Oregon’s Psilocybin Program: First Data Reveals Trends and Challenges

The nation’s first regulated psilocybin market shows promise but faces hurdles in accessibility and cost.

In 2020, Oregon became the first U.S. state to legalise psilocybin services for public use under Measure 109. The Oregon Psilocybin Services (OPS) programme launched in January 2023, with the first sessions held that summer. The Oregon Health Authority (OHA) has now released its first quarterly data for Q1 2025, covering January to April, providing insights into the programme’s early performance, client demographics, and challenges. Published in mid-June 2025 by Psychedelic Alpha, this dataset highlights the potential and pitfalls of this groundbreaking initiative.

Image credits: Unsplash

A Snapshot of Oregon’s Psilocybin Services

From January to April 2025, 1,509 clients accessed psilocybin services through approximately 24 service centres and 377 licensed facilitators. Since the programme’s start, around 10,000 clients have been dosed, reflecting consistent demand. Most clients sought psilocybin for mental health issues like depression, anxiety, or post-traumatic stress disorder (PTSD), as well as for personal growth and self-exploration. However, service centres are primarily located in urban and western counties, where awareness and resources are greater, leaving rural areas underserved.

Who’s Using Psilocybin Services?

The demographic data reveals a wealthier clientele, as session costs range from $1,200 to $3,000, which most insurance plans do not cover. This pricing raises concerns about accessibility for lower-income individuals or those with disabilities. Only 1% of clients reported disabilities impacting mobility or independence, such as difficulty walking or performing daily tasks. Geographic disparities further complicate access, with many Oregonians, particularly in rural areas, needing to travel long distances to reach a service centre. Some counties and cities have banned psilocybin services, exacerbating this issue.

Each client may purchase multiple products; this graph does not represent unique individuals dosed. Image credits: Psychedelic Alpha

Safety and Adverse Effects

Safety is a key focus of the programme. Of the 1,509 clients served in Q1 2025, only six reported adverse reactions, including behavioural, medical, or post-session issues. Research indicates that common psilocybin side effects, such as headaches or nausea, typically resolve within one to two days. However, rare cases of prolonged anxiety, existential distress, or social disconnection can persist for weeks or months. The low rate of adverse events suggests a robust safety framework, though strict regulations may contribute to high costs.

Economic and Operational Challenges

Financial and regulatory hurdles are significant. Some service centres have closed due to high operational costs and complex regulations, with no legislative funding allocated for 2025–27, according to Psychedelic Alpha. The OHA has indicated that licensing fees may rise to sustain the programme, potentially straining providers further. Even micro-dosing clients, who take smaller, non-psychedelic doses, face the same paperwork as those undergoing full-dose sessions, adding to administrative burdens. Providers also struggle with insurance, taxes, marketing, and limited public awareness, which has tempered the initial enthusiasm seen in 2023.

Urban vs. Rural Divide

The data underscores a stark urban-rural divide. Service centres cluster in urban areas like Portland, where demand is highest. This concentration aligns with greater awareness and economic resources but leaves rural residents with limited access. For homebound or disabled individuals, the lack of nearby facilities is a major barrier. Senate Bill 303 enabled the OHA’s data tracking, highlighting the need for solutions to improve geographic equity.

The Bigger Picture: A Model for the Nation?

Oregon’s programme is a potential blueprint for other states. Colorado, which legalised psilocybin in 2022, is developing a similar framework, while 22 other states are exploring psychedelic policy reforms, per Psychedelic Alpha. However, local bans and high costs in Oregon highlight scalability challenges. Advocates argue that the programme’s focus on mental health and personal growth aligns with growing evidence of psilocybin’s benefits for treatment-resistant depression and PTSD. Yet, financial and logistical barriers suggest that broader reforms, such as insurance coverage or federal decriminalisation, are needed for wider access.

What’s Next?

The OHA will continue releasing quarterly data to monitor trends, with Psychedelic Alpha updating its tracker for insights on sales, safety, and demographics. Providers like Bendable Therapy and advocacy groups like the Psilocybin Alliance are pushing for regulatory changes to lower costs and improve access. The programme’s success hinges on balancing rigorous oversight with practical measures to make psilocybin therapy affordable and equitable for all Oregonians.