New Mexico Medical Psilocybin Act

1. Introduction

Version followed: the Medical Psilocybin Act as enacted (Senate Bill 219, 2025 regular session; NMSA 1978 §§ 26-2D-1 to -11), and the New Mexico Department of Health (NMDOH) rules. 7.35.2 NMAC (producers and laboratories; hearing 24 April 2026, hearing officer report 26 May 2026) appears to have been adopted as a new rule dated 23 June 2026: the history lines in NMDOH's October 2026 amendment text read "N, 6/23/2026". NMDOH's rules index still lists 7.35.2 under "Pending Rulemakings", and amendments to it (§§ 7, 10 and 24) are going through rulemaking alongside 7.35.3 [uncertain on the exact effective date]. 7.35.3 NMAC (patients, certifying clinicians, practitioners, facilitators, healing centers, other approved locations, educational programmes) is still proposed. The draft text was published 23 July 2026 and hearings were held 28 August and 2 October 2026. The 2 October hearing packet still shows the effective date as "xx/xx, 2026". As of 24 October 2026, NMDOH's Rules & Regulations page still lists both 7.35.2 and 7.35.3 under Pending Rulemakings, with no adoption or effective date shown, so every 7.35.3 detail below comes from proposed text and may change [uncertain]. NMDOH began accepting producer permit applications in August 2026, which indicates the producer rule is operating; permits for clinicians and testing were to follow once rulemaking is complete. [source: NMDOH Rules & Regulations page, 2026 pending rulemakings; Source NM, 27 Aug 2026] Section numbers below are those of the October 2026 hearing draft. [source: SB 219 final text; NMDOH rule documents 9604, 9605, 9692, 9741, 9742, 9805, 9806, 9904; NMDOH Rules & Regulations index]

What it is. This is a state regulated-access programme, not a psychotherapy model. The Act creates a "medical use of psilocybin program" run by NMDOH's Center for Medical Cannabis and Psilocybin. Under it, qualified patients with a qualifying condition receive psilocybin from permitted producers, with "medical services" before, during and after the administration session (preparation, administration and integration), in an approved setting. [source: SB 219 §§ 2, 3, 7; NMDOH Medical Psilocybin Program page]

Legal basis and dates: Governor Michelle Lujan Grisham signed SB 219 in April 2025, and it took effect on 20 June 2025. The Act sets a statutory deadline of 31 December 2027 to implement the programme, and the 7.35.3 draft repeats the 31 December 2027 and 1 January 2028 transition dates. NMDOH's own target is earlier: its programme page says implementation by 31 December 2026, and its FAQ gives the goal as enrolling the first patients "by the end of December 2026". The FAQ also says the programme starts only once its rules take effect, and that until then psilocybin is not legally available in New Mexico outside clinical research. Both dates are verified. December 2026 is NMDOH's target, and 31 December 2027 is the legal deadline. Whether December 2026 is met depends on 7.35.3 being adopted [uncertain]; Source NM reports that a buildout and inspection period for locations is likely before treatment begins. A state Medical Psilocybin Treatment Equity Fund of $630,000 for low-income and rural residents was included in the 2026 budget (HB 2). [source: Source NM, 18 Mar and 27 Aug 2026] [source: SB 219 § 7; NMDOH programme page; NMDOH Medical Psilocybin FAQ; 7.35.3 draft (doc. 9904); Peskuski, Albuquerque Journal, 26 Sep 2026]
Qualifying conditions (statute and rule): major treatment-resistant depression, posttraumatic stress disorder, substance use disorders, end-of-life care, and other conditions NMDOH approves on the advice of the Medical Psilocybin Advisory Board. The board accepts petitions to add conditions. The proposed amendment to the 7.35.2.7 NMAC definitions uses the same list. NMDOH's FAQ names anxiety as an area of possible benefit but not as a qualifying condition, and says the rules will settle who qualifies. [source: SB 219 §§ 3, 8; 7.35.2.7 amendment (docs. 9805, 9904); NMDOH programme page and FAQ]
Legal status: In New Mexico, psilocybin and psilocin are removed from Schedule I only for medical use under the Act. Program participants are protected from state arrest and prosecution, but only for activity that complies with the Act. Psilocybin remains federally prohibited, and the Act gives no protection against federal law. The Act exempts FDA-approved psilocybin products and FDA-approved clinical trials. Use outside a compliant administration session, driving under the influence, carrying psilocybin across state lines and diverting it are all unprotected. [source: SB 219 §§ 4–6, 13; 7.35.3.22 draft; Peskuski 2026 on VA/federal status]
Who delivers it (the 'clinician-administered' model): the draft rule sets up three certified roles. A certifying clinician holds a NM licence to diagnose the qualifying conditions (the draft gives MD and NP as examples) plus a controlled-substance registration, and certifies the patient. A practitioner holds a NM licence to practise therapy, counselling or behavioural services (the draft gives PSY, LSW and LCSW as examples) and delivers and supervises services. A facilitator needs no licence, gives peer support plus logistical and administrative help, and works under the direct supervision of a practitioner. Services take place only at a certified healing center or a temporarily certified other approved location. [source: 7.35.3.9, .11, .13 draft]

