How Does Oregon's Psilocybin Program Work?

Oregon made history in 2020 by becoming the first state to legalize psilocybin therapy, creating a regulated framework that allows adults to access psychedelic treatment through licensed facilitators at approved service centers. 

The Oregon Health Authority oversees this groundbreaking program under administrative rules (OAR 333.333), which went into effect in January 2023. Since then, tens of thousands of people from around the world have traveled to Oregon to experience legal psilocybin therapy.

This guide covers the key elements you need to know: Oregon's regulatory structure, how psilocybin actually works in your brain, and the comprehensive framework that professional providers use to maximize therapeutic outcomes. 

Understanding how this system works is essential for anyone considering this powerful therapeutic approach, whether you're dealing with depression, anxiety, trauma, or seeking personal growth.

how effective is psilocybin therapy?

When administered in a safe, private and therapeutic setting with proper professional support, psilocybin therapy (even just one session) can be incredibly effective at resolving a wide range of undesired mental symptoms and behaviors.

Fractal Health reports that 95% of their clients experience 'substantial positive outcomes', and about 70% feel that one session addressed their intension entirely. Some other Centers report similar results. Facilitator experience and dosing considerations are two core factors to client success.

Feel free to watch or bookmark this 25-minute training video for later!

how psilocybin works in your brain

why this matters:

Understanding how psilocybin affects your brain helps explain its therapeutic potential:

Serotonin System Activation: Psilocybin's molecular structure closely resembles serotonin, allowing it to bind to serotonin receptors in the brain, especially those involved in active coping. This activation affects mood, perception, and cognition in profound ways.

Default Mode Network Disruption: Your brain's default mode network (DMN) is responsible for self-referential thinking, rumination, and the sense of a fixed "self." Psilocybin temporarily reduces DMN activity, allowing for new neural connections and perspectives.

Neural Plasticity Enhancement: Psilocybin promotes neuroplasticity - your brain's ability to form new neural pathways. This increased flexibility can help break entrenched patterns of thinking and behavior.

Limbic System Regulation: The limbic system processes emotions and memories. Psilocybin's effects on this region can help process trauma, reduce fear responses, and promote emotional healing.

Breaking Mental Patterns: By disrupting default neural networks, psilocybin allows people to step outside habitual thought patterns that contribute to depression, anxiety, and other conditions.

Emotional Processing: Enhanced limbic system activity helps people access and process emotions and memories that may be difficult to reach through traditional therapy alone.

Increased Openness & Adaptability: The neuroplasticity enhancement creates a window of opportunity for lasting psychological change, making people more receptive to new insights and behavioral shifts.


Watch or bookmark this 15 minute deep dive on Neuropharmacology! 

The Fractal Health 3x3 Success Model

After overseeing 600+ client administration sessions, founder & Center Director Kat Thompson built upon Oregon's 3-part therapy model to develop a more holistic 9-part framework. This systematic approach addresses the reality that successful psilocybin therapy involves much more than just consuming psilocybin and hoping for the best.

The framework recognizes that breakthrough therapeutic results are markedly improved with attention to physical, emotional, and environmental factors across three distinct phases, and that nervous system healing requires work before and after an administration session experience.

FRACTAL'S 3X3 GRID FRAMEWORK:

An emphasis is placed on education, guidance and coaching by facilitators while empowering clients to take responsibility for leading this process and choosing the activities best suited to their individual needs. No activity is directive or required.


PREPARATION PHASE (1-4 Weeks)

Physical: Optimizing diet, sleep, exercise, and medication considerations

Emotional: Processing fears, setting intentions, building readiness & openness

Environmental: Creating supportive conditions and addressing external stressors at home, in relationships and at work


ADMINISTRATION PHASE (One Day)

Setting: Carefully designed therapeutic environment for safety and comfort

Support: Multi-faceted facilitator support throughout the 4-6 hour experience

Dose: Precisely calibrated psilocybin amount based on multiple considerations


INTEGRATION PHASE (One to Six Months)

Physical Recovery: Supporting the body's return to baseline functioning

Emotional Recovery: Processing insights and emotional material that emerged

Reprogramming: Implementing new perspectives and behaviors into daily life, often with a focus on nervous system regulation and a sense of 'safety'

View Fractal Health Programs →

We define a "bad trip" as an overwhelming fear or paranoia that has no therapeutic value. This is different from a challenging experience that is still productive.

