Notes on a failed psychedelics ballot initiative: 5 Questions for TREAT’s Jeannie Fontana

Fontana discusses what precipitated the end of the TREAT California campaign and what she wants to see happen next.

Growing up in the 1960s, Jeannie Fontana had a strong negative bias against psychedelics. But in recent years she started reading about the potential of these substances in treating mental health issues. Fontana is a doctor specializing in internal medicine who also has a doctorate in biochemistry, so she approached the topic with an academic’s zeal. She began by reading over 1,500 journal articles. After a few years of learning about the topic, Fontana decided to file the paperwork for a ballot initiative called TREAT California, which would amend the state’s constitution to establish a new state institute overseeing psychedelics research, infrastructure, and delivery. The initiative would have allocated $5 billion in funding through state bond sales. The initiative was similar to California’s Proposition 71, which passed in 2004. That proposition also amended the state constitution and health code to establish the California Institute of Regenerative Medicine (CIRM) and allocated $3 billion for stem cell research through state bond sales. Fontana knew the inner workings of the stem cell proposition; she sat on the CIRM board and she felt confident that psychedelics could leverage similar support among voters.

But then in early November, just six weeks after officially launching the campaign, Fontana announced the group was suspending their efforts. The Microdose spoke with Fontana about what precipitated the end of the TREAT California campaign and what she wants to see happen next.  

What went wrong with this ballot initiative?

Over a short period of time, between 2017 to 2023, there was a huge swing in public perception about psychedelics. In 2017 around 30 percent of Americans believed that psychedelic medicines should be researched, and that’s gone up to approximately 80 percent more recently. So we thought we had a good shot. 

The process of the citizen ballot initiative is that you write the legislation and you submit it to the State Attorney General’s office. The Attorney General's office then writes the legal language that will appear on the ballot. That part is crucial — the Attorney General can write language that is favorable for you, or unfavorable. And I believe ours was written in the most unfavorable terms ever. 

The official language says that the initiative would authorize bonds and create a “state agency for psychedelic therapy research, initiative constitutional amendment and statute.” Bonds, statute — what do those terms mean to a voter? That’s a huge turnoff — who in their right mind would vote for that? California voters already have no confidence in our state agencies right now. It also says we’d create a state agency to “regulate” psychedelic medicines — but we're not doing a regulated access model. And it says we’re researching substances to produce “altered states of consciousness,” including LSD. I saw LSD and I thought, “Oh, we're screwed.” We know that LSD is particularly politically charged. 

In TREAT CA’s press release announcing the end of the campaign, you pointed to poll results suggesting Californians did not support the effort, at least not as it was described by the Attorney General. Did you also poll before, and what about that poll’s results signaled the end to you?

So we ran a poll based on the official language from the Attorney General. We did not pay for specific polling before because I didn't think we needed to, with all the great polling already out there. We got 46 percent supporting it even with this language, which is pretty good, but not good enough — in order to get donors to fund initiatives, you want to be in the 50 or 60 percent range, and we weren’t. I had a very significant donor on the line, but when he saw the polling results, he said, I can't put money in. So that's why I had to pull out; I was putting my own money in and I couldn't get anybody else to step up and donate. 

How much of your own money did you put in, and how much did you raise through fundraising? Was there any money left over? 

It cost me millions. There's nothing to get rolled over. After I was on author Sam Harris’s podcast, we got some donations on the order of $5 to $100 on average. But what I needed was $30 million. My campaign manager, who’s worked on hundreds of campaigns, told me that the average campaign that he ran had budgets of $100 million; it ranges anywhere from $50 to $250 million. When I went into this, I thought, okay, I'm just going to make sure we qualify for the ballot. I was prepared to pay for signature gathering, since that's the only way you can collect 1.4 million signatures in six months. That would be a $10 million effort, and I thought there was a chance I’d be able to fundraise and recoup those costs eventually.

But when I got those polling results, and I learned we would absolutely need at least $30 million, which I didn't have, I started thinking, I can't continue paying for all of this.

In your statement about the end of TREAT California, you announced the foundation of your new non-profit, TREAT Humanity. What is that?

Within an hour of deciding we’d stop the campaign, I realized this is way too big and important an issue to stop. I’d been talking with people in Europe, Israel, and the UK who wanted to donate to the effort but couldn’t because of campaign finance laws. Clearly, this goes beyond California — it touches the United States, and the whole world.

What became clear to me in that hour was that it's not just about mental health, it's about climate change. It’s about bringing a clean, sustainable energy source to the planet through nuclear fusion. You've got two billion people on this planet who don't have access to clean drinking water. You have tens of millions of refugees now, and there will be more because their living spaces are going to be destroyed through climate change. Unless we get a handle on what's happening to our environment, how can we address mental health and well-being? So I'm expanding beyond just bringing psychedelics to the public in a safe, responsible way, because you can't just treat the mind without treating the body, and you can't treat the body without treating the environment. 

There are several other efforts in California right now to increase people’s access to psychedelics, but from different angles: for instance, Senator Scott Wiener says he plans to introduce new legislation that could establish a regulated access program, and there’s another ballot initiative seeking to decriminalize psychedelics in the state. What do you think the prospects are for those other initiatives and have you spoken to the people behind those efforts? 

In the psychedelic space, I think people often come from a place of scarcity, and they go for the cheapest way to effect change. I understand it, but I think it's shortsighted. I agree with decrim — I don't think anybody should be in jail over smoking marijuana or doing psychedelics — but legalizing or creating this regulated access is so shortsighted for many, many reasons, the least of which is not having a safety network for people. 

Scott Wiener is repeatedly introducing this decrim legislation and that didn’t work. So with Governor Newsom suggesting they come up with a regulated access program — to me, that’s fraught with so many problems, like what's happening in Oregon and Colorado. Then you’ve got MAPS — they’ve been around 37 years and they’ve had to bring in a whole venture capital firm who took over the Public Benefit Corporation. They're commercializing MDMA. God forbid if atai or COMPASS did what MAPS is doing, they'd be tarred and feathered, but MAPS is riding on this coattail of all these good intentions of Rick Doblin. But they're commercializing MDMA — there's no mistake about it. They're turning into a pharmaceutical company. What I wanted to be able to do in the TREAT Institute was to run like a pharmaceutical company — because you have to appreciate that the process by which you bring medicines to the public is expensive —  but instead of seeking to always increase the bottom line, we’d be seeking to improve patient outcomes, and make treatment cost effective and accessible.

This interview has been edited and condensed for clarity and length.