How change is thought to happen. Neither the Act nor the rules state a theory of change. Their training topics point to the frame they assume: set and setting, preparation, a supported non-ordinary state, integration afterwards, and trauma-informed, harm-reduction and culturally competent care. That includes the social and cultural history of psilocybin, among it Native American traditional use. [source: 7.35.3.18 draft] The research safety guidelines that underpin regulated psilocybin work locate risk and benefit mainly in psychological factors (expectation, trust, environment, support) more than in physiological ones. [source: Johnson, Richards & Griffiths 2008]

2. Framework

The regulator defines the stages of patient flow. It does not set clinical session counts for patients. Where counts appear below, they come from the practicum rules (training) or from research guidelines, and are labelled as such.

Stage 0. Referral and clinician–patient relationship.

Goal: identify a possible qualifying condition and connect the client with a certifying clinician.
The draft requires an actual clinician–patient relationship. An outside psychotherapist cannot certify unless they also hold a licence to diagnose and a controlled-substance registration. Critics note that, under the draft, licensed professional clinical counsellors can deliver services but cannot sign certification. [source: 7.35.3.13 draft; Peskuski 2026]

Stage 1. Certification and enrolment.

The certifying clinician carries out an in-person physical evaluation and gives medical clearance. Telemedicine certification is allowed only if one of three things holds: there was an in-person exam within the previous six months; the clinician reviewed records from a clinician who examined the patient in person within six months; or the clinician formally consulted such a clinician.
The clinician discusses risks and benefits, and attests to the diagnosis, its date and supporting documentation, medical appropriateness, and that likely benefits outweigh risks. They also give information about the Equity and Access Fund where it applies.
The patient applies through NMDOH's electronic system with ID, a signed medical-information release, and an affirmation that they understand the risks and benefits discussed.
NMDOH decides within 30 calendar days of a complete application. Enrolment lasts two years, and the patient re-enrols after it expires.
Criterion to move on: NMDOH approval as a qualified patient. [source: 7.35.3.8, .13 draft]

Stage 2. Preparation session(s).

Individual or group (training standards treat groups as four or more patients).
Goals: informed consent, rapport and trust, expectations, the safety and emergency plan, the patient bill of rights, how to complain and how to report an adverse event, and arranging safe transport home. [source: 7.35.3.18–.20 draft]
Number of sessions: the Act requires a preparation session, an administration session and an integration session, and the proposed 7.35.2.7 amendment defines all three. Neither the Act nor the October 2026 draft fixes how many preparation or integration sessions there are, or how long they last. The Johnson, Richards & Griffiths research guidelines used at least four meetings, totalling at least eight contact hours, over about a month. That is a research standard, not a NM requirement. [source: SB 219; NMDOH FAQ; 7.35.2.7 amendment and 7.35.3.19–.20 draft (doc. 9904); JRG 2008]
Criterion to move on [synthesis, drawing on JRG 2008]: trust is established, and consent is understood and freely given. Add meetings or postpone if trust is not there.

Stage 3. Administration session.

Takes place only on the premises of a healing center or other approved location.
Staffing:
- Individual session: at least one practitioner and one facilitator.
- Group session: at least one practitioner per eight patients and one facilitator (or qualified practicum student) per two patients. NMDOH may waive the ratios.
- Remote natural sites 15 minutes or more from emergency services: a first-aid kit and an AED on site, plus two non-patient attendees with wilderness first-aid, wilderness first-responder or EMT credentials.
Practitioners and facilitators must be present at all times. Only patients, certified staff and practicum students may be present, unless every patient gives prior written consent to others attending. Staff may not use psilocybin or any other intoxicant while providing services.
Medical monitoring and medical decisions belong to the certifying clinician and medical staff, under the location's emergency plan. [source: 7.35.3.13, .20 draft]

Stage 4. Integration session(s).

Individual or group. The draft requires records of the date of the initial integration session. The number of later sessions is not specified [uncertain].
The research guidelines hold a next-day follow-up with the primary monitor, with more meetings as needed. [source: 7.35.3.13 draft; JRG 2008]

Stage 5. Reporting, continuity and renewal.

