What to know about psychedelic retreats, a booming business with few safety guardrails
WASHINGTON (AP) — Surging interest in the purported benefits of psychedelic drugs has given rise to books, documentaries and conferences dedicated to the mind-altering substances. Now add one more business to the list: psychedelic retreats.
Hundreds of outfits across the world are offering multiday trips where attendees pay for drug-assisted experiences claiming to promote psychological healing, personal growth and other benefits.
Many have safety procedures in place, but they still carry “potential for physical, psychological, and interpersonal harms,” researchers who surveyed dozens of retreats wrote in a recent paper in JAMA Network Open.
Currently no psychedelics have been federally approved in the U.S., although that may soon change. 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 like post-traumatic stress disorder. The order also directs law enforcement agencies to quickly lower restrictions on any psychedelic approved by the FDA.
The only drug to come before the FDA thus far, MDMA, was rejected as a PTSD treatment in 2024 due to concerns about its safety and effectiveness.
Dr. John Krystal, a Yale School of Medicine psychiatrist who has followed the field, says psychedelics should be approached as “a serious medical procedure that carries risks that must be carefully managed.”
People who work in the field say today's retreats are far safer than those of prior decades, when psychedelic experiences were almost always conducted underground with few safety precautions.
“The sheer visibility of psychedelics has led to more demand for these retreats,” said Brad Burge, who has worked with psychedelic nonprofits, drugmakers and retreat operators for nearly 20 years. “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.”
Here's what to know about the trend:
Virtually all the drugs offered at retreats are illegal under U.S. federal law, including magic mushrooms, ayahuasca, MDMA and LSD.
Retreat companies will not always make that explicit or sometimes claim that they are protected by a rare legal exemption for religious organizations that traditionally use psychedelics.
But only a handful of groups have formally obtained that legal status, including the Native American Church, which uses peyote in its ceremonies.
Some retreats are held in countries that don’t restrict psychedelics, including Peru and Brazil, where ayahuasca — a psychedelic brew of Amazonian plants — has been used for centuries by Indigenous cultures.
No matter where they operate, experts say there are no industrywide standards or regulations for how participants are screened, prepared or monitored afterward.
“If there is no regulation, what does that mean about the quality of care you’re going to have?” said Joshua White, founder of the Fireside Project, which runs a hotline for people experiencing distress during psychedelic trips. ”I certainly fear that there could be a race to the bottom where there is no liability or accountability."
With essentially no oversight, potential attendees are on their own when vetting different options.
“It’s really important that somebody interested in a psychedelic retreat do their research, talk to the organizers or facilitators to get more information about what is being offered and how,” said Amy McGuire, a biomedical ethicist at Baylor College of Medicine and co-author of the JAMA Network Open study.
McGuire and her colleagues documented a wide range of practices, including some companies offering multiple psychedelic drugs over the course of their retreats.
Many retreats have health professionals on site, but their roles and responsibilities are often vague. In some cases, they take psychedelics alongside participants, which could impair their ability to respond in an emergency.
Important questions when evaluating retreats include:
— Do retreat staff have training and equipment to handle a medical emergency?
— Is there a hospital nearby and transportation to get there?
— Do staffers spend significant time helping participants prepare and process the experience?
Websites that compile user reviews, such as Retreat.guru, are one source for this information.
One of the most important safety steps happens before any retreat begins: screening out people with serious medical conditions who shouldn't take psychedelics.
More than half the retreats surveyed for the study excluded participants with mental illnesses such as schizophrenia.
“Psychedelic drugs may worsen symptoms of psychotic disorders, such as schizophrenia,” noted Krystal, who was not involved in the research. “It is important that patients are carefully screened to ensure that appropriate patients enter treatment.”
Significantly, all the retreats said they rely on potential customers to truthfully disclose their medical history and health conditions.
That approach carries risks, the authors noted, since people suffering from severe afflictions may withhold information if they think it could stop them from attending.
"When you’re really desperate and hoping to access something that you think could help you, there’s an incentive not to be truthful,” McGuire said.
Another potentially risky practice: Nearly 90% of the surveyed retreats require or recommend that attendees stop taking certain medications, including antidepressants, before using psychedelics. These so-called “washout periods" ranged from one day to six weeks before the psychedelic experience.
Medical experts say safely tapering off antidepressants like Prozac can take six to 12 weeks and requires professional supervision.
"The patient needs to realize that by going off their medicine they’re at greater risk of recurrence or exacerbation of their symptoms,” said Dr. Jeffrey Lieberman, a Columbia University psychiatrist. “They should be monitored regularly to make sure nothing bad happens.”
The rationale for halting antidepressants comes from research that combining those drugs with psychedelics may cause excess levels of serotonin, a brain chemical that influences mood, sleep and other functions.
But retreat operators may also be trying to make sure the medications don’t dull the intensity of the psychedelic experience, according to McGuire.
“There’s a business rationale for wanting people to have the maximum experience when they show up and they’re paying for these retreats,” she said.
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