders, with conditions like PTSD or substance use disorder.
Other states have introduced or considered similar bills, including North Carolina, Wisconsin and Pennsylvania.
For any state that takes steps to liberalize access to psychedelics in therapeutic or health care settings, Marks is concerned that governments are ignoring conflicts with federal law that could risk programs being shut down. As one example, he cited the just-released proposed rules for psychedelic therapy in Colorado, which create a “clinical facilitator” license. These license-holders would have a health care provider role, able to diagnose and treat health conditions.
“That’s going to create some potentially huge liabilities for those clinical facilitators,” Marks said. “I don’t know how many health care professionals will be willing to get involved in that program, because it does pose risks for them. It’s not so much the state but individual practitioners and businesses who could be in trouble when they’re offering non-approved substances as medical treatment … The same would apply in Utah.”
Much remains to be seen, then, about how the state’s new law will play out in practice, even if its adoption is another clear sign of shifting political winds for psychedelics.
Photograph of Utah State Capitol by Ken Lunder via Flickr/Creative Commons 2.0