Practitioners and facilitators submit service and administration records to NMDOH, including any adverse events.
Locations report any emergency procedure, and any potential adverse health event, within two calendar days.
Continuity of care is a required training topic. Re-enrolment comes after two years. [source: 7.35.3.13, .21 draft]

Practitioner and facilitator training (for clinicians wanting to join).

Didactic requirements:
- A NM module covering the Act, medical and therapeutic use, social and cultural history including Native American traditional use, and spiritual and existential aspects.
- A psilocybin therapy module of at least 65 hours, at least a third of it in person.
- At least 10 hours of simulated-patient work.
- A role module of at least 5 hours. For practitioners it covers psilocybin-specific therapeutic approaches and non-ordinary states. For facilitators it covers peer ethics, care-team work, presence and basic psychotherapy concepts.
Practicum: at least 120 hours for practitioners and 100 for facilitators, begun after half the didactics and all simulated-patient hours are done.
- At least 80 hours of administration-day work with at least 14 patients, including individual and group sessions. The first 20 hours are with low-risk patients.
- At least 20 hours of preparation and integration work.
- Two case presentations.
- Practitioners add 20 hours supervising facilitators.
A reduced pathway of 40 contact hours applies to applicants who graduate by 31 December 2027.
Then 10 hours of mentoring after graduation, and every two years 20 hours of continuing education plus BLS/CPR-AED or EMT status.
Certifying clinicians take an 8-hour module covering pharmacology, 42 CFR Part 2, diagnosis, medical clearance, psychedelic emergencies and data collection, plus 8 hours of continuing education every two years. [source: 7.35.3.17–.19 draft]

3. Guiding principles

Work only inside the regulated frame: services, possession and use are lawful only as the Act and rules permit. In practice, never advise or arrange use outside a certified location, and make the state-versus-federal gap clear to clients. [source: SB 219 §§ 5–6; 7.35.3.22 draft]
Safety takes priority over everything else: the guidelines' wording is "volunteer safety must take priority over scientific procedures". In practice, stop, postpone or escalate whenever safety is in doubt. [source: JRG 2008]
Medical clearance is a medical gate: certification rests on an in-person evaluation, medical clearance and a benefit-over-risk judgement. In practice, the therapist supplies psychiatric history and observations, and the certifying clinician decides. [source: 7.35.3.8, .13 draft]
Trust before the session: the guidelines treat rapport as the main protection against overwhelming distress. In practice, do not go ahead until the client says, and shows, that they trust the team. [source: JRG 2008]
Set and setting: a required training topic. The guidelines favour a comfortable, non-clinical, hazard-free room. In practice, check the room, the client's expectations and their mood on the day, and treat each as a clinical variable. [source: 7.35.3.18 draft; JRG 2008]
Informed, ongoing consent: a training topic and a required patient handout. In practice, consent covers the experience, the risks, any touch, observers and data use, and you revisit it before the session. [source: 7.35.3.18, .20 draft]
Care team with clear roles: practitioners lead, and facilitators give peer and logistical support under direct supervision. In practice, agree beforehand who speaks, who stays and who escalates. [source: 7.35.3.13, .18 draft]
Never leave the patient alone: staff must be present at all times, and the guidelines keep one monitor in the room throughout. In practice, plan staff breaks and restroom escorts so that coverage never drops. [source: 7.35.3.20 draft; JRG 2008]
Trauma-informed care: a training topic. In practice, offer choice, predictability and control over pace, and expect trauma material to surface. [source: 7.35.3.18 draft]
Touch and somatic awareness: a training topic. The draft sets no touch rules. The guidelines allow supportive touch on the arm or shoulder, and hand-holding, practised during preparation. In practice, agree touch explicitly in advance and never initiate any other kind [synthesis on the limits]. [source: 7.35.3.18 draft; JRG 2008]
Harm reduction: a training topic. In practice, meet clients who use outside the programme without judgement, and focus on risk.
Cultural competency and respect for Indigenous traditions: the NM module covers Native American traditional use, and the Act requires tribal consultation and a tribal member on the advisory board. In practice, do not appropriate or perform ceremony, and defer to the communities themselves on traditional practice [synthesis]. [source: SB 219 §§ 7–8; 7.35.3.18 draft]
Spiritual and existential openness: a required module. In practice, explore the client's own meaning-making and do not impose a framework.
Equity of access: there is a treatment equity fund for income-eligible patients, and the annual assessment covers rural, subsidised-housing and reservation residents. In practice, tell eligible clients about the fund.
Confidentiality, including 42 CFR Part 2 for substance-use records: In practice, keep programme records separate, get explicit releases, and share only what is necessary. [source: SB 219 §§ 9, 11; 7.35.3.8, .11, .18 draft]
Clean boundaries: do not certify or treat relatives within the second degree of blood or the first degree of marriage, do not use psilocybin or other intoxicants while providing services, and do not share ownership between certificants and producers. In practice, screen yourself for conflicts before taking a case. [source: 7.35.3.13, .23 draft]
Continuity of care: In practice, coordinate with the client's ongoing therapist and prescriber before and after the programme. [source: 7.35.3.18 draft]

