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Updated October 22, 2024, at 11:43 p.m.

Medical professionals, billionaires, and activists from around the country are watching Massachusetts voters closely as they decide Ballot Question 4 — a complex proposal on the legalization of psychedelic substances.

Supporters — including the Washington, D.C.-based New Approach PAC and Massachusetts for Mental Health Options — have raised more than $6 million dollars in support of the ballot proposal. An opposition committee has raised just more than $100,000.

If the measure passes, Massachusetts residents over 21 would be able to grow, possess, and use certain natural psychedelics — but the commercial sale of the substances would remain prohibited. Instead, licensed centers could provide psychedelics to customers in a controlled setting. Both the centers and the substances would be regulated by a proposed state commission.

But legal experts expressed concerns that the lengthy ballot proposal proves too dense for voters to parse as they head to the polls.

“It is misleading because it’s really just a skeleton. It doesn’t tell you exactly what rules you’ll end up with,” said Mason Marks, a visiting professor at HLS who studies psychedelics law.

“You really have to be a lawyer to be able to interpret it,” he added.

James P. Davis, co-founder of the Bay Staters for Natural Medicine, said that the initiative is more complex than voting for or against psychedelic substances.

“It’s a lot more nuanced — because even the psychiatrists who are coming out strongly against it are conceding that they do have benefits and that they do have potential,” Davis said.

The complexities go beyond the language of the initiative. The ballot measure has attracted the attention of political actors and donors from across the country.

Massachusetts for Mental Health Options — the main proponent of the initiative in the state — has received funding and staff support from the New Approach PAC since its inception. The PAC, which advocates for the legalization of cannabis and psychedelic substances across the country, has given over $200,000 to MMHO since July of 2023.

Dr. Bronner’s Magic Soaps — which donated $1 million and $9.87 million to MMHO and New Approach PAC, respectively — is also providing supplies for an event hosted by the Harvard Undergraduate Psychedelics Club campaigning for the “yes” vote.

Chase M. Bourbon ’27, president of the Psychedelics Club, said the ballot measure is one of the “steps in the right direction” toward legalized psychedelic usage.

“I don’t see this being the final endpoint of where we’re going with the use of psychedelic medicine, but I see this as a step in the positive direction,” he added.

Intercontinental Real Estate CEO Peter Palandjian ’87, whose wife donated $100,000 to get Question 4 on the ballot, said that the couple supported the initiative because they believed in the positive benefits of psychedelics.

Palandjian, the brother-in-law of Harvard Corporation member Tracy P. Palandjian ’93, said that he wants “trauma victims” to have psychedelic treatments as a “tool in the tool bag.”

“I think this will be done thoughtfully — and that’s the only reason I would say my wife is supportive financially and I support it morally,” he added. “I really think we need new medicines.”

Opponents of the initiative, however, said it poses real risks for Massachsuetts patients.

Anahita Dua, a surgeon at Massachusetts General Hospital who chairs the opposition committee, wrote a brief against the ballot measure for the Information for Voters Booklet. In an interview, she said that the effects of psychedelic substances on other medications is “a giant question mark” that needs to be studied further before it is legalized.

“It’s actually way too much, too fast,” she added.

Massachusetts Psychiatric Society — an organization of over 1,500 psychiatrists — released a position paper opposing the ballot measure. MPS President Nassir Ghaemi said the initiative doesn’t address the needs of his patients, but instead benefits wealthy businesspeople.

“This bill is not about public health or mental health. It’s about the private wealth of the venture capital millionaires who want to make billions more,” said Ghaemi.

Ghaemi added that he is skeptical of the efficacy of psychedelics in treating his patient’s mental health, arguing that the substances may not more be effective than a placebo — and can be more dangerous.

“The claim that we already know enough that this will solve the mental health crisis is a highly unscientific and false statement,” he said, “It’s not science. It’s science fiction.”

Although Davis and the BSNM are vocal proponents of psychedelics, they also oppose the ballot initiative. They believe it doesn’t go far enough to ensure the substances will be accessible to all Massachusetts residents.

“The average price per session, with just a few grams of mushrooms is between $2,000 and $3,500 for a session lasting several hours,” according to a BSNM memo on Question 4 obtained by The Crimson.

“It’s not legal if no one can afford it,” Davis said of the costs of psychedelics.

Marks, the HLS professor, said that as legislators and activists debate the ballot measure’s merits, voters are bound to get lost in the complexities of the initiative.

“There’s just a lot of confused messaging about this and what it would achieve,” he said.

Correction: October 22, 2024

A previous version of this article incorrectly stated that opponents to the measure had not raised any money. In fact, the opposition committee has raised just more than $100,000.

—Staff writer Saketh Sundar can be reached at saketh.sundar@thecrimson.com. Follow him on X @saketh_sundar.