An October 2025 independent report offered to Maryland’s Task Force compares multiple policy pathways and argues that any future program should be designed for evaluation from day one. The report is independent academic policy analysis—not Maryland law, a Task Force position, or Johns Hopkins University endorsement.
Source boundary. This section summarizes the independent report as policy analysis. Enacted statutes and official Maryland records remain controlling for legal-status statements.
FDA-approved use
Approved products delivered under federal labeling and any applicable safety requirements within ordinary medical practice.
Religious use
Sacramental use operating under applicable federal religious-liberty protections or exemptions.
Deprioritization / decriminalization
Reduced criminal penalties or enforcement for specified adult possession/personal-use conduct without creating a legal retail supply.
Non-commercial peer sharing
Personal cultivation/possession and adult gifting without payment, where authorized.
Medical / therapeutic use
A state-authorized clinical pathway with screening, supervised administration, integration/support, and reporting.
Supervised adult use
A non-medical pathway with on-site consumption at licensed service centers under trained supervision.
Commercial sales
A licensed private market with production, testing, distribution, retail, taxation, and public-health monitoring.
State monopoly sales
A government-operated supply/retail model; the report discusses this only briefly.
Exposure & contextSubstance/product identifiers, setting, supervision/facilitator context, participant experience, co-medications/co-exposures, and other variables needed to distinguish regulated and naturalistic experiences.
Benefits & functioningStandardized clinical outcomes, well-being, function, social connection, access, and durability of benefit—not safety alone.
SafetyAdverse events, emergency/medical escalation, post-session reactions, poison-center and other sentinel signals where feasible, with intended psychoactive effects distinguished from adverse events.
Longitudinal follow-upThe report highlights brief early follow-up plus longer-term measurement, including 6- and 12-month outcomes, to assess durability and retreatment.
Equity & accessParticipation, geography, affordability, demographics, barriers, provider capacity, and distribution of benefits and harms.
System implementationProvider/facilitator credentials, facility standards, complaints/boundary safeguards, service volume, market conditions, costs, and program viability.
Pseudonymous longitudinal records
Participant → episode → context/exposures → pre-experience → acute → safety → 24h / 7d / 30d / 90d / 180d / 365d follow-up.
Benefits and harms
Registry architecture captures both participant-reported outcomes and structured safety events rather than treating effectiveness and safety as separate projects.
Context-sensitive data
Episode context, co-exposures, prior experience, expectations, support/facilitator variables, and setting variables support more interpretable observational analyses.
Validated measures
WHO-5, selected PROMIS domains, optional PCL-5/trauma module, and acute-experience instruments are being implemented with instrument-specific provenance and reuse review.
Privacy-protective research
Separate research consent, pseudonymous IDs, minimized identifiers, research-only exports, withdrawal handling, and governance are foundational design requirements.
Future interoperability
The registry can map its common data elements to public-health and clinical standards without claiming current integration with CRISP or Maryland government systems.