4. Intervention inventory

What the regulator publishes covers structure, roles and safety. It does not prescribe a clinical protocol, so the published frame is laid out below as procedures. The regulatory items come from the 7.35.3 NMAC draft. The session-conduct procedures come from Johnson, Richards & Griffiths (2008), the research safety guidelines that regulated psilocybin programmes commonly draw on. NM does not formally adopt these guidelines [uncertain]. Steps that neither source gives are marked [synthesis]. No dosing, product or administration detail is included: these are decisions for the certifying clinician and medical staff under NMDOH rules.

4.1 Assessing fit and referring to a certifying clinician (outside psychotherapist)

Purpose / when: a client asks about the programme or may have a qualifying condition. [source: SB 219 § 3; 7.35.3.8, .13 draft]
Steps:
1. Check whether the client has a documented diagnosis of a qualifying condition, or a condition that might be added by petition.
2. Explain the three roles: certifying clinician, practitioner and facilitator.
3. Explain the certification steps: in-person evaluation and medical clearance, the risk–benefit discussion, the online application, a decision within 30 days, and two-year enrolment.
4. With a signed release, send the certifying clinician a referral letter with your diagnosis, your treatment history and any psychiatric risk factors.
5. Tell the client about the equity fund if they may be income-eligible. [synthesis on the letter content]
Example language (illustrative): "The programme is run by the state. A medical clinician has to examine you and certify you, and the Department then has up to 30 days to decide. I can send them my notes if you'd like that."
Watch for: pressure to certify quickly. Also watch for clients whose care is through the VA or federal employment. Psilocybin remains Schedule I under federal law. The VA funds psychedelic trials, but it has published no directive (like its cannabis guidance) that says veterans will not lose benefits for psychedelic use outside trials. It also states that it "strongly discourages self-medicating" with psychedelics. The military now tests for psilocin. Ask about these issues before the client applies. [source: NMDOH FAQ; RAND RR-A4334-3, 2026, pp. 5, 15, 24; Peskuski 2026]

4.2 Psychiatric screening input

Purpose / when: before certification, to give the certifying clinician the information they need for medical clearance.
Steps:
1. Take or update a structured psychiatric history.
2. Ask specifically about current or past psychotic disorder or bipolar disorder, and the same in first- or second-degree relatives. JRG treat these as exclusions in research.
3. Ask about current suicidal ideation that needs immediate treatment, recent substance dependence, and traits the guidelines flag, such as marked rigidity or emotional lability.
4. Collect a complete list of current medications and supplements for the prescriber. JRG describe interaction concerns with some psychiatric medications, but the decisions belong to the prescriber.
5. Note medical issues for the clinician, such as cardiovascular history or pregnancy (both excluded in JRG research).
6. Write it all down. [source: JRG 2008]
Example language (illustrative): "Has anyone in your family, parents, siblings, grandparents, aunts or uncles, ever had psychosis or bipolar disorder?"
Watch for: neither the October 2026 7.35.3 draft nor NMDOH's FAQ lists specific contraindications or exclusion criteria. The FAQ says only that patients will be "carefully screened", and the draft leaves medical clearance to the certifying clinician's evaluation and training. The JRG exclusions above are research standards that NM has not adopted. Final rules could add criteria [uncertain]. Never advise a client to stop or change a medication. Refer to the prescriber. [source: 7.35.3.8, .13, .17 draft (doc. 9904); NMDOH FAQ; JRG 2008]

4.3 Informed-consent and risk–benefit conversation

Purpose / when: at certification (the clinician) and in preparation (the practitioner). NM requires a risk–benefit discussion with affirmations, and a consent handout at the location.
Steps:
1. In plain language, describe the possible experience: perceptual change, strong emotion, altered sense of time and self, and possible anxiety or paranoia.
2. Describe its timecourse in general terms.
3. Describe the known risks: acute distress, rare prolonged psychosis, and rare persisting perceptual changes.
4. Explain the legal limits, state and federal.
5. Cover the location's rules: who may be present, touch, data reporting to NMDOH, and how to complain or report an adverse event.
6. Confirm that participation is voluntary and can be withdrawn at any time, including by written notice to NMDOH. [source: 7.35.3.8, .20, .24 draft; JRG 2008]
Example language (illustrative): "You can say no at any point before the session, and saying no won't affect your other care with me."
Watch for: the client being able to explain the risks back in their own words. Recheck if they can't.

