What to know about psychedelic retreats, a booming business with few
safety guardrails
[April 21, 2026]
By MATTHEW PERRONE
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:
Psychedelic retreats are currently illegal in the US
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."
Safety procedures and staffing credentials vary
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.
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Participants lay face down on the grass during an integration circle
at an ayahuasca retreat in Hildale, Utah, Oct. 15, 2022. (AP
Photo/Jessie Wardarski, File)
 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.
Screening for risky medical conditions is not rigorous
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.
Discontinuing medications is common
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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