A Massachusetts Voter Reflects on the Failure of Psychedelics Ballot Question 4 

Last month, Massachusetts voters decisively rejected Ballot Question 4, the Legalization and Regulation of Psychedelic Substances Initiative, with 56.9% voting against it and 43.1% in favor. As someone who supports the idea of exploring psychedelics for therapeutic purposes, I was disappointed, but not entirely surprised. The result was a setback not only for the psychedelics reform movement here in Massachusetts but also for broader efforts across the country. 

Looking back at the reasons behind the defeat, it’s clear that several factors shaped voter sentiment. Concerns about public safety and mental health risks were top of mind for many.  Critics argued that the measure lacked sufficient regulatory details to ensure safe, controlled  access to psychedelics and prevent potential abuse. There were fears that legalization could lead  to increased recreational use in unsupervised settings, leaving people vulnerable to “bad trips” without adequate support structures in place. 

I personally heard these concerns echoed in conversations with friends and acquaintances. One recurring worry was about the home-growing provisions of the measure, which allowed individuals to cultivate magic mushrooms and other natural psychedelic substances in a 12×12-foot  space. One friend put it bluntly: “You could grow a lot of ‘shrooms in 144 square feet. That’s way too much for personal use.” His concern seemed to center on the possibility of underground sales and the risk of psychedelics falling into the wrong hands.  

Another fear, particularly among parents, was the potential for accidental access by teenagers or other young people. The idea of having more psychedelic substances in circulation, particularly when they could be grown at home, felt like a step too far for many voters. 

Then there’s the cultural stigma. Psychedelics still carry the weight of their 1960s counterculture associations, and for many voters, these substances remain squarely within the realm of  “dangerous drugs.” Despite a growing body of research showing that substances like psilocybin (found in magic mushrooms) and MDMA have therapeutic potential, particularly in treating PTSD, depression, and anxiety, much of the public remains unaware of these breakthroughs. The recent rejection of MDMA as a treatment by the FDA (even though MDMA wasn’t included in this ballot measure) may have muddied the waters, further dampening enthusiasm for  psychedelics reform. 

Another factor that seems to have contributed to the defeat was the lack of widespread public  education on the therapeutic benefits of psychedelics. Clinical trials are showing promising  results, but for many people, the concept of using psychedelics as a medical treatment still feels  abstract, even controversial. Without a deeper understanding of how these substances work and who might benefit from them, it’s easy to see why voters would be skeptical, especially when the  regulatory framework called for in the measure seemed so complex. 

This brings me to another thought: Could the measure have been more successful if it had  focused on one substance, like psilocybin, instead of a broader legalization of multiple  psychedelic substances? The sheer breadth of the proposal may have made it harder for voters to  get behind it. Psychedelics are a diverse class of substances, and introducing five of them all at  once—without clear, simple guidelines—might have been too much to digest. 

The Future of Psychedelics in Massachusetts

Despite the setback, I believe there’s still hope for psychedelics in Massachusetts. Advocacy  efforts are likely to continue, especially at the state level, where new legislative initiatives could  push for medical access to psychedelic therapies. The federal landscape is evolving, too. With the  potential for substances like psilocybin and MDMA to move through the FDA approval process  for therapeutic use, we could see a shift in how these substances are viewed—nationally and in  Massachusetts. 

Some people remain optimistic about the future of psychedelics and the potential for federal  progress on psychedelic healing under the right conditions, even pointing to possible  opportunities with a future Trump administration. Although this may sound surprising to some, it  reflects a broader, bipartisan interest in the potential medical benefits of psychedelics. 

Local decriminalization efforts also offer a glimmer of hope. In the 2024 election, Massachusetts  municipalities like Cambridge and Somerville, which have both already passed measures to  decriminalize certain psychedelics, and also Boston, approved the measure by comfortable margins. These local victories suggest that there is still a dedicated, albeit somewhat fragmented, base of  support for psychedelics reform in Massachusetts. As these municipalities and others in the Commonwealth have shown, even if statewide legalization isn’t on the immediate horizon,  progress can still be made at the local level. 

What’s more, according to post-election reports, even some of the most vocal opponents of  Question 4 are open to a more measured approach. Dr. Anahita Dua, a vascular surgeon at  Massachusetts General Hospital, quoted in a Cambridge Day article, said she would support the  use of psychedelics through a regulated framework, one that includes medical professionals on site during treatments. Similarly, Chris Keohan, who led the opposition campaign, has suggested  that psychedelics could eventually be legalized for limited medical use in the next 5-10 years –  provided there are adequate safeguards in place. 

In fact, Question 4’s defeat may ultimately pave the way for a more thoughtful, focused approach  to psychedelic reform. With growing support for psychedelic-assisted therapy among medical  professionals and a public that is slowly warming to the idea of therapeutic use, the next push for  reform might be more targeted and less controversial. 

As one spokesperson for the “Yes on 4” campaign put it in an email to me, “In terms of work to  be done now, there are bills in the legislature that will likely be re-filed to provide some form of  psychedelic-assisted therapy.” There’s still a lot of work ahead, and the fight isn’t over. But the defeat of Question 4 doesn’t mean that psychedelics are off the table. Far from it. They just may  be more far out (pun intended).  

The future of psychedelics in Massachusetts is still uncertain, but it’s not dead. As science  continues to reveal the therapeutic potential of these substances and as public opinion evolves, I  believe we’ll see more progress. It might take a few more years, but I’m hopeful that we’ll see  another attempt to bring psychedelic reform to Massachusetts – this time, with a more  thoughtful, nuanced approach.  

Let’s hope that when that time comes, voters will be better informed and more open to the  promise these substances hold. Science is still unfolding, and so is the path forward.