4.4 Preparation: rapport and life-history meetings

Purpose / when: to build the trust that the guidelines see as the main protection against overwhelming distress. Use from the first preparation session.
Steps:
1. Hold meetings in the room where the session will take place, if possible.
2. Ask for the client's life story: childhood, relationships, beliefs and important events.
3. Ask what they hope for and what they fear.
4. Introduce every staff member who will be present on the day.
5. Judge readiness. If trust is not enough, add meetings or postpone. [source: JRG 2008]
Example language (illustrative): "It helps us to know your story before the session, so nothing that comes up will be a surprise to either of us."
Watch for: guarded or compliant presentation and fear of the team. The guidelines link mood before the session to difficult experiences.

4.5 Preparation: orienting to the range of experience and the 'approach, don't flee' stance

Purpose / when: so the client can respond to frightening material without panicking.
Steps:
1. Describe the possible content: perceptual, emotional, autobiographical, symbolic, mystical, and loss of a sense of self.
2. Explain that the body keeps working without conscious control.
3. Encourage the client to surrender to the experience and to move towards frightening images rather than away from them.
4. Give this verbally, and avoid steering the client with published accounts. [source: JRG 2008, which uses the phrase "surrender to the experience"]
Example language (illustrative): "If something frightening shows up, try turning towards it and asking what it is. We will be right here."
Watch for: rigid expectations, such as wanting a specific mystical outcome. Gently widen them [synthesis].

4.6 Preparation: touch agreement and rehearsing interpersonal grounding

Purpose / when: to agree in advance whether supportive touch will be used and what form it takes. Touch is a NM training topic, and the guidelines recommend demonstrating it during preparation.
Steps:
1. Describe the only forms on offer: a hand on the forearm or shoulder, or holding hands. JRG call holding hands "interpersonal grounding".
2. Demonstrate it while the client is in an ordinary state.
3. Agree a signal for yes, no and stop.
4. Write the agreement down, and confirm it again on the day.
5. Make clear that no other touch will happen. [source: JRG 2008; 7.35.3.18 draft; written agreement and signal = synthesis]
Example language (illustrative): "If you reach out a hand, one of us will hold it. If you don't want touch at all, tell us and we won't."
Watch for: a trauma history involving touch. Default to no touch, and offer verbal grounding instead [synthesis].

4.7 Preparation: safety, logistics and rights briefing

Purpose / when: the NM draft requires the location to give patients: information on safe transport home; the patient bill of rights and responsibilities; information on informed consent; how to file complaints; how to report adverse events; and the safety and emergency plan.
Steps:
1. Go through each document with the client.
2. Arrange a named person to take the client home. Participants are not protected if they drive under the influence. JRG release participants to an oriented friend or relative.
3. Explain what staff will do if the client tries to leave against advice.
4. Explain the rules on who may be present, and get written consent from every patient before anyone else attends.
5. At remote sites, explain the emergency access arrangements. [source: 7.35.3.20, .22 draft; JRG 2008]
Example language (illustrative): "Who will pick you up afterwards? We'll meet them briefly so they know what to expect."
Watch for: no ride home arranged. Do not schedule the session until there is one [synthesis].

4.8 Setting preparation

Purpose / when: before each administration day, to keep the room physically and psychologically safe.
Steps:
1. Check that the room is comfortable and non-clinical; JRG describe a "living room-like setting".
2. Remove sharp or glass hazards and secure the windows.
3. Keep phones out of the room.
4. Make sure a private restroom is nearby.
5. Check that the location has a device that reaches emergency services, and that firearms are absent (healing centers) or stored under plan (other approved locations).
6. Check that product storage is locked, as the rule requires.
7. Prepare eyeshades and music if they will be used. [source: JRG 2008; 7.35.3.11, .20 draft]
Example language (illustrative): "Before you arrive, we'll walk through the room together so it feels familiar."
Watch for: noise or interruptions from outside, and staff on the day the client hasn't met.

4.9 Administration-day presence and check-ins

Purpose / when: throughout the administration session. The NM draft requires practitioners and facilitators to be present at all times. [source: 7.35.3.20 draft]
Steps:
1. Greet the client warmly and keep every staff contact courteous.
2. Confirm consent and the touch agreement once more.
3. One team member is always in the room, and only the team interacts with the client.
4. If eyeshades and music are used, check in at intervals by asking whether the client needs anything.
5. During the most intense part, discourage long talking or analysing. JRG suggest the client "collect experiences" to discuss later.
6. Later on, the client may sit up and talk.
7. Medical observation is done by medical staff, following the location's plan. [source: JRG 2008]
Example language (illustrative): "Just checking in. Is there anything you need right now?"
Watch for: signs of distress, and attempts to get up without support. Also watch your own urge to interpret: the client's own meaning-making comes later.

