A surge of interest in the purported benefits of psychedelic drugs has spawned a new industry: psychedelic retreats. Hundreds of organisations worldwide now offer multiday experiences where attendees pay for drug-assisted sessions claimed to promote psychological healing and personal growth.
However, researchers who surveyed dozens of retreats in a recent JAMA Network Open paper warn that they carry “potential for physical, psychological, and interpersonal harms.” Currently no psychedelics have been federally approved in the US, although President Donald Trump has signed an executive order directing the FDA to accelerate reviews of these substances for conditions such as post-traumatic stress disorder. In 2024, the only drug to come before the agency, MDMA, was rejected as a PTSD treatment over safety and effectiveness concerns.
Dr John Krystal, a Yale School of Medicine psychiatrist, says psychedelics should be approached as “a serious medical procedure that carries risks that must be carefully managed.” Brad Burge, a consultant who has worked with psychedelic nonprofits and retreat operators, argues that today's retreats are far safer than those of previous decades, when such experiences were almost always conducted underground. “The sheer visibility of psychedelics has led to more demand for these retreats,” he said.
Virtually all the drugs offered at retreats, including magic mushrooms, ayahuasca, MDMA and LSD, remain illegal under US federal law. Some operators claim protection through religious exemptions, but only a handful of groups, such as the Native American Church, have formally obtained that status. Many retreats are held in countries like Peru and Brazil, where ayahuasca has long been used by Indigenous cultures.
Experts say there are no industrywide standards or regulations for screening, preparation or aftercare. Joshua White, founder of the Fireside Project hotline, fears a “race to the bottom where there is no liability or accountability.” He and others advise potential attendees to research carefully. Amy McGuire, co-author of the JAMA study, says it is crucial to talk to organisers about what is offered and how. Practices vary widely, with some companies providing multiple drugs, and on-site health professionals sometimes taking psychedelics themselves, which may impair their ability to respond in an emergency.
