The New Hampshire House of Representatives has approved a bipartisan bill to legalize the regulated use of psilocybin for medical purposes.

After unanimously passing the House Health, Human Services and Elderly Affairs Committee late last month, the full chamber advanced it in voice vote on the consent calendar on Thursday. It now goes to the House Finance Committee before a final floor vote that could move it to the Senate.

The legislation from Rep. Buzz Scherr (D) would create a regulatory pathway for patients with certain conditions to access the psychedelic for therapeutic use through a program overseen by the state Department of Health and Human Services (DHHS).

Rep. Yury Polozov (R) said in a committee report that the bill would provide needed access to psilocybin “under medical supervision for conditions such as treatment-resistant depression, post-traumatic stress disorder, substance use disorders, and other qualifying diagnoses determined by an advisory board and the department.”

“This legislation offers a balanced, medically-supervised approach to therapeutic psilocybin use,” he said. “It addresses unmet needs for individuals with severe, treatment-resistant conditions by providing access in a controlled environment, grounded in emerging scientific evidence and harm reduction principles.”

Here are the key provisions of HB 1809:

• DHHS would be responsible for approving licensed medical professional to serve as providers of psilocybin for qualifying patients.
• In order to qualify for the program, patients would need to be diagnosed with treatment-resistant depression, post-traumatic stress disorder (PTSD), substance use disorder or another condition authorized by an advisory board and DHHS.
• The legislation specifically stipulates that only natural psilocybin could be administered, excluding synthetic versions of the psychedelic.
• Providers would also need to be approved by the department to grow and harvest their own psilocybin products.
• The process for treating qualifying patients with the psychedelic would need to involve a preparation session, administration session and integration session.
• A Medical Psilocybin Advisory Board would be established, comprised of a representative of DHHS, a qualifying patient, a veterans advocate and eight medical professionals.
  • Those medical experts would need to include a psychedelics researcher, two regulators overseeing existing medical psilocybin programs and specialists in the treatment of addiction, palliative care, veterans’ affairs, naturopathy, nursing and mental health counseling.
• The board would be tasked with analyzing data on patient outcomes from DHHS, consider adding qualifying conditions for participation in the program and determine whether the law should be expanded.
• The program would only be implemented if the advisory board, within two years of the bill’s enactment, notifies lawmakers, regulators and the governor that it can be effectively administered.

The prospect of the psilocybin legislation advancing to enactment into law this session remain unclear, but lawmakers have been increasingly active in pursuing psychedelics reform in recent years.

Last June, the New Hampshire Senate voted to scrap compromise legislation that would have lowered the state’s criminal penalty for first-time psilocybin possession while also creating mandatory minimum sentences around fentanyl.

As originally introduced, the legislation would have completely removed penalties around obtaining, purchasing, transporting, possessing or using psilocybin, effectively legalizing it on a noncommercial basis. However a House committee amended the bill before unanimously advancing it last March.

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Meanwhile in New Hampshire, the Senate Judiciary Committee on Tuesday rejected a House-passed bill to legalize marijuana in the state.

That proposal is one of several cannabis bills filed for the 2026 session, including legislation from Rep. Jonah Wheeler (D) that seeks to put a constitutional amendment on the state ballot that would let voters decide if they want to legalize marijuana for adults 21 and older, allowing them to “possess a modest amount of cannabis for their personal use.” Members of the House Criminal Justice and Public Safety Committee took up that legislation late last month.

Gov. Kelly Ayotte (R) has already threatened to veto any legalization bill that reaches her desk, though the constitutional amendment proposal would not require gubernatorial action.

The governor said in August that her position on the reform would not change even if the federal government moved forward with rescheduling the plant. Since then, President Donald Trump has directed the attorney general to finalize the process of moving cannabis from Schedule I to Schedule III of the Controlled Substances Act (CSA).

In the Senate, the Judiciary Committee last month also took up a bill from Sen. Donovan Fenton (D) that would allow adults over the age of 21 to legally possess up to four ounces of cannabis in plant form and 20 grams of concentrated cannabis products, as well as other products containing no more than 2,000 milligrams of THC.

Last June, the New Hampshire Senate voted to scrap compromise legislation that would have lowered the state’s criminal penalty for first-time psilocybin possession while also creating mandatory minimum sentences around fentanyl.

As originally introduced, the legislation would have completely removed penalties around obtaining, purchasing, transporting, possessing or using psilocybin, effectively legalizing it on a noncommercial basis. However, a House committee amended the bill before unanimously advancing it last March.