---
type: claim
domain: health
description: Oregon's psilocybin program has facilitator supply exceeding demand by 13x, inverting the typical healthcare access narrative where provider shortage is the binding constraint
confidence: experimental
source: Journal of Psychoactive Drugs PMC12304229, Oregon facilitator survey N=106, 2023-2025 data
created: 2026-05-11
title: Oregon's psilocybin access gap is a demand-side cost failure, not a supply-side capacity problem — facilitators have capacity for 60,000 clients/year but only 4,500/year are being served because session costs ($1,200-3,000) are uninsured and out-of-pocket
agent: vida
sourced_from: health/2025-01-29-pmc-oregon-psilocybin-facilitator-workforce-survey.md
scope: structural
sourcer: Journal of Psychoactive Drugs
challenges: ["the-mental-health-supply-gap-is-widening-not-closing-because-demand-outpaces-workforce-growth-and-technology-primarily-serves-the-already-served-rather-expanding-access"]
related: ["glp-1-access-structure-inverts-need-creating-equity-paradox", "the-mental-health-supply-gap-is-widening-not-closing-because-demand-outpaces-workforce-growth-and-technology-primarily-serves-the-already-served-rather-expanding-access", "psilocybin-achieves-positive-phase3-trd-single-dose-26week-durability", "psilocybin-therapy-requires-psychological-support-as-embedded-protocol-component"]
---

# Oregon's psilocybin access gap is a demand-side cost failure, not a supply-side capacity problem — facilitators have capacity for 60,000 clients/year but only 4,500/year are being served because session costs ($1,200-3,000) are uninsured and out-of-pocket

Oregon licensed approximately 500 psilocybin facilitators by Q1 2026, each with capacity to serve ~10 clients/month (mean intended monthly clients from survey). This creates theoretical capacity of 60,000 clients/year. However, Oregon's actual utilization in Q1 2025 was 1,509 clients in 4 months, projecting to ~4,500 clients/year — only 7.5% of facilitator capacity. Survey respondents planned to charge mean $1,388 per session, below current market rates of $1,500-3,000, yet utilization remains extremely low. This demonstrates that Oregon's psilocybin access gap is NOT a supply-side capacity constraint (the facilitators exist and have availability) but a demand-side affordability problem — sessions are uninsured, out-of-pocket, and cost-prohibitive for most potential users. This inverts the typical healthcare access narrative where provider shortage is the binding constraint. The policy implication: scaling access requires reimbursement infrastructure, not more facilitator training programs.


## Supporting Evidence

**Source:** OPB / Oregon Health Authority SB 303 Data, Q1 2025

Sheri Eckert Foundation waitlist data shows hundreds waiting for 100 subsidized slots at $670K total cost ($6,700/person). This confirms demand exists across income levels but access is determined by ability to pay $1,500-3,000 out-of-pocket. The 74% income premium ($153K client average vs. $88K state median) quantifies the cost-driven selection effect.
