Inaugural year of regulated psilocybin services in Oregon: safety, motivations, and utilization

Importance: The Oregon Psilocybin Services (OPS) program is the first statewide, regulated framework for legal psilocybin in the U.S. Analyzing inaugural-year utilization and safety is essential for informing policy and equity monitoring. Methods: We conducted a descriptive analysis of statewide aggregate data from the OPS Public Dashboard (January 1-December 31, 2025). Outcomes included service volume, client demographics, motivations, and acute adverse events. Results: In 2025, 5,935 clients participated in 5,375 sessions. Volume peaked in Q2 (n=1,758) before stabilizing in Q4 (n=1,358). Service tourism was significant, with 32.6% of participants residing outside Oregon. The largest segment was aged 35-49 (~40%); women (57.4%) and LGBTQ+ individuals (27.2%) represented substantial portions of the annual cohort. Racial diversity was limited, with White participants representing 84.1%-91.5% quarterly, while Hispanic/Latino (7.1%) and African American (2.1%) participation lagged. Adverse events were rare, with annual behavioral and medical rates of 2.42 and 2.79 per 1,000 sessions, respectively. Discussion: Full-year data indicate stabilized utilization by a predominantly midlife adult population. While the program successfully reaches sexual and gender minorities, racial disparities persist. High service tourism suggests significant socioeconomic barriers. These findings underscore the program's dual role as a wellness modality and a functional alternative for addressing mental health distress.