In a legal, regulated environment, 'bad trips' are extremely rare because the three reasons 'bad trips' happen in recreational settings are eliminated: clients receive precise dosing without the presence of other substances or adulterants, clients are in a calm setting that feels safe and nurturing, and clients are prepared and coached with clear intention & readiness.

Some clients do have emotionally difficult journeys that ultimately prove therapeutic and healing. These clients often report afterward that they received exactly what they needed for their growth.

6. How is psilocybin different from other psychedelics like LSD and ayahuasca?

5. Can I purchase psilocybin at a service center and take it home with me?

4. Is psilocybin therapy guided by the facilitator, like talk therapy is guided by a therapist?

3. What does a psilocybin therapy session feel like?

2. Is psilocybin addictive? I am sober and concerned about falling back into addictive patterns.
1. Will I have a 'bad trip' during a legal psilocybin therapy experience? How can I minimize the chances of this?

A

Q

Psilocybin is not addictive because it works on the serotonin system rather than dopamine, which is the neurotransmitter primarily associated with addiction.

Serotonin receptors have a built-in safety mechanism - they desensitize ("down regulate") when they sense excess serotonin. This means if someone tries to take psilocybin daily or multiple times per day as they would an addictive substance, they will feel little to no effect from psilocybin. In this sense, it has built-in anti-addictive properties.

Finally, people typically seek out substances for addition to escape pain or their problems. Psilocybin is an anti-dissociative, strongly urging users to actively cope with problems. Those seeking a numbing or escapism experience are unlikely to find it with psilocybin. 

6. How is psilocybin different from other psychedelics like LSD and ayahuasca?

5. Can I purchase psilocybin at a service center and take it home with me?

4. Is psilocybin therapy guided by the facilitator, like talk therapy is guided by a therapist?

3. What does a psilocybin therapy session feel like?

2. Is psilocybin addictive? I am sober and concerned about falling back into addictive patterns.
1. Will I have a 'bad trip' during a legal psilocybin therapy experience? How can I minimize the chances of this?

A

Q

Psilocybin sessions are highly individualistic, but most clients report a heightened state of emotional openness and introspection that allows access to thoughts, memories, and insights that are difficult or even impossible to reach in normal consciousness.

Sensations such as tingly fingers or mild lightheadedness can be felt around 15 minutes after taking the medicine and fully altered consciousness typically occurs about 45-60 minutes in, with the height of intensity at the 90-120 minute mark. By 3 to 4 hours, effects can be felt fading.

The experience feels different from recreational drug use due to the inner, intentional focus and lack of distractions such as friends, nature or concert music. Clients often process childhood memories, current challenges, or life transitions with great clarity and emotional access. While some moments can be challenging as old narratives dissolve or difficult memories arise to process, the overall arc tends toward healing and insight. 

The final couple hours of a journey are usually filled with intense calm, peace and gratitude.

6. How is psilocybin different from other psychedelics like LSD and ayahuasca?

5. Can I purchase psilocybin at a service center and take it home with me?

4. Is psilocybin therapy guided by the facilitator, like talk therapy is guided by a therapist?

3. What does a psilocybin therapy session feel like?

2. Is psilocybin addictive? I am sober and concerned about falling back into addictive patterns.
1. Will I have a 'bad trip' during a legal psilocybin therapy experience? How can I minimize the chances of this?

A

Q

Psilocybin therapy is quite different from talk therapy. Rather than discussing problems verbally with a therapist, you're having an internal experience while a facilitator provides various forms of support, but only as needed and client-requested. The facilitator's role is to ensure your safety and comfort while allowing your mind to do its own therapeutic work. They may offer gentle guidance if you become anxious or confused, remind you of your intentions, or provide physical comfort, but they don't direct the content of your experience like a traditional therapist would. Doing so would be counterproductive.

The "therapy" happens internally through psilocybin's effects on your brain's neural networks, particularly the default mode network responsible for self-referential thinking. This allows you to access and process emotions, memories, and patterns in ways that talk therapy often cannot reach. The facilitator holds a safe and supportive presence for you while your consciousness explores often uncharted areas of the psyche. 

Direct talking and coaching with your facilitator happens in preparation & integration sessions, before and after your psilocybin administration session. Some clients feel chatty during the last hour or two of their session as well.

6. How is psilocybin different from other psychedelics like LSD and ayahuasca?

5. Can I purchase psilocybin at a service center and take it home with me?

4. Is psilocybin therapy guided by the facilitator, like talk therapy is guided by a therapist?

3. What does a psilocybin therapy session feel like?

2. Is psilocybin addictive? I am sober and concerned about falling back into addictive patterns.
1. Will I have a 'bad trip' during a legal psilocybin therapy experience? How can I minimize the chances of this?

