Varying Approaches to Psychedelic Policy Reform in Washington State

By Jack Gorsline

Lawmakers in the Washington State Legislature have been weighing two distinct and often conflicting visions for the future of legal psychedelics, with the debate intensifying last week as one prominently-backed piece of legislation stalled out in the state’s Ways and Means Committee. 

At the center of the controversy is Senate Bill 5921, also known as the Washington Medical Psilocybin Act. While proponents argue it provides necessary clinical guardrails for vulnerable patients, grassroots organizations like Responsible Entheogen Access & Community Healing Coalition (REACH) Washington warn that without concurrent decriminalization for personal use, the state risks creating a “two-tiered system” that favors a medicalized approach that could limit access. 

The struggle in Washington reflects a national debate over how to integrate ancient medicines into modern law. SB 5921 treats psilocybin as a pharmaceutical intervention requiring strict Department of Health oversight. In contrast, a pair of competing bills – Senate Bill 5201 and House Bill1433 – treats psilocybin more like a regulated craft product under the LCB.

Senate Bill 5921 seeks to establish a medical pathway for psilocybin treatment, specifically targeting individuals with complex needs and treatment-resistant conditions. The bill mandates a structured care model, including required preparation and integration sessions, which supporters say ensures patient safety and continuity of care.

The proposal includes several features designed to integrate psychedelics into the existing healthcare infrastructure. It offers an outpatient microdosing option and creates a framework that may allow for insurance coverage under certain conditions. Furthermore, the bill emphasizes data collection and clinical research, aiming to build a more robust evidence base for psychedelic-assisted therapy.

During public testimony on Tuesday January 27, medical professionals highlighted the life-saving potential of the bill. Joy Laramie, a psychiatric nurse practitioner specializing in eating disorders, shared her experience with the University of Washington’s state-funded clinical trials.

“Early research indicates that when properly used, psilocybin is relatively low risk while holding immense promise for those who have failed standard care for anorexia nervosa, PTSD, depression, and other difficult-to-treat conditions,” Laramie testified. She noted that for families dealing with conditions like anorexia – which has a higher mortality rate than any psychiatric illness except opioid addiction – a regulated pathway is not just a luxury, but a necessity.

Brian Kennedy, a private psychotherapist with 30 years of experience in Olympia, echoed this sentiment. Having helped draft the state’s Mental Health Licensure Law, Kennedy described SB 5921 as a “cautious” and “mark-hitting” approach.

“People with serious, often treatment-resistant conditions are already seeking psychedelic interventions, frequently outside regulated medical or therapeutic frameworks,” Kennedy said. “The state is better served by creating guardrails than by ignoring that reality.”

While members of the Senate Health & Long-Term Care Committee advanced SB 5921 to the Ways and Means Committee during a hearing on Feb. 4,– the bill failed to move forward prior to the state’s formal deadline last week, effectively killing the Washington Medical Psilocybin Act for at least another year.

Regardless of the bill’s future, SB 5921 faced significant criticism from advocates who view its medicalized approach as overly restrictive. The bill requires a “qualifying diagnosis,” which critics argue reinforces a narrow clinical model that treats psychedelic use purely as an intervention to “fix” individuals rather than a tool for well-being or cultural practice.

REACH Washington has raised concerns regarding the bill’s extensive regulatory requirements. The proposed auditing, testing, and record-keeping mandates are expected to be costly. Advocates fear these high barriers to entry will incentivize the creation of high-volume psilocybin “mills,” where practitioner caseloads are maximized to cover overhead costs – a pattern that some advocates say has been previously observed in medical cannabis programs.

Furthermore, the bill applies pharmaceutical-grade testing standards to natural plant and fungi-based medicines. Critics argue these standards, designed for synthetic substances, are poorly suited to the natural variability of mushrooms and will likely make participation cost-prohibitive for small-scale, community-based models.

The opposition to SB 5921 is led by REACH whose directors argue that legalizing medical use without basic personal and community use protections is a fundamental mistake. Rachel Cervenak, Director of REACH Washington, emphasized the equity gap during her testimony on January 27. “It costs zero dollars to forage for psychedelic mushrooms that already grow in Washington – sometimes literally in one’s own backyard,” Cervenak said. “By contrast, this bill creates a costly regulatory system that many Washingtonians cannot afford to access.”

