This is a fairly complicated ballot initiative involving the legalization and use of certain psychedelics. It follows the trends in recent years of revising out thinking about psychedelics, most notably by certain authors like Michael Pollan, whose 2018 book How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence was a groundbreaking rethinking of psychedelics and the post-counter culture prejudice against psychedelics. But this is a complicated topic that esteemed scientific minds disagree on, and it’s arguably a topic that is a little bit too complicated for a ballot question.

In any case, this ballot question provides limited legalization of five psychedelic substances found in mushrooms or plants: psilocybin, psilocin, dimethyltryptamine, mescaline, and ibogaine. Licensed centers could sell the substances for on-site consumption under the supervision of a trained facilitator; sale of these psychedelic substances would remain prohibited except at such centers. 

In addition, the sale of these substances, even at licensed centers, would be subject to the state sales tax plus an additional 15% surcharge; cities and towns could also impose an additional separate surcharge of 2%. Cities and towns could also “reasonably restrict” the time, place and manner of the operation of these licensed facilities (but could not block them altogether).

The proposal also allows anyone aged 21 and older to grow these substances in a 12-foot by 12-foot area, and to use them at home; it legalizes possession of up to one gram each of psilocybin, psilocyn, and dimethyltryptamine, 18 grams of mescaline, and 30 grams of ibogaine (collectively, the “personal use amount”); it permits someone to give away up to the personal use amount to a person aged 21 or over, so long as it is for free.

The proposal also has additional provisions relative to the denial of medical care or public assistance, or the operation of a motor vehicle, and several other items.

The ballot measure also would establish a five-member commission and a 20-person advisory board to enact regulations.

In short, this law is complicated. Its text is 13 pages long, and (as is often true of proposals that originate outside of the Commonwealth and are meant for adoption by more than one state), the proposal is not in proper form as an amendment to the General Laws. (Not that anybody really cares about this, as it is easily fixable.)

The Center for State Policy Analysis evaluated the claims in Question 4 and found the following:

• Psilocybin shows promise as a treatment for some serious mental health conditions, including anxiety among patients with terminal illnesses;
• Psychedelics are also associated with some not insubstantial harms, such as cardiac problems, and lasting neurological effects; 
• Psychedelics would not be available for purchase at retail shops, but would generally have to be used at a licensed psychedelic therapy center, or through growing them at home; 
• Treatment at psychedelic therapy centers would likely be expensive, encouraging more at-home and personal use, where the lack of guidance and oversight brings heightened risk;
• While Colorado and Oregon have already legalized some psychedelics, Question 4 has a broader scope, including allowing a wider range of drugs to be offered in therapy centers.
• Federal authorities consider all of these drugs illegal, so passing Question 4 could put Massachusetts at risk of a future federal backlash.

It should be remembered that the legislature can (and often has) amended ballot initiatives to change some of the specifics. In that a ballot initiative is just like any other bill (unless it also functions as a constitutional amendment), and it seems pretty clear that if this initiative were to pass, some of the specifics would probably have to be amended. 

In effect, passage of this initiative would signal a general public approval of the medical use of psychedelics without necessarily endorsing all of the specifics included in this initiative. Without that flexibility to amend, I think I would oppose this initiative. But giving serious consideration to the medical use of psychedelics is something that I think should happen, and without the “kick-starter” of this initiative I don’t think the legislature would get there on their own.

For this reason I endorse a “yes” vote on this initiative.