A

Q

No, under Oregon's regulations, all psilocybin must be purchased and consumed at licensed service centers - you cannot take any products home, including any unused 'booster' dose. This is a key safety and legal requirement of the program. All psilocybin products must remain on the premises of licensed facilities and be consumed under professional supervision. This ensures proper dosing, safety monitoring, and compliance with state regulations.

This requirement actually serves important therapeutic purposes beyond legal compliance. Consuming psilocybin in a professional setting provides the controlled environment, proper preparation, and expert support that maximizes therapeutic outcomes while minimizing risks. The medicine's effects are powerful enough that professional guidance and a safe setting are essential components of the healing process, not just legal formalities.

It is a common misconception that psilocybin service centers are similar to marijuana retail outlets, but this is not true. They should be thought of as mental health centers, not retail drug outlets.

6. How is psilocybin different from other psychedelics like LSD and ayahuasca?

5. Can I purchase psilocybin at a service center and take it home with me?

4. Is psilocybin therapy guided by the facilitator, like talk therapy is guided by a therapist?

3. What does a psilocybin therapy session feel like?

2. Is psilocybin addictive? I am sober and concerned about falling back into addictive patterns.
1. Will I have a 'bad trip' during a legal psilocybin therapy experience? How can I minimize the chances of this?

A

Q

Psilocybin has several unique characteristics that make it particularly well-suited for therapeutic work. Though both psilocybin and LSD are serotonergic psychedelics, psilocybin has a shorter duration (4-6 hours) compared to LSD (8-12 hours), making it more manageable for therapeutic sessions. Additionally, LSD tends to have a more stimulating effect that can be less useful for therapeutic reflection and more suited to creativity.

Ayahuasca is a very bitter plant that often involves intense physical purging of both vomiting and diarrhea. Ceremonial traditions equate this to cleansing, but from a medical standpoint it is a symptom of toxicity and highly dose-dependent. Ayahuasca can also be dangerous when combined with certain medications, making it riskier to take, in particular in international settings without regulations that require proper screening.

Psilocybin is far gentler physically while still providing profound psychological insights. Psilocybin is also far easier and more accurate to dose, and it has the most robust clinical research supporting its therapeutic applications for mental health conditions. Oregon chose psilocybin specifically because of its safety profile, research backing, and suitability for regulated use.

6. How is psilocybin different from other psychedelics like LSD and ayahuasca?

5. Can I purchase psilocybin at a service center and take it home with me?

4. Is psilocybin therapy guided by the facilitator, like talk therapy is guided by a therapist?

3. What does a psilocybin therapy session feel like?

2. Is psilocybin addictive? I am sober and concerned about falling back into addictive patterns.
1. Will I have a 'bad trip' during a legal psilocybin therapy experience? How can I minimize the chances of this?

A

Q

kat thompson, lead educator

Kat Thompson leads Fractal Soul and Fractal Health with over 20 years of strategic and operational experience from Fortune 500 companies including Nike, Twitter, and Intel. After discovering how psilocybin therapy transformed her own mental health—addressing chronic anxiety, childhood trauma, and executive burnout that traditional approaches couldn't reach—Kat pivoted her career to bring this breakthrough treatment to the public.

As a licensed facilitator who has personally guided dozens of clients through transformative sessions, Kat combines deep personal experience with professional expertise to create Oregon's leading psilocybin therapy programs. Her unique background in corporate strategy and lived experience with psychedelic healing allows her to design services specifically for busy professionals and others who need results-driven mental health solutions.

Kat is a sought-after public speaker and educator, passionate about bringing science-based psychedelic therapy into mainstream professional wellness. She regularly presents to corporate audiences, healthcare organizations, and industry conferences, helping to destigmatize and democratize access to legal psilocybin therapy. When she's not facilitating breakthroughs for clients, Kat enjoys traveling, parenting, cooking, and continuing her own journey of growth and healing.

education

Bachelor's of Computer Science, Master's of Science in Tech & Healthcare Business Mgmt

specialties

Relationship Grief & Loss, Single Parenting, Alcohol Use, Generalized Anxiety & Burnout

AVAILABILITY

Available for complementary public speaking & workshops globally.
Taking limited facilitation clients in 2025 - also manages a wonderful team of highly skilled facilitators.