Adults with low incomes experiencing major depressive disorder showed significant and sustained improvements following psilocybin therapy in Oregon's regulated program, according to a groundbreaking study released by researchers from Oregon Health and Science University (OHSU) and the National University of Natural Medicine (NUNM).
The study represents the first scientific examination of Oregon's pioneering psilocybin therapy model since the program launched following voter approval of Measure 109 in 2020. Oregon became the first state to establish a legalized framework for psilocybin therapy, despite the substance remaining federally classified as a Schedule I drug alongside heroin and LSD.
Study Design and Participant Outcomes
Nineteen participants with major depressive disorder completed the study, each undergoing two psilocybin administration sessions in small group settings. The treatment protocol included two online preparation sessions, two administration sessions at licensed service centers, and two integration sessions conducted online.
Researchers measured depression severity using the Hamilton Depression Rating Scale, which scores depression from 0 to 30, with scores above 23 indicating very severe depression. "You can see after treatment one, the average goes down quite a bit; it goes even down further at the completion of treatment — after treatment two," explained Dr. Matthew Hicks of NUNM. "And then, we did a three-month follow-up again, and as is the case in most psychedelic research, there is a little bit of a rebound on average but still remains incredibly positive."
The sustained benefits extended beyond depression scores. "In the weeks and months, people experienced benefits that are not just related to their mood and their perceived sense of depression — they can feel improved social function or ability to communicate and be part of their family," said Dr. Olivia Hicks, also from NUNM.
Safety Profile and Patient Satisfaction
The study documented no serious adverse events requiring hospitalization or medical stabilization. Minor, temporary side effects included nausea, vomiting, headaches, and brief disorientation — consistent with expected psychedelic intervention effects.
Patient satisfaction remained exceptionally high, with no participant rating their experience below 4 out of 5, and most providing the maximum 5-out-of-5 rating. The average satisfaction score reached 4.8 among study completers, with only one participant dropping out for unreported reasons.
Participants also reported experiencing "strong feeling of emotional release" and "spiritual insight" during their sessions, according to the study's key findings.
Cost Considerations and Accessibility
The group therapy model demonstrated significant cost advantages over individual treatment. The entire 19-person cohort completed their therapy for $11,000 total, with facilitator costs representing more than half the expense at $140 per hour. Individual participants undergoing the same two-session protocol alone would face approximately $4,500 in costs.
These expenses reflect Oregon's self-funding regulatory structure, where facilitators pay $2,000 annually in state fees, service centers owe $10,000, and production labs face similar costs. Under Measure 109, the program must operate without tax dollars, contributing to high participation costs that effectively exclude many potential beneficiaries.
Insurance coverage remains unavailable for psilocybin therapy, creating substantial barriers for individuals who could benefit from the treatment. However, one study funding organization has set an aggressive goal of securing health insurance reimbursement for psilocybin therapy by 2030, arguing the treatment could reduce long-term mental healthcare costs.
Clinical Context and Program Growth
Since Oregon's first psilocybin service center opened in May 2023, the program has expanded to 24 locations statewide with more than 360 licensed facilitators. Over 12,000 people have participated in psilocybin therapy during the program's two-plus years of operation — more than five times the number of participants in all clinical psilocybin trials combined.
The FDA has designated psilocybin as a "breakthrough therapy" for mental health conditions, recognizing its potential for treating depression, anxiety, trauma, and addiction. Past research has consistently suggested psilocybin's efficacy for stubborn mental health conditions.
"This feasibility study demonstrated that a low-income population with depression can really benefit from psilocybin therapy done in a group. It was safe, it was well-tolerated, and we saw really meaningful improvements in their lives," said Dr. Olivia Hicks.
The researchers emphasized psilocybin's unique therapeutic profile compared to traditional psychiatric medications. "Often in medication trials, we hear about all of the horrible side effects of medications ... they fix one problem — but then, create 10 others," Olivia Hicks noted. "What we're seeing with psilocybin and other psychedelics is that we get side improvements. Not only does the depression get better, but so does the sleep, so does family relationships, so does one's ability to just show up in the world and work."
