Hundreds of psychedelic retreat operators worldwide are marketing multiday trips in which attendees pay for drug-assisted experiences framed as promoting psychological healing and personal growth, according to reporting by the Associated Press. The rapid growth has coincided with surging public interest in the purported benefits of psychedelic drugs, which has also fueled books, documentaries and conferences about the substances.
But researchers who surveyed dozens of retreats warned that, even when some safety procedures exist, the experiences can still harm participants. In a recent paper in JAMA Network Open, the authors wrote that the retreats carry “potential for physical, psychological, and interpersonal harms,” and they noted the absence of robust, consistent safety guardrails.
The legal landscape also complicates the safety picture. In the United States, virtually all of the drugs offered at retreats—including magic mushrooms, ayahuasca, MDMA and LSD—remain illegal under federal law. Retreat companies may not always spell out that status, and some have claimed protection through a rare legal exemption for certain religious organizations that traditionally use psychedelics, though only a handful of groups have formally obtained that status, including the Native American Church, which uses peyote in its ceremonies.
Some retreats operate in countries that do not restrict psychedelics in the same way. AP reported that venues in places such as Peru and Brazil offer ayahuasca experiences; Indigenous cultures in those countries have used ayahuasca—a brew of Amazonian plants—for centuries. Still, experts said that regardless of where retreats are held, there are no industrywide standards or regulations that govern how participants are screened, prepared or monitored after the trip.
As the market has expanded, people working in the field have pointed to both increased visibility and increased capacity. Brad Burge, who has worked with psychedelic nonprofits, drugmakers and retreat operators for nearly 20 years, said in an interview that “The sheer visibility of psychedelics has led to more demand for these retreats.” He added that “That growing market has allowed retreats to expand their services, hire more medical and coaching staff and take safety more seriously than we’ve ever seen in the past.”
Even so, consumer advocates say the core problem remains uneven oversight, which shifts risk onto attendees. Joshua White, the founder of the Fireside Project, which runs a hotline for people experiencing distress during psychedelic trips, said in the AP report that “If there is no regulation, what does that mean about the quality of care you’re going to have?” White said he fears “there could be a race to the bottom where there is no liability or accountability.”
Safety practices and staffing credentials vary widely from retreat to retreat, experts said. Amy McGuire, a biomedical ethicist at Baylor College of Medicine and co-author of the JAMA Network Open study, told AP that prospective attendees should do research and ask organizers for details about what is being offered and how it is delivered. McGuire and her colleagues documented a range of practices in their survey, including some retreats offering multiple psychedelic drugs during the course of a single retreat.
McGuire said many retreats have health professionals on site, but their roles and responsibilities can be unclear. In some cases, she said, the professionals also take the psychedelics alongside participants, a setup that could limit their ability to respond in an emergency. The AP report listed practical questions experts suggest attendees ask, including whether staff have training and equipment to handle a medical emergency, whether a hospital is nearby with transportation available, and whether staff spend substantial time preparing participants and supporting them during and after the experience.
One of the most important safety steps occurs before a retreat begins: screening out people with serious medical conditions who should not take psychedelics. The JAMA Network Open paper found that more than half of the retreats it surveyed excluded participants with mental illnesses such as schizophrenia. Dr. John Krystal, a Yale School of Medicine psychiatrist who told AP he was not involved in the research, said that “Psychedelic drugs may worsen symptoms of psychotic disorders, such as schizophrenia,” and that “It is important that patients are carefully screened to ensure that appropriate patients enter treatment.”
Even when screening happens, the effectiveness depends on what participants disclose. The AP report said that all of the retreats surveyed relied on potential customers to truthfully disclose their medical history and health conditions. McGuire said that approach carries risk, because people with severe conditions may withhold information if they believe it would stop them from attending—particularly when they are desperate for a potential treatment.
Medication management is another area of concern. The JAMA Network Open study found that nearly 90% of retreats surveyed required or recommended that attendees stop taking certain medications—including antidepressants—before using psychedelics. The report said these “washout periods” ranged from one day to six weeks before the psychedelic experience.
Medical experts warned that stopping antidepressants without adequate supervision can increase risk. Dr. Jeffrey Lieberman, a Columbia University psychiatrist, told AP that “The patient needs to realize that by going off their medicine they’re at greater risk of recurrence or exacerbation of their symptoms,” and that they “should be monitored regularly to make sure nothing bad happens.” The AP report said research indicates that combining antidepressants like Prozac with psychedelics may raise serotonin levels, while McGuire said retreat operators may also be seeking to ensure medications do not dull the intensity of the psychedelic experience for paying participants.
In the U.S., psychedelic drugs have not been federally approved, a limitation that continues to shape how the retreats market their services. On Saturday, President Donald Trump signed an executive order directing the Food and Drug Administration to accelerate reviews of psychedelics that show potential for conditions such as post-traumatic stress disorder, and directing law enforcement agencies to quickly lower restrictions on any psychedelic approved by the FDA. Trump’s order came after MDMA was rejected as a PTSD treatment in 2024 due to concerns about safety and effectiveness.
Krystal said that, in the meantime, psychedelics should be treated with medical caution. He told AP that the substances should be approached as “a serious medical procedure that carries risks that must be carefully managed.” For attendees considering retreat experiences, that message—paired with patchwork screening, staffing and medication guidance—underscores how little standardized oversight currently governs a business that operates across legal boundaries and differing national rules.