4.10 Physical support and restroom escort

Purpose / when: whenever the client moves around, because perception and balance may be disturbed.
Steps:
1. Steady the client as they walk.
2. Escort them to a private restroom and make sure no one else is there.
3. Keep the door unlocked, or have a key to hand.
4. Wait just outside. Ideally a same-gender team member does this [synthesis on gender, drawing on JRG's mixed-gender team advice]. [source: JRG 2008]
Example language (illustrative): "I'll walk with you and wait right outside the door."
Watch for: falls, and disorientation on the way back.

4.11 Responding to acute distress

Purpose / when: fear, panic, paranoia or overwhelming emotion during the session. The guidelines call this the most likely risk.
Steps:
1. Offer calm, reassuring presence first.
2. Avoid 'talking down' and reality-testing, which JRG note can backfire.
3. Encourage the client to turn towards the experience.
4. Offer the agreed touch (interpersonal grounding).
5. Orient them: they are in a programme session, they received psilocybin, and the effects will end.
6. If reassurance is not enough, escalate under the emergency plan to the certifying clinician or medical staff. JRG treat medication as a last resort and warn that emergency departments can prolong a difficult reaction. Any medical decision belongs to medical staff.
7. After any emergency procedure, the location reports it to NMDOH within two calendar days. [source: JRG 2008; 7.35.3.21 draft]
Example language (illustrative): "You're safe. You're in the session room, and I'm right here with you. This will pass. Let it move through you."
Watch for: distress easing as the client feels contact and orientation. If agitation, danger to self or others, or medical signs escalate, follow the emergency plan.

4.12 Managing an attempt to leave

Purpose / when: a client tries to leave during the session. The NM safety plan must say how leaving against medical advice is handled.
Steps:
1. Plan in advance for interruptions such as fire alarms.
2. Stay in contact with the client.
3. Redirect them compassionately but firmly, using reassurance and orientation.
4. If they still insist, follow the location's written plan, including emergency services where the plan says so.
5. Document what happened and report it. [source: JRG 2008; 7.35.3.20, .21 draft] Never use force beyond what the location's plan and the law permit; this is a legal and ethical question for the location [synthesis].
Example language (illustrative): "I hear that you want to go. Stay here with me for a few minutes, and let's breathe together first."
Watch for: paranoia directed at staff. A team member the client trusts should take the lead.

4.13 Group sessions (preparation, administration, integration)

Purpose / when: the NM draft provides for group sessions and trains for groups of four or more patients. The ratios are at least one practitioner per eight patients and one facilitator or qualified student per two patients.
Steps:
1. Prepare each participant individually as well as in the group [synthesis].
2. Get written consent from everyone about who will be present.
3. Assign each patient a named support person.
4. Agree group norms: confidentiality, no interference with other participants, and how to ask for help [synthesis].
5. Hold group integration with an option for individual follow-up. [source: 7.35.3.19, .20 draft]
Example language (illustrative): "Each of you has a named support person today. If you need help, raise your hand, and they'll come to you."
Watch for: one participant's distress spreading to others. Have a plan for moving to a separate space.

4.14 Release and next-day follow-up

Purpose / when: at the end of the session and the following day.
Steps:
1. Release the client only once they are clinically ready, to the pre-arranged person, who has been briefed. Medical staff decide readiness; the NM draft sets no discharge criteria [uncertain].
2. Remind the client: no driving or risky activity that day.
3. Give them an out-of-hours contact.
4. The next day, check stability and talk about the experience.
5. Ask about any lingering perceptual changes. [source: JRG 2008; 7.35.3.20, .22 draft]
Example language (illustrative): "Tonight, rest. Don't drive, and call this number if anything worries you."
Watch for: low mood, anxiety or confusion that persists, or perceptual disturbance.

4.15 Integration sessions

Purpose / when: after the session, to make sense of the experience and turn it into change linked to the qualifying condition. NM requires the initial integration session to be recorded.
Steps [synthesis beyond the source points noted]:
1. Invite an open account of the experience before you interpret anything.
2. Let the client's own meanings, including spiritual or existential ones, lead. Spiritual and existential aspects are a NM module topic.
3. Link insights to concrete goals and behaviours.
4. Address unresolved difficult material. JRG link lingering difficulties to unprocessed material.
5. Coordinate with the client's ongoing therapist, because continuity of care is a NM topic.
6. Recheck mood, suicidality and perceptual symptoms. [source: 7.35.3.13, .18 draft; JRG 2008]
Example language (illustrative): "What from that day still feels important? What would it look like to act on it this week?"
Watch for: spiritual bypassing, inflated certainty, or grandiosity. Watch too for a client wanting more sessions as a substitute for change [synthesis].

