Sen. Tom Pischke, R-Dell Rapids, speaks on Feb. 24, 2026, in the South Dakota Senate at the Capitol in Pierre. Pischke is the Senate sponsor of a bill that would legalize synthetic psilocybin for use in the treatment of mental health issues upon its federal approval. (Photo by Joshua Haiar/South Dakota Searchlight)
A bill that would legalize a psychedelic medication upon its federal approval and legalization as a mental health treatment is one vote away from South Dakota Gov. Larry Rhoden’s desk.
The Senate Health and Human Services Committee passed House Bill 1099 on a 6-0 vote Wednesday in Pierre. The lack of a no vote and the lack of opposition testimony cleared a path for the bill to appear on the Senate’s consent calendar, which is a grouping of bills that are voted on in bulk unless a member asks to pull one for discussion.
The bill passed the House of Representatives Feb. 9 on a 58-7 vote.
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The legislation is specific to crystalline polymorph psilocybin, a synthesized version of the hallucination-inducing psilocybin found in psychedelic mushrooms.
The Food and Drug Administration approved clinical trials for psychedelics in 2023 to investigate their potential as therapies for treatment-resistant depression, post-traumatic stress disorder and other mental health diagnoses.
Treatment resistant depression is diagnosed when symptoms don’t improve after the use of multiple medications, and it impacts about a third of patients with major depressive disorder, according to Johns Hopkins Medicine. Australia approved psilocybin for treatment-resistant depression in 2023. In the U.S., a synthetic version of the drug ketamine has been approved by the FDA for the same.
Psilocybin is currently classified as a schedule I drug with no acceptable medical uses by the U.S. Drug Enforcement Administration, however, and is illegal under South Dakota law.
If passed by the state Senate and signed into law by Rhoden, HB 1099 would instantly legalize the drug’s use as a prescription medication in South Dakota upon its approval by the FDA and rescheduling by the DEA. Possession for recreational use would remain illegal.
Supporters say rapid access is needed
Lawmakers in South Dakota regularly adjust state law to match federal guidance on drugs, but HB 1099 would offer quicker access to the medicines if they’re approved between legislative sessions.
“Acting now by passing this legislation is more urgent than ever, as so many South Dakotans struggle with serious mental health conditions,” said Sen. Tom Pischke, R-Dell Rapids, the bill’s prime sponsor in the Senate.
Patients failed by currently available treatments “need rapid access” to newer therapies, Pischke said.
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Veterans’ advocacy groups in particular have come to see the therapies as powerful alternatives to traditional psychiatric medications for combat veterans, who as a group have a higher risk of suicide than the general population.
Logan Davidson is a policy adviser for the nonprofit organization Veterans for Experimental Treatment Solutions, which advocates for the expansion of access to psychedelic treatments.
More than 125,000 veterans have died by suicide since 2001, Davidson told the committee, and just under a third of veterans from “the global war on terror” suffer from PTSD.
“Veterans are one of the most vulnerable populations when it comes to mental health,” said Davidson.
Alexander Root, a lobbyist for drugmaker Compass Pathways, told the committee his company’s formulation of psilocybin has shown “a highly statistically significant and clinically meaningful reduction in depressive symptoms” for patients with treatment-resistant depression during its most recent trials.
How it works
After the hearing, Compass Pathways Chief Patient Officer Dr. Steven Levine told South Dakota Searchlight the drugs can help change the neural pathways in the brain responsible for the rigid, reflexive patterns of thought that drive certain mental health diagnoses.
Patients suffering from PTSD, for example, can be “triggered” by things like sounds, images or smells and be pulled back into traumatic experiences, reliving them as though they were happening in the moment. Those with treatment-resistant depression may find themselves trapped in crippling loops of self-criticism.
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Patients prescribed psychedelics for those conditions wouldn’t pick up a prescription at a pharmacy and take them on their own, Levine said. First, they have sessions with providers, where they’re educated on the principles behind the therapy and on how to approach the drug experience to get the most out of it.
On the day the patient takes the drug, Levine said, “the medical team is just there to monitor and support them so that they can have a trusted, safe experience in this supervised setting.”
Treatment through psychedelics is meant to allow patients under their influence to approach and process their traumatic experiences or unhelpful thoughts as observers, rather than participants.
In doing so, Levine said, patients can quickly rewire the parts of their brain marked by trauma or depressive ruminations.
“We are able to see in brain imaging studies that there are acute changes in the connectivity of regions of the brain,” after the use of psychedelics, Levine said. “Essentially, they’re initially kind of taken offline or desynchronized, and then they reconnect in ways that may facilitate people shifting from these ingrained patterns of thinking.”
Back at the Senate Health and Human Services Committee, Sioux Falls Democratic Sen. Jamie Smith said he’s “been following” developments in the use of psychedelic medications for “quite a while.”
“I’m looking forward to the day that we can help these people that are suffering from this depression,” Smith said. “And I do hope that this drug does ease that in many patients.”
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