Cervenak pointed to Colorado’s Natural Medicine Health Act as a successful example of statewide decriminalization. She noted that approximately 14% of Washington’s population already lives in jurisdictions that have deprioritized the enforcement of laws against natural medicines.

Seeking a middle ground, a second legislative track – SB 5201 and its companion HB 1433 – proposes a more flexible “facilitated adult-use” program. This model draws inspiration from Oregon’s psilocybin services system, but attempts to improve upon it by designating the Liquor and Cannabis Board (LCB) as the regulator. Proponents argue the LCB has more relevant experience overseeing natural products than the Department of Health.

The Psychedelic Substances Act is designed to accommodate individuals who do not have a specific medical diagnosis, but still wish to access psilocybin in a regulated, safe environment. The framework prioritizes accessibility and inclusivity by allowing sessions to occur in diverse environments – such as homes, existing offices, or outdoor settings – thereby eliminating the overhead of dedicated “service centers” such as those that exist in Oregon. To help support a diverse and skilled workforce, the bill honors the expertise of seasoned practitioners through training waivers while mandating cultural competency for all facilitators.

The scope of the bill is comprehensive, covering both natural and synthetic psilocybin and establishing a clear pathway for the future inclusion of MDMA and ibogaine. These provisions are anchored by a “patient bill of rights,” which offers critical civil protections regarding employment, parenting, and professional licensure to safeguard those participating in the program.

However, this proposal is not without its own flaws. Grassroots advocates have voiced strong opposition to the bill’s enforcement provisions. Sections of the act would require law enforcement officers to notify prosecuting attorneys upon “reasonable suspicion” of a violation, which critics say leans toward criminalization rather than harm reduction.

Additionally, the bill restricts licensed facilitators from engaging with natural medicines sourced through unlicensed or community-based channels. This effectively prohibits the use of “home-grown” or traditionally sourced medicines within the regulated model, forcing participants into a commercialized system.

 Some of the most poignant testimony during the Senate Health & Long-Term Care Committee hearing on the proposed psilocybin legislation came from Sarah Rasor, Co-Founder of the Key Peninsula Psychedelic Society and Co-Director of REACH Washington. Rasor shared her personal journey from being a wheelchair-bound EMT to standing unassisted before the committee, credit she gives to “illegally healing” with psychedelics after traditional medicine failed her.

“That healing did not happen in a clinical or medicalized setting. It happened through intentional, personal, and community-supported use,” Rasor testified. She said that SB 5921  could criminalize the very pathways that she says saved her life. “Regulation without decriminalization creates a two-tiered system – where those who can afford expensive clinical services are considered legitimate, while others risk arrest for personal use of a natural medicine.”

During REACH WA’s lobby day on Tuesday, February 3rd the group brought over two dozen advocates to the state house and held 18 meetings with legislators and staff.

 “We were able to secure a last-minute appointment with [Senator Solomon’s] staff during our lobby day” the group noted in a statement provided to Lucid News following their lobby day, adding that “[we] are grateful for his staff’s willingness to make that possible.

“We hope that it helped reinforce the importance of this topic and the urgency of these conversations,” the statement continued, “and that Senator Salomon might consider meeting with us to discuss our proposed amendment to SB 5921 as it moves forward.” 

The Washington State Legislature stands at a crossroads. While SB 5921 offered a “cautious” path that integrates psilocybin into the medical establishment, providing hope for patients with severe psychiatric conditions, critique of the bill from advocates like Rasor and Cervenak about at the cost of personal autonomy and equity for those who cannot afford the high price of clinical care has diversified the discourse surrounding psychedelics amongst legislators from the Evergreen state

While psychedelic policy reform efforts may sit idle for another year in the Pacific Northwest, Washington lawmakers will almost certainly decide in the years to come between building a medical-first system or a more flexible model of next-gen psychedelic access. Cervenak told the committee that her organization’s primary goal is to advance a “balanced policy approach that supports a diverse range of individuals, use contexts, and community needs.”