4.16 Documentation, adverse-event and emergency reporting

Purpose / when: required for every service. Practitioners and facilitators record:
- the dates and types of services;
- the administration dates and locations;
- the product identification numbers and administration details;
- the dates of initial integration sessions;
- any adverse events. They submit these to NMDOH. [source: 7.35.3.13, .21 draft]
Steps:
1. Document as you go.
2. Within two calendar days of becoming aware of a potential adverse health event, the location reports: the patient record number, the product identification number, psychological or behavioural reactions, any medical or therapeutic attention needed, any emergency response, and any other incident with negative impact on the patient.
3. Within two calendar days of any emergency procedure, report whether the plan was followed, any deviations, and planned changes.
4. If a producer reports a failed test, pass the notice on to the affected patients.
5. Provide records to NMDOH on request. [source: 7.35.3.13, .21 draft]
Example language (illustrative): "We have to report what happened to the Department within two days. Your name stays out of their public reports." [source: SB 219 § 9 on non-identifying reports]
Watch for: under-reporting of psychological reactions. They count as adverse events.

4.17 Harm reduction and integration support for clients outside the programme

Purpose / when: a client uses psilocybin outside the programme, or plans to. That use has no state protection [synthesis, consistent with the harm-reduction training topic].
Steps:
1. Assess without judgement: risk history (psychosis or bipolar disorder, personal or family), medications, and medical conditions. Refer medication questions to the prescriber.
2. Explain the risks in general terms: acute distress, rare psychosis, perceptual persistence, legal exposure, impaired driving, unknown product content.
3. Make a safety plan: a sober trusted person present, no driving, crisis contacts.
4. Point them to the regulated programme, or FDA-approved trials, as legal routes.
5. Offer integration therapy afterwards.
- Never help them obtain, source or use psilocybin, and give no dosing advice.
Example language (illustrative): "I can't help you get or use it, but I can help you think through the risks and support you afterwards."
Watch for: high-risk profiles, crisis after use, and pressure on you to facilitate.

4.18 Practitioner supervision of facilitators

Purpose / when: facilitators work under a practitioner's direct supervision. Practitioners complete supervised hours overseeing facilitators.
Steps:
1. Brief the facilitator before each session on their scope: peer support, logistics, administration.
2. Agree how they escalate to you.
3. Debrief after the session.
4. Stop any patient care outside their scope that no licence of theirs covers. [source: 7.35.3.13, .19 draft; brief and debrief = synthesis]
Example language (illustrative): "If she becomes distressed, call me over first, before you try anything beyond being present with her."
Watch for: facilitators taking on therapy or medical roles.

5. Handling problems

Overwhelm during the session. Respond with reassurance, presence, agreed touch, orientation and encouragement to approach rather than flee. Avoid reality-testing. If that is not enough, escalate under the emergency plan to medical staff. Report any emergency procedure within two calendar days. [source: JRG 2008; 7.35.3.21 draft]

Client tries to leave, or becomes dangerous. Handle this through the pre-written plan for patients leaving against medical advice and for disruptive behaviour, with compassionate, firm redirection by a trusted team member. Restraint and police involvement are legal questions the location's plan must settle in advance [synthesis]. [source: JRG 2008; 7.35.3.20 draft]

Stuck or blocked preparation (low trust, guardedness). Add preparation meetings. Explore fears of the team, of losing control, or of what might surface. Postpone if trust stays insufficient; the guidelines advise against proceeding without it. [source: JRG 2008]

Ambivalence or withdrawal of consent. Treat it as valid. The client can withdraw at any time, and patients may relinquish enrolment by written notice to NMDOH. Explore the ambivalence without pressure. [source: 7.35.3.24 draft; exploration = synthesis]

Non-adherence to programme rules (outside use, driving, taking product off-site). Explain that these lose state protection. Use is allowed only on the premises of a certified location. Review the safety plan, and switch to harm-reduction work (4.17). Where the rules require it, report through the location's compliance processes [uncertain: the draft names no clinician duty to report patient non-compliance]. [source: 7.35.3.20, .22 draft]

Application denied or delayed.

