Surging interest in the purported benefits of psychedelic drugs has led to hundreds of outfits worldwide now offering multiday trips where attendees pay for drug-assisted experiences claiming to promote psychological healing, personal growth, and other benefits, per the AP. 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 US, although that may soon change. On Saturday, President Trump signed an executive order directing the FDA to accelerate reviews of psychedelics that show potential for conditions like PTSD. More:
- Against the law: Virtually all the drugs offered at retreats are illegal under US federal law, including magic mushrooms, ayahuasca, MDMA, and LSD. Retreat companies won't always make that explicit or sometimes claim that they're protected by a rare legal exemption for religious groups that traditionally use psychedelics. Only a handful of groups, however, have formally obtained that status, including the Native American Church, which uses peyote in its ceremonies.
- Global reach: 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.
- Safety and staffing: With essentially no oversight, potential attendees are on their own when vetting options. "It's really important that somebody interested in a psychedelic retreat do their research [and] talk to the organizers or facilitators to get more information about what is being offered and how," said Amy McGuire, a Baylor College of Medicine biomedical ethicist and co-author of the study. Many retreats have health pros 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.
- Screening: 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 Yale School of Medicine psychiatrist Dr. John Krystal.
- Discontinuing meds: Also potentially risky: 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" range 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 Columbia University psychiatrist Dr. Jeffrey Lieberman. "They should be monitored regularly to make sure nothing bad happens."
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