Real-world Evidence from Facilitated Psilocybin Sessions within Oregon's Legal Framework: Demographics, Engagement, and Motivations

Oregon's Measure 109 created the first legal framework for supervised psilocybin services in the United States, launching in 2023. Despite thousands of participants accessing these services over nearly three years, systematic data on who seeks treatment and why has remained virtually nonexistent. This study addresses that critical knowledge gap.We conducted a naturalistic, observational study from March 2024 to April 2025 at a licensed service center in Central Oregon. Of 311 individuals who applied for services, 88 completed the study, providing demographic data, mental health histories, and motivations through online surveys approved by the WCG Institutional Review Board.

‍Key Demographics: Participants were predominantly middle-aged (median 47 years), female (62%), white (77%), and well-educated (63% with four-year degrees or higher). Nearly one-third were veterans (16%), and most (59%) were employed. Annual household income exceeded $100k for 30% of participants, while 50% had previous psychedelic experience and an equal percentage were currently in counseling or therapy.

‍Mental Health Profile: Depression emerged as the most common concern (61%), followed by anxiety (42%) and acute stress (24%). Participants reported complex, treatment-resistant conditions, with many seeking alternatives after years of unsuccessful conventional treatments. Open-ended responses revealed motivations ranging from healing trauma and grief to addressing "self-defeating attitudes and obsessive compulsive tendencies."

‍Clinical Significance: This represents one of the first naturalistic investigations into legal psilocybin services, revealing that participants are primarily addressing persistent mental health challenges through Oregon's regulated framework. The demographics suggest those accessing services are strongly motivated to address mental health conditions that traditional treatments have not adequately resolved.These findings provide essential baseline data for understanding who accesses legal psilocybin services and establish a foundation for future research into mechanisms, response patterns, and long-term outcomes as psychedelic medicine advances toward potential FDA approval.