An initial patient application denied for missing requirements: the patient can request record review or informal administrative review within 30 days. A decision comes within 15 days, and there is no judicial review.
Other denials, suspensions or revocations: a hearing request within 30 days of notice.
Help the client gather the documentation. Keep current treatment going meanwhile [synthesis]. [source: 7.35.3.8, .25–.26 draft]

Condition not on the list. The advisory board accepts confidential petitions to add qualifying conditions. A client or clinician may petition. Do not suggest relabelling a diagnosis to fit [synthesis]. [source: SB 219 § 8]

Veterans, federal employees and people in federal settings. Psilocybin remains federally illegal, and VA care is federal. A 2026 RAND report finds that the VA has not issued a directive encouraging veterans to discuss psychedelic use with VA providers, and has not made clear that benefits are safe for use outside trials or Expanded Access. This contrasts with its cannabis guidance. The VA funds psychedelic research for PTSD and depression, and it "strongly discourages self-medicating" with psychedelics. Nearly half of the veterans surveyed did not know whether disclosing use risked their benefits. The military's standard drug testing now includes psilocin. In practice: tell veteran clients that the VA has published no position on state-programme participation, help them get benefits or legal advice (for example a veterans service officer) and employment advice before they apply, and discuss with them what goes into their VA record [synthesis]. People on probation, on parole or under pre-trial supervision cannot be penalised by the state for participating. [source: SB 219 § 10; RAND RR-A4334-3 (Priest, Schell, Senator & Kilmer, June 2026), pp. 5, 13, 15, 24; Peskuski 2026]

Barriers to access (cost, distance, mobility). Tell clients about the equity fund. Tell them about 'other approved locations' as well: 90-day temporary certification for patients who cannot travel, for medical necessity, for rural or frontier access, or for natural settings, with emergency safeguards at remote sites. [source: SB 219 § 11; 7.35.3.11, .20 draft]

Persisting distress after the session (anxiety, low mood, perceptual changes, rare psychosis). Hold a next-day follow-up and extra sessions. Probe for perceptual disturbance. Refer for psychiatric assessment if psychotic or manic symptoms appear. Report it as a potential adverse health event within two calendar days. [source: JRG 2008; 7.35.3.21 draft]

Suicidality before or after the session. In research, current suicidal ideation needing immediate treatment excluded people from participation. Use standard risk assessment, safety planning and lethal-means counselling (storage and removal), and coordinate with the certifying clinician [synthesis on procedure]. [source: JRG 2008]

Ruptures with the team (client feels unheard, coerced or mishandled). Name the rupture and repair it in integration. Give the client the complaint route: a written complaint to NMDOH by certified mail or through its system, and the location's own complaint procedure. [source: 7.35.3.20, .25 draft; repair = synthesis]

Boundary violations, touch beyond agreement, sexual misconduct. The draft rule sets no explicit touch or sexual-contact rule. Professional licensing-board ethics apply to licensed practitioners. NMDOH can discipline for threats or harm, reckless disregard for safety, and licensing-board discipline. Take disclosures seriously, support the client, and help them complain to NMDOH and the relevant licensing board [synthesis; uncertain whether final rules will add explicit standards]. [source: 7.35.3.18, .25 draft]

Scope creep by facilitators, or staff impairment. Facilitators may not provide patient care outside their scope. No staff member may use psilocybin or other intoxicants while providing services. The supervising practitioner intervenes, and repeated breaches are disciplinable. [source: 7.35.3.13, .25 draft]

Group contagion. Move a distressed participant to a separate space with their named support person, while ratios are kept for the rest of the group [synthesis]. [ratios: 7.35.3.20 draft]

Spiritual or cultural material (including Indigenous traditional meaning). Explore the client's own frame respectfully. Do not offer or imitate ceremony. Refer to the client's own community or religious authorities when they ask for that [synthesis]. [source: 7.35.3.18 draft]

Client wants repeated sessions as an escape from ordinary therapy. Return to treatment goals, and to integration and ongoing psychotherapy. The draft does not fix the number of sessions or an interval between them [uncertain; synthesis].

Rule changes. As of 24 October 2026, 7.35.3 NMAC is still proposed: the 2 October 2026 hearing packet has no effective date, and NMDOH's Rules & Regulations page lists it as pending. 7.35.2 NMAC appears adopted (23 June 2026) and is being amended. Before acting, check NMDOH's programme page, its Statutes, Rules and Regulations page, and the New Mexico Register for the final 7.35.3 NMAC and the 7.35.2 amendments [uncertain until published]. NMDOH contact: medical.psilocybin@doh.nm.gov. [source: NMDOH programme page; docs. 9805, 9904; NMDOH Rules & Regulations index and pending-rulemakings page]

Sources

Pages consulted:

Cited by author, year and title:

Johnson, M. W., Richards, W. A., & Griffiths, R. R. (2008). Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology, 22(6), 603–620.

Further pages consulted:

Not confirmed [uncertain]: final adoption of 7.35.3 NMAC, and the formal effective date of 7.35.2 NMAC in the New Mexico Register.

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