04 — Ohio Landscape
Boards · Statehouse · Federal · Not legal advice
Ohio’s psychedelic‑therapy landscape, kept as a living document.
What the rules say. What is being discussed. Where the public conversation goes next.
Last updated 22 September 2026
Reviewed after each CSWMFT, Nursing, and Medical Board meeting
CSWMFT = Ohio Counselor, Social Worker & Marriage and Family Therapist Board
This overview distinguishes published rules from matters still under review. It is general information, not legal or medical advice.
In this document
Status tracker
7 items
T.1
Ketamine‑assisted psychotherapy
Practiced
Ketamine is FDA‑approved as an anesthetic; psychiatric use is off‑label and directed by a prescriber. Therapists work within their existing scope alongside that prescriber.
T.2
CSWMFT Board guidance on ketamine‑assisted therapy
Approved
Approved at the Board’s 10 September 2026 meeting after public comment and edits made on the day, with the collaboration between therapists and prescribers clarified in the final text. Earlier draft provisions, including an on‑site prescriber requirement, were removed. It is guidance, not a formal rule. The Board’s minutes for that meeting are not yet posted; the July 2026 minutes record the draft under review.
T.3
State Medical Board of Ohio position
No position
No published position on psychedelic‑assisted therapy delivery models. A Medical Board member briefed the CSWMFT Board on ketamine in May 2026, and the CSWMFT Board went on to approve its own guidance in September. The Medical Board’s rules still govern prescribers.
T.4
Ohio Board of Nursing position
No guidance
APRNs with prescriptive authority already direct much of Ohio’s ketamine work. The Board has issued no psychedelic‑specific guidance. OPT‑IN is seeking dialogue with both the Nursing and Medical Boards.
T.5
Ohio General Assembly
No bill
No psychedelic‑therapy bill is pending. When the FDA approves a psychedelic medicine, Ohio will likely need state law to schedule it and define who may deliver it. OPT‑IN is opening conversations with legislators now.
T.6
Psilocybin and MDMA in Ohio
Schedule I
Both remain federally Schedule I. Ohio has no regulated‑access program and no active bill establishing one.
T.7
Federal drug development
Under review
Three psychedelic programs hold FDA National Priority Vouchers (April 2026), which can shorten review to one or two months after filing. Compass’s psilocybin application for treatment‑resistant depression is in rolling submission, due to complete in Q4 2026; Resilient’s MDMA application for PTSD was reported resubmitted in August 2026; Definium plans an LSD application in the first half of 2027. Any approval would still require DEA rescheduling and Ohio legislation and board rules to define who may deliver it. Details in §2.
§1
What’s legal now
1.1
Ketamine may be prescribed and administered by Ohio prescribers acting within their scope, including off‑label for psychiatric indications, under the State Medical Board’s and Board of Nursing’s ordinary rules.
1.2
CSWMFT licensees may provide psychotherapy before, during, and after a prescriber‑directed ketamine session, within their existing scope and competence (OAC 4757‑5). They may not prescribe, administer, or hold the medication.
1.3
No other psychedelic compound may be lawfully used in Ohio therapy outside a federally authorized clinical trial.
§2
What’s moving
2.1
The CSWMFT Board’s Alternative Therapies Ad Hoc Committee worked on ketamine‑assisted therapy through 2025–26, with emphasis on a clear diagnosis, a treatment plan, a safety plan with a medical provider available, informed consent, and competence (OAC 4757‑5‑03, ‑05, ‑06).
2.2
The Board approved its ketamine‑assisted therapy guidance statement on 10 September 2026, after reviewing public comment in July and editing the text on the day. This page will link the published statement and the September minutes as soon as the Board posts them.
2.3
Ohio’s Laws and Rules compilation was revised effective 13 April 2026. We review each revision for language touching psychotherapy adjuncts and multidisciplinary practice.
2.4
Federal policy moved in April 2026. An 18 April executive order directed federal agencies to speed the research, review and approval of psychedelic medicines for serious mental illness. On 24 April FDA issued National Priority Vouchers to psilocybin for treatment‑resistant depression (Compass), psilocybin for major depressive disorder (Usona) and methylone for PTSD (Transcend); a voucher can shorten review to one or two months after filing. On 14 July FDA finalized its guidance for psychedelic clinical trials.
2.5
Three applications to watch. Compass’s COMP360 psilocybin NDA for treatment‑resistant depression is in rolling submission, due to complete in Q4 2026, with launch targeted for the first half of 2027 subject to approval and DEA rescheduling. Resilient’s MDMA‑assisted therapy NDA for PTSD was reported resubmitted in August 2026, two years after the 2024 complete response letter, without a new Phase 3; no acceptance or decision date is public. Definium’s DT120 (LSD) has three positive Phase 3 readouts (Emerge in depression, June; Voyage and Panorama in generalized anxiety, August and September) and plans an NDA in the first half of 2027 after a pre‑NDA meeting late this year.
2.6
FDA’s 14 September public hearing on the future therapeutic use of psychedelics asked directly about staffing during dosing and monitoring, the roles and qualifications of licensed counselors and other non‑prescriber personnel, patient counseling, set and setting, informed consent, power imbalance and therapeutic touch. Written comment on docket FDA‑2026‑N‑7542 is open through 5 October 2026. See §4.
§3
Why delivery models matter
3.1
A prescriber‑only model places medication and psychotherapy in one set of hands. A collaborative model pairs a prescriber with a licensed therapist. Guidance that recognizes only one of these determines which Ohio professionals can participate at all.
3.2
Ohio has many times more CSWMFT licensees than psychiatric prescribers. Models that exclude therapists concentrate the work in the fewest hands and the most expensive settings.
3.3
Clear guidance on documentation, consent, and release of information protects clients and licensees alike. Its absence is not neutral; it pushes careful clinicians out and leaves the field to the least careful.
§4 Public comment
Make your voice heard.
The Ohio CSWMFT Board accepts written comment on proposed rules and guidance and hears from the public at its meetings. The Nursing and Medical Boards do the same for their rules, and your state representative and senator read constituent mail. If you live or practice in Ohio, your comment becomes part of the record. Federally, FDA’s docket on the future therapeutic use of psychedelics takes written comment through 5 October 2026.
01
Read the current agenda or draft on the Board’s site, or the FDA docket. Note the item or docket number and the comment deadline, if one is set.
02
Write 200–400 words: who you are, what you are asking the Board to do, and why. Specific and civil carries further than long.
03
Send it to the relevant board by email, request time to speak at a scheduled meeting in Columbus, write to your legislators, or submit it to the FDA docket at regulations.gov.
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Sources & editorial note
Last updated 22 September 2026. Links on this page point to the underlying authorities: the Ohio CSWMFT Board, the Ohio Board of Nursing, the State Medical Board of Ohio, the Ohio General Assembly, the U.S. Food and Drug Administration and regulations.gov. The CSWMFT Board’s September 2026 minutes were not yet posted at this update; the approval is reported from attendance at the 10 September meeting and will be linked to the minutes once published. Federal pipeline dates come from FDA notices and company announcements. The update date is not a claim that every Board development has been verified.